Adult-onset Focal Nesidioblastosis with Nodular Formation Mimicking Insulinoma

Nesidioblastosis is defined as the neoformation of the islets of Langerhans from the pancreatic ductal epithelium and is recognized as the most common cause of hyperinsulinemic hypoglycemia in infants. We herein report an extremely rare case of adult-onset focal nesidioblastosis with the unusual feature of hyperplastic nodular formation. A 55-year-old woman was admitted to our hospital for a tumor detected in the body of the pancreas by magnetic resonance imaging screening. Laboratory examinations showed a high insulin level in the blood. Contrast-enhanced computed tomography and the selective arterial calcium injection test suggested the presence of multiple insulinomas in the body and tail of the pancreas, and, thus, the patient underwent distal pancreatectomy. A histopathological examination of the tumor in the body of the pancreas showed the nodular hyperplasia of islet-like cell clusters. In addition, many small intralobular ductules and islet cells appeared to be budding from the proliferating ductal epithelium, forming “ductuloinsular complexes”. No other abnormal lesion was detected in the remainder of the pancreas. The histopathological diagnosis was focal nesidioblastosis. The patient has remained free of the recurrence of hypoglycemic episodes for more than 31 months. The present case of rare adult-onset focal nesidioblastosis with hyperplastic nodular formation was preoperatively identified as an apparent pancreatic tumor mimicking insulinoma. Nesidioblastosis and insulinoma need to be considered in cases of hyperinsulinemic hypoglycemia, even in adult patients.

A Rare Case of Intraductal Papilloma Arising from Minor Salivary Gland in the Floor of the Mouth

A 77-year-old woman with a rare oral intraductal papilloma arising from the minor salivary gland located on the floor of the mouth and causing the mucus retention is reported. Microscopically, the lesion was characterized by unicystic cavity exhibiting the lumen partially filled by papillary projections of the ductal epithelium with varying degree of oncocytic metaplasia. Based on the histopathological analysis, the differential diagnosis of oral intraductal papillomas and other ductal neoplasms of salivary origin are discussed.

Identification of Transmissible Viral Proventriculitis (TVP) in broiler chickens in Poland

The aim of the study was to investigate the possibility of Transmissible Viral Proventriculitis (TVP) occurrence in broiler chickens in Poland. In march 2016 proventriculi samples were collected from broiler chickens showing poor uniformity and decreased body weight, accompanied by enlarged proventriculi. Histopathological examination of affected proventriculi revealed typical lesions associated with TVP (vacuolar degeneration and necrosis of glandular epithelium, replacement of glandular epithelium by hyperplastic ductal epithelium and moderate to severe lymphocytic infiltration). To our best knowledge, up to date there is no report indicating the presence of TVP in Poland nor in Central and Eastern Europe.

Progesterone receptor expression and proliferative activity in relation to histological architecture of feline mammary fibroadenomatous change

The aim of the study was to determine the relationship between histological architecture and progesterone receptor expression as well as proliferative activity in feline mammary fibroadenomatous change (FMFAC) in female cats. The investigations were performed on 16 surgically removed FMFAC diagnosed based on their gross and microscopic appearance. The lesions were divided into 2 groups based on the number of epithelium layers: lesions with two or less ductal epithelium layers formed group A and lesions with more than two layers of epithelial cells were assigned to group B. Moreover, in each group the lesions were classified according to the cellularity of stroma into three subgroups (with poor, moderate and abundant cellularity). Immunohistochemical examinations were carried out to detect an expression of progesterone receptors (PRs) and a proliferative activity (based on Ki-67 antigen expression). The PR expression and Ki-67 antigen expression were significantly higher in epithelial cells than in stromal cells; however, the differences in above mentioned markers in ductal epithelium and stromal cells between studied groups were not significant. The results of this study indicate that there is no relationship between histological appearance, PR expression and proliferative activity in FMFAC. Moreover, a high percentage of PR-expressing cells in duct epithelium may explain the regression of enlarged mammary gland after administration of progesterone receptor blockers.