Non-neoplastic Proliferations Research Articles

Non-neoplastic B-cell predominant lymphoid proliferations at the organs exposed to external environment mimicking lymphoma: A potential diagnostic pitfall.

Background: Typically, lymphatic tissue proliferative lesions include either benign lesions or lymphoma. However, not all lymphatic lesions can currently be accurately classified into one category, particularly in mucosal areas that are in contact with the external environment.Aims: To explore the morphology, immunophenotype, and molecular changes of Non-neoplastic B-cell predominant lymphoid proliferations (NBPLP) in pathological areas that are exposed to external surroundings which mimicked lymphoma.Methods and Results: 18 cases of Atypical lymphoid hyperplasia (AtLP) were retrieved in this study. The biopsy samples were mucosal samples obtained from areas exposed to external surroundings, including intestines, urethra, cervix, tonsils, and tongue. Microscopically, there is a different level of B cell hyperplasia accompanied by morphological atypia. We categorized the morphology into 4 groups: type A (7/18), type B (3/18), type C (3/18), type D (5/18). Part of the AtLP was found positive for BCR gene rearrangement (6/15), and TCR gene rearrangement (1/4). The follow-up period ranged from 14.2 to 70 months. No evidence of lymphoma was found. Therefore, we diagnosed all of the presented cases as NBPLP. We illustrated the key differential points and provided valuable diagnostic experience on each subtype.Conclusions: Areas exposed to the external environment are commonly exposed to antigen and easily present with AtLP of NBPLP, accompanying with positive IGH rearrangement. Therefore, a comprehensive evaluation of macroscopic, morphology, immunophenotype, and molecular diagnostics is required to prevent the overdiagnosis of lymphoma.

The Correlation between VEGF and CD34 Protein Marker and Pyogenic Granuloma.

A typical non-neoplastic connective tissue proliferations called a pyogenic granuloma. A vascular adhesion molecule used to assess angiogenesis is the CD34 marker. The primary memberof a family of growth factors, VEGF helps in generating and maintaining the lymphatic and blood circulation systems. The aim of the study was to know the correlation between VEGF and CD34 protein marker and pyogenic granuloma. Thirty-one formalin fixed paraffin embedded (FFPE) blocks were taken from female pyogenic granuloma patients ranging in age from 29 to 70. The IHC was used to identify VEGF and CD34 expression in the cytoplasm of the cells. Seventeenout of 31 patients had VEGF positive expression. Twenty-sixout of 31 had CD34 positive expression and 5 with no expression (negative expression). Brown-stained cytoplasm showed high VEGF and CD34 expression, whereas blue stained cytoplasm showed no VEGF and CD34 expression in these cells. The results suggest the role of suchbiomarkers in the oral pyogenic granuloma pathogenesis, and it appears that CD34 and VEGF are valuable biomarkers in evaluating vascular and inflammatory diseases like pyogenic granuloma.

Contiguous squamous proliferations in syringocystadenoma papilliferum: A retrospective study of 14 cases.

Syringocystadenoma papilliferum is a benign adnexal neoplasm. Contiguous squamous proliferation has been rarely described in syringocystadenoma papilliferum. This study aimed to evaluate the spectrum and pathogenesis of contiguous squamous proliferation in syringocystadenoma papilliferum. All cases of syringocystadenoma papilliferum diagnosed over the past 12 years were screened for contiguous squamous proliferation. Cases with associated nevus sebaceous were excluded from the study. Immunohistochemistry for GATA3, CK7, BRAFV600E and p16 was performed. PCR for human papilloma virus, type 16 and 18, was carried out. Of a total of 30 cases, 14 cases showed associated contiguous squamous proliferation which included four cases of verrucous hyperplasia, six cases with papillomatosis, two cases with mild squamous hyperplasia and one case each of Bowen's disease and squamous cell carcinoma. In the cases with non-neoplastic contiguous squamous proliferations, the squamous component did not express CK7 or GATA3. However, the squamous component of premalignant and malignant lesions expressed CK7 and GATA3 concordant with the adenomatous component. BRAF was positive in adenomatous component in five cases while the contiguous squamous proliferation component was negative for BRAF in all but one case. p16 was negative in both components of all cases and PCR for human papilloma virus was negative in all cases. Due to the rarity of disease, the sample size of our study was relatively small with two cases in the 2nd group, that is, syringocystadenoma papilliferum with malignant contiguous squamous proliferation. Detailed molecular studies such as gene sequencing were not performed. Syringocystadenoma papilliferum with contiguous squamous proliferation is underreported, and most commonly displays verrucous hyperplasia. The premalignant and malignant contiguous squamous proliferations likely arise from syringocystadenoma papilliferum while the hyperplastic contiguous squamous proliferations likely arise from the adjacent epidermis. Relationship with high-risk human papilloma virus is unlikely. However, further molecular analysis of larger number of cases is required to establish the pathogenesis.

