The Journal of Tepecik Education and Research Hospital
Objective: The intraoperative diagnosis of neurosurgical biopsy material is usually tricky due to... more Objective: The intraoperative diagnosis of neurosurgical biopsy material is usually tricky due to small size, artifacts of freezed neural tissue. When we are using rapid techniques, we should be aware of the limitations. In this study, we evaluate the diagnostic value of smears, frozen sections in neuropathology practice. Methods: We evaluated 65 neurosurgical biopsy materials sent for intraoperative diagnosis. All of them were interpreted with both smear and frozen section preparations. Results were grouped as inadequate (normal tissue, full of necrosis, technical artifacts), inflammatory/reactive or neoplastic. Difficulties, limitations of rapid methods were discussed. Results: Frozen and paraffine diagnoses were concordant in 55 cases. Three were inflammatory/reactive and fifty-two were tumor [low grade glial tumor (11), ependymoma (1), glioblastoma (12), metastasis (5), meningioma (8), craniopharyngioma (2), pituitary adenoma (2), epidermoid cyst (1), central neurocytoma (1), medulloblastoma (2), schwannoma/neurofibroma (6), diffuse large B cell lymphoma (1)]. In two cases, the amount of the material was sufficient but we could not achieve a definitive diagnosis with squash and frozen sections. The paraffine result of these cases was giant cell ependymoma and vasculitis. In eight cases, the material was insufficient for diagnosis. The frozen material contained only necrosis in six cases [glioblastoma (4) and metastasis (2)]; normal parenchyma in a DNET case, cauterized tissue in a fibrous meningioma case. Conclusion: The accuracy of intraoperative diagnosis of neurosurgical material is very high. Also, the results of smear preparation and frozen section are concordant in most entities. The main role of rapid techniques in neuropathology is to determine whether the tissue is representative and adequate for ancillary testing such as immunohistochemistry and molecular. We should always be keep in touch with neurosurgeon and complemented morphological findings with radiological and clinical characteristics for the most reliable diagnostic interpretation.
Periductal stromal hyperplasia (PDSH) is a biphasic breast tumor characterized by spindle stromal... more Periductal stromal hyperplasia (PDSH) is a biphasic breast tumor characterized by spindle stromal cell proliferation. Fewer than 15 adult cases have been reported in the literature. A 14-year-old girl presented with swelling in axillary tail of the right breast persisting for 3 months. Ultrasonography was compatible with accessory breast tissue in both axillary regions. Macroscopic examination revealed 3x2x1 cm, non-encapsulated nodular lipomatous mass. Cut surface showed thin fibrotic bands through the adipose tissue. The major histopathological feature was spindle cell stromal cell proliferation concentrated around the ducts. There is no local recurrence during postoperative fourteen months. PDSH is a rare lesion frequently observed in older women. It has no specific clinical and radiological features. Definitive diagnosis can be made by histopathological examination of excision materials. The PDSHs do not show phyllodes tumor features. The spindle cells concentrating around ductal areas don't show marked atypia, demonstrate fewer mitosis and low proliferation index. Present case report is important in terms of unexpected age group and localization. PDSH should be kept in mind as a differential diagnosis of accesory breast tissue in children with axillary lump.
A 63-year-old woman was admitted to our hospital with macroscopic hematuria in 2013. On computed ... more A 63-year-old woman was admitted to our hospital with macroscopic hematuria in 2013. On computed tomography, the bladder wall thickness was 2 cm, suspicious for malignancy. Cystoscopy showed irregularity in the posterolateral side of the bladder. Transurethral resection was performed. Histopathological examination revealed a dense homogeneous eosinophilic material in the lamina propria which showed positive orange-red staining with apple-green birefringence under polarized light. There were no signs of systemic amyloidosis at the time of diagnosis and during the 36 months of follow-up. Differential diagnosis of amyloidosis in the bladder includes urothelial carcinoma due to its appearance on imaging and cystoscopy. Histopathological evaluation is a requirement for accurate diagnosis.
The Journal of Tepecik Education and Research Hospital, 2017
Objective: The purpose of our study was to find out the frequency of incidental carcinomas, dyspl... more Objective: The purpose of our study was to find out the frequency of incidental carcinomas, dysplasias and adenomas of the gallbladder in patients who underwent laparoscopic cholecystectomy. Methods: We reviewed pathology records of 5063 cholecystectomy specimens Hematoxylin-eosin stained sections of the patients having dysplasia, adenoma, gallbladder carcinoma (GC) were reviewed. Results: Incidental GC was detected in 6 cases, and 5 of them exhibited accompanying dysplasia. Isolated cases of dysplasia, and adenoma were detected in 13, and 2 cases, respectively. Femalemale ratios for dysplasia, and carcinoma were 12: 1, and 4: 2, respectively. Median ages of GC, and dysplasia/adenoma were 65.6, and 56.8 years, respectively. Biliary intraepithelial neoplasia (BillN3) and BillN2 were accompanied with 4, and 1 case with carcinoma. Intestinal metaplasia was noted in 3 carcinoma cases. Isolated cases with BillN3, BillN2, and BillN1without invasive carcinoma were seen in 4, 3, and 6 cases, respectively. Intestinal metaplasia was noted in 2, intestinal+pyloric metaplasia in 1, and pyloric metaplasia in 1 case with BillN. Conclusion: Incidental GC was found in 0.11% of our cases. Gallbladder stones and advance age seem to be the risk factors for GC. Incidental GC may be predicted in the presence of BillN and metaplastic changes of the gallbladder. Histopathological evaluation is still important for the diagnosis of incidental gallbladder carcinoma and preinvasive lesions. BillN3 is typically associated with invasive carcinoma. Thus, complete sampling should be performed by pathologist when carcinoma is not evident on initial histologic sections.
