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Ekrin spiradenoma ter bezi kökenli benign bir tümördür. Malign ekrin spiradenoma neredeyse daima daha önceden var olan bir spiradenoma lezyonundan gelişen nadir bir neoplazmdır. Bu yazıda daha önce benign ekrin spiradenoma tanısı konulmuş, dış kulak malign ekrin spiradenoması olan bir hasta sunuldu. Malign dönüşüm genellikle saldırgan davranış ile ilişkilendirilse de geniş eksizyon sonrası dört yıllık takipte nüks ve metastaz tespit edilmedi. Eccrine spiradenoma is a benign tumor of sweat gland origin. Malignant eccrine spiradenoma is a rare neoplasm which almost always arises from a pre-existing spiradenoma lesion. In this article, we present a patient with malignant eccrine spiradenoma of the auricula with a prior diagnosis as benign eccrine spiradenoma. Although malignant transformation is usually associated with aggressive behavior, we did not detect recurrence or metastasis in four years of follow-up after performing wide excision.

Background: The aim of this study was to evaluate the effects of long and short term systemic usage of royal jelly on bone formation in the expanded maxillary suture in a rat model. Material and Methods: Twenty eight Wistar albino rats were randomly divided into 4 equal groups: Control (C); Only Expansion (OE), Royal Jelly (RJ) group, Royal Jelly was given to rats by oral gavage only during the expansion and retention period; Royal Jelly plus Nursery (RJN) group, Royal Jelly was given to rats by oral gavage during their nursery phase of 40 days and during the retention period. After the 5 day expansion period was completed, the rats underwent 12 days of mechanical retention. All rats were sacrificed in same time. Histological examination was performed to determine the number of osteoclasts, number of osteoblasts, number of capillaries, inflammatory cell infiltration, and new bone formation. Results: New bone formation, number of osteoclasts, number of osteoblasts, and the number of capillaries in the expanded maxillary sutures were higher in the RJ and RJN groups than in the other groups. Statistical analysis also demonstrated that new bone formation and the number of osteoblasts was also highest in the RJN group. Conclusions: The systemic administration of Royal Jelly in conjunction with rapid maxillary expansion may increase the quality of regenerated bone.

WOS:000352200800008 PubMed: 24997024 Background/Objective: The aim of this study was to investigate the effect of systemic St John's wort (Hypericum perforatum) on bone formation in the expanded premaxillary suture in rats. Materials/Methods: A total of 28 rats were randomly divided into four groups of equal numbers: control (C); only expansion (OE); St John's wort extract given only during the expansion and retention period (a total of 17 days; SJW group); and St John's wort extract given during the nursery phase before expansion (a period of 40 days), and during the expansion and retention periods (a total of 57 days; N + SJW group). After the 5 day expansion period was completed, the rats in the OE, SJW, and N + SJW groups underwent 12 days of mechanical retention, following which they were killed, and their premaxilla dissected and fixed. Histological examination was performed to determine the number of osteoclasts and capillaries, as well as the number of osteoblasts, inflammatory cell infiltration, and the amount of new bone formation. Results: Statistical analysis showed that the number of osteoclasts and capillaries, and the inflammatory cell infiltration, as well as new bone formation, were higher in the SJW and N + SJW groups than in the other groups. However, statistical analysis demonstrated that among these two groups, all parameters, with the exception of the number of capillaries, were higher in the N + SJW group than the SJW group. Conclusions/Implications: Although more effective in long-term usage, systemic use of St John's wort hastens new bone regeneration at the premaxillary suture and may help prevent relapse after expansion.

WOS:000351058400054 PubMed: 25556476 Background: The aim of this study was to determine diagnostic and prognostic roles of the neutrophil to lymphocyte ratio (NLR) in breast cancer patients. To date, data are limited on associations of primary breast carcinoma (PBC) and benign proliferative breast disease (BPBD) with preoperative NLR values. Materials and Methods: Our study covered of 120 female patients with PBC and 50 with BPBD. Diagnostic values of NLR were estimated using sensitivity, specificity and areas under receiver operating characteristic curves (AUC). Results: NLR values were significantly higher in the PBC patients than in those with BPBD, with an AUC of 0.668 in the PBC case. The optimal cut-off for NLR was 2.96 and this was validated in the testing set, giving a sensitivity and a specificity of 79.7% and 76.2%, respectively, in PBC patients. Conclusions: Preoperative high NLR is a significant diagnostic predictor of distinction of breast cancer from BPBD and elevated NLR is also an important prognostic marker for primary invasive breast cancer.

