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Amaç: Kas invaziv olmayan ürotelyal karsinomlarda grade, evre, rekürrens ve progresyon açısından p53 ekspresyonu incelenmiştir. Metod: Mesane kanseri nedeniyle yapılan ilk transüretral rezeksiyonu sonucunda pTa ve pT1 papiller ürotelyal kanser tanısı almış toplam 60 hasta retrospektif çalışmaya dahil edildi. İmmünohistokimyasal olarak tüm dokular p53 ile boyandı. Hastalar rekürrens ve progresyon göstermelerine göre iki gruba ayrıldı. Sonuçlar: Spearman’s korelasyon testine göre p53 ile tümör grade’i ve evresi arasında anlamlı ilişki vardı (r = 0.372 and 0.443, p < 0.001). Multivariate analiz’ e göre p53 rekürrensi göstermede tek başına bağımsız prediktördü (OR = 12.01, 95% CI = 1 16.6). Progresyonu göstermede bağımsız bir prediktör bulunamadı. Sonuç: p53, pTa ve pT1 ürotelyal karsinomlarda rekürrensi göstermede faydalı bir belirteç olabilir. Objectives: We aimed to analysis immunostaining of p53 regarding to grade, stage, recurrence and progression in nonmuscle urotelial cancers (pTa and pT1 papillary tumors). Methods: A total of 60 patients undergoing their first transurethral resection for bladder cancer and newly diagnosed papillary urothelial carcinoma (pTa and pT1) were included in retrospective study. Immunohistochemically, all tissue sections were stained with p53. The patients were divided into two groups based on recurrence and progression. Results: Using Spearman’s correlation test, p53 was significantly positively correlated with tumor stage and tumor grade (r = 0.372 and 0.443, respectively; p < 0.001). Based on a multivariate analysis, p53 staining was found to be the only independent predictive factor for recurrence (OR = 12.01, 95% CI = 1 16.6) and no independent predictive factor for progression was found. Conclusions: p53 may be prove useful in predicting recurrence of pTa and pT1 urothelial cancers.

