Search

(1) Background: The introduction of novel therapies has led to a considerable evolution in the management of Multiple Myeloma, and chromosomal abnormalities predict the success of treatment. We aimed to characterize cytogenetic abnormalities for risk stratification in the patient population and to evaluate the predictive and prognostic value of the specified abnormalities in distinct treatment modalities. (2) Methods: This study included patients with Multiple Myeloma who applied to the Internal Medicine Clinic of the Cukurova University Faculty of Medicine. Between 2010 and 2023, 98 cases with cytogenetic abnormality data were identified. We analysed the effects of cytogenetic abnormalities on survival and response rates to first chemotherapies. (3) Results: P53 del was the most prevalent abnormality, and t(11;14) was the most common translocation. There was no significant difference in the mean survival and treatment response rates for specific cytogenetic abnormalities. When chemotherapies based on lenalidomide were initiated, patients' life-death statuses differed significantly from those of treatments without lenalidomide. Regardless of the type of chromosomal aberration, lenalidomide-based treatments independently enhanced average survival 14-fold, while there was no significant difference in overall survival among treatments. (4) Conclusions: In individuals with cytogenetic abnormalities, lenalidomide-based treatments should be started regardless of the chemotherapy to be used for the condition. [ABSTRACT FROM AUTHOR]

Macroautophagy/autophagy is an evolutionarily conserved cellular stress response mechanism. Autophagy induction in the tumor microenvironment (stroma) has been shown to support tumor metabolism. However, cancer cell-derived secreted factors that initiate communication with surrounding cells and stimulate autophagy in the tumor microenvironment are not fully documented. We identified CTF1/CT-1 (cardiotrophin 1) as an activator of autophagy in fibroblasts and breast cancer-derived carcinoma-associated fibroblasts (CAFs). We showed that CTF1 stimulated phosphorylation and nuclear translocation of STAT3, initiating transcriptional activation of key autophagy proteins. Additionally, following CTF1 treatment, AMPK and ULK1 activation was observed. We provided evidence that autophagy was important for CTF1-dependent ACTA2/α-SMA accumulation, stress fiber formation and fibroblast activation. Moreover, promotion of breast cancer cell migration and invasion by activated fibroblasts depended on CTF1 and autophagy. Analysis of the expression levels of CTF1 in patient-derived breast cancer samples led us to establish a correlation between CTF1 expression and autophagy in the tumor stroma. In line with our in vitro data on cancer migration and invasion, higher levels of CTF1 expression in breast tumors was significantly associated with lymph node metastasis in patients. Therefore, CTF1 is an important mediator of tumor-stroma interactions, fibroblast activation and cancer metastasis, and autophagy plays a key role in all these cancer-related events. Abbreviations: ACTA2/α-SMA: actin, alpha 2, smooth muscle CAFs: cancer- or carcinoma-associated fibroblasts CNT Ab.: control antibody CNTF: ciliary neurotrophic factor CTF1: cardiotrophin 1 CTF1 Neut. Ab.: CTF1-specific neutralizing antibody GFP-LC3 MEF: GFP-fused to MAP1LC3 protein transgenic MEF LIF: leukemia inhibitory factor IL6: interleukin 6 MEFs: mouse embryonic fibroblasts MEF-WT: wild-type MEFs OSM: oncostatin M TGFB/TGFβ: transforming growth factor beta [ABSTRACT FROM AUTHOR]

Background: Periductal mastitis (PM) is a rare disease characterized by chronic inflammation of the terminal mammary ducts. Complete removal of terminal lactiferous ducts with Hadfield procedure is a previously defined technique in treatment but carries various complications risks. This study aims to evaluate the effectiveness of modified techniques in the treatment of PM. Methods: Twenty women who underwent surgery due to PM between January 2012 and December 2019 were retrospectively analyzed. Types of PM were determined. All patients were operated on with three different incisions [Hadfield's operation with periareolar incision (n:11), periareolar combined radial incision (n:7), and round block incision (n:2)]. Results: The mean age was 37.5 ± 6.5 years (range: 24–49). Sixty percent of patients had type 3 PM. In Hadfield's procedure, NAC retraction (n:2), seroma (n:1), and hematoma (n:1) were seen. In the periareolar incision combined radial incision group only one patient had complications (seroma) and none in the round block method. Follow-up was 12 ± 1.5 months and disease relapse occurred in two patients in the Hadfield group. Patients who underwent round block were more satisfied with the appearance of the nipple. Conclusions: In the treatment of PM, the main principle of surgical treatment is the excision of the affected canal with a clear margin. Apart from the classical Hadfield procedure, the round block method and periareolar combined radial incision techniques can be performed in the treatment of PM. [ABSTRACT FROM AUTHOR]

