[Show abstract][Hide abstract] ABSTRACT: Background/aim:
The murine sarcoma viral (V-Raf) oncogene homolog B (BRAF) V600E mutation, which increases protein kinase activity in BRAF-mitogen-activated protein kinase kinase (MEK) - extracellular signal-regulated kinases (ERK) (mitogen-activated protein kinase (MAPK)) signaling, is found in 5-40% of all colorectal carcinoma cases. Proteins with this mutation are reported to be 130-fold more active, which results in induced proliferation, differentiation, cellular survival, and angiogenesis. The aim of the present study was to investigate tumor tissues, together with the surrounding non-tumoral tissues, for BRAF mutation presence, which may be an indicator for possible recurrence or prognosis as in the 'field carcinogenesis' model.
Materials and methods:
The BRAF V600E genotype of 152 colorectal adenocarcinoma paraffin-embedded specimens were determined by mutant-allele-specific amplification-polymerase chain reaction.
According to our results, the presence of BRAF mutation increases risk of lymph node invasion by 1.55-fold [χ(2)=3.83, p=0.05, odds ratio (OR)=1.55, 95% confidence interval (CI)=1.00-2.42], histologically medium or high-grade tumor by 1.60-fold (χ(2)=4.34, p=0.030, OR=1.60, 95% CI=1.03-2.48), vascular invasion by 1.55-fold (χ(2)=3.55, p=0.05, OR=1.55, 95% CI=0.99-2.42), perineural invasion by 1.50-fold (χ(2)=3.16, p=0.07, OR=1.5, 95% CI=0.96-2.33) and the combination of these poor prognostic features by 1.54-fold (χ(2)=2.47, p=0.11, OR=1.54, 95% CI=0.93-2.53). We also found that females are more prone to having the mutation and that being female increases the risk of having this mutation by 1.54-fold (χ(2)=3.58, p=0.05, OR=1.54, 95% CI=0.97-2.44).
BRAF V600E mutation in non-tumoral surrounding tissue in patients with colorectal cancer may be used as a valuable marker to foresee clinical outcome or a possible recurrence. To our knowledge, this was the first study to take into consideration the non-tumoral surrounding tissues in addition to the tumor tissue.
Full-text · Article · Sep 2015 · In vivo (Athens, Greece)
[Show abstract][Hide abstract] ABSTRACT: Mucoceles are mucus-filled, epithelial-lined sacs that slowly develop in the paranasal sinuses when sinus or concha bullosa drainage is obstructed by inflammatory processes, trauma, or prior surgery. They are extremely rare in children. Symptoms usually arise from the nasal obstruction or compression of neighboring structures.
This case report describes a 5-year-old Turkish boy with a 3-year history of nasal obstruction. A computed tomography scan showed a well-defined soft tissue density lesion, seemingly originating in the region of the middle concha and was suggestive of a middle concha mucocele. The mass was removed by endoscopic sinus surgery.
In the case of a child presenting with nasal obstruction, mucocele should be remembered in the differential diagnosis of intranasal tumors. Computed tomography and magnetic resonance imaging are helpful in making the diagnosis and endoscopic nasal surgery has proven successful in the treatment.
Full-text · Article · Oct 2013 · Journal of Medical Case Reports
[Show abstract][Hide abstract] ABSTRACT: Objective:
Cervical carcinoma has been included in the preventable diseases category ever since the use of cervical cytology in routine practice. The Pap test is an efficient screening test. We aimed to compare the cervical cytology diagnosis with biopsy and smear follow up results in our institution.
Material and method:
We aimed to compare the diagnosis of cytology material examined in our institution during the 2009-2012 period with their biopsy and smear follow ups. The diagnoses were compared with the follow up smears and/or cervical biopsies.
