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Objectives: In gastrointestinal stromal tumors (GIST), malignancy potential is determined by the prognostic disease risk stratification based on mitosis, tumor size, and location. Phosphohistone H3 (PHH3) is an immunohistochemical marker showing mitotic activity in cells. In this study, we aimed to evaluate mitosis in GIST with PHH3, compare the results with hematoxylin and eosin (HE) stained slides, and examine its relationship with other prognostic data. Methods: Clinicopathological findings and survival were determined in GIST cases diagnosed between 2006 and 2017. The prognostic risk score was calculated according HE- and PHH3-based mitosis. The cases were classified as Group I: HE + and PHH3 + and Group II: HE + and PHH3-. They were also grouped as those diagnosed before and after 2012 and the staining results of HE and PHH3 were re-analyzed. Results: Ninety-eight cases were included in the study. Mitosis was detected with both HE and PHH3 in 63.3% of the cases (62/98 cases) (Group I) while in 36.7% of cases, it was detected with HE but not with PHH3 (Group II). In only two cases, the risk score changed with PHH3 (very low -> intermedier grade). The ratio of HE + and PHH3 + cases in 2012 and after was significantly higher than HE + and PHH3 - cases. A statistically significant relation was found between HE- and PHH3-based risk scores (p0.05). Conclusion: In GIST cases, PHH3 can be used to determine mitosis in more recent blocks, taking into account the technical conditions of the laboratory, but it does not seem to be superior to mitosis detected by HE. Research should continue on new survival determinants for GIST. WOS:000823035600017

Objective: As there is continuing disagreement among the observers on the differential diagnosis between the epithelial changes/lesions and neoplasms of the gallbladder, this multicentre study was planned in order to assess the rate of the epithelial gallbladder lesions in Turkey and to propose microscopy and macroscopy protocols. Material and Method: With the participation of 22 institutions around Turkey that were included in the Hepato-Pancreato-Biliary Study Group, 89,324 cholecystectomy specimens sampled from 2003 to 2016 were retrospectively evaluated. The numbers of adenocarcinomas, dysplasias, intracholecystic neoplasms/adenomas, intestinal metaplasias and reactive atypia were identified with the review of pathology reports and the regional and countrywide incidence rates were presented in percentages. Results: Epithelial changes/lesions were reported in 6% of cholecystectomy materials. Of these epithelial lesions, 7% were reported as adenocarcinoma, 0.9% as high-grade dysplasia, 4% as low-grade dysplasia, 7.8% as reactive/regenerative atypia, 1.7% as neoplastic polyp, and 15.6% as intestinal metaplasia. The remaining lesions (63%) primarily included non-neoplastic polypoids/hyperplastic lesions and antral/pyloric metaplasia. There were also differences between pathology laboratories. Conclusion: The major causes of the difference in reporting these epithelial changes/lesions and neoplasms include the differences related to the institute's oncological surgery frequency, sampling protocols, geographical dissimilarities, and differences in the diagnoses/interpretations of the pathologists. It seems that the diagnosis may change if new sections are taken from the specimen when any epithelial abnormality is seen during microscopic examination of the cholecystectomy materials.

WOS: 000404812600005 PubMed ID: 28044304 Objective: This study has been conducted so as to contribute to health statistics of hydatid cyst by the data obtained from our clinic, and to discuss hydatid cysts in unusual locations. Material and Method: Cases diagnosed as hydatid cyst at Dr. Lutfi Kirdar Kartal Research and Education Hospital Pathology Clinic between 2007 and 2015 have been evaluated based on criteria such as age, sex and location. Results: A total of 364 cases, 209 females and 155 males, have been included in the study. The subjects in the cases are aged between 4 and 81 (mean: 38.84). Regarding the sites, 254 (69.8%) of the cases are located in liver, and 53 (14.6%) in the lung. Fifty-seven cases (15.6%) have been detected in unusual sites other than the lung or liver. The rate of isolated organ involvement, other than the lung and liver, has been found to be 10.3%. Conclusion: Since hydatid cyst can be found in all the body sites, it should be taken into account in the differential diagnosis of all cystic lesions.