Background: Periductal mastitis (PM) is a rare disease characterized by chronic inflammation of the terminal mammary ducts. Complete removal of terminal lactiferous ducts with Hadfield procedure is a previously defined technique in treatment but carries various complications risks. This study aims to evaluate the effectiveness of modified techniques in the treatment of PM.Methods: Twenty women who underwent surgery due to PM between January 2012 and December 2019 were retrospectively analyzed. Types of PM were determined. All patients were operated on with three different incisions [Hadfield's operation with periareolar incision (n:11), periareolar combined radial incision (n:7), and round block incision (n:2)].Results: The mean age was 37.5 ± 6.5 years (range: 24-49). Sixty percent of patients had type 3 PM. In Hadfield's procedure, NAC retraction (n:2), seroma (n:1), and hematoma (n:1) were seen. In the periareolar incision combined radial incision group only one patient had complications (seroma) and none in the round block method. Follow-up was 12 ± 1.5 months and disease relapse occurred in two patients in the Hadfield group. Patients who underwent round block were more satisfied with the appearance of the nipple.Conclusions: In the treatment of PM, the main principle of surgical treatment is the excision of the affected canal with a clear margin. Apart from the classical Hadfield procedure, the round block method and periareolar combined radial incision techniques can be performed in the treatment of PM. [ABSTRACT FROM AUTHOR]

Background: Thyroid cancer is the most common endocrine cancer, with an increasing incidence around the world in the last three decades. The increased risk of secondary cancer is associated with a genetic predisposition or radioactive iodine used in the treatment. Case Report: A 65-year old male patient was operated on for thyroid papillary cancer. He received radioactive iodine on two occasions postoperatively. After six years, he presented with malaise and fatigue with leukocytosis and eosinophlilia. The physical examination revealed inguinal lymphadenopathies and splenomegaly, after examining the bone marrow and lymph node biopsies, he was diagnosed with eosinophilic myeloproliferative neoplasia and T-cell lymphoblastic leukaemia/lymphoma. Conclusion: Leukaemia and other haematological malignencies may develop after radioactive iodine treatment. Patients with radioactive iodine ablation history should be monitored for a long time. [ABSTRACT FROM AUTHOR]

Background: Chronic lymphocytic leukemia (CLL) is the most common type of leukemia among adults in Western populations. CLL has a wide range of clinical presentations and varied outcomes. For CLL, cytogenetic assessment is essential for estimating prognoses and determining the treatment of choice. The fluorescence in situ hybridization (FISH) technique is widely used for genetic assessment due to its high sensitivity.Aim: This study aimed to evaluate the frequencies of deletions of 13q14.3, 17p13.1, 11q22.3, and 13q34 and of trisomy 12 and to observe their effects on survival in 226 Turkish CLL patients using FISH analysis.Result and Conclusion: The frequencies of abnormalities were 65.4% for del 13q14.3, 39.8% for del 17p13.1, 19% for del 11q22.3 (del ATM), and 15.9% for trisomy 12. No patients had a 13q34.3 aberration. Our results are partially consistent with literature findings. However, certain conflicts with prior results were observed, particularly with respect to the high prevalence of 17p13.1 deletions and the enhanced survival of patients with such deletions. These inconsistencies may represent population-based differences in the genetic epidemiology of CLL. [ABSTRACT FROM AUTHOR]

miRNAs are small RNAs and control the expression of protein-encoding genes. The aim of this study was to determine the association between miRNA profile and clinical variables including age, stage, B symptom, histopathologic subtype, response to treatment, disease-free survival (DFS) and overall survival (OS) in classical Hodgkin lymphoma (cHL). A total of 377 miRNAs were studied by qPCR in 32 cases with cHL, and results were compared with 60 samples taken from cases with reactive lymphadenopathy. Biogazelle qbasePLUS 2.0 software was used to analyze the results. miR-582-3p, miR-525-3p, miR-448, miR-512-3p, miR-642a-5p, miR-876-5p, miR-532-3p, miR-654-5p, miR-128, miR-145-5p, miR-15b-5p, miR-328 and miR-660-5p were found to be decreased in cHL compared with controls. In contrast, miR-34a-5p (2.626-fold), miR-146a-5p (4.32-fold), miR-93-5p (2.347-fold), miR-20a-5p (4.930-fold), miR-339-3p (4.948-fold), miR-324-3p (4.98-fold), miR-372 (7.038-fold), miR-127-3p (8.234-fold), miR-155-5p (4.947-fold), miR-320a (17.502-fold) and miR-370 (21.479-fold) ( p < 0.05) were found to be increased in cHL. There was no difference in miRNA profile according to the age, sex, stage, response to treatment, DFS and OS. However, miR-889 was found to be increased in patients with B symptom and miR-127-3p was found to be increased in nodular sclerosing subtype. Some miRNAs increase and some decrease in cHL. However, there was no clinical association between clinical variables and with the majority of the miRNA profile studied in this study. miR-889 and miR-127-3p were related to B symptom and nodular sclerosis subtype, respectively. We need more studies evaluating miRNA profile and clinical outcome in Hodgkin Lymphoma. [ABSTRACT FROM AUTHOR]

