Dilek Ertoy Baydar

Hacettepe University, Ankara, Ankara, Turkey

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Publications (44)86.5 Total impact

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    ABSTRACT: Renal carcinoid tumor is an exceedingly rare malignancy. A 57-year-old man with a renal carcinoid tumor discovered after metastasizing to intraocular and bilateral orbital structures is described. The patient presented with a blind painful OS and a right superotemporal subconjunctival mass. Imaging studies revealed a large left intraocular tumor, a mass in the left medial rectus muscle, and right lacrimal gland enlargement. The OS was enucleated, and incisional biopsies were performed from the other 2 lesions. Histopathological studies demonstrated metastatic neuroendocrine tumor with chromogranin and synaptophysin positivity. Systemic work up revealed a right renal mass and multiple hepatic metastatic lesions. Radical nephrectomy was performed, and octreotide, capecitabine, and temozolomide were administered. Removal of the primary tumor and the eye that had no prospect for useful vision and further treatment with octreotide, capecitabine, and temozolomide provided a disease progression-free period of 24 months and allowed the patient to function normally.
    Ophthalmic plastic and reconstructive surgery 04/2014; · 0.69 Impact Factor
  • Dilek Ertoy Baydar
    Turk Patoloji Dergisi 01/2014; 30(2):155-157.
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    ABSTRACT: This study was designed to investigate the possible protective effect of lycopene against the renal toxic effects of OTA. Male Sprague-Dawley rats (<200g, n=6) were treated with OTA (0.5mg/kg/day) and/or lycopene (5mg/kg/day) by gavage for 14 days. Histopathological examinations were performed and apoptotic cell death in both cortex and medulla was evaluated by TUNEL assay. Besides, biochemical parameters and activities of renal antioxidant selenoenzymes [glutathione peroxidase 1 (GPx1), thioredoxin reductase (TrxR)], catalase (CAT), superoxide dismutase (SOD); concentrations of total glutathione (GSH), and malondialdehyde (MDA) levels were measured. OTA treatment was found to induce oxidative stress in rat kidney, as evidenced by marked decreases in CAT (35%) activity and GSH levels (44%) as well as increase in SOD activity (22%) vs control group. Furthermore, TUNEL analysis revealed a significant increase in the number of TUNEL-positive cells in cortex (49%) and medulla (75%) in OTA administrated group compared to control (p<0.05). Lycopene supplementation with OTA increased GPx1 activity and GSH levels, and decreased apoptotic cell death in both cortex and medulla vs. control. The results of this study showed that at least one of the mechanisms underlying the renal toxicity of OTA is oxidative stress and apoptosis is the major form of cell death caused by OTA. Besides, our data indicate that the natural antioxidant lycopene might be partially protective against OTA-induced nephrotoxicity and oxidative stress in rat.
    Experimental and toxicologic pathology: official journal of the Gesellschaft fur Toxikologische Pathologie 01/2013; · 1.43 Impact Factor
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    ABSTRACT: A 49-year-old male presented with a painful mass in the left scrotum. An inguinal orchiectomy was performed. Pathological examination revealed a well-differentiated leiomyosarcoma completely located inside the testicular parenchyma. We report this unusual case because primary leiomyosarcoma of the testis proper is extremely rare; our patient being the 19th case recorded thus far in the medical literature. It can lead to significant clinical and diagnostic difficulty due to its wide differential diagnosis and extreme rarity.
    Turk Patoloji Dergisi 01/2013; 29(3):227-230.
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    ABSTRACT: Congenital megacalycosis is a rare renal disease characterized by calyceal dilatation without pelvic or ureteral obstruction. If not accompanied by nephrolithiasis and urinary tract infection, this disease is completely benign and does not cause renal dysfunction. We present a case of congenital megacalycosis that was diagnosed at the age of 41 (oldest case in the literature) after admitting with hematuria and acute renal dysfunction. IgA nephropathy was also diagnosed in this patient. Since renal dysfunction is not likely in these patients, if encountered; renal biopsy should be performed although technically difficult to diagnose the cause of this dysfunction.