WOS: 000279339600006, Background and Design: Kaposi sarcomas (KS) are vascular tumors with a low malignant potential which include overlapping infectious, immunologic, and neoplastic processes. Recently, many histological subtypes have been defined. Material and Method: In the present study, 151 cutaneous classic KS lesions in 56 patients were retrospectively evaluated with regard to histological subtypes. Determination of the subtypes was based on the predominant histopathological component in the lesion. We examined changes in epidermis and dermis along with intratumoral inflammatory response characteristics in the lesions. By defining histopathological variants of the cases, differences regarding subtypes were investigated. Results: Cases that bear the ordinary characteristics of KS and those that can not be classified otherwise, comprised 82..8% of the study group. Twenty-six cases showed consistency with the subtypes outlined in the literature in terms of their histopathological properties. The most common histological subtype was the lymphangiectatic variant in 7.3% of the cases. Bullous (2.6%), lymphangioma like (2.6%), intravascular (2%), and pyogenic granuloma like (2%) variants were less common. The most uncommon histological subtype was micronodular (0.6%) type. Lymphangiectatic, bullous, intravascular, and pyogenic granuloma like variants were frequently observed in the nodular stage of KSs. Lympangioma like changes were seen to be present in the early KS lesions. Lymphangiectatic type was oftenly associated with bullous component, whereas pyogenic granuloma like type demonstrated superficial ulceration and intense inflammatory response. Lymphangioma like and intravascular types exhibited a characteristic appearance, while other variants were accompanied by components belonging to different subtypes. Conclusion: In KS, histopathological subtypes can develop as a result of different pathological processes. The next stage of the current study, which is one of the largest case series in the literature, will be investigation of the clinical and prognostic characteristics of the variants. (Turkderm 2010; 44: 73-8)

Kolonun sık görülen benign mezenkimal tümörü olmakla birlikte, lipomlar gastrointestinal sistemde oldukça nadirdir. Genellikle asemptomatiktir ve kolonoskopi ya da cerrahi işlem sırasında insidental olarak saptanır. Büyük boyutta olan olgular abdominal ağrı, diyare, kabızlık, rektal kanama ve intussepsiyona sebep olabilir. Transvers kolonda lokalize yaklaşık 7 cm çapında polipoid lezyon saptanan ve submukozal lipom tanısı alan olgumuz, nadir görülmesi nedeniyle literatür bilgileri ışığında sunulmuştur

Testicular epidermoid cyst is a rare entity that accounts forapproximately 1-2 % of all intratesticular tumors. Although the histogenesis ofthe lesion is not clear, its biological behaviour is benign. It is seenfrequently in right testis and on the 2nd and 4th decades. It has to bedistinguished from teratomas and dermoid cysts and due to the malignantpotential of teratomas, this differential diagnosis has a significant value. Masslesions of left testis were found in three cases; ultrasonography findings andtumor markers lead to preoperative diagnosis of testicular tumor andsubsequently, orchiectomy was performed. At the histopathologicalinvestigation, the cysts lined by keratinized squamous epithelium overlyingdense fibrous tissue were observed and diagnosis as epidermoid cyst. Epidermoidcyst of testis, being as a rare entity, is presented and discussed by means ofliterature., Testiküler epidermoid kist nadir görülür ve intratestiküler tümörler içinde yaklaşık olarak % 1-2 oranındadır. Histogenezi tartışmalı olmakla birlikte; benign biyolojik davranışa sahiptir. En çok 2.-4. dekadlarda ve sağ testiste izlenir. Ayırıcı tanıya teratom ve dermoid kist alınmalıdır. Özellikle teratomlardaki malignite potansiyeli nedeniyle bu ayrım oldukça önemlidir. Üç olgumuzda sol testiste lokalize kitlesel lezyon tespit edilmiş; ultrasonografi bulguları ve tümör belirleyicileri eşliğinde testis tümörü ön tanısı ile orşiektomi uygulanmıştı. Histolopatolojik incelemede fibröz duvara sahip keratinize skuamöz epitel ile döşeli kistler izlendi. Olgular bu bulgular eşliğinde epidermoid kist tanısı aldı. Nadir görülen testisin epidermoid kistleri literatür bilgileri ışığında sunuldu ve tartışıldı.

Lipoleiomyomas that are amongst the mixt mesodermal tumours of uterus are defined as lipoma or lipoleiomyoma according to the amount of adipose tissue and smooth muscle they include. In this article, these two lipoleiomyoma cases are presented with regard that they are encountered rarely and besides, one of them is accompanied with an uncommon primary renal pathology, oncocytoma., Uterusun mikst mezodermal tümörleri arasında yer alan uterin lipoleiomyomlar içerdikleri yağ dokusu ve düz kas miktarına göre lipom ya da lipoleiomyom olarak adlandırılırlar. İki lipoleiomyom olgusu nadir görülmeleri nedeni ile ve bir olguya böbreğin az görülen primer lezyonlarından onkositomun eşlik etmesi nedeniyle tartışmaya uygun bulundu.

