Emine Dundar

Eskisehir Osmangazi University, Eskişehir, Eskisehir, Turkey

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Publications (25)49.91 Total impact

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    ABSTRACT: Background: Elevated serum C-reactive protein (CRP) level has been demonstrated to predict poorer survival of both localized and metastatic renal cell carcinoma. However, the prognostic value of intratumoral CRP expression has not been sufficiently studied. Patients and Methods: In the present study, the expression of CRP was evaluated with immunohistochemical analysis in 127 patients who had undergone curative surgery for clear cell renal cell carcinoma. CRP staining was scored using the immunoreactivity score. An immunoreactivity score of 4 (median value) or lower was considered negative, a score higher than 4 was considered positive CRP expression. Results: Univariate analysis revealed that Fuhrman grade, necrosis, vascular invasion, TNM stage and CRP expression were associated with tumor-specific survival. Multivariate analysis using the Cox proportional hazards regression method revealed only TNM stage as an independent predictor of tumor-specific survival (p = 0.001). A trend towards significance (p = 0.066) was observed with CRP expression, but it did not reach significance. Patients with a positive CRP score were 3.46 times more likely to die than patients with a negative CRP score. Conclusion: Our results suggest that the assessment of intratumoral CRP expression may be a useful tool for predicting the prognosis in patients with clear cell renal cell carcinoma. © 2013 S. Karger AG, Basel.
    Urologia Internationalis 12/2013; · 1.07 Impact Factor
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    ABSTRACT: The use of medical thoracoscopy (MT) for the diagnosis and/or palliative treatment of pleural effusions is expected to become more widespread in the coming years. The aims of the present study were to establish the safety of MT in a group of patients at high risk for complications and to determine the factors that affect the development of complications. A total of 355 patients who underwent MT were divided into 2 groups: patients at high risk for complications and patients who had no risk factor. After the procedure, the complications of MT were recorded. All patients were followed up for at least 24 months. To evaluate the relationship between variables and complications, logistic regression models were applied. Of the 355 patients, 106 had one or more risk factors, whereas 249 did not have any risk factor. Pain (12.3%) was the most frequent complication in the high-risk patients, and subcutaneous emphysema (10.3%) was the most frequently reported complication in the normal-risk patients. Only pain was observed more frequently in the high-risk patients compared with the normal-risk patients. Talc pleurodesis was associated with prolonged air leak (8.3%) and empyema (5%). The percentage of patients with no complication was 58.6%. The mortality rate was 0.28%. In the multivariate analysis, the presence of mesothelioma was identified as a factor that increased the risk of complication. MT is a safe method for the diagnosis of patients with pleural effusion, even in patients at high risk for complications. However, complications, found in approximately half of the patients, should also be examined in terms of cost.
    Journal of bronchology & interventional pulmonology. 07/2013; 20(3):224-31.
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    ABSTRACT: In patients with post- medical thoracoscopy histopathological diagnoses of fibrinous pleuritis, confusion can occur concerning subsequent procedures. This issue is particularly important in regions where mesothelioma is prevalent. We aimed to identify false negatives among patients where mesothelioma was common due to asbestos exposure whose histopathological diagnosis following thoracoscopy was fibrinous pleuritis. We also determined risk factors associated with patients that required additional advanced invasive procedures for diagnosis. Overall, 287 patients who underwent thoracoscopy were included in the study. Patients diagnosed with fibrinous pleuritis as a result of thoracoscopy were followed for 2 years regarding this condition. More invasive procedures were performed on patients who showed no recuperation or developed pleural disease again during the follow-up period. Fibrinous pleuritis was observed in 101 (35.2%) patients. Follow-up of these patients revealed that the false negative rate was 18% for malignant pleural diseases. The thoracoscopist's opinion regarding the pleural space, computed tomography scan findings indicating malignancy, pain and female gender were determined to be risk factors for malignant pleural diseases. In regions where mesothelioma is prevalent and one of the above-stated risk factors is present, patients whose post-thoracoscopy histopathological diagnosis is fibrinous pleuritis should be treated with a more advanced invasive diagnosis procedure.
