Two members of the vascular endothelial growth factor (VEGF) family, VEGF-C and -D, are known as lymphangiogenic growth factors and play an important role in tumor lymphangiogenesis via activation of the VEGF receptor (VEGFR)-3, which is expressed in lymphatic endothelial cells. D2-40 is a specific antibody for lymphatic vessel density (LVD). In the present study, we have aimed to evaluate whether intraand peri-tumoral D2-40-positive lymphatic vessels affect lymph node metastasis and to investigate the relationship between LVD and lymph node metastasis in breast cancer. We have evaluated the relationships between lymph node metastasis and VEGF-C, VEGF-D, VEGFR-3 and D2-40 expressions in breast cancer cells using immunohistochemistry. VEGF-C, VEGF-D and VEGFR-3 expression were found in tumor cells in the majority of the cases (83.75, 97.5 and 95%, respectively). There was a significant positive relationship between VEGF-D expression and lymph node metastasis (p < 0.05) however no significant association was found in VEGF-C and VEGFR-3 expressions. It was found that patients with high-expression of VEGF-D have a high level of both periand intra-tumoral LVD compared to those with low expression of VEGF-D (p < 0.05). Our results support that examination of VEGF-D expression in breast cancer cells may be beneficial in the identification of lymph node metastasis.

Bartholin's gland was first identified in human female in 1675 by Caspar Bartholin. The Bartholin gland is composed of several epithelial types: The body is mucinous acini, the duct is predominantly transitional epithelium, and the orifice is the squamous epithelium. Primary carcinoma of the bartholin's gland is an uncommon neoplasm. Adenoid cystic carcinoma (ACC) of bartholin gland carcinom is a rare variant of bartholin gland carcinoma, comprising 15% of all bartholin gland malignancies. ACC of the Bartholin's gland is characterized by slow growth so recurrence and distant metastases can take a long period. So distant metastasis has been found in only a few cases to the lungs, liver, bone and brain. Here, we present the case of Bartholin's gland ACC after four years follow up and presented with a lung metastasis.

Background/Aims: TSAs, despite their low incidence in colorectum, may originate in other parts of gastrointestinal (GI) tract, including stomach and small intestine. Malignant transformation for upper GI TSAs has recently been reported in the literature. We, hereby, present a series of gastric and small intestinal TSAs with the aim to characterize their morphologic and immunophenotypic features as well as their neoplastic potential in a compartmental manner using digitalized images. Materials and Methods: The study comprised of 12 GI polyps with TSA features; 5 gastric and 7 small intestinal. Extent of characteristic features of TSA including eosinophilic cells, ectopic crypt foci (ECF), slit-like serration, foveolar epithelium, goblet cells, together with dysplastic/carcinomatous foci were assessed on digitalized H&E images and were used as reference for immunohistochemical analysis. Results: All polyps in the cohort contained eosinophilic cells as the most extensive morphologic feature followed by ECF and slit-like serration in decreasing order. Serrated dysplasia was more common in gastric polyps which more frequently showed neoplastic progression compared to intestinal ones. CK20 was the most widely expressed marker with a preference to eosinophilic cells while ECF were mostly negative. Ki67 showed the opposite pattern of CK20. MUC6 and MUC2 were selectively expressed in basal zone and goblet cells, respectively. Conclusion: Our results showed that presence of eosinophilic cells with pencillate nuclei commonly accompanied by ECF and slit-like serration are the defining features of gastric and small intestinal TSAs. They frequently harbour neoplastic foci, particularly in gastric location where serrated dysplasia seems to be more common.

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare pulmonary disorder characterised by a proliferation of neuroendocrine cells within the lung. It is believed that a minority of the patients with DIPNECH can develop carcinoid tumors. Here, we report two new cases of DIPNECH with coexisting carcinoid tumors. Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare pulmonary disorder characterised by a proliferation of neuroendocrine cells within the lung. It is believed that a minority of the patients with DIPNECH can develop carcinoid tumors. Here, we report two new cases of DIPNECH with coexisting carcinoid tumors.

Background: The present study investigated gastrointestinal involvement patterns of acute graft-versus-host disease and assessed the correlation of pathologic severity with clinical grading. Methods: Pathology reports of gastrointestinal (GI) endoscopic biopsies taken from 164 post-hematopoietic stem cell transplant patients with at least 1 endoscopic gastrointestinal biopsy diagnosed as “consistent with acute graft-versus-host disease” between 2005 and 2019 were retrieved from the automated hospital database. Endoscopic, pathologic and clinical gradings were performed using Freiburg criteria, Lerner and modified Seattle-Glucksberg grading systems, respectively. Results: The majority of the patients (n = 140, 85.4%) were investigated with more than one biopsy from various gastrointestinal sites with a total of 479 biopsies: 44 (9.2%) esophagus, 90 (18.8%) stomach, 91 (19.0%) duodenum, 20 (4.2%) terminal ileum, 32 (6.7%) right colon, 87 (18.2%) left colon and, 115 (23.9%) rectum. Overall, lower gastrointestinal (n = 118/126, 93.6%) and upper gastrointestinal (n = 91/97, 93.8%) involvements were similar (P = .3). While the most severely affected site was duodenum (P = .021) in upper gastrointestinal, pathologic grades were similar in lower gastrointestinal sites, though more severe than upper gastrointestinal (P = .003). Pathologic grading had a low positive correlation with both clinical (r = 0.308, P = .001) and endoscopic grading (coefficient: 0.261, P = .003). Conclusion: Considering the similar graft-versus-host disease frequency of upper and lower gastrointestinal tract, distal colon evaluation with rectosigmoidoscopy seems to be a practical approach in patients with suspected gastrointestinal graft-versus-host disease. As it was positively correlated with both endoscopic and clinical grade, pathologic grading should be performed in these patients to assess gastrointestinal involvement patterns. Cite this article as: Kuş Öztürk S, Kırmızı A, Aras N, et al. Patterns and grading of gastrointestinal graft-versus-host disease: A clinicopathologic correlation study. Turk J Gastroenterol. 2023;34(5):516-524.