Search

The use of the antifibrinolytic agent tranexamic acid has positive effects on bleeding control, but our knowledge is still limited regarding how fibrinolysis suppression changes the process of bone formation and the quality of bone. Because of the several side effects of systemic tranexamic acid, topical usage has been established in several procedures. This study aimed to investigate the effect of local tranexamic acid on vertebral fusion by using macroscopic, radiologic, and microscopic techniques. We also attempted to determine the safe dose range in case some doses had negative effects on fusion.Twenty-eight Wistar albino rats underwent intertransverse fusion. All rats were randomized into four groups: groups treated with local tranexamic acid doses of 1 mg/kg (D1), 10 mg/kg (D10), and 100 mg/kg (D100) and the control group with no drug (D0). At the end of the eighth week, all rats were sacrificed for evaluation in terms of palpation, mammography, and histopathologic analysis.The manual palpation results presented with lower fusion rates in D10 and D100 groups than in the control group. Radiological examination results were significantly higher in the control group. The histopathologic examination revealed no significant differences between groups in the percent of new bone formation.Our results showed that local administration of tranexamic acid reduced the quality and stability of fusion without a delay in bone formation. However, doses of 1 mg/kg did not reduce the stability in the palpation test. Our findings suggest that 1 mg/kg dose is a critical threshold above which tranexamic acid reduced the bone healing process of fusion and that surgeons should consider the doses of local tranexamic acid during surgery.

Intraocular lymphomas are among the rare malignancies that present with a wide variety of clinical manifestations. Differential diagnosis can be very troublesome due to its mimicking nature, insidious disease onset, and partial treatment response to steroids. The most important step in diagnosis is a high index of suspicion. Signs of the disease are now easier to detect using multimodal imaging techniques. In this case series, we reviewed the clinical characteristics of two women aged 70 and 71 years and a 72-year-old man with intraocular lymphoma and described their multimodal imaging findings in detail. Bilateral eye involvement was present in all three cases at our first ophthalmological examination. While the disease first presented with ocular involvement in two of the three cases, ocular involvement was detected seven years after initial heart involvement in one patient. All three patients had diffuse large B-cell lymphomas (one diagnosed with retinal biopsy, one with conjunctival biopsy, and the remaining with stereotactic brain biopsy). Intraocular lymphoma should be diagnosed and treated using a multidisciplinary approach, and we share our experience in this case series.

Purpose Several studies suggest that the relation of Epstein-Barr virus (EBV) and Hodgkin lymphoma (HL). EBV and HL associations are reported at rates ranging from 20% to 100% that varies nationally and regionally. In this study; in the case of Hodgkin's lymphoma, the presence of EBV encoded RNA (EBER) by in situ hybridization method and it’s distribution according to histopathological subtypes were investigated. Methods We investigated the presence of EBV in Hodgkin Lymphoma diagnosed 107 adult cases between 2013 and 2017, which chromogenic in situ hybridization with EBV RNA probe has been in routine use were evaluated retrospectively with pathology reports. Results There were 69 males and 38. Nodular Sclerosis Classical Hodgkin Lymphoma (NSCHL) was the most common (63 cases, 58,9%) followed by Mixed Cellularity Classical Hodgkin Lymphoma (MCCHL) (23 cases,21,5%). EBV was expressed in 40 cases (45,4%). High EBV association was found with NSCHL (50%) and MCCHL (48%). None of NLPHL was positive with EBER. Conclusion In our series NSCHL is the most common histologic subtype and has higher percentages of EBV positivity as reported in developed countries. Our study has the largest series of patients investigating the relationship between HL and EBER in our country. For further comments more studies, particularly from Turkey, are needed to determine the actual epidemiological pattern of HL in the region and to define the role of EBV in HL.

Background Differentiation of multiple myeloma (MM) from osteolytic metastatic (OM) bone lesions may be critical in patients with lytic bone lesions but can be challenging for radiologists. Purpose To determine whether computed tomography (CT) can be used to distinguish between MM and other OM bone lesions. Material and Methods In this retrospective study, 320 lesions of 207 patients diagnosed with MM or OM, based on biopsy or clinical examination, were evaluated. Eight qualitative features were evaluated by two radiologists blinded to the diagnoses. The chi-square and Fisher exact tests, and logistic regression analysis, were used to evaluate the relationships between the CT findings and diagnoses. Results High-density areas were more common in OM than MM lesions (85.2% and 19%, P 2 = 0.516, P Conclusion MM and OM lesions can be differentiated by CT; OM lesions exhibit high- density areas.

Human herpes virus-8 (HHV-8) is linked to four lymphoproliferative diseases: primary effusion lymphoma, HHV-8 positive multicentric Castleman disease (MCD), HHV-8 positive diffuse large B cell lymphoma and HHV-8 positive germinotropic lymphoproliferative disorder (GLPD). The diagnosis of HHV-8 associated lymphoproliferative diseases is quite challenging because each entity is rare and has a wide morphological spectrum. Our aim is to emphasize the overlapping histopathological features of MCD and GLPD as well as to underline the importance of clinicopathological correlation in case these two entities cannot be distinguished by pathological examination. We present here a case of an 82-year-old male patient who was examined for weight loss and multiple lymphadenopathy. Histopathological examination of the axillary lymph node revealed lymphoid follicle structures of varying shapes and sizes, including some atrophic germinal centers. Plasmablast-like cells were notable in some of these areas. HHV-8 and Epstein Barr Virus (EBV) positivity were noted in some of these cells and in a small number of cells in the mantle zone. Based on these findings; a diagnosis of "HHV-8 and EBV positive lymphoproliferative disease" was established. Since HHV-8 positive MCD and GLPD have similar histopathological features, it may not be possible to distinguish these two entities by histopathological examination only. At this point, the importance of clinicopathological correlation becomes more evident, especially in the determination of the treatment protocol to be applied to the patient.

