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BACKGROUND We aimed to evaluate the effectiveness of preoperative fine-needle aspiration biopsies (FNAB) by the postthyroidectomy pathology results. METHOD Seven hundred and ninety-five patients with FNAB and following thyroid operations which have been performed between April 2008 and December 2019 were included in this study. By comparing the results of the FNAB and final pathologies, the specificity, sensitivity, FNR, false positivity ratio (FPR), accuracy and also the effect of nodule diameter on these have been evaluated. In Bethesda III subgroup according to FNAB, we investigated the malignancy rates and in whom this risk has been increased more. RESULTS In our study, the sensitivity of FNAB is 73.40%, the specificity is 95.33%, the accuracy is 91.81%, FNR is 26.60% and FPR is 4.67%. In the patients with nodules ≥4 cm and

Background We assessed the validity of using serum pepsinogen tests (sPGTs) to differentiate autoimmune atrophic gastritis (AAG) from environmental atrophic gastritis (EAG). We also investigated the correlation and prognostic value between disease stage, according to Operative Link for Gastritis Assessment (OLGA)/Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM), and sPGT results in patients with gastric atrophy. Methods We enroled 115 patients in this prospective study: 95 with atrophic gastritis (16 with AAG and 79 with EAG) and 20 non-atrophic gastritis. These patients, along with 32 control patients, underwent esophagogastroduodenoscopy. Atrophy and intestinal metaplasia of the gastric biopsy specimens were staged according to the OLGA/OLGIM staging systems. Results The median (IQR) age of the patients (83 females (56.5%)) was 58 (46–67) years. Patients in the AAG group represented histologically advanced stages. The AAG group had lower pepsinogen (PG) I and II levels, as well as a lower PGI/PGII ratio, compared with the EAG group (p Conclusions sPGT may provide valuable information for differentiating advanced-stage AAG from EAG, and in patients with atrophic gastritis, use of sPGTs and OLGA/OLGIM staging together may predict gastric cancer risk.

Sarcomatoid variant of urothelial carcinoma of the urinary bladder is a rare malignant neoplasm, which is defined with biphasic neoplasm with both an epithelial and a mesenchymal component by histopathological and immunohistochemistry. It is responsible for 0.3% off all bladder carcinomas. The aim of this study was to present the histopathological and immunohistochemical findings of a case of sarcomatoid carcinoma of the urinary bladder and to review the relevant literature. A 75-year-old man was presented to our hospital with hematuria. 6.5x5.8 cm tumor was found in the urinary bladder at ultrasonography. Magnetic resonance imaging demonstrated a large irregular-shaped 9x5 cm tumor involving the right posterolateral wall of the urinary bladder and an atrophic kidney. The patient underwent cystoprostatectomy, left nephrectomy, and lymph node dissection. Macroscopically, a 7.5x6.1x1.8 cm ulcero-vegetating tumor mass infiltrating the bladder base, right-left side wall, anterior-posterior wall, and trigon was seen. Microscopically, this tumor was composed of high-grade urotelial carcinoma and mesenchymal differentiation areas with a wide eosinophilic cytoplasm, vesicular nucleus, distinct nucleolus and spindle-shaped areas. Immunohistochemically, mesenchymal differentiation areas were stained prominently with vimentin, keratin. The case was diagnosed as sarcomatoid carcinoma. Tumor metastasis was detected in the prostate and in bilateral pelvic lymph nodes. Although the clinical findings and the age of diagnosis of sarcomatoid urothelial carcinoma are similiar to conventional urothelial carcinoma, it has a worse prognosis. The presented case died 2.5 months after surgery. Sarcomatoid carcinoma seems to represent the final common pathway of urothelial carcinoma dedifferentiation. Keeping this aggressive tumor type in mind is essential for a correct treatment approach.

In patients with breast cancer (BC), lymphovascular invasion (LVI) status is considered an important prognostic factor. We aimed to develop machine learning (ML)-based radiomics models for the prediction of LVI status in patients with BC, using preoperative MRI images.This retrospective study included patients with BC with known LVI status and preoperative MRI. The dataset was split into training and unseen testing sets by stratified sampling with a 2:1 ratio. 2D and 3D radiomic features were extracted from contrast-enhanced T1 weighted images (C+T1W) and apparent diffusion coefficient (ADC) maps. The reliability of the features was assessed with two radiologists' segmentation data. Dimension reduction was done with reliability analysis, multi-collinearity analysis, removal of low-variance features, and feature selection. ML models were created with base, tuned, and boosted random forest algorithms.A total of 128 lesions (LVI-positive, 76; LVI-negative, 52) were included. The best model performance was achieved with tunning and boosting model based on 3D ADC maps and selected four radiomic features. The area under the curve and accuracy were 0.726 and 63.5% in the training data, 0.732 and 76.7% in the test data, respectively. The overall sensitivity and positive predictive values were 68% and 69.6% in the training data, 84.6% and 78.6% in the test data, respectively.ML and radiomics based on 3D segmentation of ADC maps can be used to predict LVI status in BC, with satisfying performance.

