Aysegul Uner

Baskent University, Engüri, Ankara, Turkey

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Publications (49)106.65 Total impact

  • Aysen Terzi, Aysegul Hasegeli Uner
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    ABSTRACT: Invasive papillary carcinoma is a rare variant of breast cancer. We report an unusual case of invasive papillary carcinoma of the breast with high nuclear grade, brisk mitosis, necrosis, extensive apocrine differentiation, and intense lymphoplasmacytic infiltrate; additionally triple-negativity for estrogen and progesterone receptors and Her2 neu. The patient underwent modified radical mastectomy and adjuvant chemotherapy. But, it was a node negative breast carcinoma. Increasing the awareness of this clinicopathologic entity would be helpful in avoiding overtreatment of patients with this cancer even if the tumor has negative morphological and immunohistochemical prognosticators.
    Indian Journal of Pathology and Microbiology 10/2012; 55(4):543-5. · 0.68 Impact Factor
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    ABSTRACT: Primary central nervous system (CNS) lymphomas are rare neoplasms which are usually not associated with Epstein-Barr virus (EBV) in immunocompetent patients. The aim of this study was to investigate the incidence of EBV in primary CNS lymphomas in the Turkish population. Thirty-two primary CNS lymphomas diagnosed according to the WHO 2008 criteria were included in this study. The presence of EBV small ribonucleic acids was investigated by in situ hybridization using EBV encoded small RNA oligonucleotides. The expression of CD10, Bcl-6, MUM-1/IRF-4, Bcl-2, and Ki-67 were evaluated using immunohistochemistry. The patient cohort included 20 male patients and 12 female patients with a median age of 53.5 years (range 13-75). Seven (22%) of cases were classified as germinal center (GC) and 25 (78%) cases as non-GC phenotype according to the Hans criteria. Twenty-six (81%) of the cases showed strong Bcl-2 expression and the median Ki-67 index was 78%. EBV expression was observed in four primary CNS lymphoma cases (12.5%). Most primary CNS lymphomas show non-GC phenotype with high Bcl-2 expression and high proliferative rate. The incidence of EBV in primary CNS lymphomas from Turkey appears to be higher than that observed in the Western countries.
    Apmis 08/2012; · 2.07 Impact Factor
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    ABSTRACT: We performed this study to detect preoperative axillary metastases with ultrasound (US)-guided fine needle aspiration biopsy (FNAB), to eliminate the need for time-consuming and costly sentinel lymph node (SLN) scintigraphy and biopsy steps in the treatment of breast cancer patients, and in that of with suspicious US findings, and to evaluate the accuracy of preoperative US-guided FNAB for patients with suspicious lymph node metastases on US. Patients with a suspicious breast lump or histopathologically proven breast cancer underwent breast-axillary US. Increase in lymph node size, cortical thickening, non-hilar cortical flow, and hilar changes were evaluated with gray scale-color Doppler US. FNAB was performed if US results were suspicious for malignancy. Thirty-eight axillary lymph nodes (ALN) underwent FNAB. ALN dissection, SLN scintigraphy, and biopsy steps were bypassed in 23 axillas with positive ALN FNAB (60.5%). The sensitivity of ALN FNAB was 88.46%; specificity and positive predictive value were 100%; and negative predictive value was 66.6% (inadequate cytology included; 76.7%, 100%, 100%, 53.3%, respectively). Asymmetrical cortical thickening, non-hilar cortical flow, and increase in hypoechogenity were only detected in metastatic nodes. Cortical thickening, and lymph node and breast mass size was higher in the metastatic group. By performing FNAB on suspicious lymph nodes, the routine, high-cost SLN scintigraphy and intraoperative gamma probe steps may be skipped, and axilla dissection can be performed directly. This leads to the elimination of the need for SLN investigation in more than half of the patients. The assessment of ALN metastases with preoperative US-guided FNAB is a cost-effective method with high specificity, that eliminates the need for costly and time-consuming SLN scintigraphy and biopsy steps, and helps in preoperative staging.