40 years old female with a solid mass at the upper-lateral quadrant of the right breast. Radical mastectomy specimen revealed a nodular mass with even borders. Microscopically tumor was consisted almost 100% from malignant cells with apocrine differentiation, Sağ meme üst dış kadranda selid kitlesi olan 40 yaşındaki kadın hastanın İİAB'sinde malign epitelyal hücreler görülmesi üzerine radikal mastektomi yapılmış ve piyes kliniğimize gönderilmişti. Mikroskobik olarak tümörün tamamına yakınının apokrin differensiasyon gösteren malign hücrelerden oluştuğu görüldü.

Aggressive angiomyxom-a is a rare, slowly progressive, locally infiltrative stromal tumour. The case we present is a 27- year- old woman with an inguinal mass making.its third recurrence. Though the preferred therapy is local excision, wide excision is performed in our case to prevent another recurrence., Agresif anjiomiksoma, oldukça ender rastlanan , yavaş gelişen, lokal infiltratif bir stromal tümördür. Olgumuz 27 yaşında bir kadın hasta olup sağ inguinal bölgede üçüncü kez nüks eden kitle nedeni ile öpere edilmiştir. Tedavide lokal eksizyon önerilmekle birlikte , olgumuza yeni bir nüksün önlenmesi için geniş eksizyon uygulanmıştır.

Many epidemiological, clinicopaihological and molecular studies have shown the role of human papilloma virus (HPV) in the pathogenesis of the cervical carcinoma precursor lesions. Polimerase chain reaction (PCR), is very sensitive method for its establishment. Another method to identify HPV in cervival samples is immunohistochemistry (IHC). In this study, we aimed to determine HPV incidence in cervical invasive squamous cell carcinoma (ISCC) by using PCR and IHC and to investigate the correlation between HPV types and histological types. In our pathology department, 26 cases are investigated for HPV presence and types by PCR method. They are evaluated for HPV presence immunohistochemically by BSA-peroxidase (DAB) method. By PCR we found HPV 16 in 23%, 18 in 11.5%, 33 in 4%, 16+33 (mixt infection) in 4% of the cases. We didn't show HPV 6 and 11 in any of the cases. HPV positivity was 30.5%, immunohistochemically. In 5 of the 15 cases that were found to be negative by PCR, HPV was shown by IHC. The percentage of the cases proven to be HPV positive by PCR and/or IHC was 61.5%. When we compared the histological types with HPV types established by PCR, 18% of large cell keratinizing carcinoma (LCKC) was HPV 16 (+), 18% was 18 (+), 9% was 33 (+), 9% was 16+33 (+) and 46% was HPV(-); whereas 13% of large cell non-keratinizing carcinoma (LCNKC) was HPV 16(+), 18% was 18 (+), 69% was HPV(-) and 50% of small cell carcinoma was HPV 16(+), 50% was HPV(-). When we evaluated the histological type distribution oflHC-proven HPV positive cases, 37.5% was LCKC and 62.5% was LCNKC. We find the role and incidence of HPV in cervical carcinoma cases in our country comparable to global evidence; we conclude with the importance of screening programmes., Birçok epidemiyolojik klinikopatolojik ve moleküler çalışmalar çoğu servikal kanser prekürsör lejyonlarının patogenezinde human papilloma virüsün (HPV) varlığını ortaya koymuştur. Moleküler biyolojik tekniklerden polimeraz zincir reaksiyonu (PCR) oldukça duyarlı bir yöntemdir. Servikse ait örneklerde HPV yi belirlemede kullanılan bir başka yöntem de immünohistokimyasal (İHK) yöntemdir. Çalışmamızda serviksin invaziv skuamöz hücreli karsinomlarmda (İSHK), PCR ve İHK yöntemi kullanarak HPV insidansını belirlemekve bulunan HPV tipleri ile histolojik tip arasındaki korelasyonu incelemeyi amaçladık. Kliniğimizde İSHK tanısı almış 26 vaka PCR yöntemiyle hem HPV varlığı hem de HPV tipleri açısından; ayrıca İHK olarak HPV varlığı yönünden BSA-peroksidaz (DAB) yöntemiyle incelendi. Olgularımızda PCR yöntemiyle HPV 16 yi %23, HPV18'i %U.5, HPV33'ü % 4, HPV16+33'ü (mikst enfeksiyon) %4 oranında belirledik. HPV 6 ve IVi hiçbir olguda tespit etmedik. 26 olgumuzda İHK yöntemle % 30.5 oranında HPV pozitivitesi saptadık. PCR ile (-) bulduğumuz 15 olgudan 5'inde İHK ile HPV tespit ettik. PCR ve/veya İHK yöntemiyle HPV pozitivitesi saptadığımız olguların oranı %61.5' di. Histolojik tipleri PCR yöntemi ile bulduğumuz HPV tipleri ile karşılaştırdığımızda büyük hücreli keratinize karsinomların (BHKK) % 18'ni HPV 16 (+), % 18'ni HPV 18 (+), % 9 'nu HPV33 (+), %9'nu HPV 16+33 (+), % 46'sını HPV(-) tespit ettik. Büyük hücreli nonkeratinize karsinomların (BHNKK) % 13'üHPV16(+), %18' i HPV 18 (+), % 69'u HPV(-); küçük hücreli karsinomların (KHK) % 50'si HPV16(+), % 50'si HPV(-) di. İHK olarak pozitif olguların histolojik tip dağılımını incelediğimizde % 37.5'ni BHKK %62.5'ni BHNKK olarak belirledik. Yaptığımız çalışmada servikal karsinomlarda HPV'nin rolü ve insidansının dünya çapındaki bulgularla kesin benzerlikler gösterdiğini ve tarama programlarının önemini vurgulamaya çalıştık.