Background/aimWhile the treatment for early stage rectal cancer is surgery, when a diagnosis is made at a locally advanced stage, it is recommended to start treatment with neoadjuvant chemoradiotherapy. Therefore, it is important to determine which patients will respond best to neoadjuvant treatment. The aim of this study was to investigate which hematological, histopathological, and radiological parameters can predict the response to chemoradiotherapy. Methods and materialsA retrospective examination was made of 43 patients who underwent surgery following neoadjuvant chemoradiotherapy because of locally advanced stage rectal cancer. Demographic data were collected from the patient files, and the radiological, histopathological and laboratory findings before neoadjuvant chemoradiotherapy were compared with the findings after treatment. ResultsIn the postoperative evaluation, a pathological complete response was determined in 25.50% of the patients. Lymphovascular invasion, perineural invasion and absence of necrosisis were seen to be statistically related to major response (p, and in patients where the tumor was closer than 6cm to the anal verge, the response was betterConclusionWhen the findings were examined, histopathological lymphovascular invasion, perineural invasion, the presence of necrosis, and the anal verge distance were evaluated as parameters predicting the response to neoadjuvant chemoradiotherapy in rectal cancer.

Idiopathic granulomatous mastitis that has not had a clear consensus about its treatment since the day it was identified as a rare, benign inflammatory breast disease that mimics malignancy due to its appearance features.In our research, we intended to compare the efficiency of intralesional and systemic steroids administration in the treatment of idiopathic granulomatous mastitis.Prospective randomized controlled study.A total of 36 female patients who had been histopathologically diagnosed with idiopathic granulomatous mastitis and whose other factors had been microbiologically excluded were included in the study. The patients were randomized into two sub-groups that would be treated with systemic and intralesional steroids. All patients were evaluated through physical examination one week after the completion of the treatment. Subsequently, the follow-up of the patients was performed thorough physical examination and ultrasonography and/or magnetic resonance imaging at the 1st, 3rd, and 6th months.All patients adapted to treatment. Complete clinical regression occurred in 32 patients, while 30 of 36 patients responded to treatment both radiologically and clinically. A total of 4 patients had minor side effects. It was determined that there was no statistically significant difference between local and systemic steroid groups in terms of complete clinical regression, responded to treatment side effects, and recurrence rates.Intralesional steroid administration was also considered just as a successful treatment method as the systemic steroid administration.Idiopathic granulomatous mastitis, Intralesional steroid, Systemic steroid.La mastite granulomatosa idiopatica che non ha avuto un chiaro consenso circa il suo trattamento dal giorno in cui è stata identificata, è una rara malattia infiammatoria benigna della mammella, che imita la malignità per le sue caratteristiche del suo aspetto. Nella nostra ricerca, intendevamo confrontare l’efficienza della somministrazione intralesionale e sistemica di steroidi nel trattamento della mastite granulomatosa idiopatica con uno studio prospettico randomizzato e controllato. Sono state incluse nello studio un totale di 36 donne a cui era stata diagnosticata su base istopatologica una mastite granulomatosa idiopatica, con esclusione di altri fattori microbiologici. Le pazienti sono state randomizzate in due sottogruppi da trattare con steroidi sistemici oppure intralesionali. Tutte le pazienti sono state valutate tramite esame fisico una settimana dopo il completamento del trattamento. Successivamente è stato eseguito il follow-up delle pazienti con un esame fisico approfondito, ecografia e/o la risonanza magnetica al 1°, 3° e 6° mese. RISULTATI: tutte le pazienti si sono adattate al trattamento. La regressione clinica completa si è verificata in 32 pazienti, mentre 30 dei 36 pazienti hanno risposto al trattamento sia radiologicamente che clinicamente. 4 pazienti hanno avuto effetti collaterali minori. È stato constatato che non vi era alcuna differenza statisticamente significativa tra il gruppo delle trattate con steroidi locali e quelle con trattamento sistemico in termini di regressione clinica completa, risposta agli effetti collaterali del trattamento e tassi di recidiva. CONCLUSIONE: anche la somministrazione intralesionale di steroidi è stata considerata un metodo di trattamento efficace come la somministrazione sistemica di steroidi.