P53 immunohistochemistry discriminates between pure erythroid leukemia and reactive erythroid hyperplasia

Pure erythroid leukemia (PEL) is a rare, aggressive subtype of acute myeloid leukemia with a poor prognosis. The diagnosis of PEL is often medically urgent, quite challenging, and is typically a diagnosis of exclusion requiring meticulous distinction from non-neoplastic erythroid proliferations, particularly florid erythroid hyperplasia/regeneration. Given the frequency of TP53 mutations in the molecular signature of PEL, we hypothesize that differential p53 expression by immunohistochemistry (IHC) may be useful in distinguishing PEL versus non-neoplastic erythroid conditions. We performed p53 IHC on 5 normal bone marrow, 46 reactive erythroid proliferations, and 27 PEL cases. We assessed the positivity and intensity of nuclear staining in pronormoblasts and basophilic normoblasts using a 0–3+ scale with 0 being absent (with internal positive controls) and 3 being strong nuclear positivity. A total of 26/27 PEL cases showed strong, uniform, diffuse intense staining by the neoplastic pronormoblasts versus 0/5 and 0/46 normal and reactive controls, respectively. The control cases show various staining patterns ranging from 0 to 3+ in scattered erythroid precursor cells. Uniform, strong p53 positivity is unique to PEL and discriminates this entity from a benign erythroid mimic. Thus, p53 IHC may be a useful marker in urgent medical cases to assist in the confirmation of a malignant PEL diagnosis while awaiting the results of additional ancillary studies such as cytogenetics.

Reactive Eosinophil Proliferations in Tissue and the Lymphocytic Variant of Hypereosinophilic Syndrome.

The 2019 Society for Hematopathology and European Association for Haematopathology Workshop reviewed the spectrum of neoplastic, nonneoplastic, and borderline entities associated with reactive eosinophilia in tissue. The workshop panel reviewed 46 cases covered in 2 workshop sessions. The 46 cases were presented with their consensus diagnoses during the workshop. Reactive eosinophilia in lymph nodes and other tissues may be accompanied by or be distinct from peripheral blood eosinophilia. Reactive etiologies included inflammatory disorders such as Kimura disease and IgG4-related disease, which may show overlapping pathologic features and reactions to infectious agents and hypersensitivity (covered in a separate review). Hodgkin, T-cell, and B-cell lymphomas and histiocytic neoplasms can result in reactive eosinophilia. The spectrum of these diseases is discussed and illustrated through representative cases. Reactive eosinophilia in lymph nodes and tissues may be related to both nonneoplastic and neoplastic lymphoid proliferations and histiocytic and nonhematolymphoid processes. Understanding the differential diagnosis of reactive eosinophilia and the potential for overlapping clinical and pathologic findings is critical in reaching the correct diagnosis so that patients can be treated appropriately.

Mesenchymal lesions of the vulva.

Mesenchymal lesions of the vulva include site-specific entities limited to the lower genital tract, as well as a range of non-site-specific tumors that are more common at extragenital sites. Site-specific lesions include fibroepithelial stromal polyp, cellular angiofibroma, angiomyofibroblastoma, and aggressive angiomyxoma. Non-site-specific tumors that may occur in the vulva include those of smooth muscle, skeletal muscle, vascular, neural, adipocytic, and uncertain differentiation. This review discusses both site-specific and non-site-specific vulvar mesenchymal lesions including non-neoplastic proliferations, benign neoplasms, locally aggressive neoplasms with a predilection for local recurrence, neoplasms of indeterminate biologic potential, and frankly malignant neoplasms with a high risk of distant metastasis and death. Accurate diagnosis is essential for proper management, and is facilitated by correlation with clinical findings and targeted application of immunohistochemical and molecular studies.