WOS:000264352700011 PubMed: 19293505 We herein report an 11-year-old girl who came to our clinic with a swelling on the genital area of 2 months duration. Dermatological examination of the patient was performed and a pigmented lesion was found on the inner surface of the labium majus of the mucosa. The lesion was well circumscribed and approximately 1 cm in diameter, with homogenous color distribution. The patient was diagnosed as Spitz nevus on the basis of clinical and histopathological findings. Our case is probably the first reported case of Spitz nevus localized to the genital mucosa in the English literature.

GİRİŞ: Kanser çağımızda tüm ülkelerde en önemli sağlık sorunlarından birisidir. Bu nedenle kanserin önlenmesine yönelik çeşitli araştırmalar yapılmaktadır. Kanserle savaşta öncelikle hastalığın kimliği, boyutları ve yaygınlığının bilinmesi temel noktayı oluşturur. Böylece kanserin özellikleri ve davranışının belirlenebilmesi, koruyucu önlemlerin alınması, erken tanı, tedavi, takip ve araştırmaların planlanmasına ışık tutacaktır.Bu çalışmada kesin tanı almış tümör vakalarının raporları değerlendirilerek Bolu civarındaki tümör sıklığının saptanması, sık görülen kanser tiplerinin belirlenmesi ve bu bulguların Türkiye ve Dünya geneline göre farklılıklarının bulunarak detaylı çalışmaların yapılmasına yardımcı olmak amaçlanmıştır.GEREÇ VE YÖNTEMLER: 20 Aralık 2002 yılı ile 31 Aralık 2010 yılı arası 8 yıllık dönem içerisinde Abant İzzet Baysal Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı'nda kesin benign veya malign tümör tanısı alan hastalara ait raporların retrospektif olarak incelendiği bir araştırmadır. Bu raporlar yıl, yaş, cinsiyet ve sistemlere göre gruplandırdı, benign ve malign dağılımları incelendi. Veriler Open Office 3.1 programına girilerek aynı isimlere ait benzer sistemlerdeki aynı tümör tipine ait birden fazla veri tek veri haline dönüştürüldü. Sonuçlar sayılar ve yüzde oranları şeklinde verildi.BULGULAR: Toplam 18654 adet biyopsiye ait rapor geriye yönelik olarak tarandı. Benign ve malign tümör tanısı alan 4510 (% 24.18) olgudan 1984'ü (% 43.99) erkek, 2526'sı (%56.01) kadındır. Tümör tanısı alan olguların 1504 (% 33.35) tanesi malign olup, bunların 1020 (% 67.81) `si erkek, 484 (% 32.19) `ü kadındı. Her iki cins birlikte değerlendirildiğinde, tümör olguları en sık; malignlerde 60-69 yaş arasında, benign ve malignlerde ise 50-59 yaş aralığında görülmekteydi. Erkek hastalarda kanserler en sık 60-69 yaş arasında kadınlarda ise en fazla 40-49 yaş aralığında kanser bulundu. Çalışmamızda sistemlere göre benign ve malign tümörlere bakıldığında ilk 3 sırayı deri (%30.15), kadın genital sistem (% 21.57), sindirim sistemi (%12.92) almaktadır. Sadece malign olgularımız dikkate alındığında ise bu sıralama deri (% 21.07), erkek genital sistem (% 17.82), sindirim sistemi (% 14.96) olarak değişmektedir. Erkeklerde 1. deri (% 31.29), 2. sindirim sistemi (% 17.69), 3. erkek genital sistem (% 14.81) tümörleri, kadınlarda ise 1. kadın genital sistem (% 38.50) , 2. deri (% 29.3), 3. sindirim sistemi (% 9.20) tümörleri görülmüştürSONUÇ: Çalışmadan elde ettiğimiz sonuçların, Türkiye ve Dünyadaki benzer çalışmalarla kıyaslandığında benzerlik gösterdiği dikkati çekmektedir. Dünyada ve ülkemizde sık görülen akciğer tümörleri gibi bazı tümörlerin az görülmesi de yeni kurulan tıp fakültesi olmamız ve eleman ile teknik donanım eksikliğine bağlanabilir. INTRODUCTION: Cancer contemporarily constitutes one of the most significant health problems throughout the world. Consequently, a remarkable amount of investigations are performed in terms of preventing the development of cancer. An important aspect of measures against cancer is to determinate the extension and prevalence of cancer. Understanding characteristics and behavior of cancer is the key issue in providing preventive steps and developing proper strategies in the concept of early diagnosis and treatment.The