Multiple myeloma (MM) is a malignant condition characterized by the accumulation of malignant plasma cells. Although MM remains incurable, the survival of MM patients has improved considerably due to the application of autologous stem cell transplantation, novel agents, and advanced treatment strategies. This study aimed to determine the cytogenetic characterization and bone marrow (BM) features of Turkish patients with MM.Eighty-five MM patients were admitted to Dokuz Eylül University Hospital in Turkey. BM samples of these MM patients were subjected to cytogenetic analyses at diagnosis and during therapy as a part of therapeutical and clinical evaluation. A complete cytogenetic study was performed using the G-banding technique. Fluorescence in situ hybridization (FISH) analysis was performed using cytoplasmic immunoglobulin. The degree of BM fibrosis was determined using reticulin histochemical staining. We determined the percentage of BM plasma cells based on the extent of CD38 staining.Eighty-five MM patients were retrospectively identified between 2015 and 2021. The median age was 63 (38-90) years. Of the 85 patients, 60 (70.6%) were male and 25 (29.4%) were female. Seventy-two (84.7%) cases had BM fibrosis at the time of diagnosis. The most common was grade 2 fibrosis, recorded in 35 cases (41.2%). About 72.9% of the patients showed more than 50% plasma cells. FISH analysis indicated the presence of abnormal chromosomes in 37% (32/85) of the patients. The most frequent abnormality was Immunoglobulin heavy-chain (IGH) translocation (21.3%).Subgroup analysis of IGH mutations is crucial in the identification of high-risk MM patients. We believe that our study will contribute to the determination of BM biopsy and cytogenetic features of MM patients in our country.Multipl myelom (MM), malign plazma hücrelerinin birikmesi ile karakterize malign bir durumdur. MM tam kür sağlamanan hastalık olmasa da, uygulanan otolog kök hücre nakli ve yeni ilaçlar ve yeni tedavi stratejileri nedeniyle MM hastalarının sağkalımı önemli ölçüde gelişmiştir. Bu çalışmada MM’li Türk hastalarda sitogenetik karakterizasyon ve kemik iliği (Kİ) özelliklerinin belirlenmesi amaçlanmıştır.Türkiye’deki Dokuz Eylül Üniversite Hastanesi’ndeki 85 MM hastasını kaydettik. Bu MM hastalarının kemik iliği örneklerinde, tedavi ve klinik değerlendirmenin bir parçası olarak tanı anında ve tedavi süresince sitogenetik analiz yapıldı. G-bantlama tekniği kullanılarak tam bir sitogenetik çalışma gerçekleştirildi. Fazlar arası Floresan in situ hibridizasyon (FISH) analizi, sitoplazmik immünoglobulin ile yapıldı. Kemik iliği fibrozunun derecesi, retikülinin histokimyasal boyası kullanılarak belirlendi. Kİ plazma hücrelerinin yüzdesi, CD38 boyamasınına göre belirlendi.2015 ve 2021 yılları arasında geriye dönük olarak 85 MM hastası belirlendi. Ortanca yaş 63 (38-90) yıldı. Seksen beş hastanın 60’ı (%70,6) erkek, 25’i (%29,4) kadındı. Tanı anında kemik iliği fibrozu 72 olguda (%84,7) mevcuttu. En sık 35 hastada (%41,2) derece 2 fibrozis görüldü. Hastaların %72,9’unda plazma hücre yüzdeleri %50’den fazlaydı. FISH analizi sonuçlarında kromozom anomalilerinin varlığı %37 (32/85) oranındadır. En sık kromozom görülen anormallik IGH translokasyonuydu (%21,3).IGH mutasyonlarının alt grup analizi, yüksek riskli MM hastalarının belirlenmesinde kritik öneme sahiptir. Çalışmamızın ülkemizdeki MM hastalarının Kİ biyopsisi ve sitogenetik özelliklerinin belirlenmesine katkı sağlayacağına inanıyoruz.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL). The treatment of older NHL patients has always been a struggle; however, treatment statistics have begun showing favorable results similar to those of younger DLBCL patients thanks to newer treatment protocols. Here, we analyze the progress of our own elderly DLBCL patients who were followed between 2000 and 2016 in our center.Eighty-seven DLBCL patients, who were diagnosed and treated in the Dokuz Eylül University Department of Hematology between 2000 and 2016, were included in this study. Median age was 72 (65-89) years and 13 (14.9%) patients were older than 80 years.Median follow-up time was 19 months and 45 patients (51.7%) died during the follow-up period. Median overall survival (OS) was 55 months and median progression-free survival was calculated as 27 months. Sixty-three patients (72.4%) received standard R-CHOP therapy. Complete response was seen in 46 (52.9%) patients. The median survival time for patients who had complete response was 136 months (p0.001); however, OS was not statistically different between older (80 years) and younger patients (p=0.236).According to our findings, we think that being able to complete standard R-CHOP therapy is vital for the survival rate of elderly DLBCL patients.Diffüz büyük B hücreli lenfoma (DBBHL), Hodgkin dışı lenfomalar (NHL) arasında en sık görülen tiptir. Yaşlı NHL hastalarının tedavisi genellikle zorlu olmakla beraber günümüzde gelişen tedavi protokolleri ile birlikte yaşlı hastalarda da genç DBBHL hastalarına benzer oranda daha iyimser sonuçlar elde edilmektedir. Bu çalışmaya Dokuz Eylül Üniversitesi Hematoloji Anabilim Dalı’nda 2000-2016 yılları arasında takip ve tedavi edilmiş 87 yaşlı DBBHL hastası dahil edildi.Yaş ortalaması 72 (65-89), 80 yaşının üzerinde 13 (%14,9) hasta mevcuttu. Ortalama takip süresi 19 ay olup, tüm takip süresinde hastaların 45’inin (%51,7) öldüğü gözlendi.Ortalama genel sağkalım süresi 55 ay iken progresyonsuz sağkalım süresi 27 ay olarak hesaplandı. Hastaların 63’ünün (%72,4) standart R-CHOP tedavisi almış olduğu görüldü. Ek olarak hastaların 46’sında (%52,9) tam yanıt alındığı gözlendi. Tam yanıt izlenen hastaların ortalama genel sağkalım süresi 136 ay olarak saptandı (p0,001), ancak, 80 yaş üzeri hastalar ile altındaki hastaların genel sağkalım süreleri arasında anlamlı istatistiksel fark izlenmedi (p=0,236).Bu veriler ışığında yaşlı DBBHL’li hastalarda standart R-CHOP tedavisinin tamamlanmasının sağkalım süresine önemli etkisi bulunduğunu söyleyebiliriz.

PURPOSE: Hairy cell leukemia (HCL) is a chronic lymphoproliferative disorder which counts %2-3 percent of the leukemias. B-RAF is a member of mitogen activated protein kinase pathway, associated with cell proliferation. The most common B-RAF mutation V600E has been shown in hairy cell leukemia recently. The aim of our study is to investigate B-RAF V600E and B-RAF codon 464-469 mutations in HCL patients and compare the results with clinical parameters. METHODS: Thirteen individuals who were diagnosed and followed up with hairy cell leukemia in Dokuz Eylul University Faculty of Medicine Hematology outpatient clinic are included in our study. Demographic and clinical data are collected and B-RAF mutations are analyzed with pyrosequencing based molecular methods. RESULTS: B-RAFV600E mutation was positive in 10 (%76,9) patients. B-RAF G464E was mutated in one patient, B-RAF G466E was positive in another and B-RAF G469E mutation has been found in a patient. Two patients had both codon 600 and codon 464-469 mutations, showing no invincible difference clinically. All the patients having lymphadenopathy had B-RAFV600E mutations.(p=1.000) Response rates were similar in the groups having B-RAFV600E mutation and/or B-RAF codon 464-469 mutations. CONCLUSION: B-RAF is a commonly mutated gene in hairy cell leukemia with different types of muatations. Especially B-RAFV600E mutation can be used as a supportive diagnostic test, in cases with contraversial diagnosis or differential diagnosis of other peripheral B cell neoplasms. Also it can be used as a marker to select the candidate patients for target therapies, who did not respond to the conventional therapies.