Amac: Bu calismada, sican modellerinde glikoz toksisitesinin overdeki hasarlanma siddeti ve bu ha... more Amac: Bu calismada, sican modellerinde glikoz toksisitesinin overdeki hasarlanma siddeti ve bu hasarin NF-kappa B uzerinden etkilerinin olup olmadiginin arastirilmasi amaclandi. Gerec ve Yontem: Yedi adet sicanda deneysel olarak diyabetes mellitus modeli olusturuldu. Yedi adet kan glikoz seviyesi normal olan sican kontrol grubu olarak alindi. Sekiz hafta sonra over dokulari cikarilip histolojik olarak incelendi. Gruplarin ozellikleri, tek yonlu ANOVA ve Mann Whitney U testi ile karsilastirildi. p
Objective: The aim of this study to evaluate histopathological improvement and virological, serol... more Objective: The aim of this study to evaluate histopathological improvement and virological, serological and biochemical response rates in patients with chronic hepatitis B (CHB) who were treated with tenofovir disoproxil fumarate (TDF). Material and Method: A total of 91 nucleosid(t)e-naive CHB patients who received TDF were evaluated. Virological, serological and biochemical test results were assessed at baseline and every 12 weeks. Liver biopsy specimens were assessed according to the modified Ishak scoring. Results: The study was conducted on 52 patients. The mean age was 40±10 years and 40.4% were female. The mean follow-up period was 33±11 months. HBsAg seroclearance occurred in none of the patients. The serum level of HBV-DNA became undetectable in 94.2% of the patients. Mean histological activity index at baseline and on-treatment were 8.2±2.3 and 6.2±2.0 and the mean fibrosis scores were 2.65±1.3 and 2.33±1.1, respectively. Conclusion: We determined that TDF therapy provided remarkably good HBV DNA suppression and biochemical response rates, but low seroconversion. Improvement of liver necroinflammation was detected, but no significant change observed in fibrosis.
Symptoms of infantile inflammatory bowel disease (I-IBD) can be life-threatening and associated w... more Symptoms of infantile inflammatory bowel disease (I-IBD) can be life-threatening and associated with poor prognosis. The presence of Mediterranean fever (MEFV) gene mutations play an important role in treatment of I-IBD. In this article, we describe a case of I-IBD with a resistant fistula, in which remission occurred following colchicine therapy. The patient was a six-month-girl with complaints of bloody diarrhea and a perianal abscess of three months duration. Laboratory tests revealed elevated inflammatory parameters, hypoalbuminemia, and anemia. Results of repeated viral, bacterial and parasitic analyses were negative. Endoscopic and histopathological examinations confirmed a diagnosis of I-IBD. Although diarrhea episodes decreased following intensive conventional treatment with immunosuppressive therapy and anti-tumor necrosis factor, the perianal abscess and fistula did not resolve. Molecular genetic analysis to identify causes of infantile disease revealed the MEFV gene mutation. Thus, colchicine was added to the treatment regimen. Following treatment with colchicine, defecation returned to normal, and the fistula resolved. The MEFV gene mutation should be investigated in children with infantile colitis and resistant fistulas, particularly in Mediterranean countries. In patients with infantile colitis who have the MEFV gene mutation, colchicine treatment may be an alternative to intensive immunosuppressive therapy.
The aim of this study is to investigate the association between hepatic activity index (HAI) and ... more The aim of this study is to investigate the association between hepatic activity index (HAI) and fibrosis score (FS) with inflammation biomarkers in non-uremic and uremic hepatitis C positive patients. Fifty chronic hepatitis C (cHepC) positive patients, having a liver biopsy were included in this study. Liver biopsies were scored according to modified ISHAC scoring system. 25 healthy controls of similar age and gender were also enrolled as control group. Serum YKL-40, neutrophil/lymphocyte ratio (NLR), thrombocyte/lymphocyte ratio (PLR), CRP and Immunoglobulin (IgG, A and M) levels were used to determine inflammation. AST to Platelet Ratio Index (APRI) score was also evaluated. According to biopsy findings patients were divided into 2 groups: low (0-2) and severe (3-6) FS. Patients with cHepC had increased inflammation compared to the healthy controls. End-stage renal disease (ESRD) patients had higher levels of inflammation markers (NLR, IgG, CRP and YKL-40) and lower HCV RNA leve...
Objectives: This study aims to investigate the role of KRAS/BRAF gene mutation in the pathogenesi... more Objectives: This study aims to investigate the role of KRAS/BRAF gene mutation in the pathogenesis of oropharyngeal squamous cell carcinoma (OSCC). Patients and Methods: A total of 26 OSCC patients (23 males, 3 females; mean age 60 years; range 41 to 77 years) diagnosed between January 2003 and November 2013 were included in the study. The methods used in our study were quantitative fluorescence polymerase chain reaction for KRAS/BRAF mutation analysis. Results: Ten of the tumors were located at the tongue base, 12 in the tonsil and four at the floor of mouth. The mean tumor size was 3.8 cm. Six of the tumors were well differentiated, 18 were moderately differentiated and two were poorly differentiated. All cases were analyzed for KRAS and BRAF gene mutations and none of them showed gene mutations. Conclusion: We could not find any relation between OSCC and KRAS/BRAF gene mutations in our short case file. The role of mutations should be analyzed in larger series in OSCC to predict new targeted therapy modalities.