objective of this study was to determine the regional cancer incidence and cancer types based on the pathology records of department of pathology, Medical School, Abant Izzet Baysal University. Secondly, the aim was to discuss the properties of these cases with other similar reports both from Turkey and the world.MATERIALS AND METHODS: A systemic retrospective review of all pathology records of the cases evaluated and diagnosed at the Department of Pathology, Medical School, Abant Izzet Baysal University between December 20, 2002 and December 31, 2010 was carried out. The results were classified based on year, age, sex and organ systems. Statistical analyses were carried out using Open Office version 3.1. The duplication of data was particularly prevented by excluding the multiple records in the case of more than one biopsies of the same cancer in the same patient.RESULTS: A total of 18654 pathology records was retrospectively analyzed. The ratio of positive cases was 24.18% (4510/18654) including all benign and malignant tumors. Among them 1984 (43.99%) were male and 2526 (56.01%) were female. On the other hand, malignant tumors constituted 33.35 % (1504/18654) of all cases and the percentage of male and female patients were 67.81 % (1020/1504) and 32.19 % (484/1504), respectively. The occurrence of malignant tumors was mostly seen between 60 and 69 years of ages, while the predominant age period was between 50 and 59 years of ages when considering both benign and malignant patients. Male patients had cancers mostly after 60 years of age and the predominant period was between 60 and 69 years of ages. Considering the female patients only, they had more cancers between 10 and 60 years of age than males, and the most prevalent period was between 40 and 49 years of ages.The prevalence of both benign and malignant tumors with respect to their origin were cutaneous sites, female genital tract and gastrointestinal system in 30.15%, 21.57% and 12.92 % of cases, respectively. Considering only the malignant tumors, the distribution was as cutaneous sites, male genital tract and gastrointestinal tract in 21.07%, 17.82% and 14.96% of patients, respectively.On the other hand, the order of cancers was cutaneous sites (31.29%), gastrointestinal tract (17.69%), male genital tract (14.81%), in male patients, while it was as female genital tract (38.50 %), cutaneous sites (29.30 %), gastrointestinal tract (9.20 %) for the female patients.CONCLUSION: Due to our datas, our results are similar to the results in Turkey and the World. The reason of the lower incidence of some tumors such as lung tumors which are much higher in Turkey and the World may depend on technical inadequacy due to our faculty's being a newly established one. 72

WOS:000250244400015 PubMed: 17901145 Objective. Lipoma arborescens (diffuse articular lipomatosis) is a rare intra-articular lesion consisting of subsynovial villous proliferation of mature fat cells. The usual clinical presentation is painless swelling. The aim of this series was to emphasize the importance of gray scale and color Doppler sonography through the investigation of chronic joint swelling. Methods. Lipoma arborescens of the knee and extensor digitorum longus tendon sheath at the ankle region are described. The latter is extremely rare. We examined 2 patients with sonography before using cross-sectional modalities. Results Gray scale sonography revealed hyperechoic irregular villous and frondlike projections within prominent joint effusion. A wavelike motion of the projections was shown by dynamic compression and manipulation of the effusion. We observed moderate vascularity on color Doppler sonography. Spectral analysis revealed a low-resistance arterial waveform. Conclusions. Gray scale sonography is a useful diagnostic modality that can be performed to evaluate chronic joint swelling before the use of cross-sectional and more expensive modalities.