Objective: Purpose of the present study was to compare patients with proximal femur metastasis with actual or impending fractures who were treated by fixation or prosthetic hip replacement. Method: Twenty-seven patients underwent fixation treatment (IM nail, DHS), and 20 patients prosthetic (endoprosthesis or total hip arthroplasty) replacement. Data were analyzed regarding patient demographics, cancer type, localization and type of metastasis, actual or impending fracture, number of bone metastasis, presence of spinal or visceral metastasis and treatment data (ASA class, length of hospital stay or surgery or survival, cement usage, adjuvant treatment, postoperative walking status). Results: Fixation group (63 years) was younger than prosthesis group (70 years) (p: 0.03). Fixation was more preferred at subtrochanteric area (p˂0.001). Cementation of the lesion was more preferred and surgery time was longer at fixation group (p: 0.01). Greater number of complications (mostly medical) were more likely to be seen in the fixation group (6 ‘1 loosening’ vs 3 ‘1 dislocation’). Conclusion: It is not still clear whether one implant is clearly superior to other one, however it was revealed again that nailing was mostly preferred for the subtrochanteric area and tended to have more complications although mostly medical and unrelated to implant placement as previously reported

Background: Follicular lymphoma is the second most frequent non-Hodgkin lymphoma (NHL) accounting for 20-25% of NHL cases in western countries. Although it has an indolent character, progressive disease or relapse occurs within first two years following therapy initiation in ~20% of FL cases. Several somatic mutations were identified in genes of epigenetic regulation or other biological processes by sequencing of FL tumors. Current diagnostic and prognostic evaluations include invasive methodologies that may be less effective and more risky for the FL patients. Therefore, there is urgent need for development of non-invasive methods to improve diagnosis as well as risk stratification. Accumulating evidence has shown that circulating cell-free DNA (cfDNA) includes tumor-derived mutations in several cancer types; however, this possibility has not been comprehensively investigated in FL patients. Here we evaluated the potential diagnostic and prognostic value of cfDNA in FL cases by addressing the proportion by which cfDNA samples contains cancer-associated and prognosis-related mutations. Methods: Twenty FL cases with available clinic data were included in this study. Thirteen of these cases were symptomatic who were later treated with R-chemo whereas rest of the cases were asymptomatic who were in watchful-waiting. Plasma cfDNA, granulocyte DNA, and FFPE tumor tissue DNA samples were obtained from treatment-naive FL cases. A custom gene panel including exons and exon-intron boundaries of 110 FL-associated genes was constructed based on previously published studies for ultra-deep targeted sequencing. Paired-end sequencing of the captured regions were performed using a HiSeq system in Novogene, which generated 150 bp NGS reads. Targeted genomic regions were covered with > 1500X average effective sequencing depth for identification of somatic variants with low variant allele fractions (VAF). Variants present in cfDNA and tumor tissue DNA but not in patient-matched granulocyte DNA were identified with the GATK pipeline including the MuTect2 variant caller. Somatic variants associated with hematopoietic and lymphoid tissues in the COSMIC database were chosen for further analyses. The final high-confident list of variants was determined by visual investigation and through additional filtering of each variant using Integrative Genomics Viewer. Selected variants were cross-validated with Sanger sequencing. Survival analyses were performed with Survival and Survminer R packages. Results: Ultra-deep targeted sequencing revealed 91 somatic variants (71 missense, 12 nonsense, 4 indel, 4 splice site) in 31 genes included in the panel. Consistent with previous reports, the most frequently mutated genes were CREBBP (40%), BCL2 (30%), STAT6 (25%), EZH2 (20%), and CARD11 (20%). In symptomatic cases, 41.5% of the variants was present in both cfDNA and tumor tissue DNA, whereas 52.3% and 6.2% of them was present only in tumor tissue DNA or in cfDNA samples, respectively. In asymptomatic cases, 11.5% of the detected variants was present in both cfDNA and tumor tissue DNA, while 84.6% and 3.8% of them were in only tumor tissue DNA or cfDNA samples. Mutations previously reported to be associated with FL pathogenesis (e.g. KMT2D R2417*) were in the list of common variants observed in both cfDNA and tumor tissue DNA. We observed high Ki67 staining, elevated LDH levels, presence of BCL2 or CCND3 mutations to be significantly associated with progression-free survival (Figure 1A, B). Importantly, survival analysis by stratifying patients based on BCL2 mutations present only in cfDNA also predicted poor prognosis (Figure 1C). One of the FL patient who had progressive disease contained histological transformation-associated gene (i.e. B2M and BTG1) mutations only in the cfDNA but not in tumor tissue DNA sample. Finally, we cross-validated the selected somatic variants with VAF >20% using Sanger sequencing, which showed 100% consistency with NGS results. Conclusions: Tumor tissue-derived mutations can be detected in most FL patients albeit to a lesser extent than those in DLBCL. Plasma cfDNA genotyping may be useful for improving diagnosis and prognosis especially in symptomatic FL patients. Given that some somatic mutations associated with disease progression are detected only in plasma cfDNA samples, cfDNA genotyping may be useful for choosing appropriate therapy for high-risk FL patients. Disclosures No relevant conflicts of interest to declare.

Objective: Lipodystrophy represents a group of rare diseases characterized by loss of body fat. While patients with generalized lipodystrophy exhibit near-total lack of fat, partial lipodystrophy is associated with selective fat loss affecting certain parts of the body. Although classical familial partial lipodystrophy (FPLD) is a well-described entity, recent reports indicate phenotypic heterogeneity among carriers of LMNA pathogenic variants. Methods: We have encountered 2 unique cases with complex phenotypes, generalized fat loss, and very low leptin levels that made the distinction between generalized versus partial lipodystrophy quite challenging. Results: We present a 61-year-old female with generalized fat loss, harboring the heterozygous pathogenic variant p.R541P (c.1622G>C) on the LMNA gene. The discovery of the pathogenic variant led to correct clinical diagnosis of her muscle disease, identification of significant heart disease, and a recommendation for the implantation of a defibrillator. She was able to start metreleptin based on her generalized fat loss pattern and demonstration of the genetic variant. Secondly, we report a 40-year-old Turkish female with generalized fat loss associated with a novel heterozygous LMNA pathogenic variant p.K486E (c.1456A>G), who developed systemic B cell follicular lymphoma. Conclusion: Clinicians need to recognize that the presence of an LMNA variant does not universally lead to FPLD type 2, but may lead to a phenotype that is more complex and may resemble more closely generalized lipo-dystrophy. Additionally, providers should recognize the multisystem features of laminopathies and should screen for these features in affected patients, especially if the variant is not at the known hotspot for FPLD type 2. © 2020 Elsevier Inc., Bristol-Myers Squibb, BMS; AstraZeneca; University of Michigan, U-M; Ionis Pharmaceuticals; Akebia Therapeutics, E.A.O. and J.E.A.W. were partially supported by the Lipodystrophy Fund at the University of Michigan which is graciously funded by the Sopha Family and the White Point Foundation of Turkey. E.A.O. received grant support from and served as an advisor to Amylin Pharmaceuticals LLC, Bristol-Myers Squibb, and AstraZeneca in the past and is currently receiving grant support from Gemphire Therapeutics, Aegerion Pharmaceuticals, Ionis Pharmaceuticals, and Akcea Therapeutics and is serving as an advisor to Aegerion Pharmaceuticals, Akcea Therapeutics, and Regeneron Pharmaceuticals through funding paid to the University of Michigan. E.A.O. recently started grant support from GI Dynamics. B.A. has attended scientific advisory board meetings organized by Aegerion Pharmaceuticals and has received honoraria as a speaker from AstraZeneca, Lilly, MSD, Novartis, Novo Nordisk, Boehringer-Ingelheim, Servier, and Sanofi-Aventis. The other authors have no multiplicities of interest to disclose.

