We present seventeen cases of apocrine hidrocystoma, ten of which had pseudopapillary and solid areas of proliferation. The lesional cells were examined for the extent and intensity of immunohistochemical staining for neuroendocrine and endocrine markers. Of the ten hidrocystomas with adenomatous features, eight cases (80%) displayed immunoreactivity to Estrogen (ER) and Progesterone Receptors (PR). None of the cases showed staining for chromogranin. Conversely, none of the cases of classic apocrine hidrocystoma (0 of 7) exhibited staining for ER, PR, or chromogranin. Furthermore, all cases of hidrocystomas with and without proliferative features, behaved in a benign fashion without any recurrence. In conclusion, hidrocystomas with proliferative features are benign lesions, and we have shown this variant of apocrine hidrocystoma to have a novel staining pattern with ER and PR which has not previously been described. In addition, we offer further support based on the histological features and this unique staining pattern to the hypothesis that apocrine hidrocystomas, in particularly the proliferative variant, may be within the sequence of adenoma to carcinoma for Endocrine MucinProducing Sweat Gland Carcinoma (EMPSGC).

Background: Bone marrow examination plays a central role in clinical management of many primitive and secondary hematological diseases. We conducted a systematic evaluation of Siemens ADVIA2120i analytical performance pertaining to automated analysis of bone marrow aspirate fluids.

Methods: 88 samples of bone marrow fluids were analyzed with ADVIA2120i and compared with a flow cytometry assay for total nucleated cells and manual microscopy for differential counts.

Results: Regarding total nucleated cells, ADVIA2120i showed a strong and significant correlation with flow cytometric counts, with a positive systematic bias due to interference by lipid particles. The myeloperoxidase reaction allowed ADVIA2120i to obtain a strong and significant correlation with the elements of the neutrophilic lineage. The same was observed between myeloperoxidase negative events in the PEROX channel and manual counts of NRBCs, lymphocytes and plasma cells. Moreover, scatter-plots were found to be an important source of information for the study of bone marrow aspirates.

Conclusion: Automated cytometric analysis with ADVIA 2120i could be potentially useful for bone marrow examination

Introduction: Ziehl Neelsen (ZN) staining has been the mainstay for detection of acid fast bacilli. Multiple sputum smear screening is advised to increase the detection of pulmonary tuberculosis. A similar approach may increase detection in lymph node aspirates. This prospective, observational study was aimed to study the effect of staged approach on the detection of acid fast bacilli in ZN stained smears from fine needle aspirates of patients with suspected tuberculosis lymphadenitis.

Materials and Methods: 300 patients, in whom lymph node aspirates were performed with clinical suspicion of tuberculosis, or in whose aspirates tuberculosis was suspected on the basis of the following three reaction patterns-epithelioid cell granuloma, epithelioid cell granuloma with necrosis or necrosis only, were studied. Smears reported negative for Acid-Fast Bacilli (AFB) at routine reporting (Stage I) were rescreened by a first observer (Stage II). Negative smears were rescreened by a second independent observer (Stage III). In cases where no AFB was demonstrated, additional material, that is another smear if available (Stage IV), and/or re[1]aspirate from the same lesion (Stage V) were examined. Statistical analysis was done by applying Binomial Exact test at each stage.

Results: AFB positivity at stage I – 185/300; AFB positivity at stage II - 224/300 (p value = 0.001); AFB positivity at Stage III - 240/300 (p value = 0.119); AFB positivity at Stage IV - 263/300 (p value = 0.010) and AFB positivity at stage V - 273/300 (p value = 0.001)

Conclusions: A cascading staged approach improves AFB detection in aspirates from lymph nodes of patients with suspected tuberculous lymphadenitis. In AFB negative patients, yield of AFB can be increased by examining a second smear obtained from the same aspirate. Further increase in the AFB positivity can be obtained if repeat aspirates are examined for the presence of AFB. Combination of the above two has an additive incremental effect.

Background: Esophageal cancer is a highly aggressive neoplasm. In Brazil, it is the sixth most frequent among men and fifteenth among women. The most common type is Squamous Cell Carcinoma (SCC), responsible for 96% of cases. Twenty-eight specimens of Esophael Squamous Cell Carcinoma (ESCC) were obtained by surgery procedures.

Methods: The tissues were fixed in formalin and embedded in paraffin. In each case, all available hematoxylin and eosin stained sections were examined and a representative block was selected. The ages of these patients ranged from 40 to 93 years, with a mean age of 60 years.

Results: The histological grade of tumors was 4 well-differentiated, 19 moderately differentiated and 5 poorly differentiated. Expression of Cox-2 and VEGF in ESCC was demonstrated in 23 (82,14%) and 13 (44,43%) cases, respectively. Adjacent normal mucosa was positive in 11 (39,29%) samples and 9 (32,15%) samples for Cox-2 and VEGF, respectively. No relationship between the expression of Cox-2 and VEGF with the clinicopathological parameters, including gender, age, surgical margin, lymph node status and tumor differentiation. The median follow-up period was 60 months. Survival analysis of patients with ESCC showed no relationship with the expression of Cox-2 and VEGF.

Conclusion: VEGF and Cox-2 are expressed in ESCC. Cox-2, VEGF, play a significant role in the origin and development of ESCC and the inhibitors of these proteins could prove to be an important therapeutic tool in the control of this disease.

The aim of this report is to relate an unusual clinical presentation of breast carcinoma with medullary features. A Japanese patient aged 57 complained of right nipple lump with progressive growth over the past six months. Upon physical examination, we found no nodules in the breast, except for a pedunculated tumor from her right nipple. The breast ultrasonography revealed an irregular, not circumscribed nipple lump. The mammogram did not show any pathologic findings. The biopsy confirmed a triple negative carcinoma with medullary features (MCF). Even though a case report on invasive ductal carcinoma regarding the same clinical scenario had occurred in 1996, a MCF of the nipple without any radiologic or clinical findings in the parenchyma has not been described until the present date