Objectives: Although Hodgkin's lymphoma (HL) is one of the most curable cancers in adult patients, new targets have to be defined in cases resistant to traditional chemotherapy. The preferentially expressed antigen of melanoma (PRAME) is a cancer testis antigen and its expression is very scarce or absent in normal tissues. For this reason PRAME is a promising candidate for tumor immunotherapy. The aim of this study is to understand the correlation of PRAME expression with prognostic factors in HL, to determine the utility of PRAME as a targeted molecule for immunotherapy and to compare real-time polymerase chain reaction (real-time PCR) and immunohistochemistry (IHC) for the detection of PRAME. Methods: In 82 patients, PRAME was studied using real-time PCR and IHC. Data analyses were performed using statistical methods such as t test, Mann-Whitney U test, χ2 test, Kaplan-Meier method, log-rank test and Cox regression analysis. Results: PRAME was detected in 15 (18.3%) patients using IHC and in 8 (9.8%) patients using real-time PCR. A correlation was found between PRAME positivity and higher International Prognostic Score (p = 0.039). PRAME positivity detected using real-time PCR was found to be correlated with shorter disease-free survival (DFS) and overall survival (OS, p = 0.0005). Discussion: The demonstration of PRAME especially in histiocytes and Reed-Sternberg cells may provide guidance for immunotherapy. Although PRAME positivity increases the risk for death (3.56), independent risk factors that affected DFS and OS occurred in advanced age and high-risk groups. Conclusion: Although real-time PCR is sensitive in the detection of PRAME, IHC can be another useful method. Despite the need for studies conducted on larger patient samples, PRAME expression is considered as a poor prognostic parameter in HL. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) are new targets in cancer immunotherapy. PD-1 protein is an immune checkpoint expressed in many tumors. Epstein-Barr virus (EBV) is present in malignant Hodgkin/Reed-Sternberg (HRS) cells in approximately 40-50 % of Hodgkin lymphoma (HL). The aim of this study is to evaluate the clinical and prognostic importance of PD-1 and/or PD-L1 in HL and also to determine the association between EBV-encoded RNA (EBER) and PD-1/PD-L1. Formalin-fixed, paraffin-embedded tissue samples from 87 cases with HL were analyzed in this study. Immunohistochemical staining was performed to detect the PD-1 and PD-L1 expressions. Chromogenic in situ hybridization for EBER was performed using fluorescein-labeled oligonucleotide probes. PD-1 and PD-L1 expressions were found in 20 % of the cases. The EBER positivity was found in 40 cases (45 %). It has been found that co-expression of PD-1 and PD-L1 was associated with shorter survival although PD-1 or PD-L1 expressions were not found to be related with survival. Overall survival (OS) and disease-free survival (DFS) in cases without PD-1 and PD-L1 expressions were 135 and 107 months, respectively. OS and DFS in cases with co-expression for PD-1 and PD-L1 were 24 and 20 months, respectively, and these differences were found to be statistically significant for both OS and DFS ( p = 0.002 and p = 0.003, respectively). Cox regression analysis showed that co-expression of PD-1 and PD-L1 was found to be an independent risk factor for prognosis (OR 6.9, 95 % CI 1.9-24.3). Targeting PD-1 and/or PD-L1 is meaningful due to the 20 % expression of each in HL, and we did not find an important association between PD-1 and PD-L1 and EBER expression in HL. Very poor outcome in cases with co-expression of PD-1/PD-L1 suggests new avenues to detect the new prognostic markers and also therapeutic approaches in HL. [ABSTRACT FROM AUTHOR]

Cancer is a group of diseases characterized by DNA injury, and genetic and environmental factors are important in the etiology of the cancers. It is well known that there are association variabilities in DNA repairment and sensitivity against the cancer. The aim of this study is to look for some important gene polymorphisms associated with DNA repair in cases with B cell non-Hodgkin's lymphoma (B-NHL). Ninety-four cases with NHL and 96 healthy controls were included in this study. ERCC2 ( Lys751Gln), XPC ( Gln939Lys), ERCC5 ( Asp1104His), and XRCC3 ( Thr241Met) gene polymorphisms were studied by using Tm Shift Real-Time PCR Technology. ERCC5 Asp1104His polymorphism showed a protective effect against the B-NHL in individuals carrying this mutant allele ( p = 0.009), and differences were more prominent in males ( p = 0.001). When the patient and control groups were divided according to their smoking habit, the mutant allele of the XPC gene showed a protective effect in the nonsmoker group ( p = 0.040). The mutant allele G of ERCC5 ( CG) polymorphism was found to be protective against lymphoma ( p = 0.010). There were no differences among cases with B-NHL and controls for ERCC2 codon 751, XPC codon 939, and XRCC3 codon 241 gene polymorphisms. DNA repair gene polymorphisms can affect the risk of lymphoma, and it will be useful to detect the DNA repair gene polymorphisms in cases with lymphoma in studies covering a higher number of cases. [ABSTRACT FROM AUTHOR]

Paragangliomas are relatively rare chromaffin cell tumors which may be cured through resection. Patients with paragangliomas may develop metastatic diseases. There is no consensus regarding refractory chemotherapy for treatment of metastatic disease. In this report, we presented a case of a 43-year-old woman who was admitted to the hospital with a history of episodic headaches, diaphoresis, and weakness. Elevated plasma catecholamine levels and a right paraaortic mass were observed on computed tomography. The mass was excised, and a diagnosis of paraganglioma was confirmed. After 20 months of follow-up, local recurrence and metastases were detected in the thorax, abdomen, and skeletal system. Plasma and urinary catecholamine levels were high. Chemotherapy was administered, and no improvement was observed. Therefore, following this palliative conventional chemotherapy, sorafenib was administered for three months, and, finally, positron emission tomography showed that the patient's lesions had completely regressed. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Pathology is the property of Turkish Journal of Pathology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Hematology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Pathology is the property of Turkish Journal of Pathology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Hematology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Extramedullary plasmacytomas are rare malignancies. Most cases (80%) are seen in the head and neck region, where they represent 1% of all head and neck malignancies. We report a case of an extramedullary plasmacytoma of the tongue that was treated successfully with threedimensional conformal radiotherapy. The patient was a 50-year-old woman who was admitted to our hospital with bilateral pain and ulceration on the sides of her tongue. Findings on magnetic resonance imaging and positronemission tomography did not demonstrate any mass within the tongue or any lymphatic or distant metastasis. A tissue biopsy identified a plasma cell neoplasm. The patient was treated with a total dose of 50 Gy delivered in 2-Gy daily fractions. After 54 months of post-treatment follow-up, she exhibited no sign of systemic myeloma or local recurrence. This case is presented not only for the rarity of the tumor type, but also for its unusual location. [ABSTRACT FROM AUTHOR]

