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PURPOSE: To investigate the association between papillary thyroid cancer (PTC) and Hashimoto’s thyroiditis (HT). DESIGN: This study is a retrospective study that conducted during 7 consecutive years with a median 119.5 months follow-up. SUBJECTS AND METHOD: Patients who underwent thyroidectomy in Dokuz Eylül University Hospital during 7 consecutive years were included. Patients’ demographics, biochemical, radiological, and pathological results were retrospectively assessed. RESULTS: Four hundred sixty nine patients were evaluated. Among 469 patients who underwent thyroidectomy, 132 (28.1%) were malignant, while 182 patients were diagnosed with HT (38.8%). PTC was ranked first at 92.4% (n: 122). The prevalence of HT was 54.9% in patients with PTC and 33.1% in patients without PTC diagnosis (p

Giriş ve amaç: Smear tekniği, beyin cerrahisinde intraoperatif tanı ve stereotaktik biyopsilerin incelenmesinde önemlidir. Amacımız, merkez sinir sistemi (MSS) lezyonlarında imprint ve “squash” (ezme) preparatları frozen ve parafin kesitlerle karşılaştırmak, sitolojik özelliklerini, intraoperatif tanıya katkılarını, ayrıca imprint preparatlarda DNA içeriği ile AgNOR değerinin yararını araştırmaktır. Gereç ve yöntem: MSS biyopsilerinden frozen yapılan olguların 97’sine imprint, 19’una imprint ve “squash” preparat yapıldı, tümü H+E ve PAP ile, 53’ü gallocyanin chromalum, 28’i de AgNOR ile boyandı. Dizideki olgularımız, 36 glial tümör, 20 meningiom, 6’şar schwannoma ve hipofiz adenomu, 3 kraniofaringiom, 2 hemanjioblastom, 1’er medullablastom, gangliogliom ve lipom, 14 metastatik tümör, 5 non-neoplastik lezyon ve 2 normal beyin içermektedir. Bulgular: DNA içeriği saptanan 53 olgunun kontrol grupları ile karşılaştırılmasında, glial tümörler ile metastatik karsimonlarda kontrol gruplarına göre, istatistiksel olarak, anlamlı bir yükselme izlendi. AgNOR değeri saptanan 28 olgunun, tümör gruplarının kontrollerle karşılaştırılması, istatiksel anlamlı bulunmadı. Sonuç: İmprint yöntemi, özellikle küçük, ödemli, yumuşak dokularda ve dokunun parafin kesitler içinde saklanması gerektiğinde en iyi intraoperatif tanı yöntemidir, sınır lezyonların değerlendirmede yetersizdir. Schwannoma ve kraniofaringiomun imprintleri hiposellüler olduğundan, intraoperatif tanıda, öncelikle frozen kesitle değerlendirme yapılmalıdır. İmpirintlerle birlikte frozen doğru tanı olasılığını arttırır. Ayrıca imprint preparatta DNA içeriği ölçülebilir ve AgNOR değeri saptanabilir

Giriş ve amaç: Tiroid papiller karsinomu (TPK) tiroid karsinomlarının en sık gözlenen formu olup sıklıkla lenf düğümü metastazı yapmaktadır. Diğer dokulara metastazları ise daha seyrektir. Amacımız, saptadığımız bir TPK timus metastazı olgusunu sunmaktır. Olgu sunumu: Sol tiroid lobektomi materyalinde TPK tanısı alan, 18 yaşındaki erkek hastaya, daha sonra sol radikal boyun diseksiyonu ve sağ tiroid lobektomi ile aynı lokalizasyonda nüks olduğu düşünülen yumuşak dokuların eksizyonu olmak üzere, iki cerrahi girişim daha yapıldı. Disseke edilen lenf düğümlerinde ve yumuşak dokuda, mikroskopik olarak timusta TPK metastazı saptandı. Sonuç: Timusa TPK metastazı, ulaşabildiğimiz kaynaklarda bildirilmemiş olup, burada, diğer seyrek görülen metastazlarla birlikte, ilgili kaynakların eşliğinde tartışılmıştır

