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This study represents the largest series assessing the diagnostic accuracy of frozen section analysis in AIFRS. Frozen section analysis is an effective tool for guiding intraoperative decision making in patients with AIFRS with a high PPV. A Low NPV underscores the importance of clinical suspicion and intraoperative decision making based on endoscopic findings when negative frozen section results are encountered. Further, frozen section analysis appears to be equally effective in detecting either Mucor or Aspergillus.

A review of cases of primary adenocarcinoma of the appendix seen at the Hines VA Hospital (1950-1987) and Loyola University Medical Center (1977-1987) revealed a total of 14 cases. All patients presented with a clinical picture suggesting acute appendicitis or a right lower quadrant mass. Malignancy was not suspected in any of the patients prior to surgery. The age group ranged from 25 to 66 years (mean, 51.8 years) with 29% of the patients under 45 years old. The presence of carcinoma should be carefully looked for in middle-aged and elderly patients presenting with acute appendicitis.

Sinonasal osteoblastoma is an extremely rare entity with undefined imaging characteristics to guide preoperative decision-making. Here we reported, to our knowledge, the first description of a characteristic imaging sign of an eccentric, mature osseous cap, which corresponded histologically to a single peripheral layer rim of osteoblasts, a unique trait of osteoblastoma.

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Introduction/Objective Mucosa-associated lymphoid tissue (MALT) lymphoma of the gastrointestinal(GI) tract and synchronous precancerous/malignant epithelial lesions have been sporadically reported in literature. We sought to assess the incidence of GI MALT lymphoma and synchronous epithelial lesions. Methods/Case Report We performed a retrospective study by searching the pathology files at our institution from 1992 to December 2021, for GI lymphomas including extranodal marginal zone lymphoma(E-MZL). Results (if a Case Study enter NA) There were a total of 178 cases of lymphoma involving the GI tract. The basis of this report was formed by the 40/178(22.5%) cases, which were E-MZL. Twenty-four were males and 16 females(age range:37-80 years; mean:62 years). Sites of tumors were stomach(21), colon(6), ileum(4), duodenum(4), rectum(3), and cecum(2). Four cases were multifocal. Lymph nodes were assessed in 8/40, of which 4 were positive. One patient had malignant pleural effusion and another had retroperitoneal soft-tissue involvement. Overall, 11/40(27.5%) cases had a synchronous precancerous/malignant epithelial lesion. Gastric E-MZL were the most common (21), out of which 8(38%) were associated with synchronous epithelial lesion (3 gastric adenocarcinomas and 5 tubular adenomas(TA) at different colorectal locations). Out of 6 colonic E-MZL, 2 were associated with synchronous TAs at different colorectal sites and one rectal E-MZL was associated with cecal TA. Conclusion In our cohort, precancerous/malignant epithelial lesions were seen in 11/40(26.8%) of GI E-MZL cases. Gastric adenocarcinomas comprised 3/8 (37.5%) of gastric synchronous precancerous/malignant epithelial lesions; the association of E-MZL and gastric adenocarcinoma is well-known, arising in the background of chronic atrophic gastritis and intestinal metaplasia secondary to chronic inflammatory disorders. The remaining 8 cases of synchronous mucosal epithelial lesions were TAs at different colorectal sites. Based on our observations, unlike gastric adenocarcinoma, the association of colorectal pre-cancerous lesions with E-MZL is less likely, since, in all cases, the TAs were seen in sites other than E-ZML sites and also, sporadic colorectal TAs are a common pathology. However, possible association between E-MZL and precancerous mucosal epithelial lesions needs more work and further investigation.