Amaç: Birçok faktör hematopoetik kök hücre (HKH) engraftmanını etkiler. Bu çalışmada hematolojik kanseri olan hastalarda kemik iliğindeki myelofibrozis ve anjiogenezisin engraftman üzerine etkisi araştırılmıştır. Gereç ve Yöntem: Otolog kök hücre nakli yapılan 34 hasta (20 erkek, 14 kadın) verileri değerlendirildi. Nakilden önceki son kemik iliğindeki fibrozis 0-3 arasında derecelendirildi, anjiogenezis stereolojik metod ile ölçüldü. Hastalar anjiogenezis parametrelerinin yoğunluğuna göre de iki gruba ayrıldı. Bulgular: Hastaların çoğunluğu (%73.5) multipl myelom idi ve yarısında fibrozis saptandı. On bir hasta derece 1, 6 hasta derece 2 fibrozise sahipti. Trombosit ve eritrosit engraftman günleri açısından derece 2 fibrozisi olan grupla fibrozis saptanmayan grup arasında istatistiksel anlamlı farklılık vardı. Derece 1 ve 2 fibrozis gruplarında fibrozisi olmayanlara göre VSD ve NVES düzeyleri anlamlı olarak yüksekti. Toplam yaşam derece 2 fibrozisi olan grupta daha düşük olmakla birlikte istatistiksel anlamlılık yoktu. Sonuç: Kemik iliği myelofibrozisinin bağımsız bir risk faktörü olduğu saptanmıştır. Bunun toplam yaşamı etkilemeden otolog nakil sürecinde trombosit ve eritrosit engraftmanı üzerine negatif etkisi olabilir. Fibrozisin derecesi ile doğru orantılı olarak artmış anjiogenezis arasındaki ilişkiyi açıklamak için ileri çalışmalar gereklidir. Purpose: Hematopoietic stem cell (HSC) engraftment is influenced by many factors. We investigated the effects of bone marrow fibrosis and angiogenetic structure on engraftment in patients with hematological malignancies. Materials and Methods: Data were collected from 34 patients (20 males and 14 females) who underwent autologous HSC transplantation. Bone marrow myelofibrosis was graded from 0 to 3, angiogenesis was quantified using a stereological method in the most recent bone marrow biopsy before the transplantation. Patients were categorized into two groups according to intensity of angiogenesis parameters. Results: Half of the patients had fibrosis and majority had multiple myeloma (73.5%). Eleven patients had grade 1, six had grade 2 myelofibrosis. The engraftment day (ED) for platelets and erythrocytes was significantly different between the grade 2 fibrosis and non-fibrosis groups. VSD and NVES levels were significantly higher in the grades 1 and 2 fibrosis groups than the no fibrosis group. While the overall survival time was shorter in the grade 2 fibrosis group than the others, the difference was not statistically significant. Conclusion: Bone marrow fibrosis was found to be independent risk factor. It may have a negative effect on platelet and erythrocyte engraftment time of autologous transplantation process but this effect does not influence survival.

Langerhans Cell Histiocytosis (LCH), which is caused by neoplastic clonal proliferation of Langerhans cells, may be associated with various malignant neoplasms, especially lymphomas, in rare cases. In literature some studies observed an unexpected number of second malignancies, both prior to and after the diagnosis of MCL. Here, we report a case with concurrent LCH and mantle cell lymphoma (MCL) in a same lymph node. To the best of our knowledge, this is the second reported case of LCH associated with mantle cell lymphoma in a lymph node., Langerhans hücrelerinin neoplastik klonal proliferasyonundan oluşan Langerhans Hücreli Histiyositozis (LHH) nadir durumlarda, özellikle lenfomalar olmak üzere çeşitli malign neoplaziler ile ilişkili olabilir. Literatürdeki bazı çalışmalarda MHL tanısı öncesi ve sonrasında, beklenmeyen sayıda ikincil malignite olduğu görülmüştür. Burada aynı lenf nodunda LHH ve mantle hücreli lenfoma (MHL) birlikteliği olan bir olgu sunulmaktadır. Bildiğimiz kadarıyla, bu olgu MHL ve LHH birlikteliği olan ikinci vakadır.

Gümüşün antimikrobiyal etkisini ve titanyum nitrürün mekanik ve kimyasal özelliklerini birleştirmek için, ortopedik implant malzemesi olarak kullanılan Ti6Al4V alaşımının yüzeyine N2 plazmasında plazma daldırma iyon implantasyonu ve biriktirme (PIII&D) yöntemi ile gümüş biriktirilmiştir. Kaplamalar, PIII&D prosesinin farklı negatif darbeli yüksek gerilim ve magnetron sıçratma gerilimi değerleri kullanılarak elde edilmiştir. Kaplamaların yüzey morfolojileri atomik kuvvet mikroskobu (AFM) ve kesit morfolojileri ise alan emisyonlu taramalı elektron mikroskobu (FE-SEM) kullanılarak tespit edilmiştir. Kaplamaların fazları ve kimyasal kompozisyonları sırasıyla X-ışını difraksiyonu (XRD) ve X-ışını fotoelektron spektroskopisi (XPS) kullanılarak tespit edilmiştir. Buna ek olarak, numunelerin yüzeyinden içeri Ag iyonlarının nüfuziyetini belirlemek için XPS derinlik profili (depth profile) analizi yapılmıştır. In-vitro biyouyumluluk deneylerinde numunelerin yüzeylerine 99mTc radyoizotopu ile işaretlenmiş E.coli (Escherichia coli) mikroorganizmasının adezyonu araştırılmıştır. Çalışmada, 8 kV'luk negatif darbeli gerilimin kullanıldığı deneylerle elde edilen kaplamalarda gümüşün dominant olduğu; bunun yanında, negatif darbeli yüksek gerilimin artmasıyla yüzeyde gümüş miktarının azaldığı gözlemlenmiştir.