VII-OZET Over kanserleri jinekolojik maligniteler içinde en çok ölüme neden olan kanser türüdür. Bunların da en sık görülen tipi over yüzey epitel kökenli karsinomlardır. Bütün over malignitel erinin %40'ını seröz papiller kistadenokarsinomlar oluşturur. Diğer jinekolojik malignitelerin aksine over karsinomlannda üzerinde geniş uzlaşı sağlanmış bir histopatolojik derecelendirme sistemi olmadığından derecenin prognostik önemi iyi tanımlanmamıştır. Bu çalışmadaki amacımız; over seröz karsinomlannda ikili derecelendirme sistemini ve bu derece sistemini kullanılmakta olan diğer derecelendirme sistemleri (FIGO, Shimizu-Silverberg) ile karşılaştırmak ve bu tümörlerde birer tümör baskılayıcı gen olarak kabul edilen BRCA1 ve p53'ü immünohistokimyasal olarak çalışmaktır. Çalışmamız için DÜTF patoloji arşivinden seröz papiller kistadenokarsinom tanısı almış 58 olgu seçildi. Bunların ikili sisteme göre derecelendirmelerinde 12 (%21)'si düşük, 46 (%79)'sı yüksek dereceli, FIGO sistemine göre; 9 (%16)'u derece I, 29 (%50)'u derece II, 20 (%34)'si derece III, Shimizu-Siverberg sistemine göre ise; 11 (%20)'i derece I, 29 (%50)'u derece II, 18 (%30)'i derece III olarak bulunmuştur. P53 olguların %57 (33/58)'inde BRCA1 (GLK2) ise %67 (39/58)'sinde pozitif izlendi. BRCA1 pozitif olanların 24 (%41)'ü nükleer, 10 (%17)'u nükleer+stoplazmik, 5 (%9)'i ise sadece stoplazmik boyandı. p53 ve BRCA1 pozitifliği ile tümürün histolojik derecesi arasındaki ilişkiye bakıldığında p53'ün boyanma oranı yüksek derecelilerde (%65) düşük derecelilere (%25) oranla daha yüksektir. BRCA1 (GLK-2) ikili derecelendirme sistemine göre düşük dereceli dediğimiz olguların %92 (ll/12)'sinde yüksek dereceli dediklerinizin ise %61 (28/46)'inde pozitiftir. Sonuç olarak; ikili derecelendirme sistemi FIGO ve Shimizu-Silverberg sistemleri ile iyi bir uyumluluk göstermektedir. Ayrıca tanımlanması kolay iki kritere göre değerlendirilmesi ve yalnız iki kategoriye (düşük, yüksek) ayrılması nedeniyle, ikili derecelendirme sisteminin over seröz kistadenekarsinomlarında daha verimli olacağını desteklemektedir. P53'ün aksine yüksek dereceli tümörlerin BRC Al ekspresyon oranı düşük (%61), düşük dereceli tümörlerin ise yüksek (%92) olarak bulunmuştur. P53 ile BRCA1 immünreaktivitesi arasında herhangi bir ilişki saptanmamıştır. 38 ABSTRACT Ovarian cancer is the most lethal gynecological malignancy and surface epithelial tumors are the most common type of ovarian cancer. Papillary serous carcinoma is believed to account for 40% of all malignant ovarian tumors. In contrast to other gynecological carcinomas the prognostic relevance of grading is not well established for carcinomas of the ovary, mainly because of the lack of a universally accepted histopathologic grading system. The purpose of this study to evaluate a two-tier grading system and comparison of the usefulness between this new system for ovarian serous carcinomas and the others.(FIGO,Shimizu-Silverberg). And we examined immunohisthochemically the overexpression of BRCA1 and p53 proteins, which are classified in tumor suppressor genes, in these tumors. For this study fifthy eight cases of papillary serous carcinomas of the ovary were selected from archives of Dicle University, Medical Faculty, Department of Pathology. Using two-tier grading system cases were disributed as follows; low grade, 12 (%21) cases, high grade, 46 (%79) cases. Using FIGO grading system grade I, 9 (16%) cases, grade II, 29 (50%) cases, grade III, 20 (34%) cases and using the Shimizu-Silverberg system grade I, 11 (19%) cases, grade II, 29 (50%) cases, grade III, 18 (31%) cases. Positive p53 staining was dedected in 57% (33/58) and BRCA1 was dedected in 67% (39/58) of ovarian serous carcinomas. In 