The Journal of Tepecik Education and Research Hospital, 2016
Objective: Despite of their similar microscopic findings. Fibromatoses are divided into two group... more Objective: Despite of their similar microscopic findings. Fibromatoses are divided into two groups as superficial fibromatoses and deep fibromatoses, which have different immunohistochemical profiles and clinical characteristics Our aim was to evaluate the expressions of ERa , ER-b, b-catenin, EGFR, CD117, p53, Ki-67 and mitotic rate in superficial and deep fibromatoses. Methods: Thirty-seven cases consisting of 15 superficial and 22 deep fibromatoses were reevaluated as regards ERa , ER-b, b-catenin, EGFR, CD117, p53 expressions, Ki-67 proliferative index and the mitotic rate. Two groups were compared statistically and discussed. Results: ERa expression was not observed in any case. ER-b and b-catenin expressions were more intense in the deep fibromatoses group. The ER-b intensity, b-catenin expression, Ki-67 proliferation index and mitotic rates were statistically significantly higher in the deep fibromatoses group (p=0.04, 0.01, 0.001, 0.001 respectively). There was no statistically significant difference in CD117, EGFR, and p53 expressions between groups. Conclusion: ER-b intensity, b-catenin and Ki-67 expression rates and the mitotic index were statistically significantly higher in the deep fibromatoses group in our study. We suggest that these markers may have predictive value in determining the course of the lesions.
Hydatid disease is a parasitic infection caused by Echinococcus granulosus. Although the liver an... more Hydatid disease is a parasitic infection caused by Echinococcus granulosus. Although the liver and lung are the most common sites of hydatid disease, it can also be seen in other organs due to migration via systemic circulation. Paraspinal lumbar hydatid disease without the involvement of other organs is extremely rare. We aimed to present the imaging and histopathological findings of a case with painful lumbar swelling that was later diagnosed as primary lumbar paraspinal hydatid disease. Hydatid disease should be considered as the differential diagnosis in patients with a lumbar paraspinal mass, particularly that containing multiple well-defined, round, small cysts, and in patients living in or traveling to endemic regions.
A 50-year old male was admitted to our hospital with a slowly progressive swelling in the left pr... more A 50-year old male was admitted to our hospital with a slowly progressive swelling in the left preauricular region lasting for eight months. On physical examination, a hard, immobile, painless mass was palpable in the left parotid gland region. He had no past medical, drug or surgical history. Facial nerve examination was normal. Ultrasonographic examination revealed a 5 × 3.5 cm cystic mass in the left parotid gland. Biochemical analysis revealed blood eosinophilia and high Creactive protein (CRP) levels. Serologic tests detecting echinococcal antibodies were as follows: enzyme-linked immunosorbent assay IgG positive with a titre 1/320 and indirect haemagglutination positive with a titre 1/160. A fine needle aspiration biopsy was performed. The cytopathology of the aspirated fluid yielded no definitive diagnosis but real-time polymerase chain reaction of the fluid revealed low levels of positive Echinococcus granulosus DNA. Abdominal ultra-sound and computed tomography of the thorax revealed no cystic mass either in the liver or in the lungs. The cyst was removed with an intact wall keeping the healthy tissue around it. Macroscopic examination revealed 5 × 3.5 × 2.5 cm uniloculary cystic mass located in the superficial parotid lobe and containing a clear liquid in the lumen (Fig. 1).
International braz j urol : official journal of the Brazilian Society of Urology
Tumor diameter is a reliable parameter to estimate tumor volume in solid organ cancers; its use i... more Tumor diameter is a reliable parameter to estimate tumor volume in solid organ cancers; its use in prostate cancer is controversial since it exhibits a more irregular pattern of growth. This study aimed to examine the association between the tumor volume estimations based on transrectal ultrasound (TRUS) guided biopsy results and the tumor volume measured on the pathological specimen. A total of 237 patients who underwent radical retropubic prostatectomy (RRP) were included in this retrospective study. The differences and correlations between cancer volume estimations based on TRUS guided biopsy findings and cancer volume estimations based on post-prostatectomy pathology specimens were examined. In addition, diagnostic value of TRUS guided biopsy-based volume estimations in order to predict clinically significant cancer (>0.5 cc) were calculated. The mean cancer volume estimated using TRUS biopsy results was lower (5.5±6.5 cc) than the mean cancer volume calculated using prostate...
Objective: Triple-negative-breast-cancer that accounts for 10-20% of all breast carcinomas is def... more Objective: Triple-negative-breast-cancer that accounts for 10-20% of all breast carcinomas is defined by the lack of estrogen receptor, progesterone receptor, HER2 expression, and agressive clinical behavior. Triple-negative-breast-cancer is categorized into basal like and other types. The basal-like subtype is characterized by the expression of myoepithelial/basal markers. Material and Method: We studied 41 immunohistochemically triplenegative-breast-cancer patients to determine EGFR, Cytokeratine 5/6, p53, Ki67, GCDFP-15 expression profiles, HER2 and Chromosome 17 centromere gene status by fluorescence-in-situ-hybridization method. Results: Histological type was invasive ductal carcinoma in 90.2% of the tumors. p53, Ki67, GCDFP-15 mean positivity rates were 55.6%, 51.7%, and 3.2%, respectively. GCDFP-15 positivity was noted in 8 cases of which 6 were Cytokeratine 5/6 negative. The cutoff value for Cytokeratine 5/6 positivity was 5%. EGFR immunoreactivity was grouped into 0, 1+ as negative; 2+, 3+ as positive categories. Cytokeratine 5/6 was positive in 56,1%, EGFR was positive in 51.2% of the patients. The relation between Cytokeratine 5/6 and EGFR expression was statistically significant (p<0.01). None of the cases showed HER2 amplification by fluorescence-in-situ-hybridization method. Conclusion: GCDFP-15 alone is not a useful marker to detect the metastasis of basaloid type breast cancers. Cytokeratine 5/6 and EGFR expressions showed correlation so these markers are reliable to diagnose basaloid type tumors with a 5% cutoff value.