Role of serum protein electrophoresis in clinically suspected cases of plasma cell dyscrasia

Background: Serum protein electrophoresis (SPE) and its pattern recognition is an excellent screening technique for the detection of paraproteinemias or monoclonal gammopathies. In this study, we assessed SPE patterns in all clinically suspected cases of plasma cell dyscrasia with usual and unusual clinical presentations and correlated with ancillary investigations. Method: We analysed serum protein electrophoresis (SPE) patterns in clinically suspected cases of plasma cell dyscrasia in 2 year duration. Based on SPE pattern these cases were divided into two groups: Group I, with M-component and Group II, without M-component. These cases were reviewed with respect to clinical presentation and correlated with immunofixation electrophoresis and bone marrow aspiration/biopsy findings wherever available, especially in the M band positive cases to differentiate multiple myeloma (MM) from the other conditions. Result: A total of 80 samples were received for SPE, out of these, 56.3% were clinically suspected to have plasma cell dyscrasia. Among these cases 60% were in group I and 40% were in group II. In group II, 39% cases were essentially non neoplastic after relevant investigations. In group I, M-band was observed in 88.9% cases in γ-region and 11.1% cases in β-region. The mean fraction of the M protein was 4.7g/dl with a range of 2.0g/dl to 9.8g/dl. In group II 72.2% showed polyclonal hypergammaglobulinemia, 22.2% showed normal electrophoretic pattern and 5.6% showed hypogammaglobulinemia. Bone marrow aspiration and biopsy were available in 88.9% of all suspected cases. Various haematological neoplasms observed in both the groups, their clinical presentations with interesting facets of the cases have been discussed. Conclusion: Serum protein electrophoresis is one of the most important diagnostic modality in clinical chemistry. It helps to resolve cases with bone marrow plasmacytosis particularly in differentiating between reactive non-neoplastic plasmacytic proliferations from clonal plasma cell disorders. Moreover, it also facilitates the work-up of cases with atypical presentations and thereby paves way to clinch the diagnosis in these ambiguous cases.

Neuromas at the castration site in geldings

BackgroundInguinal pain, unexplained hind limb lameness, back pain or behavioural problems in geldings could be attributable to painful neuromas that develop as a consequence of crushing and severing the testicular nerves during castration. The presence of neuroma in this anatomical location has never been reported, hence the knowledge of possible clinical relevance is limited. The aim of this study was to histologically investigate the testicular nerves at the castration site in geldings for the presence of neuromas. Proximal spermatic cord remnants were collected from 20 geldings admitted to routine post mortem examination for various reasons. The time of castration was unknown, but it had not been performed during the last year. Spermatic cord specimens were immersed in 10% formalin, trimmed, dehydrated, embedded in paraffin, sectioned and stained with haematoxylin and eosin (HE) for light microscopy. Identification of nerve tissue was done by immuno-localization of nerve specific enolase (NSE).ResultsNeuromas were found in 21 spermatic cords from 13 geldings and were bilateral in eight of the horses. The neuromas consisted of areas with small groups of non-neoplastic proliferations of peripheral neural tissue. The tissue included neurofilaments and Schwann cells, intermingled or surrounded with, epineural, perineural and endoneural fibrous tissue. The neural tissue immunostained positive with NSE.ConclusionsThis study showed neuromas of the remnant testicular nerves at the site of castration. Further studies are required to establish if these neuromas in the castration site are painful and if certain castration methods promote their formation. Future studies should also investigate the clinical consequence of these neuromas for the individual horse.

Traumatic neuroma of buccal nerve

Background: Traumatic neuromas (TN) are non-neoplastic proliferations of a nerve arising in response to an injury, in most of the cases after direct trauma or surgical manipulation. The most common intraoral TN are found in the mental foramen, lower lip and tongue. We describe the case of extraosseous TN in the alveolar gum.