Adenoid basal carcinoma (ABC) is uncommon malignancy of the uterine cervix and it can be pure or combined with cervical intraepithelial lesions. There were less than 20 cases of ABC combined with invasive squamous carcinoma (mixed type) in English literature. These cases had similar properties as seen at postmenopausal women and diagnosed with abnormal cervical smear findings. Here we present a case of 37-year-old woman who suffered from spotting and received endocervical curettage. The pathological report revealed squamous cell carcinoma (SCC) of the cervix. The patient underwent type 3 radical hysterectomy and bilateral pelvic and para-aortic lymph node dissection. The final pathological report revealed SCC coexisting with ABC. Human papillomavirus (HPV) 16,18 and others (11 types) were negative in both components of the mixed tumor by in situ hybridization detection. Our case was cytokeratin 7 negative, cytokeratin 8 positive and p63 positive which supports the hypothesis that mixed type cervical carcinoma originates from endocervical reserve cells.

Tumor budding is an independent poor prognostic parameter in colorectal carcinoma (CRC). Golgi phosphoprotein 3 (GOLPH3) has been investigated in many solid organ tumors and has been associated with poor prognosis. In this study, the relationship of tumor budding and GOLPH3 and histopathological prognostic markers was investigated.140 colon resection materials diagnosed with adenocarcinoma between 2011 and 2018 were included in this study. Cases were reanalysed for their age, gender, tumor localization and size, histological grade, mucinous and signet ring cell differentiation, depth of invasion, lymphovascular and perineural invasion, stromal and intraepithelial tumor infiltrating lymphocyte (TIL), Crohn-like lymphoid reaction, peritumoral lymphocytic response, overall lympocytic score and lymph node metastasis. GOLPH3 antibody was applied to the sections containing the most dense tumor budding. The relationship between tumor budding and GOLPH3 expression, histopathological parameters and overall survival time was evaluated.Tumor budding was detected in 72 (51.4%) of 140 tumors. There was correlation between tumor budding and localization, size, histological type and grade, lymphovascular and perineural invasion, there was no relation with GOLPH3 expression. GOLPH3 expression was positive in 106 (75.7%) of tumors. Significant correlations were found between GOLPH3 expression and signet ring cell differentiation, stromal TIL, peritumoral lymphocytic response and overall lymphocytic score.Tumor budding and GOLPH3 expression are not correlated in CRC, but both are correlated to important prognostic histopathological parameters. In addition, tumor budding and GOLPH3 expression were not effective in overall survival, however, both parameters should be evaluated in a larger series.

Rationale and Objectives We aimed to investigate the value of magnetic resonance image (MRI)-based radiomics in predicting Ki-67 expression of breast cancer. Methods In this retrospective study, 159 lesions from 154 patients were included. Radiomic features were extracted from contrast-enhanced T1-weighted MRI (C+MRI) and apparent diffusion coefficient (ADC) maps, with open-source software. Dimension reduction was done with reliability analysis, collinearity analysis, and feature selection. Two different Ki-67 expression cut-off values (14% vs 20%) were studied as reference standard for the classifications. Input for the models were radiomic features from individual MRI sequences or their combination. Classifications were performed using a generalized linear model. Results Considering Ki-67 cut-off value of 14%, training and testing AUC values were 0.785 (standard deviation [SD], 0.193) and 0.849 for ADC; 0.696 (SD, 0.150) and 0.695 for C+MRI; 0.755 (SD, 0.171) and 0.635 for the combination of both sequences, respectively. Regarding Ki-67 cut-off value of 20%, training and testing AUC values were 0.744 (SD, 0.197) and 0.617 for ADC; 0.629 (SD, 0.251) and 0.741 for C+MRI; 0.761 (SD, 0.207) and 0.618 for the combination of both sequences, respectively. Conclusion ADC map-based selected radiomic features coupled with generalized linear modeling might be a promising non-invasive method to determine the Ki-67 expression level of breast cancer.