OBJECTIVES This study examined the frequency of chronic lymphocytic thyroiditis (CLT) in thyroid papillary carcinomas (TPC) and the relationship between the presence of tumor-infiltrating lymphocytes (TIL) and CLT. METHODS The study included 61 TPC cases. In each case, the presence of the lymphocyte infiltration in the tumor tissue and nonneoplastic parenchyma was graded semi-quantitatively using a scale of 0 to 3. The cases were classified in two groups, TPC including CLT (Group I) and TPC not including CLT (Group II). RESULTS CLT was detected in 26.3% (Group I) of the TPCs and TIL was observed in 77% of the Group I cases; no lymphoid infiltration compatible with TIL was detected in Group II. A significant difference was observed in the TIL density between Groups I and II. CONCLUSION CLT is a frequent finding in TPC, and the presence of TIL is related to CLT., AMAÇ Bu çalışmada, tiroid papiller karsinomlarında (TPK), kronik lenfositik tiroidit (KLT) görülme sıklığı araştırıldı ve tümörü infiltre eden lenfosit (TİL) varlığının KLT ile ilişkisi değerlendirildi. GEREÇ VE YÖNTEM Çalışma kapsamına 61 TPK olgusu dahil edildi. Tümör içi ve tümör çevresi parankimdeki lenfoid infiltrasyon varlığı, her biri için ayrı şekilde, semi-kantitatif olarak 0-3 arasında derecelendi. Olgular grup I (KLT içeren TPK) ve grup II (KLT içermeyen TPK) olmak üzere iki gruba ayrıldı. BULGULAR TPK'ların %26.3'ünde (grup I) KLT saptandı. Grup I'deki olguların %77'sinde TİL görülürken, grup II'deki olgularda TİL ile uyumlu olarak değerlendirilebilecek lenfoid infiltrasyon saptanmadı. Grup I ve grup II'deki olgular arasında TİL yoğunluğu açısından anlamlı farklılık belirlendi. SONUÇ Bulgularımız, TPK'da KLT'nin sık görülen bir bulgu olduğunu ve TİL varlığının KLT ile ilişkili bir parametre olduğunu göstermektedir.