Extramedullary plasmacytomas are rare malignancies. Most cases (80%) are seen in the head and neck region, where they represent 1% of all head and neck malignancies. We report a case of an extramedullary plasmacytoma of the tongue that was treated successfully with threedimensional conformal radiotherapy. The patient was a 50-year-old woman who was admitted to our hospital with bilateral pain and ulceration on the sides of her tongue. Findings on magnetic resonance imaging and positronemission tomography did not demonstrate any mass within the tongue or any lymphatic or distant metastasis. A tissue biopsy identified a plasma cell neoplasm. The patient was treated with a total dose of 50 Gy delivered in 2-Gy daily fractions. After 54 months of post-treatment follow-up, she exhibited no sign of systemic myeloma or local recurrence. This case is presented not only for the rarity of the tumor type, but also for its unusual location. [ABSTRACT FROM AUTHOR]

Rituximab (the chimeric anti-CD20 antibody) is widely used in the treatment of CD20 positive non-Hodgkin's lymphoma (NHL). The response rate at relapse after repeated use in prior CD20 positive responders is lower than 50%. Several mechanisms can be responsible for rituximab resistance. CD20 negative relapses which transformed from CD20 positive aggressive and indolent forms of lymphoma can be the one of the reason of secondary resistance to rituximab. The authors report a case with combination of aggressive and indolent form of lymphoma who relapsed after 7 months from the last dose of rituximab therapy. CD20 transformed negative from positive in her relapsed disease. Patients with CD20 positive B cell NHL must rebiopsy after first line rituximab therapy if their disease relapsed or progressed. [ABSTRACT FROM AUTHOR]

Primary lymphoma of the breast is very rare especially in a male patient. Treatment alternatives include surgery, chemotherapy, immunotherapy and radiation. It is still controversial which combination is the best. Here, we report a male patient who presented with a left breast mass. The excisional biopsy was applied, and pathological assessment revealed marginal zone lymphoma. Both conventional computed tomography and 18)F-Fluorodeoxyglucose positron emission tomography/computed tomography were used for staging. The clinical stage was IIE for Ann Arbor staging and so local radiation following chemo immunotherapy was planned. Left-sided primary breast lymphoma in a male patient is a very rare entity. Treatment modalities are still controversial. Some authors believe that primary breast lymphomas have poor prognosis, and they must be treated aggressively with combined treatment modalities. Another important point is that 18)F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET)/CT could be used for staging of disease and assessing treatment response in a patient with primary breast marginal zone lymphoma. [ABSTRACT FROM AUTHOR]

Angiogenesis and lymphangiogensis are important in the proliferation and survival of the malignant hemeopoietic neoplasms. The aim of this study is to determine the prognostic role of angiogenesis and lymphangiogenesis in the development of lymphoma. For this aim, VEGF-A and VEGF-C were explored by immunohistochemistry in 177 cases. VEGF-C and VEGF-A were found to be positive in 34 and 61% of the samples. There was a good correlation between VEGF-C and VEGF-A expression (p = 0.0001). The clinical prognostic indicators were not significantly different between VEGF-C (+) and (-) and/or VEGF-A (+) and (-) cases. Overall survival (OS) rate was shorter in cases with VEGF-A (+) and VEGF-C (+) cases than with negative cases (p = 0.03 and p = 0.0005, respectively). The OS was significantly shorter in aggressive lymphomas expressing VEGF-A and VEGF-C but not in indolent lymphomas. The results of Cox regression analyses showed that VEGF-A and VEGF-C expressions are independent prognostic parameters (OR: 2.6, 95% CI: 1.3-5.0 for both (+) cases). In conclusion, VEGF-C and VEGF-A were positive in 34 and 61%, respectively, of the cases with NHL. The significant correlation between VEGF-C and VEGF-A suggests that lymphangiogenesis is important in the pathogenesis of lymphomas as shown in angiogenesis. The significantly shorter survival rates of VEGF-C and/or VEGF-A expressions indicate that angiogenesis and lymphangiogenesis are important in clinical outcome. Autocrine VEGF-A and VEGF-C crostalks in lymphoma cells are important in lymphoma biology and inhibition of these signals with anti-angiogenic/anti-lymphangiogenic drugs and combination with chemo-immunotherapy regimens will be more useful in these cases. [ABSTRACT FROM AUTHOR]