    Respiratory medicine 05/2012; 106(8):1177-83. · 2.33 Impact Factor
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    ABSTRACT: This prospective study was conducted to examine the factors that affect swallowing during thyroid fine-needle aspiration biopsy (FNAB). Consecutive patients who were to undergo FNAB were approached for inclusion in the study. The depth and size of the nodule were measured in all patients. In a random fashion, patients were told not to swallow during the procedure, or they were not given any instructions regarding swallowing. Regarding the 143 participants in the study, no significant differences in age (P = .07), diameter and depth of the thyroid nodules (P = .14; P = .46, respectively), or cytologic diagnosis of thyroid aspirates (P > .20) were found between the swallowing (n = 50) and nonswallowing (n = 93) patient groups. Swallowing was observed in 29 patients who were instructed not to swallow (36%) and in 21 patients who were not given any instructions regarding swallowing (34%; P = .95). The mean duration of the procedure for swallowing patients was 19.8 seconds, and it was 15.7 seconds for nonswallowing patients. The duration of the procedure was significantly shorter in patients who did not swallow (P = .001). More male patients swallowed than female patients (P = .003). Giving specific instructions about not swallowing did not make a difference regarding swallowing by patients during the FNAB procedure. More male patients swallowed than female patients. A longer duration of the FNAB procedure meant that the operator was more likely to encounter swallowing (and thus displacement of the thyroid) while doing the procedure. Completing the procedure quickly is the surest method to avoid a moving thyroid while performing FNAB.
    Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 09/2010; 29(9):1291-5. · 1.40 Impact Factor
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    ABSTRACT: In cases of pleural effusion, tissue samples can be obtained through Abrams needle pleural biopsy (ANPB), thoracoscopy, or cutting-needle pleural biopsy under the guidance of CT scan (CT-CNPB) for histopathologic analysis. This study aimed to compare the diagnostic efficiency and reliability of ANPB under CT scan guidance (CT-ANPB) with that of medical thoracoscopy in patients with pleural effusion. Between January 2006 and January 2008, 124 patients with exudative pleural effusion that could not be diagnosed by cytologic analysis were included in the study. All patients were randomized after the CT scan was performed. Patients either underwent CT-ANPB or thoracoscopy. The two groups were compared in terms of diagnostic sensitivity and complications associated with the methods used. Of the 124 patients, malignant mesothelioma was diagnosed in 33, metastatic pleural disease in 47, benign pleural disease in 42, and two were of indeterminate origin. In the CT-ANPB group, the diagnostic sensitivity was 87.5%, as compared with 94.1% in the thoracoscopy group; the difference was not statistically significant (P = .252). No difference was identified between the sensitivities of the two methods based on the cause, the CT scan findings, and the degree of pleural thickening. Complication rates were low and acceptable. We recommend the use of CT-ANPB as the primary method of diagnosis in patients with pleural thickening or lesions observed by CT scan. In patients with only pleural fluid appearance on CT scan and in those who may have benign pleural pathologies other than TB, the primary method of diagnosis should be medical thoracoscopy. Trial registration: clinicaltrials.gov; Identifier: NCT00720954.
    Chest 02/2010; 137(6):1362-8. · 5.85 Impact Factor
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    ABSTRACT: Several studies have already addressed the potential role of an increased fluorine 18 fluorodeoxyglucose (18F FDG) uptake in identification of pleural malignancy. In this pilot study, we investigate the role of 18F-FDG positron emission tomography/computed tomography (PET/CT) for differentiating asbestos-related benign pleural disease from malignant mesothelioma. The study population comprised 31 consecutive patients (17 malignant mesotheliomas, nine benign asbestos pleurisies, and five diffuse pleural fibrosis) with a mean age of 61 years between January 2006 and December 2008. Thoracoscopy or image-guided pleural needle biopsy were systematically performed to reveal pathologic diagnosis and/or clinical follow-up for at least 3 years for presence or absence of malignant pleural effusion. ROCs analyses for standardized uptake value (SUV) adjusted to body weight were calculated between benign and malignant pleural diseases. 18F-FDG PET/CT imaging correctly detected the presence of malignancies in 15 of 17 patients with malignant mesothelioma for sensitivity, specificity, and overall accuracy of 88.2%, 92.9%, and 90.3%, respectively. 18F-FDG PET/CT imaging correctly identified 13 of 14 cases of benign pleural disease. The mean SUV values were 6.5 +/- 3.4 for malignant mesothelioma cases and 0.8 +/- 0.6 for benign pleural diseases (p < 0.001). When we compared the two groups of pleural disease, a cut-off value of 2.2 for SUV gave the best accuracy with 94.1%, 100%, 100%, and 93.3% for sensitivity, specificity, positive predictive value, and negative predictive value, respectively. Preliminary results of this trial provide evidence that 18F-FDG PET/CT imaging is a highly accurate and reliable noninvasive test to decide for further investigation of differentiating malignant mesothelioma from benign pleural disease.
    Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 10/2009; 4(12):1480-4. · 4.55 Impact Factor
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    ABSTRACT: Uterine adenomatoid tumors are usually solitary lesions. Adenomatoid tumors diffusely infiltrating the entire myometrium have rarely been reported in the literature. A feature common to half of the reported cases of diffuse uterine adenomatoid tumor was an immunocompromised status of the patient caused by the medications for renal transplantation. In this article, we describe an unusual case of diffuse uterine adenomatoid tumor in a patient with chronic hepatitis C virus infection. Pelvic examination showed an irregular and enlarged uterus. Supracervical hysterectomy and bilateral salpingo-oophorectomy was performed with a clinical diagnosis of uterine leiomyoma. Pathological examination showed, in addition to multiple leiomyomas, diffuse uterine adenomatoid tumor. We suggested that the diffuse pattern in our patient might be related to immunosuppression secondary to chronic hepatitis C virus infection.
    International Journal of Gynecological Cancer 01/2009; 19(2):242-4. · 1.94 Impact Factor
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    ABSTRACT: To assess the apoptosis rate in eutopic and ectopic endometrial stromal and glandular cells, normal peritoneum and adhesions in women with endometriosis. A total number of 97 women with (n:60) and without (n:37) histopathologically confirmed endometriosis who underwent laparoscopy or laparotomy in the early follicular phase of the menstrual cycles for pain and infertility were included in this study. Stage I/II and stage III/IV were categorized as early staged and late-staged endometriosis. The endometrial samples were obtained with a Novack cannula from the corpus of the uterus. Normal-looking peritoneum, peritoneal implants and adhesions were sampled and fixed in formaldehyde for immunohistochemical staining with Bcl-2 and Bax. Tissue samples were fixed in formaldehyde for the assessment of apoptosis via terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) and M30 cytoDEATH antibody. The intensity of Bax staining of normal-looking peritoneum in early staged endometriosis was higher, compared to women with late-staged and women without endometriosis (P = 0.03). However, degree of Bcl-2 staining did not differ among early and late-staged endometriosis and women without endometriosis (P = 0.1). In terms of Bcl-2 and Bax staining in the stromal and glandular parts of the eutopic endometria, no significant differences were detected among three groups. In cases with early- and late-staged endometriosis the intensity of Bax and Bcl-2 stainings did not differ in both stromal and glandular parts of ectopic endometria. Number of cells with positive apoptotic signals assessed via TUNEL (P = 1.0) and M30 cytoDEATH antibody (P = 0.59) in normal-looking peritoneum did not differ between three groups. In addition, no difference in term of numbers of apoptotic cells obtained from adhesions was observed between three groups (for TUNEL, P = 0.29, for M30, P = 0.19). Apoptosis patterns did not differ in the eutopic and ectopic endometria as well as adhesions of women with or without endometriosis.
    Archives of Gynecology 01/2009; 280(2):195-9. · 0.91 Impact Factor
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    ABSTRACT: The aim of the present study is to investigate the treatment efficiency of intra-rectal (IR) and intra-peritoneal (IP) application of Origanum onites essential oil (OOEO), which is a well-known antioxidant, in the colitis model induced by 2,4,6-trinitrobenzenesulfonic acid (TNBS) and ethanol (E) in comparison with dexamethasone therapy through the morphologic damage score. Monoclonal antibodies against intercellular adhesion molecule-1 (ICAM-1, CD54), anti-rat granulocytes, and myeloperoxidase (MPO), were also investigated immunohistochemically. There was a significant difference in terms of ulceration, mucus cell depletion, inflammatory cell infiltration, vascular dilatation (p<0.001), crypt abscesses (p<0.01), and edema (p<0.05) between OOEO-1mg/kg-IR and control colitis groups. A significant difference was encountered in terms of mucus cell depletion, crypt abscesses, inflammatory cell infiltration, vascular dilatation (p<0.01), and ulceration (p<0.05) between the OOEO-0.1mg/kg-IR and control colitis groups. A significant difference was noticed in terms of ulceration, inflammatory cell infiltration, mucus cell depletion (p<0.001), vascular dilatation (p<0.01), and mucosal atrophy (p<0.05) between the OOEO-1mg/kg-IP and control colitis groups. There was a significant difference in terms of ulceration, mucus cell depletion, inflammatory cell infiltration (p<0.001), crypt abscesses, vascular dilatation (p<0.01), and mucosal atrophy (p<0.05) between the OOEO-0.1mg/kg-IP and control colitis groups. No significant difference was determined in terms of ulceration, inflammatory cyst, mucosal atrophy, edema, and vascular dilatation between the dexamethazone and control colitis groups (p>0.05). Under the present conditions, we concluded that IR and IP OOEO treatment, applied at the dosage of 0.1 or 1mg/kg/day, have a significant protective effect on the colonic injury.