Amaç: Bu çalışmada Abant İzzet Baysal Üniversitesi (AİBÜ) Tıp Fakültesi'nde ilk tanısı pTa ve pT1 transisyonel hücreli mesane karsinomlu hastalarda evre ve grade gibi histopatolojik parametrelerin yanısıra yaş, tümör boyutu, tümör sayısı ve reTUR gibi klinik verilerin rekürrens ve progresyonla ilişkisinin ortaya konması amaçlanmıştır. Yöntem: 2008-2013 yılları arasındaki Abant İzzet Baysal Üniversitesi'nde ilk transüretral rezeksiyon (TUR) sonrası patolojik tanısı transizyonel hücreli mesane kanseri olarak rapor edilen (pTa, pT1) ardışık 119 hasta retrospektif olarak değerlendirildi. Bu hastalara ait klinik veriler ve histopatolojik preparatlar AİBÜ Üroloji ve Patoloji A.D. arşivinden elde edildi. Bulgular: Çalışmamıza dahil edilen hastaların 109'u erkek, 10'u bayandı. Ortalama takip süresi 30.14ay (2.86-80.74) idi. Univariate analizinde rekürrens ile tümör boyutu, grade'i, evresi, sayısı, Re-TUR ve sigara kullanımı arasında istatistiki fark varken progresyon ile tümör grade'i, boyutu, sayısı ve sigara kullanımı arasında istatistiki fark vardı. Multivariate analizde rekürrensi belirlemede bağımsız prediktif faktörler tümör boyutu (OR: 5.26,%95CI: 1.42-19.55) ve sigara kullanımı(OR: 4.65,%95CI: 1.2317.53) iken progresyonu belirlemede sadece tümör grade'i saptandı(OR: 5.32,%95CI 1.37-20.59). Kaplan Meier analizinde tümör boyutu =3 cm'nin üzerindeki hastalarda tahmini rekürrens zamanı sırasıyla 14.8ay (11.41-18.31) ve 7.6 ay (5.76-9.49) iken tümör sayısı tekli grup ile çoklu grupta sırasıyla 14.43ay (6.51-22.35) ve 7.17ay (5.63-8.70) idi. Gruplar arasında istatistiki anlamlı fark vardı (p=0.009). Sonuç: pTa ve pT1 mesane tümörlü hastaların progresyonunu öngörmede grade'in tek başına çok önemli olduğu ve WHO 2004'te güncellenen ikili derecelendirme sisteminin bu tümörleri derecelendirmede daha kolay ve uygun olabileceği düşünülmüştür. Evrelendirmede bu tümörlerin rekürrens açısından farklılık gösterdiği ve aslında klinik olarak yüzeyel başlığı altında aynı kategoride yer almasının çok da doğru bir yaklaşım olmadığı sonucuna varılmıştır. Objective: In this study our aim was to determine the association between the histopathological (such as grade and stage) and clinical parameters (age, tumor size, the number of tumor and reTUR) and prognosis in pTa and pT1 bladder carcinomas which diagnosed in Medical Faculty of Abant Izzet Baysal University (AIBU). Method: In total 119 consecutive and newly diagnosed patients with pTa and pT1 bladder tumors were analyzed retrospectively between 2008 and 2013. The histopathological and clinical data were obtained from Pathology and Urology Department of AIBU. Results: There were 109 men and 10 women in this study. The average follow-up period was 30.14 months (2.86-80.74). There was statistically significant difference between recurrence and tumor size, grade, stage, the number of tumors, re-TUR and smoking; as well as between progression and grade, tumor size, the number of tumors and smoking in univariate analyses. The independent predictive markers were tumor size (OR: 5.26, %95CI: 1.42-19.55) and smoking (OR: 4.65,%95CI: 1.23-17.53) in recurrence and only grade (OR: 5.32,%95CI 1.37-20.59) in progression according to multivariate analyses. The estimated recurrence time was respectively 14,8 months (11.41-18.31) and 7,6 months (5.76-9.49) in the size of tumor =3 cm and 14.43 months (6.51-22.35) and 7.17 months (5.63-8.70) in single group of tumor numbers and multiple group of tumor numbers. There were statistically significant differences between groups (p=0.009). Conclusion: Grade is independent predictor of pTa and pT1 bladder cancer progression. Our thought that the using of 2004 World Health Organization (WHO) binary grading system is easy and convenient in bladder cancer grading. The nomenclature of pTa and pT1 bladder tumors as superficial tumors is not very accurate approach due to staging of these tumors shows differences in recurrence.