Cyclooxygenase 2 (Cox-2) is a key enzyme in prostaglandin synthesis and it has an important role in the pathogenesis of various malignancies. Cox-2 has been studied in solid tumors; however, studies about the role of Cox-2 in non-Hodgkin's lymphomas (NHL) are limited. The aim of this study is to determine the importance of Cox-2 expression in lymphomas. To this end, Cox-2 expression was determined in 177 cases with NHL. In histological terms, 60 cases (33%) had low grade and 117 (67%) had aggressive lymphoma. Ninety-nine cases were found to be positive for Cox-2 (56%); Cox-2 score was between 50 and 100, 101 and 200 and over 200 in 38, 46 and 15 cases, respectively. There was an important association between aggressive histology and Cox-2 expression: Cox-2 was negative in about half of the cases with indolent morphology, while two thirds of the Cox-2 positive cases had aggressive histology (p = 0.036).There was no significant association between Cox-2 expression and clinical-laboratory parameters. Although the overall survival times were longer in cases with lower or no Cox-2 expression as compared with higher Cox-2 expression, the difference was not significant. In conclusion Cox-2 expression is seen about 60% of the cases with NHL and is associated with aggressive morphology. [ABSTRACT FROM AUTHOR]

Kimura disease is a rare, slowly progressive, immune-mediated disorder of unknown origin, usually affecting young Asian male patients. The typical triad of this disorder comprises (1) painless unilateral cervical adenopathy or subcutaneous masses predominantly in the head and neck region; (2) blood and tissue eosinophilia; and (3) marked elevated serum IgE levels.1 Because this disease can mimic a neoplastic process, early diagnosis can save the patient from any harmful and unnecessary invasive diagnostic procedures. We describe herein a Turkish man with Kimura disease who developed nephrotic syndrome and was treated with steroid therapy. [ABSTRACT FROM AUTHOR]

Thirty-two cases of granulocytic sarcoma (GS) are reported in this paper. Age range was from 16 – 70 years. GS was accompanied by AML in 13 cases, ALL (My+) in one case, CML in 11 cases and MDS in two cases. GS was diagnosed simultaneously with leukemia in five cases and preceded the leukemia in eight. Lymph node and soft tissue were the most commonly detected localizations. Seven cases had first been diagnosed as NHL. Histopathologically blastic, immature and mature variants were found in 11, nine and 11 cases respectively and overall survival was shortest in the blastic type. Myeloperoxidase and lysozyme were found to be positive in 30 and 24 cases respectively. Therapy was radiation in five cases and surgery in three. Systemic chemotherapy was given to the cases. The clinical outcome of the patients after the diagnosis of GS was poor. GS is a unique entity; prognosis is poor but it is important to detect the signaling pathways associated with migration of myeloid cells to the extra-medullary tissues. The critical factors for detecting this interesting tumor are to be aware of this disease, cooperation between clinician and pathologist and the application of special stains to detect the myeloid origin. [ABSTRACT FROM AUTHOR]

Bilateral testicular tumors are a rare complication of congenital adrenal hyperplasia. It can be extremely difficult to distinguish histologically between Leydig cell tumors and adrenocortical rest hyperplasia, which may lead in some cases to unnecessary orchidectomy. A 7-yr-old boy was admitted because of precocious puberty and enlargement of testicles. Hormonal studies established the diagnosis of congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Testicular biopsy revealed interlacing strands, cords, and rests of cells resembling interstitial (Leydig) cells but with no Reinke crystalloids. Here we report a case of testicular adrenal rest hyperplasia in congenital adrenal hyperplasia and discuss the pathological and clinical features and origin of this rare lesion by using immunohistochemical evaluation. [ABSTRACT FROM AUTHOR]

The article presents a study on the diagnosis of cutaneous leishmaniasis (CL). A polymerase chain reaction (PCR) was conducted to determine the validity of the technique for diagnosis of CL. PCR was positive in all 20 cases when the Leishmania parasite was detected by light microscopy. Overall, the PCR-based method appears to be a useful diagnostic approach for identification of suspected cases of CL.

Apoptosis plays a crucial role in glomerulonephritis (GN) as a regulatory mechanism and is controlled by various molecules including Fas antigen, Bcl-2 and p53 oncoproteins. The aim of the present study is to evaluate the correlation between the expression of these molecules and clinical and laboratory data in different types of GN.The expression of Fas antigen, Bcl-2 and p53 protein in five normal human kidney specimens and 55 tissues from patients with several types of GN were examined by immunohistochemistry and correlated with clinical and laboratory findings. The number of Fas-positive intraglomerular cells was significantly increased in proliferative GN when compared with non-proliferative cases. Numbers of Bcl-2- and p53-positive cells in proliferative GN were not different from the non-proliferative cases and there was no correlation between the changes in Fas, Bcl-2 and p53 themselves. Significant correlation of expression of these molecules with clinical and laboratory findings was not found, except between p53 and blood urea nitrogen levels.Apoptosis is a complex molecular process and the results of the present study should be supported with other methods to understand whether apoptosis contributes to progression or resolution of GN. Increased glomerular expression of Fas, Bcl-2 and p53 molecules in all types of GN might contribute new therapeutic approaches by modulating the expression of these molecules. [ABSTRACT FROM AUTHOR]