13610 Pap tests were examined during September 2009-July 2012. Among these cases, there were 370 atypical squamous cells of undetermined significance (ASCUS), 29 atypical squamous cells-high grade intraepithelial lesions cannot be excluded (ASC-H), 155 low grade squamous intraepithelial lesion (LSIL), 33 high grade squamous intraepithelial lesion (HSIL), and 5 atypical glandular cell (AGC) diagnoses. The ratio of atypical squamous cell (ASCUS and ASC-H) to squamous intraepithelial lesions was 2.12. Squamous intraepithelial lesion was verified in 47 of 91 ASCUS cases. Among patients who had a cervical biopsy, 52 of 64 LSIL cases and all of the 21 HSIL cases had biopsy-proven SIL.
Atypical squamous cell (ASC) is the most common diagnosis in abnormal cervical cytology. As it is indefinite, ASC is used as a quality assurance parameter and the aim is to decrease its use. As the ratio of epithelial cell abnormality is variable in different populations, the ASC/SIL is a more definite variable to be used for quality assurance. The efficiency in clinical use of the cervical cytology screening test is determined by biopsy verification. Our epithelial cell abnormality, ASC/SIL ratio and cytology-histology correlation values were parallel to the literature, proving that the methods are used reliably at our institution.
No preview · Article · Sep 2013 · Turk Patoloji Dergisi
[Show abstract][Hide abstract] ABSTRACT: This study aimed to evaluate the rate of endocervical glandular involvement, positive surgical margins, multicentricity, and disease extent between low-grade and high-grade cervical intraepithelial lesions after loop electrosurgical excision procedure (LEEP). Pathology medical records of patients who underwent LEEP were reviewed retrospectively. Patients with negative LEEP results were excluded. Loop electrosurgical excision procedure reports of patients with cervical intraepithelial neoplasia (CIN) 1, 2, and 3 were compared. There was no statistically significant difference between patients with CIN 1 (n = 24), CIN 2 (n = 27), and CIN 3 (n = 64) when age and surgical margin positivity were considered. Endocervical glandular involvement, multicentricity, and disease extent were higher in patients with CIN 3 (P = .001, P = .002, and P = .001, respectively). In conclusion, we recommend that patients with endocervical glandular involvement, lesions involving more than two-thirds of the LEEP specimen, and multicentricity be followed up more closely.
No preview · Article · May 2013 · Annals of diagnostic pathology
[Show abstract][Hide abstract] ABSTRACT: Malignant primary peritoneal mesothelioma is a rare and highly aggressive tumor. This tumor can be misdiagnosed as ovarian carcinoma.
Two cases of malignant primary peritoneal mesothelioma that were misdiagnosed as ovarian carcinoma were operated in our instutition. Patients were 74 and 45 years-old at admittance.
Malignant primary peritoneal mesothelioma is being a problem for gynecologic oncologists because of the close similarity with epithelial ovarian cancer. Diagnosis and treatment of these patients are still under debate.
No preview · Article · Nov 2012 · European journal of gynaecological oncology
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to determine the role of Papanicolaou (pap) smears in the diagnosis of lower genital tract infections.
A retrospective study was planned by reviewing charts of patients for trichomonas vaginalis, bacterial vaginosis, actinomyces, candida and nonspecific vaginitis.
Charts of 9,080 patients were reviewed and 1,733 women had a diagnosis of lower genital tract infection in the pap smear or had had a clinically treated lower genital tract infection. Only 33.5%, 30.4%, 43.3%, and 0% of patients with bacterial vaginosis, trichomonas vaginalis, candida and actinomyces, respectively on pap smear were diagnosed and treated clinically. Postmenopausal patients had a higher rate of trichomonas vaginalis infection and a lower rate of candida infection when compared to women of the reproductive age group. Patients using an intrauterine device for contraception had a statistically significantly increased rate of trichomonas vaginalis and candida infection when compared to women using other contraceptive methods or those who were not using any contraception.