Amaç: Fillodes tümör; memenin nadir görülen fibroepitelyal bir neoplazmıdır. Tümör histolojik kri... more Amaç: Fillodes tümör; memenin nadir görülen fibroepitelyal bir neoplazmıdır. Tümör histolojik kriterler göz önüne alınarak benign, borderline ve malign olarak sınıflandırılmaktadır. Bugüne değin benign/malign ayrımında kullanılmış olan stromal sitolojik atipi, stromal hipersellülarite, mitoz hızı, stromal aşırı büyüme ve tümör sınırları kriterlerinin, kendi olgu dizinimiz için geçerliliği yanısıra eklenebilecek yeni kriterlerin araştırılması amaçlanarak geriye dönük bir çalışma tasarlanmıştır. Gereç ve Yöntem: Arşivimizde yer alan, fillodes tümör tanılı 22 olgu çalışma kapsamına alınmış, olgular, yaş, tümörlerin yerleşim yeri ve makroskopik boyutları yönünden patoloji kayıtları esas alınarak kaydedilmiş, olgulara ait Hematoksilen-Eozin kesitler tekrar gözden geçirilerek daha önce tanımlanmış histolojik kriterlerle tekrar değerlendirilmiştir. Bunlara ek olarak tümörde yapraksı büyüme paterni varlığı, stromal hyalinizasyon ve kalsifikasyon, stromal dev hücre varlığı, stromal nötrofil lökosit ve mononükleer lenfositik infiltratın yoğunluğu kalitatif (var/yok) ve yarı sayısal (hafif, orta, şiddetli) olarak değerlendirilip kaydedilmiştir. Tüm parametreler yönünden benign ve malign gruplar arasında anlamlı farklılık olup olmadığı istatistiksel olarak Mann-Whitney U Testi ve chi-square yöntemi ile araştırılmıştır. Bulgular: Fillodes tümör tipini (benign, borderline, malign) belirlemede kullanılan histolojik kriterler bizim çalışmamızda da istatistiksel olarak anlamlı bulunmuştur. Tümörde izlenebilecek stromal dev hücre, stromal hyalinizasyon ve kalsifikasyon, stromal nötrofil varlığı ve mononükleer lenfositik infiltrat yoğunluğunun benign ve malign grup arasında anlamlı bir fark göstermediği izlenmiştir. Sonuç: Histolojik olarak malign fillodes tümörlerde; artmış stromal sellülarite, orta/şiddetli derecede stromal sitolojik atipi, artmış mitotik aktivite, stromal aşırı büyüme ve infiltratif tümör sınırı saptanmıştır. Yine malign fillodes tümörler, benign tümörlere göre daha ileri yaşta ve daha büyük boyutta izlenmiştir.
The journal of Tepecik Education and Research Hospital, 2021
INTRODUCTION: Parathyroid neoplasms are tumors seen in about 0.1% of the population.Although para... more INTRODUCTION: Parathyroid neoplasms are tumors seen in about 0.1% of the population.Although parathyroid adenomas are the most common,carcinomas are also rarely seen.Our aim in this study is to evaluate the clinical, laboratory and histopathological characteristics of patients who underwent parathyroidectomy in our hospital in the last 5 years. METHODS: 156 patients who underwent parathyroidectomy in our hospital and examined in the pathology department were included in the study.The types of operations performed in cases were grouped as those who underwent only parathyroid excision and those who underwent thyroid partial/total excision with parathyroid excision.Age,gender, pre- and post-operative parathyroid hormone values, size,weight,pathological diagnosis of the parathyroid gland, presence of complications,comorbidities and clinical follow-up were evaluated. RESULTS: 84% of 156 cases were female,16% were male.The mean age is 53.82+13.49.The mean preoperative parathyroid hormone ...
arathyroid tumors can be investigated in three groups; parathyroid adenoma (PA), atypical parathy... more arathyroid tumors can be investigated in three groups; parathyroid adenoma (PA), atypical parathyroid adenoma (APA), and parathyroid carcinoma (PC). PC is the least common of these tumors and makes up less than 1% of all parathyroid tumors. 1-5 The incidence is higher in Japan and Italy. 4,6,7 This regional difference is not fully understood, but it is thought to be due to geographic differences or the use of different diagnostic criteria. 1,2,8 PC cases clinically present with symptoms related to increased calcium levels in the blood due to invasive/metastatic carcinoma and palpable masses at the anterior region of the neck. 2,3,5 Definite diagnostic criteria have been identified for the diagnosis of PC (e.g., metastasis, perineural invasion, capsular/vascular invasion). However, some cases present diagnostic difficulties and auxiliary diagnostic criteria have been identified. These include nuclear atypia, thick fibrous bands in the parenchyma, trabecular growth pattern, and increased mitotic activity. These are commonly found in PCs but can also be seen in benign parathyroid tumors. 8-10 The term APA can be used for intermediate cases that did not demonstrate the essential criterias of malignancy, but those auxiliary diagnostic criterias were conspicuous. The search for more objective markers instead of subjective diagnostic criterias continues for the differential diagnosis of these lesions and immunohistochemistry (IHC) markers as well as molecular techniques are used in this regard.