    Renal Failure 12/2012; · 0.94 Impact Factor
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    ABSTRACT: The prognostic value of the type and extent of extracapillary proliferation (ECP) in pauci-immune necrotizing crescentic glomerulonephitis (PIGN) was evaluated in this study. In 141 PIGN cases, all glomeruli with ECP were grouped according to type (cellular, fibrocellular and fibrous) and extent of the lesions in Bowman's space; (segmental, semicircumferential and circumferential, which might be termed full moon-FM). Cases with cellular and fibrous lesions involving ≥50% of glomeruli with ECP were classified as cellular and fibrous groups, respectively, while the remaining cases were classified as fibrocellular. Cases with segmental and circumferential (FM glomerulus) lesions involving ≥50% of glomeruli with ECP were classified as ECPI and ECPIII (FM) groups, respectively, while the rest were classified as ECPII. All the cases were classified according to Berden et al. Significant results were only nearly obtained for the FM group, including the need for dialysis. The Cox regression model revealed a 2.6-fold risk for FM cases regarding dialysis requirement. We propose that the percentage of FM glomeruli should be noted in the pathology report, and cases with more than 50% of FM glomeruli (FM group) should be identified in the group with increased risk of dialysis requirement. Our series also suggests that classification according to Berden et al. is of clinical relevance.
    Pathology - Research and Practice 12/2012; · 1.21 Impact Factor
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    ABSTRACT: Glomerulopathy with fibronectin deposits is a rare hereditary kidney disease characterized by the extensive deposition of fibronectin in glomeruli, particularly in mesangial regions and subendothelial zones. Prognostically, the disease is known as slowly progressive, leading to kidney failure in most cases. We recently diagnosed glomerulopathy with fibronectin deposits in a 24-year-old man in whom proteinuria was detected incidentally. Genetic analysis of the fibronectin 1 (FN1) gene showed heterozygosity for the Y973C mutation. The same mutation was found in his elder brother, who similarly experienced proteinuria. Both patients had normal kidney function but persistent proteinuria after 30 months and 11 years of follow-up, respectively.
    American Journal of Kidney Diseases 12/2012; · 5.29 Impact Factor
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    ABSTRACT: OBJECTIVE: To determine the incidence of dysplasia as a preneoplastic change and high-risk human papilloma virus (HPV) infection in penile condylomas, which are common HPV-related lesions and considered a risk factor for penile cancer. METHODS: Histologic analysis was done of 58 consecutive penile condylomas with tissue diagnosis. An immunohistochemical panel that included stains for p53, Ki-67, and p16(INK4a) was also used. HPV typing was successfully performed in 43 lesions. Genotyping was accomplished through polymerase chain reaction and flow-through hybridization with an HPV GenoArray Diagnostic Test kit. RESULTS: Dysplasia was observed in 13 of the 58 condylomas (22%). High-risk HPV DNA was detected in 5 of 10 dysplastic lesions (50%) for which tissue blocks were available for study. High-risk HPV was not detected in the nondysplastic lesions (P <.001). Ki-67 ≥20% above the basal layer of epithelium and p53-positive immunostaining occurred more frequently in dysplastic lesions than in nondysplastic lesions; however, the difference was not statistically significance. Staining for p16(INK4a) was not helpful. CONCLUSION: Anogenital condylomas in men are usually treated using destructive methods or with medication. We suggest that at least a part of the lesion must be removed and sent for histopathologic examination. If the histologic result shows significant dysplastic alteration, the lesion should be further investigated to determine the subtype of infective virus, because 50% of such lesions are associated with high-risk HPV. When oncogenic pathogens are found, careful patient follow-up for recurrences and counseling for the patient and his sexual partner(s) may be warranted.
    Urology 11/2012; · 2.42 Impact Factor
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    ABSTRACT: OBJECTIVE: To investigate the effects of bilirubin in a rat model of pyelonephritis. METHODS: Experimental pyelonephritis was induced in 32 wistar rats and 4 groups were formed: group 1 (no treatment), group 2 (antibiotic), group 3 (bilirubin), and group 4 (antibiotic + bilirubin). Antibiotic was given on days 3 to 8, and bilirubin was administered between days 0 and 8 of bacterial inoculation. Half of the rats were killed on the 9th day (early period) and histopathological parameters, immunohistochemical renal fibrosis markers, apoptosis, and oxidant/antioxidant system activities were evaluated. The rest of the rats were killed at the 6th week of the study and evaluated for histopathological parameters and renal fibrosis markers. RESULTS: Inflammatory activity was significantly lower in rats treated with antibiotic + bilirubin vs no treatment group both in the early and late periods. In the late period, inflammatory cell intensity was lower in rats treated with bilirubin vs no treatment and the antibiotic + bilirubin groups. Interstitial fibrosis/tubular atrophy was lower in the antibiotic + bilirubin group vs the no treatment and antibiotic groups, and in bilirubin vs antibiotic group. Tissue inhibitor of metalloproteinase-1 expression was lower in the bilirubin vs antibiotic group. Terminal deoxynucleotidyl transferase mediated 2'-deoxyuridine, 5'-triphosphate nick end labeling(+) cells were significantly lower in bilirubin and antibiotic + bilirubin groups vs no treatment group. Malondialdehyde levels were significantly lower in the antibiotic + bilirubin vs the no treatment group and superoxide dismutase activity was significantly higher in the antibiotic and antibiotic + bilirubin groups vs the no treatment group. CONCLUSION: Bilirubin may have protective effects on pyelonephritis-associated inflammation in both early and late periods in addition to fibrosis and apoptosis when applied with antibiotics. When used alone, bilirubin may also prevent inflammation (in the late period) and apoptosis.