Histopathologic spectrum of vulvar lesions in South India with an emphasis on morphological classification of vulvar squamous cell carcinoma: a retrospective study of 8 years

Background Vulvar diseases comprise inflammatory and neoplastic conditions. Comprehensive data in Indian population is lacking. Vulva is also prone to HPV related lesions and the prevalence of HPV related vulvar squamous cell carcinoma (SCC) in the study population is not known. Objectives The primary aim of this study was to describe the range of vulvar lesions over a period of 8 years in South Indian population. Additionally the vulvar squamous neoplasias were subclassified into morphological types in an attempt to differentiate the HPV and non HPV associated lesions, which helps in triaging cases for HPV testing. Methods The vulvar lesions from database were categorised as inflammatory, cysts, non-neoplastic proliferations and neoplasms. The inflammatory lesions were classified as lichenoid and acanthotic patterns. The squamous neoplasias were morphologically categorised into HPV and non HPV associated types. Results There were 204 biopsies from 192 adults and 10 children. Epithelial ones were commoner than mesenchymal (48 vs.18). Benign adnexal neoplasms included hidradenoma papilliferum, syringoma , apocrine adenoma. The commonest malignancy was squamous cell carcinoma (SCC) (n=21) of which 17 were classified as HPV associated and 4 non-HPV associated. SCC subtypes were warty (n=3), basaloid (n=5), mixed (n=1) and arising from differentiated VIN(n=8). One case of basal cell carcinoma was reported. There were 15 cases of VIN [5 LSIL and 10 HSIL {3 warty, 5 basaloid,2 mixed}], one extramammary Paget’s disease. Vascular neoplasms were the commonest mesenchymal lesions. There was one case each of leiomyosarcoma and angiosarcoma. Among non-neoplastic proliferations, fibroepithelial polyps were the commonest (n=9). Lichenoid inflammatory lesions (n=75) was more common than acanthotic (n=4). Conclusion The study highlights the importance of histopathologic typing of SCC and VIN, which helps in triaging cases for HPV testing in resource limited setting.

Bcl-2 expression in reactive oral lesions with atypical epithelium and in oral epithelial dysplasia associated with carcinogen exposure.

Background:Reactive lesions of the oral cavity are nonneoplastic proliferations with very similar appearance to benign neoplastic lesions and are associated with chronic local irritation or trauma. Although these lesions are uncommonly associated with carcinogen exposure, at times, they present histopathologically with dysplastic epithelium, thus making it difficult to differentiate it from true potentially malignant disorders. Hence, the present study was conducted to evaluate the expression of Bcl-2 protein, an antiapoptotic marker, in reactive lesions with and without atypical epithelium and in true epithelial dysplasia, which clinically presents as premalignant disorders.Materials and Methods:The samples included 15 cases each of normal oral mucosa (NOM), reactive lesions with and without dysplasia and oral epithelial dysplasia (OED) associated with carcinogen exposure. All the samples were subjected to immunohistochemical staining using Bcl-2 antibody. The total number of cells in the basal and parabasal layers in each field and total number of cells expressing Bcl-2 among them and the staining intensity were assessed.Statistical Analysis:Kruskal–Wallis ANOVA test was used to compare the number of positive cells among the four groups. The comparison of average percentage of positive cells between the study groups was done using Mann–Whitney U-test.Results:The immunohistochemical staining for Bcl-2 protein was identified in few cells in the basal layers of NOM, reactive lesions without atypical epithelium and in the basal and parabasal layers in reactive lesions with atypical epithelium and OED, as a granular cytoplasmic staining and as an accentuation around the nuclear membrane. There was a gradual increase in the expression and intensity of staining from Group I to IV.Interpretation and Conclusion:The altered or increased expression of Bcl-2 oncoprotein in reactive lesions with atypical epithelium and in OED with carcinogen exposure may lead to prolonged cell survival and can be considered as an early molecular event in carcinogenesis, helping us in understanding the nature of dysplasia in reactive lesions, which was not considered during the histopathology reporting.