The Journal of Tepecik Education and Research Hospital
Objective: The intraoperative diagnosis of neurosurgical biopsy material is usually tricky due to... more Objective: The intraoperative diagnosis of neurosurgical biopsy material is usually tricky due to small size, artifacts of freezed neural tissue. When we are using rapid techniques, we should be aware of the limitations. In this study, we evaluate the diagnostic value of smears, frozen sections in neuropathology practice. Methods: We evaluated 65 neurosurgical biopsy materials sent for intraoperative diagnosis. All of them were interpreted with both smear and frozen section preparations. Results were grouped as inadequate (normal tissue, full of necrosis, technical artifacts), inflammatory/reactive or neoplastic. Difficulties, limitations of rapid methods were discussed. Results: Frozen and paraffine diagnoses were concordant in 55 cases. Three were inflammatory/reactive and fifty-two were tumor [low grade glial tumor (11), ependymoma (1), glioblastoma (12), metastasis (5), meningioma (8), craniopharyngioma (2), pituitary adenoma (2), epidermoid cyst (1), central neurocytoma (1), medulloblastoma (2), schwannoma/neurofibroma (6), diffuse large B cell lymphoma (1)]. In two cases, the amount of the material was sufficient but we could not achieve a definitive diagnosis with squash and frozen sections. The paraffine result of these cases was giant cell ependymoma and vasculitis. In eight cases, the material was insufficient for diagnosis. The frozen material contained only necrosis in six cases [glioblastoma (4) and metastasis (2)]; normal parenchyma in a DNET case, cauterized tissue in a fibrous meningioma case. Conclusion: The accuracy of intraoperative diagnosis of neurosurgical material is very high. Also, the results of smear preparation and frozen section are concordant in most entities. The main role of rapid techniques in neuropathology is to determine whether the tissue is representative and adequate for ancillary testing such as immunohistochemistry and molecular. We should always be keep in touch with neurosurgeon and complemented morphological findings with radiological and clinical characteristics for the most reliable diagnostic interpretation.
Periductal stromal hyperplasia (PDSH) is a biphasic breast tumor characterized by spindle stromal... more Periductal stromal hyperplasia (PDSH) is a biphasic breast tumor characterized by spindle stromal cell proliferation. Fewer than 15 adult cases have been reported in the literature. A 14-year-old girl presented with swelling in axillary tail of the right breast persisting for 3 months. Ultrasonography was compatible with accessory breast tissue in both axillary regions. Macroscopic examination revealed 3x2x1 cm, non-encapsulated nodular lipomatous mass. Cut surface showed thin fibrotic bands through the adipose tissue. The major histopathological feature was spindle cell stromal cell proliferation concentrated around the ducts. There is no local recurrence during postoperative fourteen months. PDSH is a rare lesion frequently observed in older women. It has no specific clinical and radiological features. Definitive diagnosis can be made by histopathological examination of excision materials. The PDSHs do not show phyllodes tumor features. The spindle cells concentrating around ductal areas don't show marked atypia, demonstrate fewer mitosis and low proliferation index. Present case report is important in terms of unexpected age group and localization. PDSH should be kept in mind as a differential diagnosis of accesory breast tissue in children with axillary lump.
A 63-year-old woman was admitted to our hospital with macroscopic hematuria in 2013. On computed ... more A 63-year-old woman was admitted to our hospital with macroscopic hematuria in 2013. On computed tomography, the bladder wall thickness was 2 cm, suspicious for malignancy. Cystoscopy showed irregularity in the posterolateral side of the bladder. Transurethral resection was performed. Histopathological examination revealed a dense homogeneous eosinophilic material in the lamina propria which showed positive orange-red staining with apple-green birefringence under polarized light. There were no signs of systemic amyloidosis at the time of diagnosis and during the 36 months of follow-up. Differential diagnosis of amyloidosis in the bladder includes urothelial carcinoma due to its appearance on imaging and cystoscopy. Histopathological evaluation is a requirement for accurate diagnosis.
The Journal of Tepecik Education and Research Hospital, 2017
Objective: The purpose of our study was to find out the frequency of incidental carcinomas, dyspl... more Objective: The purpose of our study was to find out the frequency of incidental carcinomas, dysplasias and adenomas of the gallbladder in patients who underwent laparoscopic cholecystectomy. Methods: We reviewed pathology records of 5063 cholecystectomy specimens Hematoxylin-eosin stained sections of the patients having dysplasia, adenoma, gallbladder carcinoma (GC) were reviewed. Results: Incidental GC was detected in 6 cases, and 5 of them exhibited accompanying dysplasia. Isolated cases of dysplasia, and adenoma were detected in 13, and 2 cases, respectively. Femalemale ratios for dysplasia, and carcinoma were 12: 1, and 4: 2, respectively. Median ages of GC, and dysplasia/adenoma were 65.6, and 56.8 years, respectively. Biliary intraepithelial neoplasia (BillN3) and BillN2 were accompanied with 4, and 1 case with carcinoma. Intestinal metaplasia was noted in 3 carcinoma cases. Isolated cases with BillN3, BillN2, and BillN1without invasive carcinoma were seen in 4, 3, and 6 cases, respectively. Intestinal metaplasia was noted in 2, intestinal+pyloric metaplasia in 1, and pyloric metaplasia in 1 case with BillN. Conclusion: Incidental GC was found in 0.11% of our cases. Gallbladder stones and advance age seem to be the risk factors for GC. Incidental GC may be predicted in the presence of BillN and metaplastic changes of the gallbladder. Histopathological evaluation is still important for the diagnosis of incidental gallbladder carcinoma and preinvasive lesions. BillN3 is typically associated with invasive carcinoma. Thus, complete sampling should be performed by pathologist when carcinoma is not evident on initial histologic sections.