AMAÇ: İğsi hücreli lipomun histolojik ve tipik immunhistokimyasal özelliklerini araştırmak ve diğer subkutan yerleşimli benzer histolojik ve immunhistokimyasal özellikleri olan neoplazmlarla ayırıcı tanısını yapmaktır. YÖNTEMLER: İstanbul Eğitim ve Araştırma Hastanesi patoloji laboratuarında lipom tanısı almış 3100 olguda son Dünya Sağlık Örgütü Yumuşak Doku Tümörleri Sınıflamasına göre alt tipler belirlendi ve bunların içinden 22 İHL çalışmaya alındı. 22 iğsi hücreli lipom olgusunda klinik (yaş, lokalizasyon, cinsiyet, nüks), morfolojik özellikler (tümör boyutu, alt tip, histoloji, mast hücre varlığı ve immunhistokimya), tümörlerin natürü ve ayrıcı tanı problemleri değerlendirildi. BULGULAR: 3100 lipomun alt tiplere göre dağılımı şu şekildeydi: 2864 klasik lipom (%90), 293 anjiyolipom (%9), 1 kondroid lipom (%0.03), 1 miyolipom (%0.03 ve 22 iğsi hücreli lipom (% 0.7). 22 iğsi hücreli lipomların 9’u fibröz, 3’ü miksoid, 1’i anjiyomatoid ve 9’u nonfibröz alt tipti. Erkek kadın oranı 18/4 olarak belirlendi. Olguların 2’si sırt, 3’ü omuz, 1’i ön kol, 1’i oral olup 15’ü baş-boyun bölgesinde lokalize idi. Ortalama tümör çapı 3.2 cm olup en büyük ve küçük çaplar 1 cm ve 6.1 cm olarak ölçüldü. Fibromatöz alt tipte belirgin olmak üzere Toluidin blue boyasıyla her olguda mast hücresi mevcuttu. Mast hücre sayısı on büyük büyütme alanında ortalama 23 olarak bulundu. S–100 tüm iğsi hücrelerde negatif ve yağ hücrelerinde pozitif olarak tespit edildi. CD34 olguların 21’inde pozitif, 1’inde negatif bulundu. Hiçbir olguda nüks izlenmedi. SONUÇ: İğsi hücreli lipom, subkutan lokalizasyonlu, iyi sınırlı, iğsi hücreli komponenti CD34 pozitif, mast hücrelerinden zengin bir tümör olup birçok subkutan tümörle ayırıcı tanı yapılmasını gerektiren nadir bir antitedir. OBJECTIVE: To investigate the histologic and immunohistochemical properties of spindle cell lipoma and to make its differential diagnosis from other subcutaneous neoplasms having similar histologic or immunohistochemical charecteristics. METHODS: 3100 cases of lipoma diagnosed in the Pathology Laboratory of İstanbul Educational and Research Hospital were reclassified according to the recent classification of Soft Tissue Tumors by World Health Organization and 22 spindl cell lipomas were included in the study. Clinical (age, gender, location, and recurrences) and morphologic features (tumor size, subtype, histology, presence of mast cells, and immunohistochemistry) as well as tumor nature and problems in differential diagnosis were evaluated. RESULTS: The histologic subtypes of 3100 lipomas were as follows: 2864 classical lipoma (90 %), 293 angiolipoma (9 %), 1 chondroid lipoma (0.03 %), 1 myolipoma (0.03 %) and 22 spindl cell lipoma (% 0.7). Of the 22 spindl cell lipoma 9 were fibrous, 3 myxoid, 1 angiomatoid and 9 non-fibrous subtypes. Male to female ratio was 18: 4. 2 cases were localized in dorsal region, 3 in shoulders, 1 in forearm, 1 in oral cavity and 15 in head and neck. Average tumor diameter was 3.2 cm ranging from 1 to 6.1 cm. Mast cells highligtened by Toluidin blue were seen in all cases, most prominently in the fibrous subtype. Mast cell count in 10 high power field was 23. S–100 was negative in all spindle cells while lipomcytes were positive. CD34 was positive in 21 cases and negative in 1 case. No case recurred. CONCLUSION: Spindl cell lipoma is a subcutaneous, well-circumscribed tumor rich in mast cells with a CD34+ spindle cell component and is an uncommon entity requiring differential diagnosis with several subcutaneous tumors.

Basal cell carcinoma is the most commonly seen nonmelanoma skin cancer which is rarely encountered in the childhood period. An 11-year old child was admitted to our clinic due to an erythematous and a slightly pigmented lesion with a 3×4 cm diameter on his posterior scalp. Macroscopically, the lesion was excised with a 10 mm safety margin. Pathologic examination revealed a basal cell carcinoma. No symptoms or signs of a syndrome were observed both in the patient and his family.

WOS:000354418400009 PubMed: 26017881 There are many scoring methods evaluating the expression of p16 in the bladder immunohistochemically. In this study our aim was to determine an optimal p16 scoring method by discussing different staining methods related with p16 expression in bladder cancers and to establish the association of p16 and Ki-67 expressions, alone or in combination, with recurrence and progression. Ninety patients undergoing their first transurethral resection for bladder cancer and newly diagnosed papillary urothelial carcinoma (pTa and pT1) were included in the study. Four different scoring methods were used for p16 (p16a, p16b, p16c, p16d). The patients were divided into two groups based on recurrence and progression. There was a statistically significant difference between recurrence and abnormal p16d staining (p = 0.005). In other staining patterns of p16, there was no statistically significant difference in terms of recurrence or progression.In the multivariate logistic regression analysis, combined Ki-67 >= 10 and abnormal p16d staining was found to be the only independent predictive factor for recurrence (OR = 2.26, 95% CI: 0.13-46.41, p = 0.035) and no independent predictive factor for progression was found. Determining an adequate expression scoring by taking normal transitional epithelial staining pattern as a reference would be an objective approach in p16 evaluation. Moreover, it was found that evaluating p16d and Ki-67 in combination would be significant in predicting recurrence in pTa and pT1 urothelial carcinomas.