    Experimental and Toxicologic Pathology 05/2008; 59(6):399-408. · 2.62 Impact Factor
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    ABSTRACT: In malignant pleural mesothelioma (MPM) patients, local dissemination (LD) of the tumor is frequently observed at the sites of intervention where diagnosis/treatment are performed. We evaluate the factors affecting LD frequency and discuss the use of PR in MPM patients. Histopathologically diagnosed 212 MPM patients who had not received PR were evaluated in terms of development of LD. Of the 212 patients, 29 received supportive therapy, 157 received chemotherapy and 26 received multi-modal therapy. The LD frequency was 13.2% for all patients. The median survival rate was 9 or 10 months in patients with or without LD, respectively. A higher LD frequency was observed in patients receiving thoracotomy. The LD appearance time in supportive care is short. The LD frequency in patients treated with chemotherapy that revealed progressive disease was higher than the patients who revealed stable disease or objective response. LD developed in 2 months in patients with sarcomatous and mixed cell type, and the survival rate was low. LD was not associated with the stage of the disease. The most suitable candidate groups for PR are patients receiving supportive therapy, thoracotomy without multi-modal therapy or patients with sarcomatous and mixed cell type tumors.
    Lung Cancer 03/2008; 61(2):255-61. · 3.39 Impact Factor
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    ABSTRACT: A 5-year-old boy with acute lymphoblastic leukemia and probable pulmonary aspergillosis developed a hard, protuberant, white-yellow and aggressive elongated lesion on the left side of his tongue during a febrile agranulocytopenic episode. Despite the use of broad-spectrum antibiotics and other supportive therapies, the lesion increased to about 2x4 cm in size within two days and became grey-black with an erythemateous, irregular line. Partial excision of the tongue was performed and isolates recovered from the tongue biopsy specimen were identified as Aspergillus flavus. An increase in the systemic dose (7 mg/kg/day) and local intraoral delivery of liposomal amphotericin B was successful in treating the patient and resulted in improved clinical and laboratory findings. Herein, we document the observation of tongue aspergillosis in a leukemic child with probable pulmonary aspergillosis receiving liposomal amphotericin B therapy and the successful treatment of tongue aspergillosis with an increased dose (7mg/kg) of liposomal amphotericin B. To the best of our knowledge, this is the youngest patient with documented intraoral aspergillosis and only the second case of tongue aspergillosis caused by Aspergillus flavus.
    Medical Mycology 01/2007; 44(8):767-70. · 1.98 Impact Factor
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    ABSTRACT: The "nested" variant is a rare form of urothelial carcinoma and its biologic behavior is highly aggressive. Herein two new cases of nested variant of urothelial carcinoma with immunohistochemical examination are presented. In one of the cases, the tumor extended through the bladder wall into the perivesicular soft tissue, prostatic urethra and left vesicula seminalis, and metastasized to obturator lymph nodes. In the other case, invasion of muscular layer was observed and three recurrences were developed during a follow-up period of 23 months. Both tumors of our study demonstrated high p53 and Ki-67 indices, supporting the aggressive nature of such tumors.
    Pathology & Oncology Research 02/2006; 12(2):105-7. · 1.56 Impact Factor
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    ABSTRACT: Actin bundling protein fascin has been previously associated with tumor progression in human cancers. We evaluated whether fascin also plays a role in endometrioid carcinomas. Cases of 28 proliferative and hyperplastic endometrium and 43 endometrioid carcinomas were examined by immunohistochemistry using antihuman fascin antibody. Weak fascin expression in glandular epithelium was observed in 39% of non-neoplastic samples and various degrees of fascin expression were observed in 74% of neoplastic samples. The number of positively stained samples and intensity of epithelial staining were significantly higher in endometrioid carcinoma compared to the non-neoplastic group (p < 0.001). The number of positively stained samples and total fascin scores of stroma were significantly higher in proliferative and hyperplastic endometrium biopsies compared to the endometrioid carcinoma (p < 0.001). Higher grade endometrioid carcinoma cases had significantly increased total epithelial fascin scores (.042, p < 0.05). There was also a significant difference between tumor grade and patient survival (.040, p < 0.05). There was a significant correlation between microvessel count and disease-free survival (r = .412, p = .006). In the proliferative and hyperplastic endometrial biopsies microvessels stained homogeneously in all cases (28/28), but in the endometrioid carcinoma group eight out of 43 cases showed heterogeneous fascin staining of microvessels. The difference was significant (.019, p < 0.05). Our study supported the dynamic role of actin bundling protein fascin in generating and maintaining endometrial neoplasms. It also showed that in the development of neoplasia, stromal fascin expression decreases but epithelial fascin expression up-regulates.