Amac: Bu calismada, sican modellerinde glikoz toksisitesinin overdeki hasarlanma siddeti ve bu ha... more Amac: Bu calismada, sican modellerinde glikoz toksisitesinin overdeki hasarlanma siddeti ve bu hasarin NF-kappa B uzerinden etkilerinin olup olmadiginin arastirilmasi amaclandi. Gerec ve Yontem: Yedi adet sicanda deneysel olarak diyabetes mellitus modeli olusturuldu. Yedi adet kan glikoz seviyesi normal olan sican kontrol grubu olarak alindi. Sekiz hafta sonra over dokulari cikarilip histolojik olarak incelendi. Gruplarin ozellikleri, tek yonlu ANOVA ve Mann Whitney U testi ile karsilastirildi. p
Objective: The aim of this study to evaluate histopathological improvement and virological, serol... more Objective: The aim of this study to evaluate histopathological improvement and virological, serological and biochemical response rates in patients with chronic hepatitis B (CHB) who were treated with tenofovir disoproxil fumarate (TDF). Material and Method: A total of 91 nucleosid(t)e-naive CHB patients who received TDF were evaluated. Virological, serological and biochemical test results were assessed at baseline and every 12 weeks. Liver biopsy specimens were assessed according to the modified Ishak scoring. Results: The study was conducted on 52 patients. The mean age was 40±10 years and 40.4% were female. The mean follow-up period was 33±11 months. HBsAg seroclearance occurred in none of the patients. The serum level of HBV-DNA became undetectable in 94.2% of the patients. Mean histological activity index at baseline and on-treatment were 8.2±2.3 and 6.2±2.0 and the mean fibrosis scores were 2.65±1.3 and 2.33±1.1, respectively. Conclusion: We determined that TDF therapy provided remarkably good HBV DNA suppression and biochemical response rates, but low seroconversion. Improvement of liver necroinflammation was detected, but no significant change observed in fibrosis.
Symptoms of infantile inflammatory bowel disease (I-IBD) can be life-threatening and associated w... more Symptoms of infantile inflammatory bowel disease (I-IBD) can be life-threatening and associated with poor prognosis. The presence of Mediterranean fever (MEFV) gene mutations play an important role in treatment of I-IBD. In this article, we describe a case of I-IBD with a resistant fistula, in which remission occurred following colchicine therapy. The patient was a six-month-girl with complaints of bloody diarrhea and a perianal abscess of three months duration. Laboratory tests revealed elevated inflammatory parameters, hypoalbuminemia, and anemia. Results of repeated viral, bacterial and parasitic analyses were negative. Endoscopic and histopathological examinations confirmed a diagnosis of I-IBD. Although diarrhea episodes decreased following intensive conventional treatment with immunosuppressive therapy and anti-tumor necrosis factor, the perianal abscess and fistula did not resolve. Molecular genetic analysis to identify causes of infantile disease revealed the MEFV gene mutation. Thus, colchicine was added to the treatment regimen. Following treatment with colchicine, defecation returned to normal, and the fistula resolved. The MEFV gene mutation should be investigated in children with infantile colitis and resistant fistulas, particularly in Mediterranean countries. In patients with infantile colitis who have the MEFV gene mutation, colchicine treatment may be an alternative to intensive immunosuppressive therapy.
The aim of this study is to investigate the association between hepatic activity index (HAI) and ... more The aim of this study is to investigate the association between hepatic activity index (HAI) and fibrosis score (FS) with inflammation biomarkers in non-uremic and uremic hepatitis C positive patients. Fifty chronic hepatitis C (cHepC) positive patients, having a liver biopsy were included in this study. Liver biopsies were scored according to modified ISHAC scoring system. 25 healthy controls of similar age and gender were also enrolled as control group. Serum YKL-40, neutrophil/lymphocyte ratio (NLR), thrombocyte/lymphocyte ratio (PLR), CRP and Immunoglobulin (IgG, A and M) levels were used to determine inflammation. AST to Platelet Ratio Index (APRI) score was also evaluated. According to biopsy findings patients were divided into 2 groups: low (0-2) and severe (3-6) FS. Patients with cHepC had increased inflammation compared to the healthy controls. End-stage renal disease (ESRD) patients had higher levels of inflammation markers (NLR, IgG, CRP and YKL-40) and lower HCV RNA leve...
Objectives: This study aims to investigate the role of KRAS/BRAF gene mutation in the pathogenesi... more Objectives: This study aims to investigate the role of KRAS/BRAF gene mutation in the pathogenesis of oropharyngeal squamous cell carcinoma (OSCC). Patients and Methods: A total of 26 OSCC patients (23 males, 3 females; mean age 60 years; range 41 to 77 years) diagnosed between January 2003 and November 2013 were included in the study. The methods used in our study were quantitative fluorescence polymerase chain reaction for KRAS/BRAF mutation analysis. Results: Ten of the tumors were located at the tongue base, 12 in the tonsil and four at the floor of mouth. The mean tumor size was 3.8 cm. Six of the tumors were well differentiated, 18 were moderately differentiated and two were poorly differentiated. All cases were analyzed for KRAS and BRAF gene mutations and none of them showed gene mutations. Conclusion: We could not find any relation between OSCC and KRAS/BRAF gene mutations in our short case file. The role of mutations should be analyzed in larger series in OSCC to predict new targeted therapy modalities.