    Journal of breast cancer. 06/2012; 15(2):211-7.
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    ABSTRACT: Primary gastric diffuse large cell lymphoma is one of the most common extranodal lymphomas of the gastrointestinal system. Diagnosing gastrointestinal lymphomas can be difficult, since there is no pathognomonic sign in endoscopy to distinguish it from other malignancies. In some cases biopsy can be non-diagnostic. Therefore, multiple endoscopic examinations and biopsies can be necessary. With using confocal endomicroscopy, histology of the tissue can be seen in vivo and a range of diseases can be identified by using this technique. We are presenting a case, which is diagnosed as primary gastric diffuse large cell lymphoma during the evaluation of erythema nodosum etiology. We want to emphasize the role of confocal laser endomicroscopy for in vivo diagnosis of gastric lymphoma and directing the endoscopist for sampling the diseased mucosa. Confocal endomicroscopy decreases non-diagnostic rates in endoscopic biopsy and can be performed successfully in cases of gastric lymphoma. Pit patterns of gastric lymphoma, ring cell gastric carcinoma and gastric adenocarcinoma are similar. To best of our knowledge, this case is the fifth case of confocal laser endomicroscopy aided in diagnosing gastric lymphomas (Tab. 1, Fig. 2, Ref. 13). Keywords: confocal laser endomicroscopy, gastric lymphoma, extranodal, endoscopy, pit pattern, erythema nodosum, primary gastric diffuse large cell lymphoma.
    Bratislavske lekarske listy 01/2012; 113(11):680-2. · 0.47 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
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    ABSTRACT: Diffuse large B-cell lymphomas (DLBCLs) are a biologically heterogeneous group in which various gene alterations have been reported. The aim of this study was to investigate the frequency and prognostic impact of BCL2, BCL6, and MYC rearrangements in cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab (R-CHOP)-treated DLBCL cases. Tissue microarrays were constructed from 239 cases of DLBCL, and the expressions of CD10, BCL6, MUM1/IRF4, and BCL2 were evaluated by immunohistochemistry. MYC, BCL2, and BCL6 rearrangements were investigated by interphase fluorescence in situ hybridization on tissue microarrays. Survival analysis was constructed from 145 R-CHOP-treated patients. MYC, BCL2, and BCL6 rearrangements were detected in 14 (6%), 36 (15%), and 69 (29%) of 239 DLBCL patients. Double or triple rearrangements were detected in 7 (3%) of 239 DLBCL cases. Of these, 4 had BCL2 and MYC, 2 had BCL6 and MYC, and 1 had BCL2, BCL6, and MYC rearrangements. The prognosis of these cases was extremely poor, with a median survival of 9 months. MYC rearrangement was associated with significantly worse overall survival (P = .01), especially for the cases with GC phenotype (P = .009). BCL6 rearrangement also predicted significantly shorter overall survival (P = .04), especially for the non-GC phenotype (P = .03). BCL2 rearrangement had no prognostic impact on outcome. International Prognostic Index (P = .004) and MYC rearrangement (P = .009) were independent poor prognostic factors. Analysis of MYC gene rearrangement along with BCL2 and BCL6 is critical in identifying high-risk patients with poor prognosis.
    Cancer 12/2011; 118(17):4173-83. · 5.20 Impact Factor
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    ABSTRACT: Accumulated evidence has shown the importance of Epstein-Barr virus in the pathogenesis of various lymphomas. This study aimed to determine the prevalence of Epstein-Barr virus expression and its effect on survival amongst diffuse large B-cell lymphoma (DLBCL) cases from two large tertiary care centres in Turkey with a particular interest in identifying cases of 'Epstein-Barr virus-positive DLBCL of the elderly'. Diffuse large B-cell lymphoma cases diagnosed between 1999 and 2009 were retrieved and 340 cases were used to construct tissue microarrays. The presence of Epstein-Barr virus small ribonucleic acids was examined by in situ hybridization using Epstein-Barr virus (EBV)-encoded small RNA (EBER) oligonucleotides. A total of 18 cases (5.3%) showed Epstein-Barr virus expression. Twelve cases were classified as Epstein-Barr virus-positive DLBCL of the elderly. Epstein-Barr virus-positive DLBCL cases showed a significantly inferior overall survival as compared with Epstein-Barr virus-negative cases (p < 0.001). In our study group Epstein-Barr virus expression is not prevalent in DLBCLs. Epstein-Barr virus-positive DLBCL of the elderly is also rare in the Turkish population. The presence of Epstein-Barr virus, however, is associated with poor prognosis.