    European journal of gynaecological oncology 01/2006; 27(5):481-6. · 0.58 Impact Factor
  • Lung Cancer. 01/2006; 54.
  • Journal of the American Geriatrics Society 03/2005; 53(2):352-4. · 3.98 Impact Factor
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    ABSTRACT: Inflammatory bowel disease (IBD) has been associated with an increased generation of nitric oxide (NO). Different authors have shown that NO in IBD can be either harmful or protective. The aim of this study was to investigate the efficiency of intrarectal (i.r.) and intraperitoneal (i.p.) application of N(G)-nitro-L-arginine methyl ester (L-NAME), a non-specific nitric oxide synthase inhibitor, in experimental acute colitis in the rats. Acute colitis was induced in rats by 2,4,6-trinitrobenzenesulfonic acid (TNBS) and ethanol. Twenty-eight rats were divided into four groups. L-NAME (50 mg/kg/day) was administered i.p. (Group 1) and i.r. (Group 2) for 7 days following the day when colitis was induced. Group 3 rats were not given any treatment after induction of colitis. Control group rats were given saline solution i.r. instead of TNBS. The presence of hyperemia, inflammation and ulcer was evaluated to score of macroscopic morphologic damage. The severity of colitis was assessed by microscopic criteria including ulceration, mucus cell depletion, crypt abscesses, inflammatory cysts, mucosal atrophy, edema, inflammatory cell infiltration, and vascular dilatation. Rectal tissue myeloperoxidase (MPO) activity and serum-rectal tissue nitrite levels were measured. Serum and rectal tissue nitrite levels increased in Group 3 rats. Both i.p. and i.r. L-NAME treatment significantly reduced serum and rectal tissue nitrite levels, but no effect on MPO activity and histologic damage score was observed. Under the present conditions we concluded i.r. and i.p. L-NAME treatment, applied at the dosage of 50 mg/kg/day, does not have any protective effect on the colonic injury.
    Experimental and Toxicologic Pathology 12/2003; 55(4):271-6. · 2.62 Impact Factor
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    ABSTRACT: The aim of the present study is to evaluate the effects of sodium phosphate (NaP) and polyethylene glycol-electrolyte (PEG-EL) colon cleansing solutions on histopathology of 2,4,6-trinitrobenzene sulfonic acid (TNBS) and ethanol (E)-induced colitis in the rat and normal rat colon. The presence of hyperemia, inflammation and ulcer was evaluated to score of macroscopic morphologic damage. The microscopic criteria including ulceration, mucus cell depletion, crypt abscesses, inflammatory cysts, mucosal atrophy, edema, inflammatory cell infiltration, and vascular dilatation were evaluated to determine the extent of inflammatory reaction. Colitis findings were determined on the rats which were administered TNBS-E. Aphthoid lesions were seen 30% and 20 % of rats, respectively, by NaP and PEG-EL solutions in healthy group. Microscopic examination of aphthoid lesions revealed edema within the lamina propria and lymphoid hyperplasia in the mucosa and submucosa without erosion, ulceration and inflammatory cell infiltration. No significant difference was statistically found either macroscopically or microscopically in terms of the effects of saline, NaP and PEG-EL solutions in healthy rats and rats with colitis (p > .05). Under the present conditions, we concluded administration of NaP and PEG-EL solutions did not cause evident morphological changes on the rectal mucosa macroscopically and microscopically, although in a proportion of rats aphthoid lesions seem as a marker of mucosal damage macroscopically.
