The presence of abnormal urinalysis was not more common in patients with psoriasis than in controls. However, the increased prevalence of pathologic albuminuria and its positive correlation with psoriasis severity may suggest subclinical glomerular dysfunction in these patients.

Malignant fibrous histiocytoma arising in the vulva represents an example of vulvar sarcomas. Since the diagnostic criteria and natural history of this tumor still remain poorly defined, further case studies may be helpful to elucidate these issues as well as the optimal therapeutic approach of this heterogeneous group of malignancies.

The role of topically applied mitomycin C in preventing postoperative perineural fibrosis was examined by gross anatomical dissection and histological analysis in rats. The sciatic nerve was exposed bilaterally in 24 Wistar adult male rats, and an abrasion injury was produced on the exposed surface of the biceps femoris muscle in all animals. In the experimental group, cotton pads soaked with mitomycin C (0.5 mg/ml) were placed around the nerves for 5 min, whereas cotton pads soaked with saline were applied to the control group. Four weeks after surgery, the neurolysis sites were evaluated by blinded surgical dissection. Perineural adhesions were graded using a numerical grading scheme. The scar tissue formation index was also calculated, and a grading was made according to the number of fibroblasts/fibrocytes counted around the epineurium in histological evaluation. Mitomycin C-treated nerves showed significantly less perineural adhesions than controls. Quantification of the dense connective tissue surrounding the nerves revealed a statistically significant reduction around nerves treated with mitomycin C, and the number of fibroblast/fibrocytes was also significantly reduced. Application of topical mitomycin C might be effective in preventing epineural scar formation after neurolysis of peripheral nerves.

Lues maligna, which is characterized by noduloulcerative lesions, is a rare form of secondary syphilis. It is mainly seen in either HIV-infected or malnourished patients suffering from a depression in immunity. We presented a chronic alcoholic, HIV negative male patient with noduloulcerative lesions diagnosed as lues maligna based on his skin eruptions, results of serologic tests, and, histopathologic findings. We believe that chronic alcoholism could be the cause of immunosuppression in our case and wanted to emphasize the possibility of an association between lues maligna and chronic alcoholism.

BACKGROUND: Tracheal stenosis constitutes one of the most frequently seen problems in thoracic surgery. Although many treatment modalities to prevent fibroblast proliferation, angiogenesis, or inflammation that causes tracheal stenosis have been attempted, an effective method has not yet been found. In this study, a transforming growth factor beta3 (TGF-␤3)/chitosan combination was used for this purpose. METHODS: A slow-release preparation containing a thin layer of TGF-␤3 with a chitosan base was made. Thirty albino Wistar rats were divided into 3 groups. A full-layer vertical incision was made in the anterior side of the trachea of each rat between the second and fifth tracheal rings. The tracheal incision was sutured. Group A was evaluated as the control group. In Group B, a chitosan-based film was placed on the incision line. In Group C, a slow-release TGF-␤3/chitosan-coated substance was placed on the incision line. The rats were killed on day 30, and their tracheas were excised by cutting between the lower edge of the thyroid cartilage and the upper edge of the sixth tracheal ring together with the esophagus. Epithelialization, fibroblast proliferation, angiogenesis, inflammation, and collagen levels were evaluated histopathologically by the same histopathologist. RESULTS: Statistically significant differences were not found among the 3 groups. Cold abscesses were observed at the incision sites in both the TGF-␤/chitosan and chitosan groups. These were thought to have formed due to the chitosan. CONCLUSIONS: As this was the first experiment in the literature to use this type of TGF-␤3 formulation, we intend to change the formulation and perform this study again with a different TGF-␤3/chitosan preparation.

Renal cell carcinoma (RCC) is the most common solid lesion of the kidney. Bilateral synchronous benign and malignant renal tumors have been defined in some reports. However, unilateral concordance of malignant renal tumors is very rare and there are only a few cases that had synchronous different subtypes of malignant renal tumors arising within the same kidney. Herein, we describe a 67-year-old male patient who had clear cell RCC and papillary RCC in his right kidney that were successfully treated with radical nephrectomy. We also reviewed the pertinent literature.