    Apmis 04/2011; 119(4-5):309-16. · 2.07 Impact Factor
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    ABSTRACT: Most basal-like breast carcinomas are estrogen receptor negative, progesterone receptor negative, and cerb-B2/HER-2/neu negative--the so-called triple-negative breast carcinomas--with high epidermal growth factor receptor (EGFR) expression, which makes EGFR a target of treatment. We evaluated EGFR expression by immunohistochemistry (IHC) with two different clones (EGFR.31G7 and EGFR.25) and gene copy number by fluorescence in situ hybridization (FISH) with Locus specific identifier EGFR/CEP 7 dual probe in 62 triple-negative breast carcinomas. Any complete or incomplete membranous and/or cytoplasmic expression was regarded as IHC positive. Cases showing gene amplification (a ratio of EGFR gene to chromosome 7 of ≥ 2 or 15 copies per cell in ≥ 10% of cells) and high polysomy (≥ 4 copies in ≥ 40% of cells) were considered FISH po sitive. We detected EGFR.31G7 positivity in 38 of 62 cases (61.4%), which was composed of 12 of 62 (19.4%) cytoplasmic, 14 of 62 (22.6%) incomplete membranous, and 12 of 62 (19.4%) complete membranous staining. Among 38 of 49 (77.6%) EGFR.25-positive cases, 7 of 49 (14.3%) exhibited cytoplasmic, 10 of 49 (20.4%) exhibited incomplete membranous, and 21 of 49 (42.9%) exhibited complete membranous staining pattern. Ten of 62 (16.1%) FISH-positive cases were identified; 1 of 62 (1.6%) showed amplification, and the rest showed high polysomy. All FISH-positive cases were also found to be IHC positive (P = 0.01) by both EGFR clones. The amplified case displayed strong complete membranous staining with both clones. Among the high polysomic cases; 4 of 9 (44.4%) incomplete membranous, 4 of 9 (44.4%) complete membranous and 1 of 9 (11.1%) cytoplasmic expression of EGFR.31G7, and 6 of 8 (75%) complete membranous and 2 of 6 (25%) cytoplasmic expression of EGFR.25 were detected. Here, we report that membranous EGFR expression is associated with increased gene copy number (P = 0.035 for EGFR.31G7 and P = 0.026 for EGFR.25 clone). Because the markers to predict anti-EGFR treatment response in other system tumors such as EGFR mutation and amplification seem to be rare events in breast cancer, membranous staining pattern of EGFR might be the best way to decide the patient eligibility for anti-EGFR therapy.
    Cancer genetics and cytogenetics 12/2010; 203(2):222-9. · 1.54 Impact Factor
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    ABSTRACT: The aim of this study was to identify the immune response in sentinel lymph nodes (SLNs) of patients with endometrial and patients with cervical cancers by analyzing the number of S-100-, CD1a-, CD83-positive (+) dendritic cells that are the major antigen-presenting cells. A total of 56 patients with early-stage cancer (n = 32, with cervical; n = 24, with endometrial cancer) underwent SLN biopsy. Sentinel lymph nodes and non-SLNs were stained with antibodies against S-100, CD1a, and CD83 as markers for dendritic cells to find out whether SLNs were immunomodulated compared with non-SLNs. The mean values of S-100(+) and CD1a(+) dendritic cells in both the tumor-free and the metastatic SLNs were significantly higher than those of both the tumor-free and the metastatic non-SLNs. When metastatic SLNs were compared with nonmetastatic SLNs, CD83(+) dendritic cells were found significantly more abundant in nonmetastatic SLNs. Significantly higher numbers of S-100(+) and CD1a(+) dendritic cells in the SLNs compared with those in the non-SLNs may indicate that SLNs are the first sites of immunostimulation. Immunosupression may be the underlying factor for the metastatic involvement of SLNs, which might be secondary to the significantly decreased number of mature dendritic cells in metastatic SLNs compared with tumor-free SLNs.