Finding trichomonas vaginalis, bacterial vaginosis and actinomyces infections in pap smears might be considered an indication for treatment without performing other diagnostic tests. Treatment of asymptomatic infections can prevent complications in selected patients. Candida can be a commensal bacteria in the vagina, therefore asymptomatic patients may not require treatment. Detection of a higher rate of trichomonas vaginalis and candida infection in IUD users shows that IUDs can increase the risk of vaginal infections and associated complications.
No preview · Article · Nov 2012 · Clinical and experimental obstetrics & gynecology
[Show abstract][Hide abstract] ABSTRACT: Objective:
The description of Barrett's esophagus which is a risk factor for esophageal adenocarcinoma has differences, and the need of goblet cells for diagnosis is controversial. However, the pathophysiology in the metaplasia seen in Barrett's esophagus is not totally understood and new methods are searched for the assessment of progression to dysplasia. We aimed to search the immunohistochemical expression of CDX2, COX2 and MUC2 in Barrett's esophagus to detect any early evidence of intestinal metaplasia or dysplasia.
Material and method:
The staining properties were examined in the intestinal metaplastic (goblet cell-containing columnar epithelium), columnar (non-goblet columnar epithelium), distant columnar (non-goblet columnar epithelium distant from intestinal metaplastic epithelium) and squamous epithelium in 59 pathologically diagnosed Barrett's esophagus, 22 of which having dysplasia. The results were compared statistically with Pearson and Fisher exact tests.
The distribution of the staining of intestinal metaplastic, non-goblet columnar distant columnar, and squamous epithelium, respectively were as follows: for CDX2 76.3%, 23.7%, 1.7%, 0%; for COX-2 93.2%, 47.5%, 8%, 62.9%; for MUC2 93.2%, 11.9%, 4% and 0%. The expression of CDX2, COX2 and MUC2 in the intestinal metaplastic epithelium was higher than the expression in distant and non-goblet columnar epithelium. The expression of CDX2, COX2 and MUC2 in the foci of dysplasia decreased significantly (18.2%, 27.3%, 31.9%, and p=0.039, 0.0001, 0.0001, respectively). COX2 expression in squamous epithelium was also lower when the adjacent mucosa has dysplasia (p=0.014).
The CDX2, COX2 and MUC2 expressions were seen in the intestinal epithelium having goblet cells. The use of the markers in the diagnosis is controversial but the difference in the Barrett esophagus-dysplasia sequence seems to be meaningful.
No preview · Article · Sep 2012 · Turk Patoloji Dergisi
[Show abstract][Hide abstract] ABSTRACT: The incidence of tuberculosis (TB) has increased worldwide in the past decade and it still remains an important global public health problem.
A retrospective clinicopathological study of 1,548 cases of female genital tuberculosis between 1940 and 2011 was conducted.
The mean age of the cases was 29.49 years. Involvement of the endometrium was noted in 1,073, fallopian tubes in 164, cervix in 157, and 154 had multiple organ involvement. Clinically, 115 cases (7.4%) were diagnosed as having primary infertility and 12 cases (0.8%) as having secondary infertility. There was a coexistent carcinoma in 1.5% of the cases. Peritoneal tuberculosis in 21 cases and tuberculous lymphadenitis in 7 cases were seen as well.
The clinicopathological criteria of female genital tuberculosis in the different organs are described, and special attention is paid to infertility associated with tuberculous lesion, and awareness of the fact that the disease is still with us is thus particularly important.
