Abstract. Mature cystic teratomas are common benign tumors of the ovary. The most common form of malignant transformation is squamous cell carcinoma, however, malignant transformation is rarely observed and cases are usually asymptomatic. Carcinoid tumors are rare tumors of the neuroendocrine system. A number of the carcinoids result in clinical syndromes due to the secretion of vasoactive substances produced by the tumor. A 75-year-old woman suffering from groin pain was admitted to the Faculty of Medicine at Bezmialem Vakıf University (Istanbul, Turkey). An adnexal mass was detected during the physical examination. Magnetic resonance imaging scans exhibited an 8x7-cm mass in the right ovary. Surgical excision of the mass was performed and histopathological examination revealed a mature cystic teratoma with three germ layers. An area consisting of nests and trabeculae was evident in the cyst wall. The pathological diagnosis was of an insular and trabecular variant of carcinoid tumor arising in a mature cystic teratoma. The patient did not present with carcinoid syndrome, and no recurrence was observed after 11 months of follow-up examinations.

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Abnormalities in proto-oncogene B-Raf (BRAF) are typical in several subgroups of gliomas, including pilocytic astrocytomas, optic nerve gliomas, pleomorphic xanthoastrocytomas (PXA), anaplastic PXAs and gangliogliomas. However, they are rarely reported in adult gliomas. BRAF alterations are frequent in a distinct variant of glioblastomas (GBMs) known as epithelioid GBMs (E-GBMs). There are limited studies on whether immunohistochemistry (IHC) can be used to determine the presence of BRAF VE1 mutations in these tumors. The aim of the current study was to examine BRAF V600E mutations in 20 GBMs, including GBMs with epithelioid features, giant cell GBMs and conventional GBMs. V600 mutations were detected using the Cobas 4800 BRAF V600 Mutation Test, and IHC analysis was also performed. Of the 6 cases of GBM with epithelioid features, 1 exhibited a BRAF V600E mutation, while the other cases did not. IHC staining was positive in 3 out of the 8 conventional GBMs. Vemurafenib is a targeted therapy that has mainly been used for the treatment of melanoma patients for several years, and as a possible alternative treatment for cases of GBM harboring BRAF mutations, its existence may make testing for BRAF status important.

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Objective: A major target of quality assurance is the minimization of error rates in order to enhance patient safety. Six Sigma is a method targeting zero error (3.4 errors per million events) used in industry. The five main principles of Six Sigma are defining, measuring, analysis, improvement and control. Using this methodology, the causes of errors can be examined and process improvement strategies can be identified. The aim of our study was to evaluate the utility of Six Sigma methodology in error reduction in our pathology laboratory. Material and Method:The errors encountered between April 2014 and April 2015 were recorded by the pathology personnel. Error follow-up forms were examined by the quality control supervisor, administrative supervisor and the head of the department. Using Six Sigma methodology, the rate of errors was measured monthly and the distribution of errors at the preanalytic, analytic and postanalytical phases was analysed. Improvement strategies were reclaimed in the monthly intradepartmental meetings and the control of the units with high error rates was provided.Results: Fifty-six (52.4%) of 107 recorded errors in total were at the pre-analytic phase. Forty-five errors (42%) were recorded as analytical and 6 errors (5.6%) as post-analytical. Two of the 45 errors were major irrevocable errors. The error rate was 6.8 per million in the first half of the year and 1.3 per million in the second half, decreasing by 79.77%. Conclusion:The Six Sigma trial in our pathology laboratory provided the reduction of the error rates mainly in the pre-analytic and analytic phases.

Aims:We aimed to investigate the immunocytoexpression profiles of a novel assay ProEx C for topoisomerase II alpha (TOP2A) and minichromosome maintenance protein 2 (MCM2) in abnormal interpreted smears.Settings and Design:Screening programs with Papanicolaou smear and high risk group human papilloma virus testing have yielded a dramatic reduction of cervical cancer incidence. However, both of these tests have limited specificity for the detection of clinically significant cervical high grade lesions. ProEx C for topoisomerase II alpha (TOP2A) and minichromosome maintenance protein 2 (MCM2) has been considered to have tight association with high grade intraepithelial lesions.Materials and Methods:A total number of 54 SurePath cervical cytology specimens of patients previously interpreted as atypical squamous cells–undetermined significance (ASC-US), atypical squamous cells–cannot exclude high grade squamous intraepithelial lesion (ASC-H), low grade squamous intraepithelial lesion (LSIL), and high grade squamous intraepithelial lesion (HSIL) were included in our study.Results and Conclusions:ProEx C was positive in 14 of HSILs (100%), 3 of 19 LSILs (16%), 2 of 4 ASC-Hs, and none of ASC-USs (0%). The ProEx C test showed very intense nuclear staining in all cytologically abnormal cells. Further studies are indicated to evaluate the diagnostic role of ProEx C.