    International Journal of Gynecological Cancer 10/2009; 19(7):1239-43. · 1.94 Impact Factor
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    ABSTRACT: Autoimmune diseases are defined as specific, adapted immune reactions against self antigens. Immune mechanism deficiency is a causal factor for B-cell lymphoma in primary Sjögren's syndrome and autoimmune thyroid disease. Thyroid mucosa-associated lymphoid tissue (MALT) lymphoma is a 67-fold and parotid lymphoma is a 44-fold increased risk in Sjögren's syndrome and thyroiditis. MALT lymphoma was not reported in rheumatoid arthritis. We herein report the case of a 56-year-old woman with maltoma of thyroid in rheumatoid arthritis patient.
    Medical Oncology 09/2009; 27(3):826-32. · 2.14 Impact Factor
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    ABSTRACT: RET finger protein (RFP), which belongs to the large B-box RING finger protein family, has been reported to be expressed in breast carcinoma cell lines. We conducted this study to evaluate the expression level of RFP in breast carcinomas. Tissue microarrays were constructed from 133 cases of invasive breast carcinoma. Sections obtained from tissue arrays and whole sections from 10 non-neoplastic breast tissues were stained for ER, PR, ErbB2, and RFP using immunohistochemistry, and ErbB2 gene status was evaluated by FISH. The correlation between various immunohistochemical markers was determined. We found nuclear RFP expression in 41.4% of invasive carcinomas and in none of the non-neoplastic breast tissues. We also stained whole sections of 29 cases of invasive breast carcinoma, which included the TMA study, and 10 cases of ductal carcinoma in situ (DCIS) by RFP. We observed that four (40%) of the DCIS cases were positive with RFP. In statistical analysis, there was a significant, positive association between RFP and ErbB2 status at the protein level (p=0.002) and the gene level (p=0.049). There was no statistically significant association between the expression of RFP and tumor size, LN status, ER, PR, and grade (p>0.05). However, we found a significant association between age and RFP expression. RFP expression was stronger in patients 50 years or older (p=0.048). In our study, the expression of RFP correlated strongly with ErbB2 status. Our study is the first in the literature to show expression of RFP in patients with breast carcinoma. However, the possible role of RFP in breast carcinogenesis needs to be investigated in more detailed clinical and experimental studies.
    Pathology - Research and Practice 03/2009; 205(6):403-8. · 1.21 Impact Factor
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    ABSTRACT: We describe a 19-year-old male patient with a previous diagnosis of familial Mediterranean fever (FMF), nephrotic syndrome and secondary amyloidosis, who presented with anemia and leukopenia. The bone marrow assessments showed dysplastic precursors including vacuolated myeloid and erythroid precursors and increased proportion of immature cells up to 19%. The patient received erythropoietin and G-CSF for myelodysplastic syndrome (MDS). No response was observed. During his evaluations copper deficiency was detected. One month after oral copper replacement, the peripheral blood counts and bone marrow findings became completely normalized. An evaluation to identify the cause of copper deficiency, revealed intestinal amyloidosis. Based on our experience we recommend serum copper determination in the diagnostic workup of MDS in patients with comorbidities.