The Journal of Tepecik Education and Research Hospital, 2016
Objective: Despite of their similar microscopic findings. Fibromatoses are divided into two group... more Objective: Despite of their similar microscopic findings. Fibromatoses are divided into two groups as superficial fibromatoses and deep fibromatoses, which have different immunohistochemical profiles and clinical characteristics Our aim was to evaluate the expressions of ERa , ER-b, b-catenin, EGFR, CD117, p53, Ki-67 and mitotic rate in superficial and deep fibromatoses. Methods: Thirty-seven cases consisting of 15 superficial and 22 deep fibromatoses were reevaluated as regards ERa , ER-b, b-catenin, EGFR, CD117, p53 expressions, Ki-67 proliferative index and the mitotic rate. Two groups were compared statistically and discussed. Results: ERa expression was not observed in any case. ER-b and b-catenin expressions were more intense in the deep fibromatoses group. The ER-b intensity, b-catenin expression, Ki-67 proliferation index and mitotic rates were statistically significantly higher in the deep fibromatoses group (p=0.04, 0.01, 0.001, 0.001 respectively). There was no statistically significant difference in CD117, EGFR, and p53 expressions between groups. Conclusion: ER-b intensity, b-catenin and Ki-67 expression rates and the mitotic index were statistically significantly higher in the deep fibromatoses group in our study. We suggest that these markers may have predictive value in determining the course of the lesions.
Hydatid disease is a parasitic infection caused by Echinococcus granulosus. Although the liver an... more Hydatid disease is a parasitic infection caused by Echinococcus granulosus. Although the liver and lung are the most common sites of hydatid disease, it can also be seen in other organs due to migration via systemic circulation. Paraspinal lumbar hydatid disease without the involvement of other organs is extremely rare. We aimed to present the imaging and histopathological findings of a case with painful lumbar swelling that was later diagnosed as primary lumbar paraspinal hydatid disease. Hydatid disease should be considered as the differential diagnosis in patients with a lumbar paraspinal mass, particularly that containing multiple well-defined, round, small cysts, and in patients living in or traveling to endemic regions.
A 50-year old male was admitted to our hospital with a slowly progressive swelling in the left pr... more A 50-year old male was admitted to our hospital with a slowly progressive swelling in the left preauricular region lasting for eight months. On physical examination, a hard, immobile, painless mass was palpable in the left parotid gland region. He had no past medical, drug or surgical history. Facial nerve examination was normal. Ultrasonographic examination revealed a 5 × 3.5 cm cystic mass in the left parotid gland. Biochemical analysis revealed blood eosinophilia and high Creactive protein (CRP) levels. Serologic tests detecting echinococcal antibodies were as follows: enzyme-linked immunosorbent assay IgG positive with a titre 1/320 and indirect haemagglutination positive with a titre 1/160. A fine needle aspiration biopsy was performed. The cytopathology of the aspirated fluid yielded no definitive diagnosis but real-time polymerase chain reaction of the fluid revealed low levels of positive Echinococcus granulosus DNA. Abdominal ultra-sound and computed tomography of the thorax revealed no cystic mass either in the liver or in the lungs. The cyst was removed with an intact wall keeping the healthy tissue around it. Macroscopic examination revealed 5 × 3.5 × 2.5 cm uniloculary cystic mass located in the superficial parotid lobe and containing a clear liquid in the lumen (Fig. 1).
International braz j urol : official journal of the Brazilian Society of Urology
Tumor diameter is a reliable parameter to estimate tumor volume in solid organ cancers; its use i... more Tumor diameter is a reliable parameter to estimate tumor volume in solid organ cancers; its use in prostate cancer is controversial since it exhibits a more irregular pattern of growth. This study aimed to examine the association between the tumor volume estimations based on transrectal ultrasound (TRUS) guided biopsy results and the tumor volume measured on the pathological specimen. A total of 237 patients who underwent radical retropubic prostatectomy (RRP) were included in this retrospective study. The differences and correlations between cancer volume estimations based on TRUS guided biopsy findings and cancer volume estimations based on post-prostatectomy pathology specimens were examined. In addition, diagnostic value of TRUS guided biopsy-based volume estimations in order to predict clinically significant cancer (>0.5 cc) were calculated. The mean cancer volume estimated using TRUS biopsy results was lower (5.5±6.5 cc) than the mean cancer volume calculated using prostate...
Objective: Triple-negative-breast-cancer that accounts for 10-20% of all breast carcinomas is def... more Objective: Triple-negative-breast-cancer that accounts for 10-20% of all breast carcinomas is defined by the lack of estrogen receptor, progesterone receptor, HER2 expression, and agressive clinical behavior. Triple-negative-breast-cancer is categorized into basal like and other types. The basal-like subtype is characterized by the expression of myoepithelial/basal markers. Material and Method: We studied 41 immunohistochemically triplenegative-breast-cancer patients to determine EGFR, Cytokeratine 5/6, p53, Ki67, GCDFP-15 expression profiles, HER2 and Chromosome 17 centromere gene status by fluorescence-in-situ-hybridization method. Results: Histological type was invasive ductal carcinoma in 90.2% of the tumors. p53, Ki67, GCDFP-15 mean positivity rates were 55.6%, 51.7%, and 3.2%, respectively. GCDFP-15 positivity was noted in 8 cases of which 6 were Cytokeratine 5/6 negative. The cutoff value for Cytokeratine 5/6 positivity was 5%. EGFR immunoreactivity was grouped into 0, 1+ as negative; 2+, 3+ as positive categories. Cytokeratine 5/6 was positive in 56,1%, EGFR was positive in 51.2% of the patients. The relation between Cytokeratine 5/6 and EGFR expression was statistically significant (p<0.01). None of the cases showed HER2 amplification by fluorescence-in-situ-hybridization method. Conclusion: GCDFP-15 alone is not a useful marker to detect the metastasis of basaloid type breast cancers. Cytokeratine 5/6 and EGFR expressions showed correlation so these markers are reliable to diagnose basaloid type tumors with a 5% cutoff value.