PubMedID: 24782296 Objective: The aim of this study was to determine the rate of Her-2 gene amplification in breast cancer cases with a previous negative Her-2 result as determined by immunohistochemistry (score 0 or 1). Material and Method: 552 cases of invasive breast carcinoma were assessed with the contribution of 9 centers. Previous immunohistochemistry score was either 0 or 1+ in all cases. These cases were re-tested by Her-2 silver in situ hybridization in the central laboratory. Her-2 gene amplification was defined as Her-2/CEP 17 ratio of more than 2.2. Cases with a ratio between 1.8 and 2.0 were defined as equivocal and cases with a ratio of less than 1.8 were defined as negative. Results: Re-testing of the 552 cases with silver in situ hybridization showed a total of 22 cases with Her-2 gene amplification, of which 11 (3.2%) were found to be score 0, and 11 were found to be score 1+ (5.3%) by immunohistochemistry previously. Her-2 gene amplification rate of cases (score 0 and 1+) ranged from 0% to 10.48% among the centers. Polysomy was found in 28 (8.1%) of the score 0 cases and 25 (12.1%) among the score 1+ cases. Five (9.4%) of the cases with polysomy were found to be amplified, and 48 (90.6%) were not. Conclusion: The results of the study show that a group of cases (3.98%) with a potential to benefit from anti-Her-2 therapy may be missed with the immunohistochemical method. This indicates the importance of quality assurance, especially in central laboratories with many breast cancer cases in daily practice.

Purpose: Triple negative (TN) breast carcinomas (estrogen receptor/ER, progesterone receptor/PR and HER-2/neu negative) constitute 15-25% of all breast carcinomas and have been correlated with aggressive behavior and poor prognosis. Our aim was to describe and characterize the immunophenotype of these tumors in a group of patients from Turkey.

Purpose: Male breast cancer (MBC) is a rare disease. However; as global populace ages, there is a trend for MBC increase. Although its etiology is still unclear, constitutional, environmental, hormonal (abnormalities in estrogen/androgen balance) and genetic (positive family history, Klinefelter syndrome, mutations in BRCA1 and BRCA2) risk factors are already known. One potential target is the vitamin D receptor (VDR). We have investigated whether polymorphisms in the VDR gene are associated with altered MBC risk in a Turkish population.

Objective: The primary goal of this study is to evaluate predictors of nodular goiter in Graves Disease (GD). Materials and Methods: A total of 202 consecutive patients (mean age: 45; 145 female, 57 male) were enrolled. All patients were treated with antithyroid drugs as initial therapy. TSH, FT3, FT4, TRAb, ATPO, and ATG were measured. Radioactive iodine uptake and thyroid ultrasonography were performed, and thyroid volume and nodule diameter were assessed. Ultrasound-guided fine needle aspiration was performed on thyroid nodules ≥ 8mm. Results: Diffuse goiter was detected in 51% of patients. Solitary nodules were detected in 16%, and multi-nodular disease in 33%. Mean nodule diameter was 8.82 mm. Nodular disease was slightly more common in women (p=0.063). Patients with nodular GD were older (p=0.004), had lower levels of FT3 (p=0.016) and TRAB (p=0.002) when compared with subjects with diffuse GD. Age (OR:6.867) was the independent variable predicting nodular GD. Conclusions: Increased prevalence of nodules was associated with advanced age and milder thyrotoxicosis. Apoptosis of thyroid follicular cells due to excess iodine might interfere with nodule formation, and lead to diffuse goiter in severe thyrotoxicosis. Because of increased rate if malignancy in GD, comprehensive evaluation of thyroid nodules of any size is mandatory.

The frequency of new neoplastic diseases among patients cured of testicular cancer is higher than in normal population. For these patients, synchronous occurrence of multiple neoplasms is not common. Also, less than 1% of all cases of breast cancer occur in males. We present herein a case having both breast and concurrent pancreatic cancer after being effectively treated for testicular cancer. To the best of our knowledge, this is the first case of synchronous breast and pancreatic cancer in a male patient following testicular cancer Second cancer is the most severe long-term complication of chemotherapy or radiotherapy for patients with testicular cancer and the possibility of multiple cancers has to be taken into consideration when multiple lesions are present.