    Leukemia Research 04/2008; 32(3):495-9. · 2.76 Impact Factor
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    ABSTRACT: Angiotensin-converting enzyme (ACE) is involved in the control of cellular proliferation. Tumor-associated macrophages promote lymphoma pathogenesis via affecting tumor cell growth and associated survival factors. We assessed ACE expression in the neoplastic lymph node microenvironment of Hodgkin's lymphoma (HL), particularly in macrophages and in nonneoplastic lymphoid tissue. Paraffin sections of the lymph nodes from randomly selected 20 HL cases with nodular sclerosing and 20 mixed cellular types were included into the study. Five normal tonsils and five lymph nodes showing reactive lymphoid hyperplasia were used as controls. Immunohistochemistry of lymph node biopsies had been performed with monoclonal antibody against human ACE. Sections were evaluated by two pathologists. ACE-expressing histiocytes were observed in lymph nodes of HL. ACE staining was also observed in the vascular endothelium in all the tissues evaluated. Neoplastic lymphoid tissues and control tissues did not express ACE. ACE expression of the lymphoma-associated macrophages in the lymph nodes of HL may represent the point of cross-talk between renin-angiotensin system (RAS) and lymphomagenesis. ACE could serve in the pathobiological function of the tissue-based macrophages in tumorigenesis of HL.
    Journal of the National Medical Association 12/2007; 99(11):1243-4, 1246-7. · 0.91 Impact Factor
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    ABSTRACT: Local renin-angiotensin system (RAS) may affect leukaemic cell production within the bone marrow microenvironment. Angiotensin-converting enzyme (ACE), renin, and angiotensin could influence leukaemogenesis. In this study, mRNA expressions of the major RAS components (ACE, renin, and angiotensinogen) in K562 human erythroleukaemia cell line have been searched by Real Time quantitative polymerase chain reaction. K562 blasts are multipotential, haematopoietic malignant cells that spontaneously differentiate into recognisable progenitors of the erythrocyte, granulocyte and monocytic series. We observed significant expressions of ACE, renin, and angiotensinogen in K562 leukaemic blast cells. Therefore, K562 human erythroleukaemia cell line may serve as an in vitro model to elucidate the role of RAS in leukaemia and to test the effects of RAS-affecting drugs on leukaemic cellular proliferation.
    Journal of Renin-Angiotensin-Aldosterone System 10/2007; 8(3):145-7. · 2.29 Impact Factor
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    ABSTRACT: We report successful treatment of a refractory myelodysplastic syndrome-associated pyoderma gangrenosum with the combination of thalidomide and interferon-alpha2a in a single patient. A non-healing wound developed on a 40-year-old woman's left thumb after minor trauma. Massive ulcerovegetative lesions developed after reconstruction surgery. Histopathological examination of the bone marrow and cytogenetic studies revealed an atypical myeloproliferative/myelodysplastic syndrome. The skin lesions resolved dramatically after two months of thalidomide and interferon-alpha2a combination therapy and the haematological status improved.
    The Netherlands Journal of Medicine 01/2007; 64(11):422-4. · 2.38 Impact Factor
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    ABSTRACT: Herpes simplex virus (HSV) causes life-threatening infections in immunocompromised patients such as transplant recipients and patients with hematologic malignancies. We herein describe the case of a patient with chronic myeloid leukemia blastic transformation who developed severe herpetic tonsillitis complicated by tonsillar abscess formation. Abscess formation was determined by computed tomography, whereas tonsillitis due to HSV was confirmed by pathologic and immunohistochemical examinations of the tonsillar biopsy. For molecular confirmation, HSV DNA was amplified by LightCycler PCR and type (HSV-1) determined by melting point analysis. The patient responded promptly to antiviral treatment and there were no signs of recurrent infection at the follow-up. To our knowledge, this case is unique for being the first case of tonsillar abscess formation due to HSV-1, also emphasizing the importance of herpetic infections in the differential diagnosis of oropharyngeal small-sized lesions in the immunocompromised patient population.