    Experimental and Toxicologic Pathology 10/2003; 55(2-3):213-20. · 2.62 Impact Factor
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    ABSTRACT: Local cellular immune response and traditional histopathologic parameters in endometrial carcinoma patients 50 years old and younger were compared with those of patients older than 50 years of age. We retrospectively compared the clinicopathologic factors and outcomes of 24 younger and 82 older women who were operated on for endometrioid type endometrial carcinoma at our institution. No significant difference was determined in survival with respect to age and menopausal status in patients with endometrial carcinoma. Younger and older age groups had a similar distribution of most pathologic features including myometrial invasion, cervical involvement, lymph node metastasis, vascular invasion, perivascular lymphocytic infiltrates and tumor infiltrating lymphocytes. While older women had higher-grade tumors, younger women had more frequent ovarian metastasis. Tumor infilrating lymphocytes were seen more frequently in the postmenopausal group than those of the premenopausal group. The distribution of local cellular immune response, most histopathologic parameters and survival were the same for younger and older women.
    European journal of gynaecological oncology 02/2002; 23(3):243-6. · 0.58 Impact Factor
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    ABSTRACT: The aim of this study was to describe a child with a right cerebellar hemisphere metastasis from primary clear cell sarcoma of the kidney without evidence of bone metastases, and to investigate the immunohistochemical features of primary and metastatic tumors. A 12-month old boy was admitted our hospital due to an abdominal mass. Abdominal computed tomography revealed a large right renal tumor. Tumor was removed with nephrectomy. Histopathologic examination of tumor revealed clear cell sarcoma of the kidney. The patient received radiotherapy and chemotherapy in postoperative period. He suffered from gait disturbance and confusion 8 months later. A computed tomography scan revealed a tumor that was enhanced with contrast medium at right cerebellar hemisphere concomitant with ventricular enlargement. After ventriculo-peritoneal shunting procedure, tumor was excised totally and histopathologic diagnosis showed metastasis of clear cell sarcoma of the kidney. Immunohistochemically vimentin, actin, desmin, neuron specific enolase, cytokeratin, P 53, Ki-67 and P-170 were performed using formalin fixed, paraffin embedded sections. Both of the tumors were positive for vimentin and negative for desmin, actin, neuron specific enolase, cytokeratin and P 53. Scattered nuclei were stained by Ki-67 in primary and metastatic cerebellar tumor. Both primary and metastatic tumors were negative for p53 and P-170. The treatment consisted of surgery, radiotherapy and chemotherapy. The patient is alive and well without evidence of recurrence 16 months after second surgery. Clear cell sarcoma of the kidney is most commonly associated with bone metastasis. Cerebellar metastasis of clear cell sarcoma of the kidney is very unusual. To the best of our knowledge, this patient is second case in the English literature. With review of the literature, our immunohistochemical findings support the theory that relapse and metastasis of primary clear cell sarcoma of the kidney are not related with increase of aggressiveness.
    Journal of neurosurgical sciences 01/2002; 45(4):228-31; discussion 231. · 0.53 Impact Factor
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    ABSTRACT: To determine the correlation between bcl-2 expression and clinicopathological findings in cervical intraepithelial neoplasias (CIN I, II, III) and invasive cervical lesions, and its effect on overall survival rate. Fifty specimens derived from 22 preinvasive and invasive cervical cancer cases up to surgical stage IIb (21 squamous cervical carcinoma and 7 adenocarcinoma cases) were preserved in paraffin blocks from primary surgery and constituted the study group. Tissues were processed and stained by immunohistochemical methods to assess the degree of bcl-2 expression. Positive bcl-2 expression was detected in 54% (13/21) of invasive lesions, while negative in 46% of cases. In CIN's, overall bcl-2 positivity was detected in 68% of cases. Bcl-2 expression was highly relevant between low grade (CIN I) and high grade (CIN II-III) lesions (p < 0.05). As regards degree of tissue staining for bcl-2 in CIN III cases, a statistically relevant difference was detected in comparison with low-grade preinvasive lesions (p < 0.05). In invasive cervical cancer cases, patients with bcl-2 positivity had a longer survival rate. By using the Cox regression model, univariate analysis did not show any specific prognostic factor to be important for survival rate, whereas, on multivariate analysis, histopathologic subtypes (p = 0.0390) and stage of tumor (p = 0.0451) had a statistically significant impact on overall survival rate. Bcl-2 expression, especially in preinvasive lesions, may play a role in the apoptotic process and be regarded as a marker for disease progression. In invasive cervical carcinomas, bcl-2 expression has not been shown to be effective in overall survival rates.
    European journal of gynaecological oncology 01/2002; 23(5):419-22. · 0.58 Impact Factor