OBJECTIVES: Several studies have established the functional markers that play role in human breast carcinomas and help the activities of anticancer agents. Although the treatment modalities of mammary carcinomas are chosen by evaluating prognostic parameters, none of the molecular markers has yet been accepted as an independent prognostic factor. However, recently, p53 tumour supressor gene and bcl-2 protooncogene have gained increasing interest. As well as estrogen receptor (ER) protein, progesterone receptor (PR) protein and c-erbB-2 levels are shown to have importance in individual response to hormonotherapy, radiotherapy and chemotherapy. Approaches of combining molecular markers provide more clinicopathological criteria that result in better predictions. In this study, we aimed to investigate the relationship of p53 and bcl-2 which are rather new markers, with c-erbB-2, ER and PR proteins. METHODS: In our pathology department, 65 mammary invasive ductal carcinoma cases are investigated for p53 and bcl-2, c-erbB-2, ER and PR expressions immunohistochemically (IHC) by using HRP-AEC methods. Besides, the staining percentages and staining intensity of the cases are compared statistically. RESULTS: Forty-seven out of 65 cases (72.3%) showed positive staining by p53, bcl-2 and PR protein. Forty-five out of 65 cases (69.2%) had positive staining by ER protein and 23 (35.3%) by c-erbB-2. Results were analysed by using chi square statistical analysis. There was no statistically significant correlation between p53 and bcl-2, c-erbB-2, ER or PR protein expressions (p>0.05) and between bcl-2 and c-erbB-2, ER or PR protein expressions (P>0.05). CONCLUSION: Although each one is accepted to have value regarding prognosis, our results, in acccordance with various literatures, did not show any statistically significant correlation between neither p53 nor bcl-2 and the selected prognostic parameters., Bazı çalışmalar insan meme karsinomlarmda rol oynayan ve antikanser ajanlarının aktivitelerine yardım eden fonksiyonel işaretleyicilerin (marker) varlığını ortaya koymuştur. Prognostik parametreler değerlendirilerek seçilmiş olan meme karsinomlarının tedavi modalitelerine rağmen, moleküler marker 'ların hiçbiri henüz bağımsız bir prognostik faktör olarak kabul edilmemiştir. Bununla birlikte, son zamanlarda, p53 tümör supresör gen proteini ve bcl-2 protoonkogeni giderek artan önem kazanmışlardır. Ostrojen (ER) kadar, progesteron reseptör proteini (PR) ve c-erbB-2 seviyeleri hormonoterapi, radyoterapi ve kemoterapiye bireysel yanıtta öneme sahip olduklarını göstermişlerdir. Moleküler marker'ların kombinasyonuna ilişkin yaklaşımlar,, daha iyi tahminlerle sonuçlanan daha fazla klinopatolojik kriter sağlar. Bu çalışmada, c-erb B-2, ER ve PR proteinleri ile daha yeni markerlar olan bcl-2 ve p53'üri ilişkilerini araştırmayı amaçladık. METODLAR: Patoloji bölümümüzde, 65 invasiv duktal meme karsinom vakasının p53 ve bcl-2, c-erbB-2, ER ve PR ekspresyonları HRP-AEC yöntemi kullanılarak immünohistokimyasal olarak (IHK) araştırılmıştır. Bunun yanısıra, boyanma oranları ve boyanma yoğunlukları istatistiksel olarak karşılaştırılmıştır. BULGULAR: 65 olgunun 47'si (% 72.3) p53, bcl-2 ve PR proteini ile pozitif boyanma göstermiştir. 65 vakanın 45'i (% 69.2) ER proteini ile, 23 'ü (%35.3) c-erbB-2 ile pozitif boyanmıştır. Sonuçlar ki kare istatistiki analizi kullanılarak analiz edilmişlerdir. p53 ve bcl-2, c-erbB-2, ER veya PR protein ekspresyonları arasında (p>0.05) ve bcl-2 ile c-erbB-2, ER veya PR protein ekspresyonları (p>0 05) arasında istatistiksel olarak önemli korelasyon saptanmamıştır. SONUÇ: Her birinin prognoza ilişkin değere sahip olduğu kabul edilmiş olmasına rağmen, bizim sonuçlarımızda, çeşitli literatürlere uygun olarak ne p53 ne de bcl-2 ve seçilen diğer prognostik parametreler arasında hiçbir istatistiksel öneme sahip korelasyon görülmemiştir.

Aim. Cavernous hemangioma-like Kaposi sarcoma is a rare morphologic type of Kaposi sarcoma. So far there are no cases in the literature defining the histological features of this morphologic spectrum in detail. In this study we presented two classical-type cutaneous Kaposi sarcoma cases with histologic findings resembling cavernous hemangioma in company with clinical and histopathological data. Cases. One hundred and eighty-five classical-type cutaneous Kaposi sarcoma lesions in 79 patients were assessed retrospectively in terms of histopathological features. Findings of two cases showing features of cavernous hemangioma-like Kaposi sarcoma whose clinical data could be accessed were presented in accompany with the literature data. Both cases were detected to have bluish-purple, protruded, irregularly bordered cutaneous lesions. Histopathological examination revealed a lesion formed by cavernous hemangioma-like vascular structures organized in a lobular pattern that became dilated and filled with blood. Typical histological findings of early-stage KS, consisting of mononuclear inflammation, extravasated erythrocytes, and a few immature vascular structures in superficial dermis, were observed. All cases were serologically HIV-1 negative. A positive reaction with HHV-8, CD31, CD34, and D2-40 monoclonal antibodies was identified at both cavernous hemangioma-like areas and in immature vascular structures. Results. Cavernous hemangioma-like Kaposi sarcoma is a rare Kaposi sarcoma variant presenting with diagnostic challenges, that may be confused with hemangioma. As characteristic morphological features may not be observed in every case, it is important for diagnostic purposes to show immunohistochemical HHV-8 positivity in this variant.

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