In daily practice, signet ring cell morphology immediately brings to the mind the possibility of an adenocarcinoma at first glance. The signet ring cell appearance has been described and is well-known in a wide variety of some other neoplasms as well. Surprisingly however, neoplastic cells having the same morphology can unexpectedly be encountered in not previously well-documented tumors. Here, we present an 85-year-old man diagnosed with primary pulmonary squamous cell carcinoma and a large signet ring cell population. Examination of the lobectomy specimen and further radiological workup was consistent with stage I disease. Signet ring cell variant of squamous cell carcinoma is a very infrequent tumor and has been reported in only eight cases from skin, cervical and oral cavity biopsies as well as in one case of pulmonary acantholytic variant of squamous cell carcinoma with focal signet ring cells. To be aware of this entity is crucial for pathologists to reach the correct diagnosis, particularly in cytological samples, because of its potentially modifying effect on treatment options and patient management compared to adenocarcinomas. Our patient remained in clinical remission during the 9-month follow-up.

Objective: Cystic ameloblastoma, keratocystic odontogenic tumor, dentigerous cyst, and radicular cyst are the most commonly encountered cystic odontogenic lesions. The aim of this study was to investigate the expressions of survivin, E-cadherin, CD138, and CD38 in these lesions and their potential diagnostic usage. Material and Method:A total of 20 cases, consisting 5 radicular cysts, 5 dentigerous cysts, 5 keratocystic odontogenic tumors and 5 cystic ameloblastomas were included in our series. For all cases, sections from the selected blocks were stained against the antibodies for survivin, E-cadherin, CD138, and CD38 on an automated device.Results: All cystic ameloblastomas and keratocystic odontogenic tumors showed diffuse and strong nuclear survivin expression. No specific survivin immunoreactivity was observed in the dentigerous and radicular cysts. E-cadherin expression was stronger in all dentigerous cysts and radicular cysts when compared to others. CD138 expression in stromal cells was prominent in cystic ameloblastomas, but gradually decreased in the other three lesions. All cases were negative for CD38. Conclusion:In the present study, loss of E-cadherin expression in epithelial cells, strong CD138 expression in stromal cells and strong nuclear survivin expression both in epithelial and stromal cells in cystic ameloblastomas and keratocystic odontogenic tumors were the most remarkable findings. These findings are also reinforced by the studies suggesting their role in the aggressiveness and pathogenesis of these tumors. Key Words: Odontogenic tumors, Odontogenic cysts, Immunohistochemistry ÖzAmaç: Kistik ameloblastoma, keratokistik odontojenik tümör, dentijeröz kist ve radiküler kist en sık karşılaşılan kistik odontojenik lezyonlardır. Çalışmada bu lezyonlarda survivin, E-cadherin, CD138 ve CD38 ekspresyonları ve bunların potansiyel tanısal kullanımları araştırılmıştır. Gereç ve Yöntem:Çalışma serimiz 5 kistik ameloblastoma, 5 keratokistik odontojenik tümör, 5 dentijeröz kist ve 5 radiküler kist olmak üzere toplam 20 olgudan oluşmaktadır. Bütün olgulara ait seçilmiş bloklardan sağlanan kesitler otomatize bir cihazda survivin, E-cadherin, CD138, and CD38 antikorları ile boyandı. Bulgular:Kistik ameloblastoma ve keratokistik odontojenik tümörlerin hepsi yaygın ve kuvvetli nükleer survivin ekspresyonu gösterdi. Dentijeröz ve radiküler kistlerde spesifik survivin ekspresyonu gözlenmedi. E-cadherin ekspresyonu diğer lezyonlarla karşılaştırıldığında, dentijeröz ve radiküler kistlerde daha belirgindi. CD138 ekspresyonu kistik ameloblastomalarda stromal hücrelerde daha belirgindi, ancak diğer lezyonlarda giderek azalan oranlardaydı. CD38 olguların hepsinde negatifdi.Sonuç: Çalışmada, keratokistik odontojenik tümörlerde ve kistik ameloblastomada epitelyal hücrelerde E-cadherin kaybı, stromal hücrelerde kuvvetli CD138 ekspresyonu ve hem epitelyal hem de stromal hücrelerde kuvvetli nükleer survivin ekspresyonu en karakteristik bulgulardır. Bu bulguların bu tür lezyonların patogenezini ve agresif davranış...

Persistent Mullerian duct syndrome (PMDS) is a rare form of the 46 XY disorders of sexual differentiation, characterized by the presence of a uterus and fallopian tubes due to the failure of Mullerian duct regression in genotypically normal males. More than 150 cases have been recorded, most of them in adults. In most cases, the PMDS is discovered during surgery for inguinal hernia or cryptorchidism, or by the presence of transverse testicular ectopia (TTE). The presence of PMDS with TTE is even more uncommon. In TTE, both testes descend through the same inguinal canal into the same scrotal sac. Patients with TTE present with symptoms of unilateral cryptorchidism and a contralateral inguinal hernia. For patients with inguinal hernia and cryptorchidism associated with TTE, PMDS should be kept in mind, and radiologic evaluation such as ultrasonography or magnetic resonance imaging of the genitourinary system and karyotyping are recommended. Whereas radiologic evaluation could be helpful in the diagnosis of TTE, it cannot diagnose the malignancy itself. The case explained in this report will offer urologists additional useful treatment strategies for patients with inguinal hernia and cryptorchidism.

No abstract

Otolaryngologists should be aware of anatomic variations of the submandibular duct(s) to avoid possible complications, especially intraoperatively, because rutine preoperative radiologic preparation does not include investigation of possible accessory ducts.