    Transplant Infectious Disease 10/2006; 8(3):166-70. · 1.98 Impact Factor
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    ABSTRACT: Local bone marrow renin-angiotensin system (RAS) is an autocrine-paracrine system affecting hematopoiesis. Angiotensin II type 1a (AT1a) receptors are present on the CD34+ hematopoietic stem cells. Angiotensin II stimulates the proliferation of bone marrow and umbilical cord blood hematopoietic progenitors. There are preliminary data that local RAS might also be involved in leukemogenesis. ACE hyper-function may lead to the acceleration of negative hematopoietic regulator peptide, AcSDKP, metabolism, which in turn lowers its level in the bone marrow micro-environment, finally removing the anti-proliferative effect of AcSDKP on the hematopoietic cells and blasts. Renin expression could have a role on the leukemia development and angiotensin may act as an autocrine growth factor for acute myeloid leukemia (AML) cells. The aim of this study is to search ACE (CD 143) surface antigen by flow-cytometric analyses on the leukemic blast cells taken from the bone marrow of the patients with AML. Bone marrow aspiration materials and peripheral blood samples were obtained from 11 patients with AML (eight males, three females; aged 46 (range 26-67) years) and six patients with non-malignant hematological disorders (four males, two females; aged 56 (range 22-71) years). ACE (CD 143) surface antigen was shown to be over-expressed in leukemic myeloid blast cells. ACE is positively correlated with bone marrow blast count. Elucidation of the pathological activity of the local RAS-mediated regulation of the leukemogenesis is both pathobiologically and clinically important, since the angiotensin peptides represent a molecular target in the disease management.
    Leukemia and Lymphoma 06/2006; 47(5):891-6. · 2.30 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 BMT. Our report describes a case of an extramedullary recurrence and breast relapse after second-allografting in a female patient with Ph+-acute lymphoblastic leukemia (ALL), occurring when there was active hepatic GHVD. This case illustrates the complex relationship between graft-versus-host disease (GVHD) and graft-versus-leukemia since she had no evidence of leukemia in her marrow demonstrating 100% full-donor chimerism while she had ALL relapse in her breast.
    Hematology 05/2006; 11(2):105-7. · 1.39 Impact Factor
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    ABSTRACT: The diagnosis of low-grade lymphoproliferative disorders during a long clinical course sometimes represents a great clinical challenge. The idiopathic hypereosinophilic syndrome (HES) represents a pre-malignant state in some patients and close follow-up is necessary to detect early signs of malignant transformation. Kimura's disease (KD) mimicking HES is an immune mediated inflammatory disorder that usually involves the head and neck region, primarily affecting the salivary glands, adjacent muscle and regional lymph nodes. Clinically, it is very difficult to differentiate KD from salivary gland lymphoid malignancies. Lymphomas may uncommonly present as a parotid mass. One, herein, would like to present a 35-year-old patient with changing clinical presentation patterns over a period of more than 6 years of follow-up. The first clinical presentation of the patient was HES. The 'diagnosis' of KD was reached after 4 years of management with HES. The final manifestation was parotid gland, preauricular and cutaneous manifestations of a peripheral T-cell lymphoma. This unique clinical presentation pattern of the patient may represent the distinct pathobiological progression of a clonal neoplastic lymphoproliferative disorder.
    Leukemia and Lymphoma 03/2006; 47(2):357-60. · 2.30 Impact Factor
  • Article: 167-P
    Human Immunology - HUM IMMUNOL. 01/2006; 67.

Publication Stats

226 Citations
99 Downloads
3k Views
106.65 Total Impact Points

Institutions

  • 2012
    • Baskent University
      • Department of Pathology
      Engüri, Ankara, Turkey
  • 2001–2012
    • Hacettepe University
      • • Department of Radiology
      • • Department of Pathology
      • • Department of Internal Medicine
      • • Department of Haematology
      Ankara, Ankara, Turkey
  • 2007
    • Hacettepe Üniversitesi Ana Sayfasi
      • Department of Internal Medicine
      Engüri, Ankara, Turkey
  • 2005
    • Ankara University
      Engüri, Ankara, Turkey