WOS:000346638300057 PubMed: 25435981 Primary tumors of the paratesticular region are rare, with paratesticular sarcomas constituting a major proportion of these tumors, particularly in the elderly. The paratesticular region consists of mesothelial, various epithelial and mesenchymal cells and may therefore give rise to a number of tumors with various behaviors. Defining the association between the paratesticular mass and the testicle, and differentiation between benign and malignant masses using radiology is challenging, therefore the mass is usually considered to be malignant and radical orchiectomy with high ligation is performed. The present study reports the cases of seven patients with tumors of the paratesticular region and presents the clinical and significant histological features of the tumors. In total, two patients suffered from dedifferentiated liposarcoma (DDLS), two exhibited leiomyosarcoma, two exhibited low-grade fibromyxoid sarcoma and one case of undifferentiated pleomorphic sarcoma was identified. Radical orchiectomy with high ligation was performed in five cases; simple orchiectomy was performed in one case and excisional biopsy was performed in the remaining case. A leiomyosarcomatous and epithelial membrane antigen (EMA) positive whorl pattern was observed during microscopy in the two DDLS cases. Additionally, one of the low-grade fibromyxoid sarcoma patients exhibited pleomorphism and mitosis in focal areas. To the best of our knowledge, the present study is the second time low-grade fibromyxoid sarcoma cases with paratesticular localization have been reported in the literature. Of the seven cases, four patients succumbed to the disease, one patient is living with the disorder and the two cases of DDLS are living without the disease. Paratesticular sarcomas are often aggressive and a multidisciplinary approach is required for the diagnosis and treatment of these tumors.

Aim: To evaluate the effects of montelukast and Hypericum perforatum against ischemia/reperfusion (I/R)-induced intestinal damage. Materials and methods: Twenty-eight hamsters were divided into 4 groups following midline abdominal laparotomy: control group (n = 7), I/R group (n = 7), montelukast and I/R (MIR) group (n = 7), and Hypericum perforatum and I/R (HPIR) group (n = 7). After 60 min of ischemia through obstruction of the superior mesenteric artery, 24 h of reperfusion was maintained. Ten minutes prior to the reperfusion period, the MIR group received 7 mg/kg of intraperitoneal montelukast and the HPIR group received 7 mg/kg of intraperitoneal Hypericum perforatum. Malondialdehyde, glutathione, myeloperoxidase, and cardiotrophin-1 levels were measured from blood samples. A semiquantitative histological evaluation was performed. Results: Montelukast and Hypericum perforatum significantly reduced malondialdehyde levels and increased glutathione levels compared to the I/R group (P < 0.008). A statistically significant difference was also found between the I/R group and MIR and HPIR groups in terms of myeloperoxidase levels (P < 0.008). The MIR and HPIR groups showed increased cardiotrophin-1 levels compared to the control and I/R groups (P < 0.008 for all). The MIR and HPIR groups showed significantly lower histological scores compared to the I/R group (P = 0.03 and P = 0.007, respectively). Conclusion: This study demonstrated the preventive effects of montelukast and Hypericum perforatum on I/R-induced intestinal injury

WOS:000364114900037 Introduction: Ascaris lumbricoides (AL), is an intestinal Parasite with various clinical presentations. It is common in underdeveloped rural areas both in Turkey and in the rest of the World; Ectopic localizations of AL are rare, and there only a few reported cases of mental localization. Case: We present a rare case in which an omental and a paratubal mass were detected during cesarean section in an asymptomatic pregnant patient. The histopathological examination revealed a granulomatous reaction and AL eggs inside the masses. Discussion: Infection With AL causes various intestinal complications like acute appendicitis, volvulus, invagination, intestinal perforation and gramdotnatous peritonitis. Conclusion: It should be kept in mind that granulomatous lesions presenting as mental masses may be randomly detected in asymptomatic individuals and pregnant woman infected with AL.