Background In recent years, GATA-binding protein 3 (GATA3) has been indicated as a marker showing good prognosis in breast cancer. In luminal breast cancer, which has good a prognosis, it shows more significant elevation in small-sized and low-grade tumors. In contrast, Ki-67 is defined as a poor prognostic factor. The aim of this study was to emphasise the prognostic importance of GATA3 and the inverse relationship with Ki-67. Materials and methods In our study, 90 patients with invasive ductal breast cancer were immunohistochemically evaluated for Ki-67 and GATA3 expression. The relationship between GATA3 and Ki-67 expression was examined. In addition, the relationship between these two factors with estrogen, progesterone, human epidermal growth factor 2 receptor antibodies and other prognostic parameters such as disease-free survival and local recurrence was investigated. We accepted the level of ≥5% nuclear reaction as positive for GATA 3. A Ki-67 cut-off value of 20% was accepted as positive. Results In GATA3 positive breast cancers, good prognostic parameters were seen including high estrogen receptor (ER) positivity, progesterone receptor (PR) positivity, small tumor size and low histological grade as well as low Ki-67 expression. In breast cancers showing high Ki-67 expression, ER, PR, and GATA3 positivity were lower and there was higher human epidermal growth factor receptor 2 (HER2) positivity and high histological grade while the tumor size was larger. Conclusion Our study has revealed that GATA3 has an inverse relationship with Ki-67, whereas it has a positive releationship with good prognostic factors.

Objectives: This study was an examination of malignancy risk determined according to clinical characteristics and preoperative diagnosis in vocal cord lesions compared with the definitive pathology results. Methods: This was a retrospective study of the files of patients who were admitted to a clinic due to hoarseness and/or a laryngeal lesion and underwent a suspension laryngoscopy (SL) between 2014 and 2018. The patient files were examined and the parameters of age, gender, smoking status, alcohol use, and the site of the lesion were compared for the risk of malignancy. The details of the preoperative diagnoses, peroperative findings, and definite pathology results were evaluated for agreement. Results: In all, 296 cases were reviewed. Since some patients had undergone multiple SL procedures, only the final pathology results of these patients were included in the study and the final total was 260 patients. The study population consisted of 191 (73.5%) male and 69 (26.5%) female patients. Of the group, 169 (65%) were smokers and 13 (5%) consumed alcohol. The lesions were left-sided in 106 (40.8%), right-sided in 120 (46.2%), and bilateral in 34 (13.1%) cases. A total of 68 (26.2%) cases were malignant, 165 (63.5%) were benign, and 27 (10.4%) were determined to be premalignant. Analysis of patient age revealed that the risk of malignancy was significantly higher in patients in the fifth or sixth decade of life (p

Aim To investigate the efficacy of adalimumab treatment in an experimental rat sclerosing encapsulated peritonitis (SEP) model. Methods The study involved 40 Wistar albino rats divided into four groups: chlorhexidine (CH) group, control group, CH + adalimumab group, and CH + resting group. The control group received normal saline intraperitoneally (i.p.). Other groups received 0.1% CH gluconate, 15% ethanol, and normal saline mixture i.p. for three weeks in order to induce SEP. CH + adalimumab group received 5 mg/kg adalimumab i.p. at the beginning of week 4 and week 6, while CH + resting group was followed-up for three weeks without applying any procedure after the onset of SEP. Rats in groups CH and control group were sacrificed on day 21, and rats in group CH + adalimumab and CH + resting were sacrificed on day 42. All groups were evaluated for peritoneal thickness, inflammation, vascularization, and fibrosis. Results CH + adalimumab group showed a significant decrease in peritoneal thickness, fibrosis score, and vascular score compared with CH group and CH + resting group. Conclusion Adalimumab can prevent SEP development.

Appendiceal mucinous neoplasms constitute a diagnostic spectrum ranging from adenoma to mucinous adenocarcinoma. To date, many classification systems have been proposed to reflect the histomorphological diversity of neoplasms in this range and their clinical correspondence, and also to form a common terminology between the pathologist and clinicians. The aim of this review is to provide an updated perspective on the pathological features of appendiceal mucinous neoplasms. Using the 2016 Modified Delphi Consensus Protocol (Delphi) and the Eighth Edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 19 cases presented from June 2011 to December 2016 were evaluated and diagnosed with appendiceal mucinous neoplasia. According to the Delphi, non-carcinoid epithelial tumours of the appendix were categorized in eight histomorphological architectural groups. These groups are adenoma, serrated polyp, low-grade appendiceal mucinous neoplasm, high-grade appendiceal mucinous neoplasm, mucinous adenocarcinoma, poorly-differentiated adenocarcinoma with signet-ring, signet-ring cell carcinoma and adenocarcinoma. The most common symptom was right lower quadrant pain. The median age of these cases was 60±15 years. There was a preponderance of females (F/M: 15/4). In our re-evaluation, six cases were diagnosed as serrated polyp. There were 11 cases in the LAMN group and two cases in the mucinous adenocarcinoma group. Using the Delphi and the AJCC manual, there were many changes in the classification, evaluation and treatment of appendiceal mucinous neoplasms. These classification systems have facilitated the compatibility and communication of clinicians and pathologists and have guided clinicians on treatment methods.

