BackgroundIdiopathic granulomatous mastitis (IGM) is a benign rare inflammatory disease of the breast. Due to its uncommon etiology, diagnosis and treatment is still unknown. Selection of a standard method for diagnosing idiopathic granulomatous mastitis is sophisticated. In view of non-definitive clinical and imaging finding, histopathology is the cornerstone of definitive diagnosis.ObjectiveTo determine and help solve the dilemma of treatment and diagnosis of idiopathic granulomatous mastitis.MethodsThis historical cohort study was conducted on 48 patients who referred to the general surgery clinic of Imam Khomeini Hospital of Urmia, were diagnosed with IGM and were histopathologically selected by census using the registry system, in Urmia city, Iran, during 2010–2015 so that medical reports, ultrasonography (US) and mammography (MMG) findings, follow-up information and recurrence rate were obtained from records. The data were analyzed using SPSS software version 18 and descriptive statistics were used.ResultsAccording to records, 68.75% of patients (n=33) had palpable mass, 45.83% of patients (n=22) had breast pain and swelling, erythema and 20.83% of patients (n=10) had purulent drainage. Of the 48 patients 12 (25%) had mammography, which revealed the following findings: mass with irregular border in 6 patients, skin thickness in 2 cases (4.16%), and parenchymal asymmetry in 4 cases (8.33%). Minimum follow-up was 24 (range 24–56) months.ConclusionsAccording to our findings, histopathology of the disease is fundamental for correct diagnosis. Steroid therapy as a therapeutic method such as prednisolone was an effective and applicable choice in the treatment of idiopathic granulomatous mastitis by decreasing in inflammation.

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Objective: Renal cell carcinomas (RCCs) include about 2% of adult neoplasms and 90-95% of all renal tumors. Mostly, it is possible to distinguish RCC subtypes using hematoxylin-eosin staining. However, overlapping morphologic features cause some difficulties in making a precise diagnosis. In order to render an accurate diagnosis, additional methods such as immunohistochemical staining for c-kit have been recommended. In this study, we aimed to investigate c-kit gene expression in various subtypes of RCC. Material and methods:We reviewed 65 diagnosed RCC cases. Formalin-fixed, paraffin-embedded specimens were available for the cases. The expression of c-kit was evaluated using immunohistochemistry. The correlation between c-kit expression and clinicopathological parameters including patients' age and gender in addition to grade, stage, and size of the tumor were investigated.Results: Six cases of 39 clear cell types (15.4%), 8 of 13 papillary types (61.5%), 11 of 12 chromophobe types (91.7%), and no sarcomatoid type were positive for c-kit expression. Based on chi-square test results, there was a significant relationship between RCC subtypes and c-kit expression (p= 0.001). There was no significant correlation between age, sex, grade, stage, and size of the tumor and c-kit expression. Conclusion:The expression of c-kit in RCC may have diagnostic significance in subtypes of RCC especially papillary and chromophobe subtypes of RCC.

Objective: Information contained in request forms for histopathological examinations plays a critical role in the microscopic interpretation of tissue changes. Despite its importance, studies have shown inadequacies in the information communicated by clinicians. This study aimed to determine how well the necessary information is provided on the histopathology request forms and to compare its variability among different departments of a hospital. Material and Method:A retrospective, 3-month, cross-sectional study was conducted to evaluate all consecutive histopathology request forms received from different departments of a tertiary, academic hospital for three months, regarding the documentation of 12 criteria.Results: None of the 2040 requests received had all the required items. Four items of specimen description, laboratory and imaging findings, and physician contact number were available only in less than 12.5% (range between 0.05 to 12.45%) of the requests. However, four other items of patient name and contact number, physician name, and anatomical site of the lesion were documented in more than 90%. The median number of the documented items was the highest in the surgery and orthopedics (9 items) and the lowest in the pulmonology department (7 items). Comparison between departments showed that the documentation of items in the surgery department were significantly better than that of the ENT, urology, and internal medicine departments (p<0.001). Also, the internal medicine department was significantly different from all other departments (p<0.001) except neurosurgery (p=0.88). Conclusion:Our results point out a serious gap in the adequacy of pathology request forms, especially clinical items. Given the implication of such information to ensure patient safety, further studies are recommended to evaluate the impact of educational and supportive computerized interventions such as clinician education and barcoding and specimen tracking systems to help fill in the required items completely.

Background & Aims: To determine how well the standard criteria were utilized in reporting breast cancer pathology and to compare the variability among a public teaching, a public nonteaching, and a private hospital in Urmia, Iran. Materials & Methods:Three hundred and fifty pathology reports of mastectomy samples with diagnosis of primary breast cancer were retrieved from archives of pathology departments of three hospitals; one public teaching (121 reports), one public nonteaching (99 reports), and one private hospital (130 reports). The reports were assessed for tumor laterality, size, color, consistency, type and grade, sample size, description of prior biopsy site, specimen condition (fresh, or in fixative), number of excised and involved lymph nodes, previous frozen section (FS), surgical margins, lymphovascular invasion, and in situ carcinoma.Results: None of the reports had all the suggested items. Specimen condition was the only item recorded in all of the reports. The teaching hospital reports had significantly higher number of reported items than the two other hospitals (P<0.001). Key items (tumor size, type and grade, surgical margin, vascular invasion, and in situ carcinoma) were also indicated more frequently in teaching hospital (P<0.001). Conclusion:We showed evident variations in reporting breast cancer pathology in the studied different hospitals. It seems that the teaching program in the public-teaching hospital can be a reason for the better results in this hospital. So we suggest using standard universal protocols for cancer reporting as well as creating an effective audit system to evaluate complete utilization of the protocols.

Adrenal lipomas are rare, small, usually nonfunctional tumors with an incidence of 2-4%. Most cases have been found incidentally during investigation for unrelated problems or autopsy. We report a 76 years old woman with symptomatic right sided giant adrenal lipoma of 17 cm in diameter presented with abdominal pain. Keywords: Adrenal gland; giant; lipoma Özet Adrenal lipomlar insidansı %2-4 olan nadir, küçük, genellikle fonksiyonel olmayan tümörlerdir. Olguların çoğu otopsi veya ilgisiz problemlerin araştırılması sırasında tesadüfen bulunur. Biz, abdominal ağrısı olan 17 cm çapında semptomatik sağ taraflı dev adrenal lipomlu 76 yaşındaki kadını sunuyoruz.