Gümüşün antimikrobiyal etkisini ve titanyum nitrürün mekanik ve kimyasal özelliklerini birleştirmek için, ortopedik implant malzemesi olarak kullanılan Ti6Al4V alaşımının yüzeyine N2 plazmasında plazma daldırma iyon implantasyonu ve biriktirme (PIII&D) yöntemi ile gümüş biriktirilmiştir. Kaplamalar, PIII&D prosesinin farklı negatif darbeli yüksek gerilim ve magnetron sıçratma gerilimi değerleri kullanılarak elde edilmiştir. Kaplamaların yüzey morfolojileri atomik kuvvet mikroskobu (AFM) ve kesit morfolojileri ise alan emisyonlu taramalı elektron mikroskobu (FE-SEM) kullanılarak tespit edilmiştir. Kaplamaların fazları ve kimyasal kompozisyonları sırasıyla X-ışını difraksiyonu (XRD) ve X-ışını fotoelektron spektroskopisi (XPS) kullanılarak tespit edilmiştir. Buna ek olarak, numunelerin yüzeyinden içeri Ag+ iyonlarının nüfuziyetini belirlemek için XPS derinlik profili (depth profile) analizi yapılmıştır. In vitro anti-bakteriyel etkinlik deneylerinde numunelerin yüzeylerine 99mTc radyoizotopu ile işaretlenmiş E. coli (Escherichia coli) mikroorganizmasının adezyonu araştırılmıştır. Çalışmada, 8 kV'luk negatif darbeli gerilimin kullanıldığı deneylerle elde edilen kaplamalarda gümüşün dominant olduğu; bunun yanında, negatif darbeli yüksek gerilimin artmasıyla yüzeyde gümüş miktarının azaldığı gözlemlenmiştir., In order to combine the antimicrobial effect of silver with mechanical and chemical properties of titaniumnitrate, Ag was deposited on the surface of Ti6Al4V (orthopedic implant material) in N2 plasma by using plasma immersion ion implantation and deposition (PIII&D) method. The coatings were formed by usingvaried negative pulsed high voltage and magnetron sputtering voltage values of PIII&D process. Surfacemorphologies of coatings were determined with atomic force microscopy (AFM), while cross-section morphologies were determined with field emission scanning electron microscopy (FE-SEM). The phases and chemical compositions of coatings were investigated by using X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS), respectively. XPS depth profile analysis were done to reveal thepenetration of Ag+ ions into the surface of specimen. In in vitro anti-bacterial effectiveness experiments,the adhesion of E. coli (Escherichia coli) microorganism, which were marked with 99mTc radioisotope, on surfaces of specimens was investigated. It was consequently determined that Ag was dominant in thecoatings obtained by applying 8 kV negative pulsed high voltage, while Ag decreased on the surfacedepending on the increase in the voltage.

Achilles tendon ruptures are characterized by a long recovery period, high re-rupture rate and late return to work (1–3). Treated either conservatively or surgically, some patients may present with re-ruptures during the late phases of healing, generally between the 4th and 12th weeks (1,4), especially when the tissue quality is poor. As such, some biochemical agents including hyaluronic acid (5), calcitonin (6) and butyric acid (7), and various biomaterials, such as amniotic membrane and fluid (8), porcine intestinal submucosa (9,10), porcine dermal patch (11–13) and human dermal tissue matrix (14) have been used to augment tendon repair. Researchers have recently exhibited interest in growth factors that were shown to have positive effects on tendon healing (15–19) via acting on target cells present at the site of injury (1). Many studies have reported that autologous platelet-rich-plasma (PRP), derived from a patient’s venous blood, includes a mixture of growth factors (20–22) and can be used to treat tendon injuries as well as other sports-related disorders, and enhance cellular response to injury (20–22) and angiogenesis (23), despite the lack of evidence-based findings. However, the number of animal studies (1,24–28) that have reported both histopathological and biomechanical findings post-administration of PRP to the Achilles tendon and the number of human trials (3,29–32) are insufficient. As such, the present experimental study aimed to determine the histopathological and biomechanical effects of autologous PRP on the treatment of Achilles tendon rupture.

SUMMARY 1. In endothelial cells, the major receptor for the binding and internalization of oxidized low-density lipoprotein (LDL) is the lectin-like oxidized LDL receptor (LOX-1). The aim of the present study was to investigate the effects of taurine on intimal thickening and LOX-1 expression under normal and oxidative conditions. 2. The iliac artery of rabbits were subjected to balloon injury and oxidative stress was induced by 14 days treatment of rabbits with 75 mg ⁄kg, s.c., buthionine sulfoximine (BSO), a specific inhibitor of glutathione synthesis. Taurine was administered in drinking water (1% ,w ⁄v) for 14 days in the presence (BSO + Taurine group) and in the absence of BSO treatment (Taurine group). In taurine and placebo groups, rabbits were injected with 4 mL, s.c., 0.9% NaCl (vehicle for BSO) for 14 days. 3. Taurine (1% in drinking water, w ⁄v) preserved plasma levels of anti-oxidants and lowered the increased blood pressure induced by BSO. The stenosis rate of 29.92% in the placebo group increased to 72.20% in the BSO group, which was significantly reduced to 42.21% by taurine (P < 0.001; n = 5). Localization of LOX-1 to the intima and media of the iliac artery was demonstrated in the present study. Taurine treatment reduced the BSO-induced increase in LOX-1 expression at both the protein and mRNA levels (P < 0.05 and P < 0.01, respectively). 4. The results demonstrate that the stenosis rate and LOX-1 expression correlate well with oxidative status. Manipulation of LOX-1 expression by taurine may have therapeutic benefits in

WOS: 000298720200003, Objective: Collagen in the extracellular matrix (ECM) plays an important role in modulation of response to the vascular injury during the progression of atherosclerosis and restenosis. Collagen can regulate smooth muscle cell (SMC) proliferation, migration and matrix metalloproteinase (MMP) production. Therefore, collagen turnover in the arteries is an important determinant of intimal thickening. Heat shock protein 47 (HSP47), a collagen-specific molecular chaperone, is thought to be essential for the processing and secretion of procollagen molecules. Endothelin (ET) is a strong chemoatractant and mitogen promoting SMC proliferation and migration. The aim of this study was to investigate the possible role of HSP47 and its relation to collagen synthesis, and the effects of a nonselective ETA/ETB receptor antagonist, TAK-044 in collar-induced early atherosclerosis model. Material and Methods: New Zealand white rabbits were divided into two groups. Both groups received vehicle (0.9% NaCl 0.8 ml/kg/day, s.c.) or TAK-044 (5 mg/kg/day, s.c.) for three weeks. On 8th day, a non-occlusive silicon collar was placed around the left carotid artery. The right carotid artery was sham-operated. HSP47 expression in carotid arteries were determined immunohistochemically. Furthermore, total collagen levels, collagen expression and type I procollagen expression were established. Results: HSP47 expression correlated with collagen expression did not change in collared arteries. TAK-044 treatment did not affect HSP47 and collagen levels. Conclusion: There was a correlation between HSP47 expression and collagen expression in carotid arteries. However, intimal thickening did not induce HSP47 expression and early collagen development. The ineffectivenes of TAK-044 suggests that ET-1 signaling may not be implicated in HSP47 and collagen in this model., Ege UniversityEge University [04ECZ 020], This study was supported by Ege University Research Fund (Project No: 04ECZ 020 to Z.K.).