No preview · Article · Mar 2012 · Archives of Gynecology
[Show abstract][Hide abstract] ABSTRACT: Purpose: The endometrial and ovarian malignancy suspicion of intra-operative Frozen Section pathology results of paraffin block wheal formation in the results compared and shown the importance of intraoperative FS. Material-Method: 52 patients were taken in this study who were operated with suspicion of ovarian and endometrial malignancy. Intraoperative FS results were determined and compared to final pathologic diagnosis. Findings: 16 patients had uterine lesion, 36 patients were available adneksial-pelvic lesion. According to the results of the FS; 21 patient were undertaken TAH BSO, 13 ovarian cystectomy, 10 TAH BSO +PPLND+ Omentectomy + Appendectomy. According to the results of the FS, uterin lesions (n = 16,% 30.8); leiomyoma (n = 10,% 19.2), normal endometrium (n = 2,% 3.8) and endometrium adenocarcinoma (n = 1, 2%), endometrial polyp (n = 1,2%), vaginal kafda fibrous tissue (n = 1, 2%), complex atipili hyperplasia (n = 1, 2%) were detected. FS is the most frequently detected ovarian lesions in serous cystadenom (n = 7,% 13.5) and the endometrioma (n = 7,% 13.5) have been identified. The result of evaluation of the results of all FS, 8 cases of malignancy from benign cases 44 detected.
No preview · Article · Jan 2012 · Turk Jinekolojik Onkoloji Dergisi
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: Xanthogranulomatous tissue reaction is a well-documented process that is most common in kidney. There are other uncommon sites being documented as case reports in the literature. We would like to describe the clinicopathologic findings in a case of xanthogranulomatous sialadenitis that involved the parotid gland, which was clinically thought to be a tumoral mass, and compare it with the 4 previously reported cases. CASE REPORT: A 52-year-old man presented with a left parotid mass. Fine needle aspiration biopsy was consistent with Warthin's tumor. The mass lesion was excised. DISCUSSION: The lesion measured 2.5 × 1.5 × 1.5 cm. Microscopic examination revealed sheets of foamy macrophages centrally admixed with neutrophils, eosinophils, lymphocytes, plasma cells and scattered giant cells indicating a xanthogranulomatous reaction. As a conclusion xanthogranulomatous tissue reaction can mimic neoplasms.
No preview · Article · Nov 2011 · Oral and Maxillofacial Surgery
[Show abstract][Hide abstract] ABSTRACT: Although the clinical and histopathological findings of hepatocellular carcinoma are well described, there are few national studies. In this study, we aimed to investigate the relationship between these findings in total or partial hepatectomy specimens in our series.
We first collected 190 cases of total or partial hepatectomies performed because of hepatocellular carcinoma, cirrhosis or other disorders from the archives of Pathology. After re-examining the histopathological and clinical features such as age, gender and etiology, the relationship between them and serology results were statistically analyzed using the chi square and Multiple Comparison Tests.
Among 190 cases, there were 168 (88.5%) total and 18 (9.5%) partial hepatectomies and 4 (2%) tumorectomy or metastasectomy cases. After gross and microscopic examination, 170 (89.5%) cases had a diagnosis of cirrhosis, 85 (44.7%) hepatocellular carcinoma, 3 parasitic cyst, 7 metastasis, 1 hepatoblastoma, 1 hepatocellular adenoma, 2 cholangiocarcinoma, 2 Budd Chiari Syndrome, 1 focal nodular hyperplasia, 1 cavernous hemangioma, and 2 acute fulminant hepatitis. Among the hepatocellular carcinoma cases, 53 had Hepatitis B virus, 15 Hepatitis C virus , 3 Hepatitis B virus and Hepatitis C virus, and 3 Hepatitis B virus and Hepatitis delta virus etiology, while 6 were alcoholic and 4 were due to other causes. Among cirrhosis patients, 84 (49.4%) had hepatocellular carcinoma. The male to female ratio of hepatocellular carcinoma cases was 74/11. The mean age was 55 and the median age 56.7.
The results of this study demonstrated that the most common hepatic disorder was cirrhosis due to Hepatitis B virus in the hepatectomy specimens of our series that mostly consisted of total hepatectomies performed for transplantation where 50% had hepatocellular carcinoma.