Amaç: Fillodes tümör; memenin nadir görülen fibroepitelyal bir neoplazmıdır. Tümör histolojik kri... more Amaç: Fillodes tümör; memenin nadir görülen fibroepitelyal bir neoplazmıdır. Tümör histolojik kriterler göz önüne alınarak benign, borderline ve malign olarak sınıflandırılmaktadır. Bugüne değin benign/malign ayrımında kullanılmış olan stromal sitolojik atipi, stromal hipersellülarite, mitoz hızı, stromal aşırı büyüme ve tümör sınırları kriterlerinin, kendi olgu dizinimiz için geçerliliği yanısıra eklenebilecek yeni kriterlerin araştırılması amaçlanarak geriye dönük bir çalışma tasarlanmıştır. Gereç ve Yöntem: Arşivimizde yer alan, fillodes tümör tanılı 22 olgu çalışma kapsamına alınmış, olgular, yaş, tümörlerin yerleşim yeri ve makroskopik boyutları yönünden patoloji kayıtları esas alınarak kaydedilmiş, olgulara ait Hematoksilen-Eozin kesitler tekrar gözden geçirilerek daha önce tanımlanmış histolojik kriterlerle tekrar değerlendirilmiştir. Bunlara ek olarak tümörde yapraksı büyüme paterni varlığı, stromal hyalinizasyon ve kalsifikasyon, stromal dev hücre varlığı, stromal nötrofil lökosit ve mononükleer lenfositik infiltratın yoğunluğu kalitatif (var/yok) ve yarı sayısal (hafif, orta, şiddetli) olarak değerlendirilip kaydedilmiştir. Tüm parametreler yönünden benign ve malign gruplar arasında anlamlı farklılık olup olmadığı istatistiksel olarak Mann-Whitney U Testi ve chi-square yöntemi ile araştırılmıştır. Bulgular: Fillodes tümör tipini (benign, borderline, malign) belirlemede kullanılan histolojik kriterler bizim çalışmamızda da istatistiksel olarak anlamlı bulunmuştur. Tümörde izlenebilecek stromal dev hücre, stromal hyalinizasyon ve kalsifikasyon, stromal nötrofil varlığı ve mononükleer lenfositik infiltrat yoğunluğunun benign ve malign grup arasında anlamlı bir fark göstermediği izlenmiştir. Sonuç: Histolojik olarak malign fillodes tümörlerde; artmış stromal sellülarite, orta/şiddetli derecede stromal sitolojik atipi, artmış mitotik aktivite, stromal aşırı büyüme ve infiltratif tümör sınırı saptanmıştır. Yine malign fillodes tümörler, benign tümörlere göre daha ileri yaşta ve daha büyük boyutta izlenmiştir.
The journal of Tepecik Education and Research Hospital, 2021
INTRODUCTION: Parathyroid neoplasms are tumors seen in about 0.1% of the population.Although para... more INTRODUCTION: Parathyroid neoplasms are tumors seen in about 0.1% of the population.Although parathyroid adenomas are the most common,carcinomas are also rarely seen.Our aim in this study is to evaluate the clinical, laboratory and histopathological characteristics of patients who underwent parathyroidectomy in our hospital in the last 5 years. METHODS: 156 patients who underwent parathyroidectomy in our hospital and examined in the pathology department were included in the study.The types of operations performed in cases were grouped as those who underwent only parathyroid excision and those who underwent thyroid partial/total excision with parathyroid excision.Age,gender, pre- and post-operative parathyroid hormone values, size,weight,pathological diagnosis of the parathyroid gland, presence of complications,comorbidities and clinical follow-up were evaluated. RESULTS: 84% of 156 cases were female,16% were male.The mean age is 53.82+13.49.The mean preoperative parathyroid hormone ...
arathyroid tumors can be investigated in three groups; parathyroid adenoma (PA), atypical parathy... more arathyroid tumors can be investigated in three groups; parathyroid adenoma (PA), atypical parathyroid adenoma (APA), and parathyroid carcinoma (PC). PC is the least common of these tumors and makes up less than 1% of all parathyroid tumors. 1-5 The incidence is higher in Japan and Italy. 4,6,7 This regional difference is not fully understood, but it is thought to be due to geographic differences or the use of different diagnostic criteria. 1,2,8 PC cases clinically present with symptoms related to increased calcium levels in the blood due to invasive/metastatic carcinoma and palpable masses at the anterior region of the neck. 2,3,5 Definite diagnostic criteria have been identified for the diagnosis of PC (e.g., metastasis, perineural invasion, capsular/vascular invasion). However, some cases present diagnostic difficulties and auxiliary diagnostic criteria have been identified. These include nuclear atypia, thick fibrous bands in the parenchyma, trabecular growth pattern, and increased mitotic activity. These are commonly found in PCs but can also be seen in benign parathyroid tumors. 8-10 The term APA can be used for intermediate cases that did not demonstrate the essential criterias of malignancy, but those auxiliary diagnostic criterias were conspicuous. The search for more objective markers instead of subjective diagnostic criterias continues for the differential diagnosis of these lesions and immunohistochemistry (IHC) markers as well as molecular techniques are used in this regard.
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Papers by Emel Ebru Pala