Aim: Investigation of the diagnostic role of technetium-99m methoxyisobutylisonitrile (Tc-99m sestamibi) scintimammography in non-palpable, suspicious breast lesions described as microcalcification, moss and increased density using mammography. Patients, method: 35 women with non-palpable breast lesions were enrolled in the study. Anterior, left and right lateral, ipsilateral posterior oblique images were obtained 15 min after the injection of 740 MBq of Tc-99m sestamibi. All scintigraphic images were evaluated visually and focal increased Tc-99m sestamibi uptake was accepted as malignant lesion. Breast lesions were classified as microcalcification (13 women), mammographic mass (16 women) and increased density (6 women). Excisional biopsy was performed in all of them irrespective of the scintigraphic results. Results: The focally increased Tc-99m sestamibi uptake was seen in 11 breast lesions with malignant lesions and in 4 breast lesions with benign lesions. The diffuse uptake of Tc-99m sestamibi was seen in 18 breast lesions with benign lesions and 2 breast lesions with malignant lesions. There was no false positive result of Tc-99m sestamibi in microcalcification group and there was no false negative result of the mammographic mass and increased density groups. Conclusion: Scintimammography might be a complementary method in decision making for the non-palpable, suspicious breast lesions that were evaluated as microcalcification, mass and increased density mammograpically.

Childhood tuberculosis might have unusual clinical presentation. A seven-year-old female patient was admitted with fever and pleural effusion. Her pneumonia resolved following 21-day treatment period. An atelectatic appearance remained on the right middle zone in her chest X-ray. Taberculin skin test showed 13 mm induration. Triple drug antituberculosis treatment was started. Since atelectasis persisted on her follow-up radiograph one month later, bronchoscopy was performed which revealed a hemorrhagic polypoid mass occluding the right upper lobe anterior segment orifice. Surgical removal was performed by right upper lobectomy. The pathological diagnosis was necrotizing granulomatous infection suggesting tuberculosis. The patient has been well on follow-up after completing a nine-month course of antituberculous treatment.

Familial association of congenital camptodactyly and arthropathy without evidence of concurrent inflammation has an autosomal recessive pattern of inheritance. We describe four children born to consanguineous parents in two families with congenital camptodactyly and polyarthropathy which were misdiagnosed and treated as juvenile rheumatoid arthritis (JRA) for some time. The siblings in the second family also had fibrosing pleuritis. Histopathological examination of the synovial tissues of the children in the first family revealed synovial hypertrophy and presence of multinucleated giant cells with minimal inflammation and vasculitis. On the other hand, prominent fibrosis with no inflammation was present in the synovial tissue of the elder boy in the second family. Thus, while the children in the first family had the phenotypic characteristics of congenital familial hypertrophic synovitis, the latter siblings probably represent a form of the familial fibrosing serositis.

BACKGROUND: Curschmann's spirals, first described more than 100 years ago, are common in cytologic specimen from the respiratory tract and have also been observed in cervical smears, urine, and peritoneal and pleural effusions. No simple theory can explain the exact mode of spiral formation, which is presumed to be a complex physical and biochemical phenomenon.

OBJECTIVE: To evaluate the use of stereologically estimated tumor cell counts in the mitotic index as well as to investigate its correlation with the currently used method and test the reproducibility of the method.

Purpose: Hydatid cysts in cardiac echinococcosis mostly involve left ventricle and septums. Up to this time, in these cases CT has been used complementary to echocardiography. Here, we report a right atrial hydatid cyst case with review of cardiac hydatid disease and the role of MR imaging in these cases. Method: On chest X-ray of a 57-year old man there were multiple parenchymal masses, and right cardiac contour was slightly prominent. Following chest x-ray, CT, echocardiography and MR imaging were performed. At cardiac surgery a large perforated cyst was extracted. Results: Both CT and MRI were effective in demonstrating the masses in pulmonary parenchyma, but due to cardiac motion, it was not possible to demonstrate the contents of the cyst in the right atrium by CT MR was as efficient as echocardiography in demonstrating the content of the mass in cardiac location. Conclusion: With MRI, it is possible to demonstrate the cyst in pulmonary and cardiac locations, and in cases like cardiac echinococcosis, MR imaging must be the choice of imaging modality complementary to echocardiography.