    Urology 09/2012; · 2.42 Impact Factor
  • Kemal Kosemehmetoglu, Dilek Ertoy Baydar
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    ABSTRACT: PURPOSE: Behçet's disease (BD) is a rare inflammatory disorder with variable articular and systemic manifestations. Amyloidosis is an uncommon complication of BD. The aim of this study is to present clinicopathological characteristics and outcome of 8 patients with renal amyloidosis secondary to BD. METHODS: A total of 220 cases of secondary-type renal amyloidosis diagnosed over 26-year period (1981-2007) in a single institution via needle biopsy were reviewed retrospectively, and accompanying BD was found in ten of them. Clinical and follow-up information of the patients was gathered from hospital records and computer-based data system. Two cases were excluded from the study due to another concomitant preamyloidotic condition. Biopsy slides of remaining 8 cases were culled from the archives and re-examined. Extent and pattern of renal amyloid deposition were explored. Amyloid typing was accomplished via immunohistochemistry. Factors acting on outcome and renal survival were explored. RESULTS: Patients were all male (age range 27-56). Duration of BD before diagnosis of amyloidosis varied from 24 to 192 months, and mean follow-up period was 89 months. Nephrotic syndrome was the most common presentation. Immunohistochemical typing revealed AA-amyloid in all cases. Two cases showed glomerular-dominant, one case vascular-dominant amyloid deposition, and rest were codominant glomerular and vascular, except one that was indeterminate. Patients were treated with steroids and/or different immunosuppressives, three progressed to end-stage kidney failure. CONCLUSION: Behçet's disease is one of the rare diseases that lead to AA amyloidosis. Morphology of renal amyloidosis due to BD has diversities in terms of differential amyloid deposition in renal compartments. Patients follow variable clinical courses accordingly.
    International Urology and Nephrology 09/2012; · 1.33 Impact Factor
  • Gunes Guner, Bulent Akdogan, Dilek Ertoy Baydar
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    ABSTRACT: We report a case of a 72-year-old male that underwent two sets of transrectal prostatic needle biopsy (TPNB) within 9 month period. Pathology showed unremarkable benign prostatic tissues in the first group of biopsies while extensive diffuse inflammation with the characteristic features of malakoplakia in the second set. Three cores in the repeat biopsy contained foci of prostatic adenocarcinoma as well. Occurrence of malakoplakia several months after TPNB in our case suggests that microorganisms may have been inoculated to the prostate during the biopsy procedure. We believe that malakoplakia must be added to the list of complications after TPNB.
    The Canadian Journal of Urology 02/2012; 19(1):6124-7. · 0.74 Impact Factor
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    ABSTRACT: Extramedullary recurrences with or without bone marrow involvement are reported in up to a half of leukemic relapses after bone marrow transplantation. Extramedullary relapse of acute lymphoblastic leukemia (ALL) in the kidney after allogeneic stem cell transplantation (allo-SCT) is rare. We herein, report an additional case with extramedullary recurrences and renal relapse after first-allografting for Ph+-acute lymphoblastic leukemia. He had no evidence of leukemia in his marrow demonstrating 98% full-donor chimerism while he had ALL relapse in his kidney.