Introduction: We investigated whether CA9 protein could be used as a prognostic tumor marker as well as a diagnostic biomarker in renal clear cell carcinoma. Materials and Methods: Nephrectomy specimens from 92 patients were used in this study. 80 of these were renal cell carcinomas, 10 adenomas and 2 oncocytomas. Of the renal cell carcinomas, 67 were clear cell carcinomas. Immunohistochemical analysis using CA9 monoclonal antibody (M75) was performed on paraffin-embedded specimens. CA9 staining was correlated with tumor stage, grade, lymph node involvement, distant metastasis and cumulative survival time. Results: CA9 was present in 91.2% of clear cell carcinomas. Low staining was a poor prognostic factor, and conversely high staining a good prognostic one. CA9 expression was found to be the best prognostic factor when compared with T stage and grade. Even in low-grade and stage tumors, the presence of low expression correlated with lowered survival times. Conclusions: On the basis of our study, CA9 is a significant molecular marker in renal clear cell carcinomas. Decreased CA9 expression is independently associated with poor survival. CA9 can be used to predict clinical outcome and identify high-risk patients in need for adjuvant immunotherapy and CA9 targeted therapies. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Lymphoma is a malign disease of the lymphoid system. A variety of risk factors have been described in pathogenesis of disease. We investigated the role of Cyclooxygenase-2 (Cox-2) in malign lymphomas. A total of 52 patients who were admitted to the Oncology Unit of Mersin University with histologically diagnosed lymphoma were enrolled to this study. Ten of the patients had Hodgkin's disease (HD), and 42 had non-Hodgkin's lymphoma (NHL). An immunuhistochemical method was used for Cox-2 expression. Cox-2 expression was detected in 24 of the 42 patients (57%) with NHL, and it was found in seven of the 10 patients (70%) with HD. The mean patient age expressing Cox-2 was 50.2 ± 16.6 years and 48.0 ± 15.5 years for patients without Cox-2 expression. This difference was not statistically significant ( P  = 0.660). The overall survival of Cox-2-positive patients was less than for those without Cox-2 expression but the difference was not significant statistically (16.4 ± 11.4 vs. 14.7 ± 8.2 months, respectively, P  = 0.552) in NHL. There was a correlation between Cox-2 and stage of disease. As the stage increased the Cox-2 expression increased ( P  = 0.037) in NHL. The complete response rate to therapy was significantly higher in Cox-2-negative patients than the Cox-2-positive group (70.6% vs. 20.8%, respectively, P  = 0.001) in NHL. There was no correlation between Cox-2 expression and IPI score, extranodal involvement, tumor grade, and B symptoms. Our findings demonstrate that there is a clinical correlation between the Cox-2 expression and prognostic factors in lymphoma patients. The combination of Cox-2 inhibitors with standard chemotherapeutics may enhance the potential of treatment options for malign lymphomas. [ABSTRACT FROM AUTHOR]

Summary. The growth and proliferation of multiple myeloma (MM) cells are influenced by various cytokines produced by bone marrow stromal cells. As cytokine interaction between malignant plasma cells and neighbouring stromal cells is important in the pathogenesis of MM, the understanding of intracellular signalling events elicited by this interaction is of central importance. Recent reports have shown that protein kinase C (PKC) is directly involved in modulating apoptosis in different cells types, including those of haematopoietic neoplasms. In the present study, we analysed the expression patterns of PKC isoforms in the myeloma cell lines U266, RPMI-8226 and K620. This analysis demonstrated common expression of PKC-δ, PKC-ι, PKC-µ and PKC-ζ in all three myeloma cell lines. PKC-δ expression in plasma cells from 11 patients with MM was also shown by immunohistochemistry, utilizing a monoclonal mouse anti-human PKC-δ antibody. U266 cells treated with the broad PKC inhibitor safingol (l-threo-dihydrosphingosine) or the PKC-δ-specific inhibitor rottlerin (3′-[(8-Cinnamoyl-5,7-dihydroxy-2,2-dimethyl-2H-1-benzopyran-6-yl)methyl]-2′,4′,6′-trihydroxy-5′-methylacetophenone) showed decreased PKC-δ in the particulate fraction and resulted in significant apoptosis. Primary myeloma cells also showed apoptosis after treatment with the PKC inhibitors, as detected by both flow cytometric and morphological evaluation. Our results indicate that PKC-δ is commonly expressed in myeloma cells and plays an important role in plasma cell survival. [ABSTRACT FROM AUTHOR]

Demonstrates that constitutively active nuclear factor-*kappaB (NF-κ B) is present both in myeloma cell lines as well as in primary multiple myeloma (MM) cells. Analysis of NF-κ B status in primary samples from patients with MM; Evaluation of constitutive activation of NF-κ B; Use of adenovirus vector with dominant negative I*kappa B α.