To investigate the haemostatic efficacy and histopathological effects of a new haemostatic agent, ankaferd blood stopper, in a rat conjunctival incision model.Twenty Wistar albino rats were divided into two equal groups (A, B). Limbal incisions of 90-120° were performed in both eyes of all rats. In group A, bleeding at the site of incision was controlled by the administration of ankaferd blood stopper to the right eyes and balanced salt solution to the left eyes. In group B, bleeding was controlled by the application of ankaferd blood stopper to the right eyes and cautery to the left eyes. Time to haemostasis was recorded. After a 4-week period, conjunctival vascularity and postoperative adhesion between Tenon's capsule and sclera were assessed. Additionally, eyes were enucleated and evaluated histopathologically.In group A, the mean bleeding times were 15.2 and 66.7 s for right and left eyes, respectively (P = 0.002). In group B, the mean bleeding times were 17.6 and 17.5 s for right and left eyes, respectively (P = 0.939). Cautery was found to cause significantly more adhesion (P = 0.04). Histopathological examination of the conjunctiva and scleral revealed no statistically significant difference between the samples.Given the ease of use and lack of histopathological side-effects in the conjunctival incision model, ankaferd blood stopper is promising for use in ophthalmic surgery. Ankaferd blood stopper is a potent haemostatic agent. Its use in ophthalmic surgery should be investigated further in a larger cohort of patients and tested in clinical and experimental models.

Objectives: We investigated the potential beneficial effects of local hypothermia applied during different periods of ischemia-reperfusion injury in a rat model.Methods: An isolated gracilis muscle model of ischemiareperfusion injury was used consisting of four groups, each with six rats. Ischemic injury was induced by clamping the femoral artery for six hours. Local hypothermia at 10 °C was applied during only ischemia (IH), during reperfusion (RH) for four hours, and during both ischemia and reperfusion (IRH). The control group remained untreated. After 24 hours of perfusion, the rats were sacrificed and the gracilis muscles were removed to determine muscle edema (wet-to-dry weight ratio), polymorphonuclear leukocytes (PMNL), and the percentage of necrosis.Results: Compared to the control group (193.7 ±38.9), the PMNL count was significantly lower in the IH, RH, and IRH groups (111.5±36.2, p, Amaç: Sıçan modelinde lokal hipotermi uygulamasının iskemi-reperfüzyon hasarının farklı evrelerindeki etkileri incelendi.Çalışma planı: Grasilis kası iskemi-reperfüzyon modeli için, her birinde altı sıçan olan dört grup oluşturuldu. Femoral arterin altı saat süreyle klemplenmesiyle iskemik hasar oluşturulan kaslara sadece iskemik dönemde (İH), sadece dört saatlik reperfüzyon döneminde (RH) veya iskemi ve reperfüzyon dönemlerinde (İRH) 10 °C’de lokal hipotermi uygulandı. Kontrol grubuna hipotermi uygulanmadı. Yirmi dört saatlik perfüzyon dönemi sonunda yaşamları sonlandırılan deneklerin grasilis kasları çıkarıldı ve örneklerde kas ödemi (yaş/kuru ağırlık oranı), polimorfonükleer lökosit (PMNL) sayımı ve nekroz yüzdesi incelendi.Sonuçlar: Kontrol grubuyla karşılaştırıldığında (193.7 ±38.9), PMNL sayıları İH grubunda (111.5±36.2; p

Inflammatory myofibroblastic tumor (IMT) of the kidney or perirenal soft tissue is a rare benign lesion that can mimic a malignant renal neoplasm. We describe the case of a 51-year-old woman that had originally been misdiagnosed as renal cell carcinoma in another hospital. Histologic re-evaluation of the tumor in our institution showed that it was in fact an IMT. Awareness of this entity is required for rendering the accurate diagnosis. An association with inflammatory infiltrate, frequent erythrocyte extravasations, edematous or myxoid stroma, absence of atypical mitosis, and the results of a detailed immunohistochemical panel might help in the differential diagnosis. Our patient is recurrence-free in the 18th month of post-operative follow-up. © 2007 Elsevier GmbH. All rights reserved.