Focal adhesion kinase (FAK) is a protein tyrosine kinase essential for intracellular regulatory events, such as cell growth, differentiation, migration and tumor metastasis. The aim of this study was to analyze the expression of FAK protein in a series of normal and neoplastic lymphoid tissues. An anti-FAK antibody was used to study the protein expression in paraffin-embedded samples of normal and neoplastic, hematolymphoid and non-hematolymphoid tissues by immunohistochemistry. In normal hematolymphoid tissue, the strongest expression of FAK was detected in germinal center and marginal-zone B cells; positive staining was also found in mantle zone B cells. In human lymphomas, FAK was expressed mostly in B-cell lymphomas and was predominantly negative in T-cell lymphoma. In Hodgkin lymphomas, FAK was found only in the neoplastic cells of lymphocyte predominant type, whereas the tumor cells of the classical form were FAK-negative. We demonstrate for the first time the expression of FAK in paraffin-embedded hematolymphoid tissue samples. Its differential expression in lymphomas may be of relevance for some B-cell neoplasms by using it as an additional marker to distinguish B- from T-lymphoblastic leukemia/lymphoma to further differentiate lymphocyte predominant from classical Hodgkin lymphoma.

The neoplastic Reed-Sternberg cells characteristic of classical Hodgkin's lymphoma (cHL) are of B-cell origin but they almost always show striking loss of a range of B-cell-associated molecules. In contrast, the neoplastic cells found in lymphocyte predominant Hodgkin's lymphoma (LPHL) (L&H cells) are traditionally thought of as possessing the full repertoire of features associated with germinal centre B cells (eg BCL-6 expression, 'ongoing' Ig gene mutation). In the present paper, we report an extensive phenotypic analysis of L&H cells which revealed down-regulation of a number of markers associated with the B-cell lineage (eg CD19, CD37) and with the germinal centre maturation stage (eg PAG, LCK). The promoter methylation status of three of these down-regulated genes (CD10, CD19, and LCK) was further studied in microdissected L&H cells, and this revealed that their promoters were unmethylated. In contrast, these genes showed promoter methylation in cell lines derived from CHL. Further investigation of the mechanisms responsible for the deregulation of these molecules in L&H cells may provide new insights into the genetic abnormalities underlying LPHL. Copyright (c) 2007 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

The effect of altitude on renal failure and bone mineralization is not well known. This topic is studied in a 5/6 nephrectomy rat model. After hemoglobin, creatinine clearance and proteinuria were determined in 28 Wistar rats. Two 5/6 nephrectomy (Nx1-Nx2, n=7 each) and two sham (Sh1-Sh2, n=7 each) groups were formed. The Nx1-Sh1 and Nx2-Sh2 groups were kept at sea level and at 1200 m altitude, respectively. The same analyses were performed after 3 months just before sacrifices in order to harvest kidneys and femurs for histopathologic examination. Hemoglobin, creatinine clearance, and proteinuria were similar in all groups at the onset. Final hemoglobin was higher in Nx2-Sh2, but only Sh2 vs. Sh1 was significant (p=0.001). Creatinine clearance decreased (p=0.001 for Nx1) and proteinuria increased (p=0.002 for Nx1 and p=0.005 for Nx2) after 5/6 nephrectomy, but Nx1 vs. Nx2 was similar. Histopathological changes in the remnant kidneys were prominent, but Nx1 vs. Nx2 was not different. Although the relative osteoid volume increased in Nx groups, only Nx1 vs. Sh1 was different (p=0.006). In conclusion, exposure to 1200 m altitude, compared to the sea level, preserved the creatinine clearance better in 5/6 nephrectomized rats. No change was observed in proteinuria, renal histopathology, and bone mineralization.

There is little quantitative information about the amount of fibrosis in lymphomas. The aim of the present study was to investigate the amount of fibrosis in lymphomas and to highlight the relationship between fibrosis and mast cells, the key players of fibrosis. Tissue sections of 60 patients with diagnosis of lymphoma were reevaluated for classification. The mean fibrotic-stained area percentage (F-SAP) was determined in van Gieson-stained digital images using image analysis (Mediscope, Dokuz Eylul University, Clinical Engineering, Turkey). Mast cells were visualized using streptavidin peroxidase immunohistochemistry with anti-tryptase staining. Twenty-seven (44%) cases were Hodgkin's lymphoma (HL). F-SAP was 11.09+/-8.96 and 1.72+/-1.76 for HL and non-HL cases (Mann-Whitney U, p0.000), and the mean mast cell count (MMCC) was 24.63+/-13.58 and 8.03+/-8.07, respectively (Mann-Whitney U test, p0.000). There was a significant difference between F-SAP and MMCC concerning different types of lymphomas (Kruskal-Wallis test, p0.000). F-SAP was highest in nodular sclerosis HL, and MMCC was highest in mixed cellular HL. There was a strong positive correlation between MMCC and F-SAP (Pearson Correlation test, p0.000, r=0.51). These results suggest that the amount of fibrosis demonstrates differences in subtypes of lymphomas, and mast cells are increased in fibrosing lymphomas. However, it seems likely that more than one cell type is involved.

Objectives: Mucoid degeneration (MD) leads to nontraumatic tears of the meniscus even in the young population. The tears are often irrepairable. The purpose of this study is to find out if there is any relationship between the severity of mucoid degeneration (MD) and the biochemical environment of the knee. Our hypothesis is that meniscal tears due to more severe MD are associated with higher levels of markers in the synovial fluid. Methods: Synovial fluid samples were taken during isolated arthroscopic meniscectomies. Samples of excised menisci were sent to the department of pathology for grading of MD. According to the Copenhaver staging classification, stage 1-2 menisci comprised group A (n:13), and grade 3 menisci group B (n:19). Cases with instability and with greater than grade 2 chondral lesions were excluded. Synovial fluid samples were also aspirated from 9 normal knees of individuals operated from other sites of lower extremities; these comprised the control group (C). The synovial fluids were examined for MMP-3,TIMP-1,COMP and proteoglycan (PG)fragment levels. Results were statistically analyzed with nonparametric Mann Whitney's U test. Results: PG fragment levels were significantly higher in group B as compared to group A (p=0.044).When groups B and C were compared, the difference between PG fragment levels almost displayed significance (p=0.055).There were no significant differences between the groups A,B and C for MMP-3,TIMP-1,and COMP levels. MMP-3 levels were significantly higher for traumatic meniscal tears than nontraumatic tears (p=0.025). Conclusion: In this study, our hypothesis was partially confirmed. Higher levels of PG fragments were found in knees with higher grade of meniscal mucoid degeneration. MD may be associated with an insidious degenerative process in the knee.

Alternative sources for repair of cartilage defects are limited and donor sites are associated with morbidity. It is known that cartilage development from periosteal grafts is possible. Various factors have been found positively to affect this process in experimental settings. However, all of these studies were limited to joint cartilage. We conducted an experimental study in rabbits for the investigation of the elastic cartilage regeneration from perichondrial and periosteal grafts together with the effects of hyaluronan on this process. 1×1 cm 2 cartilage defects were created on the elastic ear cartilage of rabbits. Four experimental groups with 18 ears in each group were created: Group 1 (repair with perichondrium graft), group 2 (repair with periosteum graft), group 3 (repair with periosteum graft+hyaluronan), group 4 (defect-only control group). Macroscopic and microscopic evaluations were done on the 4th, 8th and 12th weeks. Cellular morphology of the regenerated cartilage and its integration and similarity with adjacent cartilage were evaluated. Cartilage regeneration groups 1, 2 and 3 were found to be statistically different from the control group. There was not a significant difference between groups 1 and 2 or 2 and 3. There is no significant difference between perichondrial and periosteal grafts in cartilage regeneration, and hyaluronan has no beneficial effect on this process.