Background: The aim of the study is a comparison of the expression of cytoskeletal proteins, alpha smooth muscle actin (α-SMA), vimentin, and desmin in fetal, normal kidney and proliferative (diffuse proliferative and membranoproliferative glomerulonephritis) and nonproliferative (membranous glomerulonephritis) glomerulonephritis. Methods: We have studied the expression of cytoskeletal proteins (α-SMA, vimentin, desmin) in the paraffin embedded tissue sections from the kidneys of 10 normal kidney (adults and infants), 13 fetal kidney, 12 membranous glomerulonephritis (MGN), 8 membranoproliferative glomerulonephritis (MPGN), 8 diffuse proliferative glomerulonephritis (DPGN). Interstitial and glomerular positive stainings were evaluated. Results: Vimentin expression was similar in normal infant and adult kidneys with positive staining in glomeruli and negative staining in interstitium. In fetal kidneys, glomerular mesangial and epithelial cells and blastematous areas showed positive reactivity with vimentin. α-SMA staining was different among the groups. In fetal kidney, α-SMA expression was found in glomerular mesangial cells and blastematous areas. α-SMAstaining was positive in peritubular area and glomerular mesangial cells in infant kidney. In adult kidneys, glomerular staining with α-SMA disappeared but peritubular positivity continued. Interstitial staining with α-SMA was positive in fibrotic areas of proliferative (MPGN, DPGN) and non-proliferative (MGN) glomerulonephritis, but positive glomerular staining with α-SMA was found only proliferative glomerulonephritis. Desmin expression was negative in all groups. Conclusions: Desmin is not expressed in early stages of kidney growth, infant and adult kidneys, and proliferative and nonproliferative glomerulonephritis. Interstitial staining of vimentin in the diseased kidney tissues revealed increased fibrosis. α-SMA revealed important differences in different stages of nephrogenesis. Glomerular mesangial staining with α-SMA in developing (fetal and infant kidneys) and proliferative glomerulonephritis suggest that it may be a marker of proliferation. In addition, it shows myofibroblastic differentiation in interstitium in diseased kidneys. [ABSTRACT FROM AUTHOR]

Acute promyelocytic leukaemia (APL;M3) is a unique form of acute myelogenous leukaemia characterized by t(15;17) translocation. The induction of apoptosis via inhibiting protein kinase C (PKC) has been recently viewed as a promising tool for the eradication of several malignant disorders. In the present study, we investigated the effect of two different protein kinase C inhibitors, Gö6976 and safingol, on the induction of apoptosis in the APL cell line NB4 and its all trans retinoic acid (ATRA)-resistant variant NB4.306. The effect of the PKC inhibitors on leukaemic cells obtained from three APL patients was also studied. We also evaluated the possible involvement of the caspases in apoptosis induced by PKC inhibitors. Significant time- and concentration-dependent apoptotic changes were demonstrated using Gö6976 and safingol. In addition, our results demonstrated that the caspases were involved in the apoptosis induced by the PKC inhibitors. In conclusion, our study illustrates that the PKC inhibitors Gö6976 and safingol induce apoptosis in APL and hence could be potential therapeutic agents for the treatment of this disease. [ABSTRACT FROM AUTHOR]

Actinomycosis is a chronic suppurative infection, for which immune suppression is a predisposing factor. In unusual cases, this disease may present as an abdominal wall involvement simulating a soft tissue tumor as seen in the present case. The presented patient had no signs of trauma or surgical approach and the pathology was considered to be a primary abdominal wall actinomycosis. Preoperative diagnosis is difficult due to the nonspecific nature of clinical presentation, radiographic and laboratory findings. Surgery combined with antibiotic treatment is a curative approach for this relatively rare infection. Surgeons must be aware of this disease in order to ensure correct diagnosis and to prevent performing any unnecessary procedures. The present study describes a case of abdominal actinomycosis with multiple myeloma, together with a review of important points related to this disease. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the clinical and demographic characteristics of patients with idiopathic granulomatous mastitis (IGM) and to compare treatment methods. Materials and Methods: The demographic characteristics, clinical findings and treatment methods of 42 patients diagnosed with idiopathic granulomatous mastitis between January 2010 and January 2019 were reviewed retrospectively. Results: The mean age of the patients was 35.2 (23-50) years. One patient had nulliparous, three had pregnancy and four had additional rheumatologic diseases. The most common complaints were mass, redness and discharge. Breast USG was performed in all patients and breast MRI was performed in 23 patients. While irregular confined fluid collections were frequently detected on breast USG, contrast enhanced mature and immature abscess foci were the most common findings on breast MRI. Idiopathic granulomatous mastitis was diagnosed by incisional biopsy in 7 patients and tru-cut biopsy in 35 patients. Six patients underwent abscess drainage after diagnosis. All patients were started on methylpredinizolone (64 mg/day) and called for a follow-up visit 6 weeks later to assess treatment response. Methylprednisolone treatment was continued in patients whose clinical and radiological regression was detected and they were called for control at 4-week intervals. Patients who did not respond to methylprednisolone treatment or developed side effects were referred to surgical treatment. The mean duration of methylprednisolone use was 14.8 (6-60) weeks. The mean follow-up period was 14.5 (2-48) months. Methotrexate was initiated in 3 patients due to early inability to tolerate methylprednisolone. There was no recurrence in this subgroup. Complete response was achieved clinically and radiologically with methylprednisolone in 27 patients. After complete repetition of the disease, 3 patients developed recurrence and were referred to surgical treatment. Surgical treatment was performed in 15 patients. Mastectomy was performed in 5 patients and segmental mastectomy was performed in 10 patients. Conclusion: Autoimmunity is thought to be responsible for the development of idiopathic granulomatous mastitis. Therefore, methylprednisolone and other immunosuppressive agents play an important role in the treatment. However, the difficulty in tolerating the side effects of immunosuppressive therapy and nonresponsiveness to treatment necessitates surgical treatment of the patients although it is a benign disease and causes organ loss. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Hematology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The kidney is frequently affected in patients with sickle cell syndrome, i.e., homozygous and heterozygous patients, with a consequently large spectrum of renal abnormalities that may range from minimal functional changes to chronic renal failure. Here, we present a 13-year-old boy with sickle cell anemia (SCA) (HbSS) who was referred to our unit with nephrotic syndrome. Renal biopsy revealed AA type amyloidosis on the basis of light microscopic findings, indicating Congo red staining and immunohistochemistry. He had neither a family history of familial Mediterranean fever (FMF) nor any complaint of recurrent abdominal pain, arthritis, and fever, but frequent painful vaso-occlusive crises. The patient was found to have no MEFV gene (Mediterranean feVer) mutations either. Painful episodic attacks might provoke recurrent acute inflammation, leading to repeated stimulation of acute phase responses and cause secondary amyloidosis. To our knowledge, this boy is the first case of SCA complicated by renal amyloidosis observed in childhood. [ABSTRACT FROM AUTHOR]