Breast hamartomas are rare, benign, tumor-like nodules composed of glandular, adipose and fibrous tissue. The hamartoma was first described in 1971 as a lipofibroadenoma, fibroadenolipoma or adenolipoma, based on the predominant component of the breast tissue. Clinical findings resemble fibroadenoma and if there is a palpable mass, the patients may receive an immediate diagnosis. Ductal hyperplasia, apocrine metaplasia, calcification and adenosis may occur within the hamartoma, with rarer instances of lobular or ductal intraepithelial neoplasms. Although hamartoma is usually benign, a malignant transformation is possible. An excision and histological examination is necessary for the differential diagnosis and also for any epithelial lesions of the hamartoma. Simple excision is enough for treatment if there is no coincidental epithelial malignant lesion. The patients in the present study were treated by simple excision as there were no proliferative changes in the lesions. No recurrence or other problems were detected in the 18-month follow-up. The current study presents two cases of breast hamartoma that were diagnosed as an adenolipoma and a fibroadenolipoma, and then describes the macroscopic and microscopic observations of these lesions.

InTRoDuCTIonChordoma is a rare malignant bone tumor originating from notochordal remnants (1,2). The complete resection of this tumor is usually not available because of its invasiveness to adjacent structures. although radiotherapy and gamma knife surgery have been tried for treatment, local control cannot be provided in most of the cases due to the extensive recurrence ability of the tumor (3). There are few studies investigating the effect of treatment modalities on the survival and prognosis of chordoma patients (3,4). Histopathological properties of this tumor such as mitosis and necrosis have been analysed in a number of studies in order to understand their relations with the prognosis and survival. However limited information is available from these studies and also the sample sizes are small because of the rare incidence of chordoma. There are also discordances between the results of different studies. Despite several proposed prognostic parameters, no evidence-based parameter has been defined to predict survival (5-7) receptor tyrosine kinases (rtks), besides being the key regulators of cell processes including cell growth and angiogenesis, have critical roles in the development and progression of tumors.The epidermal growth factor receptor (eGFr), erbB2 (Her-2 neu) and c-met are the members of erbB family of rtks. These trans-membrane proteins are activated by binding with peptide growth factors of the eGFfamily of proteins. eGFr and its three related proteins (the erbB family) play essential roles in both normal physiological conditions and malignancies. Upon binding its ligands, dynamic conformational changes occur in both extracellular and intracellular domains of the receptor ABsTRACTObjective: Chordoma is a rare malignant bone tumor with a poor outcome. although radiotherapy and gamma knife surgery have been used for treatment, providing a cure for the tumor is not easy, because of the frequent recurrences. Molecular targeted therapy against tyrosine kinases has been effective in the treatment of malignancies such as breast and lung cancers and brain tumors. We aimed to analyse the histopathological features of chordomas and the immunoexpression profiles of the three receptor tyrosine kinases of eGFr, c-Met and c-erb-B2 in chordomas. We have correlated these results with recurrence and overall survival status of the patients. Material and Method:We studied 49 chordoma patients in order to evaluate the histopathological features and immunohistochemical stainings by eGFr, c-Met and c-erbB2 antibodies. Of the 49 patients, follow up data was available for 40 patients. Clinical data of the patients were correlated with histopathological features and survival analysis was performed.Results: the immunostaining rate by eGFr and c-Met was 73.5% and 12.2% respectively. none of the cases showed immunoreactivity by c-erbB2 (0%). Of the 40 cases, 17 cases showed recurrences. eGFr expression was detected in 14 recurrent (14/17) and 17 non-recurrent cases (17/23). Four of the 17 recurrent cases (4/17) were posit...