De novo pure erythroid leukemia: refining the clinicopathologic and cytogenetic characteristics of a rare entity

AbstractPer the revised fourth edition World Health Organization classification of acute myeloid leukemia, pure erythroid leukemia is now the sole type of acute erythroid leukemia. The diagnosis of this rare entity is often challenging and the cytologic overlap with non-neoplastic (eg, megaloblastic anemia) and neoplastic entities (eg, other types of acute leukemia and non-hematopoietic malignancies) warrants a significant degree of clinical, laboratory, immunophenotypic, and genetic investigation. Given the limited number of reports of this rare and diagnostically challenging entity, we report detailed clinicopathologic characteristics from 15 patients, the largest series thus far, of primary de novo pure erythroid leukemia to provide further diagnostic insights into this entity and reveal strategies for making the diagnosis. We found that de novo pure erythroid leukemia is a disease of adults (median age 68 years), exhibits a striking male predominance, is universally associated with an abnormal karyotype and has an exceedingly poor overall median survival of 1.4 months. Given the general inability of immunophenotypic markers to discriminate neoplastic from non-neoplastic erythroid proliferations, key features identified in this study to help establish the diagnosis of pure erythroid leukemia and exclude mimickers include circulating pronormoblasts, clear-cut dysplasia in erythroid, granulocytic, and/or megakaryocytic lineage, utilization of a broad immunophenotypic panel, TP53 immunohistochemical positivity, and identification of a complex, often highly complex, karyotype. Given the gravity of a diagnosis of de novo pure erythroid leukemia, it should be rendered with utmost confidence.

Polypoid fibroadipose tumors of the esophagus: ‘giant fibrovascular polyp’ or liposarcoma? A clinicopathological and molecular cytogenetic study of 13 cases

Giant fibrovascular polyp of the esophagus is a descriptive diagnostic term intended to encompass rare, large, polypoid esophageal masses composed of fibroadipose tissue. Despite sometimes dramatic clinical presentations, they have historically been considered to represent reactive, non-neoplastic proliferations. Recently, however, a small number of reports have described well-differentiated liposarcomas of the esophagus, mimicking giant fibrovascular polyps. In order to clarify the relationship between esophageal liposarcoma and giant fibrovascular polyp, we retrieved esophageal cases coded as 'giant fibrovascular polyp,' 'lipoma' and ‘liposarcoma’ from our archives and re-examined their clinicopathologic features and MDM2 amplification status. Thirteen cases were identified (lipoma (n=1), giant fibrovascular polyp (n=5), well-differentiated liposarcoma (n=3), dedifferentiated liposarcoma (n=3)). The tumors ranged from 5.2 to 19.5 cm and arose predominantly in the cervical esophagus. All consisted chiefly of mature adipose tissue, with a variable component of fibrous septa. In all cases, close inspection of these fibrous septa showed them to contain an increased number of slightly enlarged spindled cells with irregular, hyperchromatic nuclei, similar to those seen in some well-differentiated liposarcomas. Three cases, all previously classified as dedifferentiated liposarcoma, showed in addition solid zones of non-lipogenic spindle cell sarcoma. By fluorescence in situ hybridization (FISH), all cases showed MDM2 amplification, confirming diagnoses as well-differentiated (N=10) and dedifferentiated (N=3) liposarcoma. Clinical follow-up (8 cases, range 22–156 months, median 33 months) showed 3 patients with local recurrences (1 well-differentiated and 2 dedifferentiated liposarcomas), 1 patient with liver metastases (dedifferentiated liposarcoma) and 2 deaths from disease (both dedifferentiated liposarcomas). These results suggest that the great majority of large, polypoid, fat-containing masses of the esophagus represent well and dedifferentiated liposarcoma, rather than 'giant fibrovascular polyps.' We suggest that the diagnosis of 'giant fibrovascular polyp' should be made with great caution in the esophagus, and only after careful morphological study and MDM2 FISH has excluded the possibility of liposarcoma.

Controversies in Odontogenic Tumours: Review.