24 (41%) cases BRCA1 was dedected in the nucleus, in 10 (17%) cases was dedected both the nucleus and cytoplasmic, in 5 (%9) cases was dedected only cytoplasmic. The relationship between p53 and BRCA1 proteins and histopathologic grade was analysed. High grade ovarian serous carcinomas had a higher rate of p53 expression (65%) compered to low grade (25%) tumors. BRCA1 immunstaining was dedected in 92% (1 1/12) of low grade and 61% (28/46) of high grade tumors according to two-tier grading system. As a results, there is a good correlation between the two-tier grading system and the FIGO and the Shimizu-Silverberg grading systems. Because this system is based on defined criteria that are easy to follow and because it involves only two diagnostic categories, it should provide better reproducibility in the grading of serous cystadenocarcinomas. In contrast to p53,- high grade tumors had a lower rate of BRCA1 expression (61%) compered to low grade (92%) tumors. And there was not found any relationship between the p53 and BRCA1 immunreactivity. 39 45

ÖZET Hodgkin hastalığı (HH), reaktif yangısal hücrelerden oluşan, fibrozisin eşlik ettiği bir zeminde neoplastik RS hücreleri ve diğer Hodgkin hücreleri ile karakterize malign lenfomadır. HH için geliştirilen Rye sınıflandırması uzun yıllar kullanılmıştır. Lenfomalar için önerilen son REAL ve WHO sınıflandırmaları HH'nı da kapsamaktadır. Bu çalışmadaki amacımız bölgemizdeki HH'nın klinikopatolojik özelliklerini incelemektir. Bu çalışmada, Dicle Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı'nda 1987- 2003 tarihleri arasında, HH tanısı alan 160 olgu, Rye ve WHO sınıflandırmasına göre yeniden incelenerek subtiplerine ayrıldı. Bu tiplerin yaş, cins, lokalizasyon, evre ve B semptomları gibi parametreler arasındaki ilişki araştırıldı. Olgularımızın 111'i (%69.4) erkek, 49'u (%30.6) kadın olup, erkek/kadın oranı 2.3/1 'idi. En çok olgu (%25.6) 2. dekatta izlendi ve olgularımızın 95 (%59.4)'i ilk üç dekattaydı. Olgularımızın 109 (%68.1)'unda servikal, 14 (%8.8)'ünde aksiller, 13 (%8.1 )'ünde abdominal, 9 (%5.6)'unda supraklavikuler, 9 (%5.6)'unda inguinal ve 6 (%3.7)'sında mediastinal lenf düğümleri tutulmuştu. Rye sınıflamasına göre; 160 olgumuzun 39 (%24.4)'u LZHH, 33 (%20.6)'ü NSHH, 62 (%38.8)`si MSHH ve 26 (%16.2)'sı LFHH idi. MSHH en sık, LFHH ise en az görülen histolojik alttiplerdi. WHO sınıflandırmasına göre olgularımızın -3 (%1.9)'ü NLPHH, 157 (%98.1)'si klasik tip HH idi. 32 olguya immunohistokimyasal boyama yapıldı. Dosyalarına ulaşılan 90 olgunun- 47'sinde B semptomları vardı ve NSHH, MSHH ile LFHH olguları daha ileri evrelerde saptandı. Sonuç olarak; gelişmiş batı ülkelerinin aksine, bulgularımız ülkemiz gibi sosyoekonomik yönden benzer ülkelerin bulguları ile uyumludur. Bununla birlikte, bölgemizde özellikle MSHH başta olmak üzere olgularımızın daha erken yaşlarda görüldüğü izlenmektedir. ¦ >¦ Anahtar kelimeler: Hogkin hastalığı, klasifikasyon, histolojik alttipler 54 SUMMARY Hodgkin's disease (HD) is a malign lymphoma, including characteristic Reed- Sternberg cells and other Hodgkin cells.in reactive inflamatory and fibrotic background. Rye classification was developed for HD and used for a long time. Recently REAL and WHO classifications proposed for lymphomas have included HD, also. The purpose of this study is to investigate the clinicopathologic features of the HD in our region. In this study, 160 cases dignosed as HD was re-classified according to Rye and recent WHO classifications between 1987 to 2003 at Dicle University, Medical Faculty, Department of Pathology. The relationship between the histopathological subtypes and some parameters such as age, sex, localization, stages and B symptoms