    UHOD - Uluslararasi Hematoloji-Onkoloji Dergisi 01/2012; 22(1):46-50. · 0.35 Impact Factor
  • Dilek Ertoy Baydar, Celik Tasar
    The American journal of surgical pathology 11/2011; 35(11):1754-7. · 4.06 Impact Factor
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    ABSTRACT: Idiopathic nephrotic syndrome (INS) is a genetically heterogeneous group of disorders characterized by proteinuria, hypoalbuminemia, and edema. Because it typically results in end-stage kidney disease, the steroid-resistant subtype (SRNS) of INS is especially important when it occurs in children. The present study included 29 affected and 22 normal individuals from 17 SRNS families; genome-wide analysis was performed with Affymetrix 250K SNP arrays followed by homozygosity mapping. A large homozygous stretch on chromosomal region 12p12 was identified in one consanguineous family with two affected siblings. Direct sequencing of protein tyrosine phosphatase receptor type O (PTPRO; also known as glomerular epithelial protein-1 [GLEPP1]) showed homozygous c.2627+1G>T donor splice-site mutation. This mutation causes skipping of the evolutionarily conserved exon 16 (p.Glu854_Trp876del) at the RNA level. Immunohistochemistry with GLEPP1 antibody showed a similar staining pattern in the podocytes of the diseased and control kidney tissues. We used a highly polymorphic intragenic DNA marker-D12S1303-to search for homozygosity in 120 Turkish and 13 non-Turkish individuals in the PodoNet registry. This analysis yielded 17 candidate families, and a distinct homozygous c.2745+1G>A donor splice-site mutation in PTPRO was further identified via DNA sequencing in a second Turkish family. This mutation causes skipping of exon 19, and this introduces a premature stop codon at the very beginning of exon 20 (p.Asn888Lysfs*3) and causes degradation of mRNA via nonsense-mediated decay. Immunohistochemical analysis showed complete absence of immunoreactive PTPRO. Ultrastructural alterations, such as diffuse foot process fusion and extensive microvillus transformation of podocytes, were observed via electron microscopy in both families. The present study introduces mutations in PTPRO as another cause of autosomal-recessive nephrotic syndrome.
    The American Journal of Human Genetics 06/2011; 89(1):139-47. · 11.20 Impact Factor
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    ABSTRACT: Drug-induced interstitial nephritis is one of the causes of graft dysfunction in renal transplant recipients. Although commonly implicated as a cause of drug-induced interstitial nephritis in the general population, proton pump inhibitor-induced interstitial nephritis has not yet been reported in renal transplant recipients. Trimethoprim-sulfamethoxazole is responsible for most cases of interstitial nephritis in this population. Here, we describe the first case of proton pump inhibitor-related interstitial nephritis in a renal transplant recipient.
    International Urology and Nephrology 05/2011; · 1.33 Impact Factor
  • Dilek Ertoy Baydar, Ibrahim Kulac, Bora Gurel, Angelo De Marzo
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    ABSTRACT: Prostate carcinomas showing aberrant diffuse-nuclear p63 expression are extremely rare, and there is only 1 article in the literature reporting a series of 21 such cases. We document an additional case of p63-positive prostatic adenocarcinoma in a 60-year-old man, whose diagnosis was difficult. The patient was found to have an elevated prostate-specific antigen (PSA) level at a general health check-up and was referred to the hospital. His serum PSA was 4.2 ng/mL. Digital rectal examination and transrectal ultrasonography did not reveal a lesion. Transrectal needle biopsy of the prostate detected atypical, small prostatic glands suspected for adenocarcinoma at 2 cores. However immunohistochemistry showed nuclear p63 expression in the suspicious glands. Repeat biopsy revealed only high-grade prostatic intraepithelial neoplasia. In the third transrectal biopsy, finding of the same atypical glands showing perineural invasion facilitated the diagnosis of malignancy. The patient underwent a radical prostatectomy. Five different small tumor foci were seen in the prostate after pathological evaluation, one of which was p63 positive and the others p63 negative. The largest of the classic p63-negative tumors showed a TMPRSS2-ERG translocation by fluorescent in situ hybridization while the p63-positive tumor did not. The authors submit that this subtype (p63-positive prostate adenocarcinoma) should be listed among the recognized rare variants of prostatic adenocarcinoma.
    International Journal of Surgical Pathology 02/2011; 19(1):131-6. · 0.76 Impact Factor
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    Samir Abdullazade, Ali Ergen, Dilek Ertoy Baydar
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    ABSTRACT: Press Elmer Articles © The authors | Journal compilation © J Med Cases and Elmer Press™ | www.journalmc.org Abstract Testicular mesothelioma originating from tunica vaginalis is a very rare disease. A 70-year-old man complained of left testicular swelling and was operated with the clinical diagnosis of hydrocele. Intra-operative examination revealed diffuse thickening of tunica vaginalis, which was thought to be infl ammatory and benign by the urologist. Nevertheless an incisional biopsy was performed and atypical mesothelial proliferation was reported in histopathology. Morphologic fi ndings were insuffi cient for defi nitive diagnosis of malignancy. Patient was followed-up for ten months. Due to the persistance of paratesticular thickening and additional appearance of nodularities, left inguinal orchiectomy was performed. Microscopy revealed classical malignant mesothelioma originating from tunica vaginalis. Two years after the diagnosis, patient had metastases to the paraaortic lymph nodes. Malignant mesothelioma of the testis may represent with diagnostic diffi culties both clinically and pathologically. In all cases where paratesticular tissues may deviate from normal, mesothelioma must enter into the differential diagnosis.