The purpose of this study was to investigate whether quantitative assessment of cytologic anaplasia and angiogenesis may predict the clinical prognosis in medulloblastoma and stratify the patients to avoid both undertreatment and overtreatment. Medulloblastomas from 23 patients belonging to the Pediatric Oncology Group were evaluated with respect to some prognostic variables, including histologic assessment of nodularity and desmoplasia, grading of anaplasia, measurement of nuclear size, mitotic cell count, quantification of angiogenesis, including vascular surface density (VSD) and microvessel number (NVES), and immunohistochemical scoring of vascular endothelial growth factor (VEGF) expression. Univariate and multivariate analyses for prognostic indicators for survival were performed. Univariate analysis revealed that extensive nodularity was a significant favorable prognostic factor, whereas the presence of anaplasia, increased nuclear size, mitotic rate, VSD, and NVES were significant unfavorable prognostic factors. Using multivariate analysis, increased nuclear size was found to be an independent unfavorable prognostic factor for survival. Neither the presence of desmoplasia nor VEGF expression was significantly related to patient survival. Although care must be taken not to overstate the importance of the results of this single-institution preliminary report, pathologic grading of medulloblastomas with respect to grading of anaplasia and quantification of nodularity. nuclear size, and microvessel profiles may be clinically useful for the treatment of medulloblastomas. Further validation of the independent prognostic significance of nuclear size in stratifying patients is required. (C) 2004 Elsevier GmbH. All rights reserved.

Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease has multiple clinical features with variable courses creating several pitfalls in clinical diagnosis. There are number of reported cases mimicking malignant skeletal tumors such as chondrosarcoma. However, no case of CPPD disease with radiographic noncalcified soft tissue mass has been reported in the literature. Here we report a case of CPPD disease clinically mimicking soft tissue tumor with its magnetic resonance imaging appearance and histopathology.

Objective: Although 25-45% of all schwannomas are reported to occur in the head and neck region, nasal cavity and paranasal sinus involvement is rare, with 32 such cases described till 1999. Of these cases, only three were cystic. Herein we present a cystic schwannoma of the maxillary sinus of a 66-year-old, otherwise healthy male patient. Methods: The tumor tissue was routinely processed, embedded in paraffin, and stained with H&E. Immunostaining was performed for S-100 protein, epithelial membrane antigen (EMA) and cytokeratin. Results: A mass with sudden enlargement, inhomogenous enhancement with cystic areas, S-100 positive membrane-like structures lining the cystic cavity of an otherwise classical schwannoma were the main features encountered in our case. Conclusion: We recommend that cystic schwannoma should be kept in mind in the differential diagnosis of cystic masses of the maxilla. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.

© 2014 Cehreli et al.Background: Mast cell leukemia (MCL) is rare type of neoplasia with an incidence of 1% in a large series of 342 adult patients with systemic mastocytosis (SM). Chronic basophilic leukemia (CBL) is an extremely rare type of leukemia with appearance of 7 cases in the literature. Case presentation: A 73 year-old female patient who presented with weaknes, had a prolonged duration of hematologic remission after treatment of her CBL by hydroxyurea (HU). Evolution of SM occurring as a second neoplasia concurrently with relapse of de novo CBL was demonstrated by mast cells (MCs) infiltration in the bone marrow (BM) biopsy and smear and increase in tryptase level. Transformation to MCL with simultaneous occurrancof accelerated phase of CBL were documented by the appearance of MCs in both BM and peripheral blood (PB) smears, antigen expressions detected by flow cytometry and spesific stains. Sequence analysis of c-kit gene revealec-kit exon 11 K550N mutation. Undefined associations of MCL with different mast cell morphology, increase in IL-6 level and accelerated phase of de novo CBL was described. Conclusion: Elevations in CRP and IL-6 levels occurring with increases in basophil counts to high levels revealed that febrile episodes with abdominal pain seen in our patient were induced by increase in IL-6 levels released from neoplastic basophils. Neoplastic basophils with diffuse and coarse basophilic granules possibly mimic neutrophils with toxic granules and cause wrong characterization of neoplastic basophils as neutrophils by the automated blood cell counters and misleaded physicians.

Dear Editor, We read with interest by Lee et al. (1) about “Retropharyngeal Spindle Cell/Pleomorphic Lipoma”, published in the May/June issue of the 2013 Korean Journal of Radiology. We would like to report a distinct radiologic presentation of a “fat-free” retropharyngeal spindle cell lipoma on magnetic resonance (MR) imaging. Our patient was a 54-year-old woman who presented with dysphagia and neck swelling. She also complained of dyspnea with several months of duration. Neck CT and MRI were performed with routine parameters. MR imaging revealed a well-defined tumor arising from the retropharynx and extending to the parapaharyngeal region on the left side especially. The tumor was iso-intense to the muscles on both of T1and T2-weighted images (WI) and had within tumor slightly hyper-intense areas on fat saturated T2WI (Fig. 1). The lesion showed mild heterogeneous enhancement on contrast enhanced T1WI and did not contain visible fat on all radiologic images. The patient underwent a surgical excision of the tumor via transcervical approach. The tumor appeared as a well-circumscribed

Acute lymphoblastic leukemia (ALL) is a pediatric malignancy associated with remissions and relapses. Common relapsing sitesare meninges, testis and ovary. Testicular scintigraphy is a highly specific modality used mainly in the differential diagnosis of testicular torsion and epidydimitis/epidydimo-orchitis. There is only one interesting image on leukemic infiltration with scrotal scintigraphy in the literature. The aim of this case presentation is to report that although the scintigraphic appearance of testicular torsion was observed in a patient with the diagnosis of ALL, testicular ALL infiltration was revealed in pathologic examination.None declared.Akut lenfoblastik lösemi (ALL), çocukluk çağında görülen, relaps ve remisyonlarla seyreden bir malignitedir. Relapsları sıklıkla meninksler, testis ve overlerde izlenir. Testis sintigrafisi, esas olarak epididimit/epididimoorşit ve testis torsiyonu ayırıcı tanısında kullanılan oldukça spesifik bir yöntemdir. Literatürde skrotal sintigrafide lösemik infiltrasyon ile ilgili sadece bir adet görüntü mevcuttur. Bu olgu sunumunda amacımız, ALL tanısı ile takip edilen hastada sintigrafik olarak testis torsiyonu görünümü olmasına rağmen, patolojik incelemede testiste ALL infiltrasyonu görüldüğünü bildirmektir.

BACKGROUND: Curschmann's spirals, first described more than 100 years ago, are common in cytologic specimens 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. CASE: A 29-year-old woman, gravida 2, para 2, underwent right ovarian cyst excision after an abdominal ultrasound examination revealed a cystic mass of the right ovary. Histologically, the cyst was an immature cystic teratoma containing respiratory epithelium with mucous glands in the submucosa. Cytologic examination of the cyst fluid showed the presence of Curschmann's spirals. CONCLUSION: To the best of our knowledge, the formation of Curschmann's spirals associated with an immature cystic teratoma has not been previously reported. In this situation, the presence of spirals could be explained by formation from mucus normally found in that environment.