Odontogenic tumours are lesions that occur solely within the oral cavity and are so named because of their origin from the odontogenic (i.e. tooth-forming) apparatus. Odontogenic tumours comprise a variety of lesions ranging from non-neoplastic tissue proliferations to benign or malignant neoplasms. However, controversies exist regarding the pathogenesis, categorisation and clinical and histological variations of these tumours. The recent 2017 World Health Organization classification of odontogenic tumours included new entities such as primordial odontogenic tumours, sclerosing odontogenic carcinomas and odontogenic carcinosarcomas, while eliminating several previously included entities like keratocystic odontogenic tumours and calcifying cystic odonogenic tumours. The aim of the present review article was to discuss controversies and recent concepts regarding odontogenic tumours so as to increase understanding of these lesions.

Endocrine and neuroendocrine cytopathology.

Cytology is an easily-accessible, cost-effective, and safe procedure for the initial evaluation of most endocrine/neuroendocrine lesions. Both fine-needle aspiration cytology and exfoliative cytology have shown good sensitivity and specificity in detecting endocrine/neuroendocrine benign proliferations and malignancies. Thanks to its utility for early diagnosis, cytology has contributed to the decline in mortality of endocrine/neuroendocrine neoplasms. The endocrine system comprises different endocrine organs, such as the thyroid, adrenal glands, paraganglia, parathyroid, pancreas, hypothalamus, pituitary gland, ovaries and testes, which can give rise to non-neoplastic, benign and malignant proliferations. In addition, several neuroendocrine cells do not form specific endocrine organs, but are widely present along other systems, notably in the lungs and in the gastrointestinal tract. The general diagnostic approach to proliferations originating from neuroendocrine cells is similar to that of endocrine organs. This review focuses on the cytological features of neuroendocrine proliferations, with particular emphasis on their most common sites of origin, i.e. the thyroid, pancreas, lungs and skin. Ancillary approaches applied to cytological material to improve diagnosis will also be discussed.

BONY TUMOURS OF MAXILLOFACIAL REGION : RETROSPECTIVE STUDY OF CLINICO-PATHOLOGICAL PROFILE AND THEIR MANAGEMENT

Introduction: Maxillo-facial tumours are a group of heterogenous diseases that ranges from
 hamartomas or non-neoplastic tissue proliferations to benign neoplastic to malignant tumors
 with metastatic potentials. The aim of the present study is to evaluate the clinico-pathological
 profile and management of primary lesions of facio-maxillary region.
 Material and Methods: Retrospective data of bony tumors of maxilla-facial region was
 retrieved for 2 years from March 2015 to April 2017. The data included the gender, age,
 diagnosis based on radiology, histopathology and the site of origin.
 Results: A total of 18 patients were diagnosed as a bony tumour of maxillofacial region and
 treated surgically. Fibrous dysplasia, Odontogenic cyst and Ameloblastoma were the most
 common lesions.
 Conclusion: Bony tumours of Maxillofacical region though uncommon and mostly benign,
 pose a great challenge to preserve the functions and cosmesis.

Odontogenic Tumours of Jaw: A Prospective Study on Clinico-Pathological Profile and Their Management.

Odontogenic tumours are a group of heterogeneous diseases that range from hamartomatous or non-neoplastic tissue proliferations to benign neoplasms to malignant tumours with metastatic potential. They are rare, comprising about <2-3% of all oral and maxillofacial biopsy specimens. The aim of the present study was to determine the clinico-pathological presentation of this heterogeneous group of lesions and review of literature. The present study was conducted in the ENT department of a Government Medical College and Hospital, West Bengal, India, over the period of 5years from January 2011 to December 2015. It included a total of 15 patients who were clinico-radiologically diagnosed as odontogenic tumours, and were given appropriate treatment. Their diagnostic and management approaches are discussed. Among 15 odontogenic tumours, 13 were benign and two were malignant. Male to female ratio was 2:3. Mandible to maxilla ratio was 1.8:1. The patients were in between 4 and 56years of age with highest incidence in 3rd decade of life. All patients are doing well till date with a minimum follow-up of 1year. Incisional biopsy is considered as gold standard for preoperative diagnosis but FNAC can offer clinicians a less invasive alternative. CT is the choice of investigation for study of lesion, analysis of its extension and surgical planning. The challenge to proper management lies in balancing between conservative and radical approach to reduce morbidity and recurrence both. Final diagnosis is made by post-operative histopathological examination.