was investigated. Of our all cases, 1 1 1 (69.4%) men and 49 (30.6%) women, the male to female ratio was 2.3/1. The most of cases (25.6%) were in the second decade and 95 cases (59.4%) were in the first three decades. The 109 cases (68.1%) in cervical, 14 cases (8.8%) in axillar, 13 cases (8.1%) in abdominal, 9 cases (5.6%) in inguinal, 9 cases (5.6%) in supraclavicular and 6 cases (3.7%) in mediastinal lymph nodes were localizated. According to Rye. classification, of 160 cases, 39 cases (24.4%) LPHD, 33 cases (20.6%) NSHD, 62 cases (38.8%) MSHD and 26.cases (16.2%) were LDHD. MCHD were the most common histological subtype and LDHD were the least common histological subtype. According to WHO classifications, 3 (1.9%) of all our cases were NLPHD and 157 cases (98.1%) were classic type of the HD. Immunohistochemical staining applied to only 32 cases. The 47 cases of the 90, reached archive files, had B symptoms and also, NSHD, MCHD and LDHD cases had more advance stages. As a results, in contrast to developed Western countries, our results consistent with developing countries' results, having same socioeconomic condition like our country. However, in our region, HD has been encountered earlier age than the other developing countries, especially MCHD. Key words: Hodgkin disease, classification, histologic subtypes 55 62

WOS:000268967000008 PubMed: 19707493 Objective : To evaluate the potential effects of risedronate (RIS) which shows a higher anti-resorptive effect among bisphosphonates, after a posterolateral lumbar intertransverse process spinal fusion using both autograft and allograft in a rat model. Methods : A total of 28 Sprague-Dawley rats were randomized into 2 study groups. A posterolateral lumbar intertransverse process spinal fusion was performed using both autograft and allograft in a rat model. Group I (control) received 0.1 mL of steril saline (placebo) and Group II (treatment) received risedronate, equivalent to human dose (10 mu g/kg/week) for 10-weeks period. Results : The fusion rates as determined by manual palpation were 69% in the group I and 46% in the group II (p = 0.251). According to radiographic score, the spinal segment was considered to be fused radiographically in 7 (53%) of the 13 controls and 9 (69%) of the 13 rats treated with RIS (p = 0.851). The mean histological scores were 5.69 +/- 0.13 and 3.84 +/- 0.43 for the control and treatment groups, respectively. There was a significant difference between the both groups (p = 0.001). The mean bone density of the fusion masses was 86.9 +/- 2.34 in the control group and 106.0 +/- 3.54 in the RIS treatment group. There was a statistical difference in mean bone densities of the fusion masses comparing the two groups (p = 0.001). Conclusion : In this study, risedronate appears to delay bone fusion in a rat model. This occurs as a result of uncoupling the balanced osteoclastic and osteoblastic activity inherent to bone healing. These findings suggest that a discontinuation of risedronate postoperatively during acute fusion period may be warranted.

WOS:000363312600007 PubMed: 26492967 Solitary rectal ulcer syndrome is a rare benign disorder that has a wide range of clinical presentations and variable endoscopic findings which makes it difficult to diagnose and treat. The clinical and endoscopic picture in this condition can also mimic malign ulceration, malignancy or Crohn's disease. Behcet's disease can affect the gastrointestinal tract. However to the best of our knowledge, no case with solitary rectal ulceration has been reported so far in literature. We herein present a patient diagnosed with Behcet's disease admitted to our clinic with rectal bleeding due to solitary rectal ulceration.