We present two adenomatous hyperplasia of the rete testis (AHRT) cases. One of them was a 67-year old patient with prostatic adenocarcinoma and the other was a 38-year old patient with undescended testis. AHRT is a rarely seen lesion and usually detected as incidental microscopic finding. It may be confused with malignancy and related to testicular atrophy and hormonal imbalance.The treatment of choice is complete excision. [ABSTRACT FROM AUTHOR]

Objective: It is a rare fibroepithelial breast tumor which makes up 0.3-0.9% of primary breast neoplasms. In this article, we aimed to investigate the demographic, clinicopathological findings and treatment methods of patients treated with phyllodes breast tumors. Materials and Methods: Data of 23 patients with phyllodes tumor treated between January 2010 and July 2019 were reviewed retrospectively. Results: The mean age was 44.1 (20-64) years. The most common presenting symptom was a rapidly growing mass. The disease was in the right breast in 12 patients and bilateral in 1 patient. Radiologically, 14 patients were evaluated by breast USG, 5 patients by USG + mammography, 4 patients by USG + mammography + breast MRI. Of the 14 patients admitted to the outpatient clinic, 8 were diagnosed after an excisional biopsy. Of the 9 patients who underwent preoperative tru-cut biopsy in our clinic, 5 were diagnosed with fibroepithelial lesions, 3 with phyllodes tumor and 1 with malignant phyllodes tumor. 14 patients underwent segmental mastectomy, 5 patients underwent simple mastectomy, 4 patients underwent subcutaneous mastectomy and appropriate reconstruction. The mean tumor size was 64.6 (20-220) mm. Histopathologically, 9 benign, 6 borderline and 8 malignant phyllodes tumors were detected. Lobular carcinoma in situ was detected in one patient with benign phyllodes tumor. The mean follow-up period of patients with malignant phyllodes tumor was 39.5 (6-46) months. One of the patients with malignant phyllodes tumors received chemotherapy for distant metastasis, and three received radiotherapy for surgical margins. One patient who refused radiotherapy was admitted with local recurrence 6 months later. Conclusion: Phyllodes tumors are rare, mixed breast tumors. It may be confused with breast fibroadenomas clinically, radiologically and histopathologically. Diagnosis should be confirmed by preoperative tru-cut biopsy to perform appropriate treatment even in patients with suspected fibroadenoma. Because of high local recurrence rates and malignancy potentials, they should be diagnosed preoperatively and treated with correct surgery in a single session. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 62-year-old male patient with abdominal pain in the left lumbar region. Computed tomography scanning was performed of the abdomen and thorax which showed the masses in the left and right adrenal gland. He underwent the chemotherapy that was completed in five months and patient has no sign of any radiological progression. The article discusses the presence of primary adrenal lymphoma (PML) in the cases of non-hodgkin lymphoma.

The article presents a case study of a 15-year-old female patient with the neck mass from 6 months and shortness of breath at night. She was undergone the physical examination which shows the palpitation revealing the mass. The pathological report of her revealed the signs of Castleman's diseases. She was treated with the external radiotherapy. The article discusses the importance of radiotherapy for the Castleman's diseases as the masses cannot be resected by surgery.

The article provides information on a study regarding the unexpected complication after varicella or also known as chickenpox. Chickenpox has a mortality rate of <2 oer 100,000 cases. It is a common contagious childhood disease with complications that are known to be rare. Case report of a healthy 8-year-old girl who waas admitted to a hospital with rash, pallor, and fatigue is also discussed.

Lymphadenopathy (LAP) that is seen in adult onset Still’s disease (AOSD) may be confused with lymphoma. Here we present a patient with AOSD and with LAP that histopathologically mimicked T-cell lymphoma. [ABSTRACT FROM AUTHOR]

Discusses the treatment of a 48-year-old male patient with hemolytic anemia associated with relapsed splenic marginal zone lymphoma with leukemic phase. White blood cell count; Platelet count; Bone marrow aspiration and biopsy; Efficacy of chimeric monoclonal antibody rituximab therapy; Drug dose.