    J medical cases. 01/2011; 2(6):275-278.
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    Dilek Ertoy Baydar, Haluk Ozen, Pinar O Geyik, Bora Gurel
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    ABSTRACT: Telomeres function in human somatic tissues to stabilize chromosome ends. Telomere shortening can be one of the ways that cause chromosomal instability in the pathogenesis of prostatic carcinoma. In the current study, we evaluated telomere length (TL) in normal and malignant prostate tissues, and its association with prognostic factors and with time to biochemical tumor recurrence. Tissue microarrays constructed from paraffin blocks from radical prostatectomy specimens containing 61 randomly selected cases were used. Sections were hybridized with a Cy3-labeled telomere-specific peptide nucleic acid probe. TL, proportional to probe fluorescence intensity, was visually evaluated. Statistical analysis was done to relate TL clinical and pathological prognostic variables. The majority (49/61) of prostate cancers displayed abnormally short telomeres. Univariate analysis revealed inverse correlation between telomere shortening in tumor and Gleason scores (p=0.017). Multivariate analyses pointed to TL as an independent predictor in addition to serum pre-operative PSA for reduced biochemical progression-free survival (p=0.035). Telomere shortening is a common alteration in prostatic adenocarcinoma. Normal or long telomeres are rarely seen and, when present, seem to provide a growth advantage for the tumor as being an advocate for poor differentiation.
    Pathology - Research and Practice 10/2010; 206(10):700-4. · 1.21 Impact Factor
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    ABSTRACT: To analyze p53, Ki-67 and bcl-2 expressions immunohistochemically and their predictive role in biochemical recurrence after radical prostatectomy. Seventy one patients who had undergone radical prostatectomy between 1992 and 2001 were randomly selected. Tissue microarrays were constructed from their radical prostatectomy specimens. They contained four cores from neoplastic and additional four cores from corresponding non-neoplastic regions. Gleason score ranged from 6-9, and pathological stage ranged from T2N0Mx to T3BN1. Staining for bcl-2 was scored visually taking percent negative, weak, moderate and strong positivity into consideration. Strong immunoreactivity was considered positive for p53. Ki-67 index was measured as the percentage of positive nuclei among tumor cells. Statistical analysis was performed to explore correlations between staining patterns and clinicopathological prognostic parameters. The follow-up period extended from 13 to 112 months with a mean 60 (48 ± 23, 2) months. Of all, 38.02% had no evidence of disease, 52.1% were alive with disease and 9.8% were died during follow-up. The expression of p53, Ki-67 and bcl-2 in tumors were 39%, 76% and 5% respectively. While the secretory layer showed negative or weak bcl-2 staining in most cases, expression in basal cells was often stronger. Statistical analysis revealed differences in staining between normal and carcinoma for all three markers. There was no correlation between staining patterns and time to biochemical relapse. On the other hand, cases with higher Gleason sum showed the tendency for over expression of p53, Ki-67 and bcl-2 although the differences were not statistically different. Multivariate analysis revealed CMS group and seminal vesicle invasion as the independent predictors of PSA failure (log rank P = 0.0039 and P = 0.001, respectively). The proteins bcl-2, p53 and Ki-67 were expressed at a different rate in normal and neoplastic prostate tissue. Bcl-2 was mainly expressed by basal cells in normal glands. p53 and Ki-67 expression were increased in most prostate carcinomas. However, overall expression levels did not correlate with biochemical recurrence in this study.
    Indian Journal of Urology 04/2010; 26(2):206-12.
  • Dilek Ertoy Baydar, Fazil Tuncay Aki
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    ABSTRACT: Spindle cell tumors of the prostate are rare and mostly primary. We report a case of retroperitoneal sarcoma, which is a low-grade fibromyxoid sarcoma involving the prostate secondarily by metastasis. The patient was a 44-year-old man who presented with progressing abdominal pain. Computed tomography showed a large retroperitoneal mass. The patient underwent surgical resection. Intraoperatively, a second smaller mass was identified in the pelvis and was left untouched. The resected retroperitoneal specimen and prostate transrectal needle biopsies taken afterward showed the same mesenchymal tumor. Radical cystoprostatectomy was performed. Metatatic tumor involving the prostate, bilateral seminal vesicles, and base of the urinary bladder was found. Microscopic examination revealed typical histomorphologic features of low-grade fibromyxoid sarcoma. The patient is without evidence of disease 3 years postoperatively. This case is the first documentation of metastatic sarcoma to the prostate and expands the list of malignant mesenchymal neoplasms that may involve this organ.
    Annals of diagnostic pathology 03/2010; 15(1):64-8.