Full-text · Article · Jan 2011 · Turk Patoloji Dergisi
[Show abstract][Hide abstract] ABSTRACT: Ectopic pancreas is a commonly seen congenital anomaly in gastrointestinal system, but jejunal pancreatic heterotopia is seen rarely. Although every pathological change that occurs in the pancreas can be seen in its heterotopic counterpart, neoplasia is an unusual complication. Intraductal papillary mucinous neoplasms (IPMNs) are tumors originate from ductal epithelial cells of the pancreas that constitute the main pancreatic duct or its major side branches and have a low incidence. Only two cases regarding the IPMN in heterotopic pancreas have been reported previously, but none of them were located in the jejunum. An IPMN in an ectopic pancreas tissue located in the jejunum in a 62-year-old male patient who presented with ileus is presented. It is important to recognize a tumor arising in heterotopic pancreas in order to prevent its misinterpretation as metastatic tumor or direct invasion of another tumor. To the best of our knowledge, this is the first reported IPMN case occurring in ectopic pancreas tissue located in the jejunum.
Preview · Article · Jan 2011 · Turkiye Klinikleri Journal of Medical Sciences
[Show abstract][Hide abstract] ABSTRACT: Müllerian adenosarcoma (MS) is a rare neoplasm of uterine cervix composed of benign epithelial and malignant stromal components. An aggressive variant of adenosarcoma, müllerian adenosarcoma with sarcomatous overgrowth (MASO) is extremely rare. The difference between MS and MASO is the pure high grade sarcoma features in MASO. In this report we present a MASO case, derived from uterine cervix of a 60 year-old-female patient presenting as a cervical polypoid mass, to our knowledge the second case of the English literature. In spite of sarcomatous overgrowth, high mitotic activity and huge tumor size of 12,5 cms, it displayed no myometrial invasion, vascular invasion and heterologous elements. The patient has been clinically free of disease for 14 months of follow up after total abdominal hysterectomy and bilateral salpingo-oopherectomy. The difficulties in diagnosis and treatment of this entity will be evaluated in this report.
Full-text · Article · Jul 2009 · Upsala Journal of Medical Sciences
[Show abstract][Hide abstract] ABSTRACT: Carcinomas of the biliary tree are rare tumors of the gastrointestinal tract, with an increasing incidence in recent years. Biliary neoplasms are classified into intra- and extrahepatic cholangiocarcinoma (Klatskin tumor, middle and distal extrahepatic tumors), gallbladder adenocarcinoma, and ampullary carcinoma. We aimed to determine the expression profile of matrix metalloproteinase (MMP)-2, MMP-9 and MMP-14 in the biliary neoplasms classified according to their localization and the relation with the prognosis.
Ten gallbladder adenocarcinoma, 8 distal bile duct carcinomas (distal cholangiocarcinoma), 8 Klatskin tumors, 8 intrahepatic cholangiocarcinomas and 10 ampullary carcinomas were included in the study. The immunohistochemical expression of MMP-2, MMP-9 and MMP-14 was detected in the nontumoral, metaplastic, dysplastic and tumoral epithelia. The tumor differentiation, angiolymphatic and perineural invasion of the tumor, and presence of lymph node and distant metastasis were determined. Survey of the patients was noted from the patient follow-up data.
The nontumoral epithelia of the gallbladder, intrahepatic ducts, and Klatskin tumor did not express MMP-2. MMP-2 expression was detected in the distal part of the biliary ducts, in 75% (6/18) of cases and in the nontumoral epithelia of the ampullary region in 50% (5/10) of cases. The metaplastic and dysplastic epithelia were positively stained in all of the gallbladder adenocarcinoma, distal cholangiocarcinoma and ampullary tumors. In the intrahepatic cholangiocarcinoma, the hepatocytes were positively stained but the infiltrative tumors were spared. Klatskin tumors were also not stained with MMP-2. The gallbladder adenocarcinoma, distal cholangiocarcinoma and ampullary carcinomas expressed MMP-2 in 30%, 37% and 40% of the cases, respectively. MMP-9 and MMP-14 were expressed in normal, metaplastic, and dysplastic epithelium and tumoral cells in all of the cases of the groups. Expressions of MMPs were higher in subjects with neural invasion, but there was no correlation between MMP expression and tumor differentiation or angiolymphatic invasion.