Endobronchial involvement of extrapulmonary malignant tumors is uncommon and mostly associated with breast, kidney, colon, and rectum carcinomas. A 68-year-old male with a prior diagnosis of colon non-Hodgkin lymphoma (NHL) was admitted to the hospital with a complaint of cough, sputum, and dyspnea. The chest radiograph showed right hilar enlargement and opacity at the right middle zone suggestive of a mass lesion. Computed tomography of thorax revealed a right-sided mass lesion extending to thoracic wall with the destruction of the third and the fourth ribs and a right hilar mass lesion. Fiberoptic bronchoscopy was performed in order to evaluate endobronchial involvement and showed stenosis with mucosal tumor infiltration in right upper lobe bronchus. The pathological examination of bronchoscopic biopsy specimen reported diffuse large B-cell lymphoma and the patient was accepted as the endobronchial recurrence of sigmoid colon NHL. The patient is still under treatment of R-ICE (rituximab-ifosfamide-carboplatin-etoposide) chemotherapy and partial regression of pulmonary lesions was noted after 3 courses of treatment.

Objective:The aim of this study was to investigate the interobserver agreement in determination of the dominant histological pattern and the final diagnosis in lung adenocarcinomas. Material and Method:A total of 12 patients with a diagnosis of primary lung adenocarcinoma were included in the study. twelve pathologists from eight study centers were asked first to determine the dominant histological pattern in these cases and then to decide whether the final diagnosis was in situ, minimally invasive or invasive adenocarcinoma. Results:The kappa value for the agreement in determining the dominant pattern among the pathologists was 0.36 (p<0.001), with the values for the lepidic, acinar, papillary, solid, micropapillary patterns and mucinous character of adenocarcinoma being 0.34, 0.28, 0.30, 0.80, 0.16 and 0.38 respectively (p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001). none of the cases was diagnosed as in situ adenocarcinoma. On the other hand, the kappa value for the agreement in differentiating minimally invasive from invasive adenocarcinoma among reviewers was 0.17 (p<0.001). Conclusion:The agreement among pathologists in determining the subtype of lung adenocarcinomas that depends on the identification of the dominant pattern was at intermediate level. In addition, the agreement in deciding whether the case is minimally invasive or invasive, was at low level. The criteria defining the histological patterns should be clarified and described in more detail. Educational activities and larger multicenter studies might be helpful in improving the agreement and standardization. ÖZAmaç: bu çalışmanın amacı, akciğer adenokarsinomunda baskın histolojik patern belirlemede ve nihai tanı konusunda değerlendiriciler arası uyumun araştırılmasıdır. Gereç ve Yöntem:Komplet cerrahi rezeksiyon uygulanan ve mikst tipte primer akciğer adenokarsinom tanılı 12 olgu çalışmaya alındı. Çalışma sekiz merkezden 12 patologun katılımı ile yapıldı. Değerlendiricilerden baskın patern tayini ile son tanı olarak invaziv adenokarsinom, minimal invaziv adenokarsinom arasında seçim yapmaları istendi. Bulgular: Patologlar arasında baskın patern uyumunda kappa değeri 0.36 idi. lepidik, asiner, papiller, solid, mikropapiller ve musinöz paternde uyum sırasıyla 0,34, 0,28, 0,30, 0,80, 0,16, 0,38 (p<0,001, p<0,001, p<0,001, p<0,001, p<0,001, p<0,001) idi. Hiçbir olgu in situ adenokarsinom tanısı almadı. Minimal invaziv adenokarsinom ve invaziv adenokarsinom tanısı için değerlendiriciler arasındaki uyum düşüktü (kappa değeri 0,17 (p<0,001)).Sonuç: Patologlar arası akciğer adenokarsinomunu baskın patern saptamasında uyum orta düzeyde bulundu. Minimal invaziv adenokarsinom ile İAK arası uyum ise düşük düzeyde idi. Histolojik patern kriterleri daha açık ve daha detaylı olarak tanımlanmalıdır. Eğitim programları ve çok merkezli çalışmalar tanıların standardizasyon ve uyumunu geliştirilebilir.