Diffuse large B-cell infiltration of the skin includes mainly primary cutaneous follicle center lymphoma (PCFCL) with diffuse architecture and diffuse large B cell lymphoma (PCDLBCL), leg type. Differentiation of these lymphomas on morphology may be troublesome. Immunohistochemistry panel, including CD20, CD79a, bcl-6, bcl-2, MUM-1, FOX-P1 is mandatory. However, in minority of cases, these markers would not suffice. In order to search the value of another marker, IgM, 30 cases of PCFCL and 10 cases of PCDLBCL, leg type were included in the study. As suggested in a recent literature, our study denoted that expression of IgM was useful as an additional tool for differentiation. (C) 2011 Elsevier Ltd. All rights reserved.

Diagnosis of low-grade chondrosarcoma, especially discrimination between enchondroma and low-grade chondrosarcoma, may be difficult pathologically. The aim of this study was to evaluate the value of thallium-201 (Tl-201) scintigraphy in the diagnosis of chondrosarcoma and to investigate whether there was a correlation between Tl-201 uptake and tumor grade. We retrospectively evaluated 121 patients with pathologically proven bone and soft tissue tumors diagnosed between the years 1999 and 2007. All patients were followed by the Bone and Soft Tissue Tumor Working Group in our hospital. Twenty-three patients, mean age 44 ± 15 (range 17–72) years, with a diagnosis of cartilaginous tumors were included. Increased Tl-201 uptake at the lesion sites greater than background was evaluated as malignant tumor. For the pathologic classification, a grading system (grade 1–3) based on the histopathologic findings was used. Pearson correlation coefficient was used to determine whether there was any correlation between Tl-201 uptake and tumor grade in chondrosarcoma. There were 7 enchondromas and 16 chondrosarcomas. Four of 16 patients with chondrosarcoma had lesions pathologically classified as grade 3, 5 as grade 2, and 7 had grade 1 chondrosarcoma. Increased Tl-201 uptake was observed in all patients with grade 3 chondrosarcoma and 2 patients with grade 2 chondrosarcoma. Of 10 patients with chondrosarcoma, 3 grade 2 chondrosarcomas and 7 grade 1 chondrosarcomas, there was no Tl-201 uptake in the tumor region. A significant correlation was found between Tl-201 uptake and tumor grade in chondrosarcoma (p = 0.002, r = 0.71). Only a few reports in literature have demonstrated false negative results in low-grade chondrosarcoma. Tl-201 uptake was related to tumor grade in chondrosarcoma. If there is a possibility of chondrosarcoma, Tl-201 scintigraphy should be reported with caution.

It is believed that viral infections and the hyperimmune reaction due to these infections are involved in the etiology of Kikuchi-Fujimoto Disease (KFD), a rare cause of fever of unknown origin. Axillary lymphadenopathy and neurologic involvement are rare in KFD. We present a patient diagnosed with KFD histopathologically during an investigation of the origin of fever and axillary lymphadenopathy. Subsequently, incidental sinus aspergilloma was diagnosed radiologically in the patient and acute disseminated encephalitis developed during follow-up. This report aims to draw attention to the co-existence of KFD and Acute Disseminated Encephalomyelitis, two diseases of which the origins are not clear.

Matrix metalloproteinases (MMPs), and, in particular, gelatinases (MMP-2 and MMP-9), have been implicated in vascular cell proliferation and/or migration, contributing to intimal thickening, an essential stage in the development of atherosclerosis and restenosis following balloon angioplasty. Endothelin, a strong chemoatractant and mitogen, has been shown to promote smooth muscle cell proliferation and migration by activating MMPs via endothelin-A (ETA) receptors. The positioning of a soft silicon collar around the left carotid artery in rabbits results in intimal thickening. In this study, we investigate the possible role of gelatinases and the effect of a nonselective ETA/ETB receptor antagonist, TAK-044 (5 mg/kg body weight/day, subcutaneously [sc]), on these enzymes. Our results demonstrated that both MMP-2 and MMP-9 activities increased in response to collaring in placebo group, while treatment with TAK-044 significantly suppressed both gelatinase activities and proMMP-2 levels, and inhibited intimal thickening in collared arteries. These results suggest that either enhanced MMP expression or endothelin receptor antagonism may be involved in the formation of intimal thickening in this model.

To evaluate the clinical significance of immunoperoxidase staining for CD10, bcl-6, mum-1 and bcl-2 to subdivide DLBCL into prognostic subgroups, we analysed 50 DLBCL cases using immunohistochemical methods.Fifty DLBCL patients were evaluated retrospectively. The expression of CD10 was associated with better OS (p=0.04) whereas expression of mum-1 was associated with worse OS (p=0.009). There were no significance of OS in case of expression of bcl-6 (p=0.05) and bcl-2 (p=0.3). They were subclassified using CD10, mum-1, bcl-6 as germinal center B-cell like (GCB) lymphoma (30%) and non-GCB lymphoma (70%). The OS and EFS (event free survival) were longer in GCB group (p=0.002) and 5-year OS for GCB group was 92% compared with only 44% for the non-GCB group (p=0.02). The OS of the GCB group also was longer compared to that of the non-GCB group in low IPI subgroup (p=0.01).The existence of survival differences between GCB a non-GCB group also in the patients with low IPI score, showed the importance of prognostic classification in the risk-adaptive treatment approaches. The classification as GCB and non-GCB based immunostains may enable to define more accurate prognostic groups in DLBCL.

IATROGENIC ANGIOMATOUS KAPOSI’S SARCOMA OF THE GINGIVA IN A PATIENT WITH SMALL LYMPHOCYTIC LYMPHOMA/CHRONIC LYMPHOCYTIC LEUKEMIA Sulen Sarioglu, Sermin Ozkal, Guray Akturk, Ersoy Dogan, Mehmet Arici, Fatih Demirkan, Dokuz Eylul University, Faculty of Medicine, Department of Pathology, Izmir, Turkey; Dokuz Eylul University, Faculty of Medicine, Department of Otorhinolaryngology and Head and Neck Surgery, Izmir, Turkey; Dokuz Eylul University, Faculty of Medicine, Department of Hematology, Izmir, Turkey Fifty year old male patient presented with gingival hypertrophic, purple lesion of 4 cm diameter. He had a history of small lymphocytic lymphoma/chronic lymphocytic leukemia with deletion of 13q14.3; diagnosed 9 months ago. He had received fularabine, retoximabe and cyclosporine theraphy was induced and 6 cures could be admitted. Due to low platelet counts biopsy could be performed at the 3rd month. The biopsy revealed surface mucosal ulceration and a submucosal mass of spindle cells and vascular structures filled with blood cells. There was cellular atypia and few atypical mitosis. HHV8, CD31, CD38, D2-40 were positive and ki-67 index was 29%. Final diagnosis was angiomatous type Kaposi sarcoma (KS). The patient was HIV negative. KS of the oral cavity is most frequent in HIV positive patients but, however exceedingly rara, this diagnosis should be kept in mind in patients in cases receiving chemoteraphy for lymphoma.