When tumors of the biliary system are divided as intrahepatic and extrahepatic cholangiocarcinomas, MMP-2 expression was present in the extrahepatic cholangiocarcinomas including gallbladder carcinomas. Like the intrahepatic cholangiocarcinoma, Klatskin tumors also did not express MMP-2. This can be related with its characteristic growth pattern. MMP-9 and MMP- 14 were present in metaplasia, dysplasia carcinoma sequence in all of the bile tract tumors, suggesting that MMPs play an important role in carcinogenesis. The higher expression of the MMPs with neural invasion suggests the significant role of those tumors in the invasion activity.
No preview · Article · Apr 2009 · The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology
[Show abstract][Hide abstract] ABSTRACT: Castleman hastalığı, lenfoid dokunun benign proliferasyonu ile karakterize, nadir görülen bir hastalıktır. Genellikle genç erişkinlerde görülür ve asemptomatik seyreder. Hastalığın en yaygın yerleşimi mediasten olsa da retroperiton, boyun, aksilla ve batında da görülebilir. Retroperiton yerleşimli kitlelerin çoğu maligndir. Klinik ve radyolojik olarak Castleman hastalığının malign tümörlerden ayırıcı tanısının zor olması nedeniyle retroperitoneal kitlesi olan olgularda akla gelmelidir. Stromadan zengin varyant, Castleman hastalığının yeni tanımlanan bir alt grubu olup zaman zaman morfoimmunofenotipik özellikleri iğsi hücreli tümörlerden ayırıcı tanısının yapılmasını gerektirmektedir. 45 yaşında retroperitoneal yerleşimli stromadan zengin varyant hyalen vasküler tip Castleman hastalığı olgusu, bu lokalizasyonda az görülmesi ve malign hastalıklarla karışması nedeniyle sunulmuştur. Anahtar Kelimeler: Castleman Hastalığı, Stromadan Zengin Hyalen Vasküler Tip, Retroperitoneal Tümör Stroma-Rich Variant of Castleman Disease Mimicking Retroperitoneal Malign Tumor: Case Report Castleman's Disease is a rare entity which is characterized by the benign proliferation of lymphoid tissue. Generally it is asymptomatic and seen in young adults. Mostly it is located in mediastinum but it can also be seen at neck, axillary, intraabdominal and retroperitoneal locations. Most of the retroperitoneal masses are malignant. Because of difficulty in differentiate benign Castleman's Disease from malign tumors clinically and radiologically, Castleman's Disease should be remembered in differential diagnosis of retroperitoneal masses. The stroma rich variant is a new subtype of Castleman's disease and its morphoimmunophenotypical characteristics make it necessary to be differentiated from spindle cell tumors. A 45 years old woman with stromal rich variant hyaline vascular type of Castleman's Disease with retroperitoneal location is reported due to its rare presence in this localization and possibility of interference with malignant disease.
[Show abstract][Hide abstract] ABSTRACT: Müllerian adenosarcoma (MS) is a rare neoplasm of uterine cervix composed of benign epithelial and malignant stromal components. An aggressive variant of adenosarcoma, müllerian adenosarcoma with sarcomatous overgrowth (MASO) is extremely rare. The difference between MS and MASO is the pure high grade sarcoma features in MASO. In this report we present a MASO case, derived from uterine cervix of a 60 year-old-female patient presenting as a cervical polypoid mass, to our knowledge the second case of the English literature. In spite of sarcomatous overgrowth, high mitotic activity and huge tumor size of 12,5 cms, it displayed no myometrial invasion, vascular invasion and heterologous elements. The patient has been clinically free of disease for 14 months of follow up after total abdominal hysterectomy and bilateralsalpingo-oopherectomy. The difficulties in diagnosis and treatment of this entity will be evaluated in this report.
No preview · Article · Feb 2007 · Upsala journal of medical sciences