Odontogenic tumors: Review of 127 cases in Marathwada region of Maharashtra.

Introduction:Odontogenic tumors (OTs) are a group of heterogeneous lesions derived from epithelial or ectomesenchymal tissues or both, which are part of the tooth-forming apparatus. They range from hamartomatous or nonneoplastic tissue proliferations to malignant neoplasms with metastatic capacity. OTs are comparatively rare, comprising about 4.79% of all oral and maxillofacial biopsy specimens diagnosed. Several retrospective studies carried out in Africa, Asia, Europe and America, show that differences exist in the relative frequency of the various histologic types. Very few studies are reported among Asians, especially from the Indian subcontinent. Hence, the present study is designed to determine the frequency of the OTs and compare them with reports of various other part of the world.Study Design:A retrospective study was carried out with the ethical clearance and permission from the authority. The histopathology records from the Department of Oral Pathology and Microbiology, within the period from January 1992 to June 2012 were obtained. A total number of OTs were analyzed for age, gender, site of the tumor and histopathological type. The odontogenic keratocyst now considered as kerato cysticodontogenic tumor (KCOT) was also included in the present study.ResultsTotally, 2652 tissue specimens were received for histopathologic examination out of which 127 were OTs. All these reported cases were benign except two cases of malignancy. Among these male: female ratio of 1.04:1 with an overall mandible: maxilla ratio of 1.01:1. The most common benign odontogenic tumor was KCOT (44.9%). Ameloblastomas were the second most common benign tumors (35.43%), followed by odontome (7.08%) and adenomatoid odontogenic tumor (4.72%). Age distribution showed a peak occurrence of the odontogenic tumor in the fourth decade (31.49%).Conclusion:OTs are rare lesions in the studied population and are represented mainly by the KCOT, ameloblastoma and odontoma. Data from the reviewed cases have shown a possible geographic variation of OTs. With the introduction of the KCOT in the 2005 WHO classification, this neoplasm is now one of the most prevalent OT types.

Caracterização clínica e terapêutica de lesões mamárias não neoplásicas em fêmeas da espécie felina

The fibroepithelial hyperplasia and cystic dysplasia correspond to feline mammary gland nonneoplastic proliferations. Although benign, they have the carcinoma as the main differential diagnosis. The study aimed to establish the clinical-epidemiological and therapeutic profile of nonneoplastic mammary neoformations of domestic cats, in order to help veterinary clinicians in the management of feline mastopathies. Information was obtained retrospectively from the Veterinary Hospital of the Semi-Arid Rural Federal University clinical records. Historical information, clinical appearance of the lesions and microscopic diagnosis were collected, besides the therapy used and the respective clinical response. The data were distributed in frequencies. It was found that most disorders (91%) corresponded to fibroepithelial hyperplasia, in contrast with one (9%) case of cystic dysplasia. Cytology was enough to confirm all cases of fibroepithelial hyperplasia, while the cystic dysplasia definitive diagnosis was obtained only by the histopathological exam. Many of the cats studied were under one year old, having not usually been ovariectomized yet, but already subjected to progestin treatment. The most common clinical sign were local cyanosis. In 90% of the female patients with breast fibroepithelial hyperplasia, primary treatment consisted of antiprogestagen drug (aglepristone) administration. After complete regression of the breast tissue, the patients underwent ovariosalpingohysterectomy. For the cystic dysplasia case, it was established the association of surgical sterilization with mastectomy. For all situations, the different therapies promoted permanent remission of the mastopathies. The data obtained become crucial for clinical management and therapy of feline patients suffering from nonneoplastic mammary gland neoformations.

Spindle cell hemangioma of femur

Spindle cell hemangioma (SCH) an uncommon vascular tumor typically appears as solitary or multiple cutaneous and subcutaneous nodules in middle-aged adults. Its occurrence in bone is extremely rare. We report a case of SCH arising at an uncommon site, the distal femur with radiological local invasion, but without histological pleomorphism and mitosis. It is important to avoid misdiagnosis as these lesions are considered to be benign, non-neoplastic reactive vascular proliferations, with high incidence of recurrence.