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.

Meme kanseri oldukça sık görülen bir hastalıktır ve farklı biyolojik davranışlar sergileyen heterojen bir tümördür. Yaş, histolojik derece, tümör boyutu, östrojen reseptör (ER) durumu gibi klinik ve patolojik prognostik faktörler hastaların adjuvan hormon tedavisi, radyoterapi ve kemoterapiye ihtiyaçları olup olmadıklarını belirlemek için kullanılmaktadır. Fakat bu geleneksel prognostik faktörler, bireysel farklılıklar ve meme tümörlerinde gözlenen heterojenite nedeniyle her hastada prognozu belirlemede, tedaviyi yönlendirmede, lokal rekürrens ve mortaliteyi önlemede yeterli başarıyı gösterememektedir.Henüz kabul edilmiş kesin sınırlar olmamakla birlikte çalışmalarda en sık kullanılan moleküler sınıflama 5 alttipi içerir. Bunlar 'lüminal A, lüminal B, human epidermal büyüme faktörü reseptörü 2 (HER2) eksprese eden, bazal-like ve null tip'dir. Bu çalışmada, kliniğimize gelen invaziv meme karsinom tanısı almış 79 olgunun retrospektif olarak immünohistokimyasal boyanma profillerinin analizini yapmak yolu ile moleküler alt tiplerinin belirlenmesi ve bu subtiplerin prognostik faktörlerle ilişkisinin değerlendirilmesi amaçlanmıştır. Tüm olgulara ait seçilmiş tümör bloklarında immünohistokimyasal olarak, ER, PR, HER2 ve CK5/6 ekspresyonları değerlendirilmiştir.Sonuç olarak, en sık görülen histolojik tip İnvaziv Duktal Karsinomdu. Lüminal A, en sık moleküler subtipti. Lüminal A'ların çoğunun grade'i II iken, bazal-like tümörlerin tamamı grade III olarak bulundu. Grade I olguların çoğu lüminal A tipindeydi. Olguların yarısına yakınında tanı anında tümör çapı 2-5 cm arasındaydı. İstatiksel olarak moleküler subtipler ve prognostik faktörlerle anlamlı ilişki saptanamamıştır. Ancak literatürle uyumlu olarak, 2 cm'den küçük tümör oranı lüminal A tipte fazlaydı. 2 adet medüller karsinom olgusu literatürle uyumlu olarak bazal-like tip olarak bulundu. Bazal-like grupta tümör grade'inin diğer tiplere göre daha yüksek olduğunu gözlemledik. Breast cancer is a very common disease and heterogeneous tumor that exhibits very different biological behavior. Some clinical and pathological prognostic factors such as age, histological grade, tumor size and estrogen receptor (ER ) status are used for patients to determine whether the needs of adjuvant hormonal therapy, radiotherapy and chemotherapy. However, for each patient, this traditional prognostic factors can not demonstrate sufficent success; determinig the prognosis, choice of treatment, to prevent local recurrence and mortality due to individual differences, and the heterogeneity observed in breast tumors.Although, there is not adopted strict limits yet, classification of 5 subtype is used most commonly in studies. These are 'luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) overexpressing, basal-like and null type.' In this study, it is aimed to evaluate the relation between prognosis and these subtypes. We analyzed retrospectively by immunohistochemical staining profiles of molecular subtyping of 79 invasive breast carcinomas in our clinic. ER, PR, HER2 and CK5/6 were stained to all of the tumors by immunohistochemically. Finally, the most common histological type was invasive ductal carcinoma. Luminal A was the most frequent subtype. While most luminal A tumors were grade II, most basal-like tumors were grade III. The majority of grade I tumors were luminal A. Nearly half of the patients had tumors between 2-5 cm in diameter at diagnosis. A statistically significant correlation with prognostic factors and molecular subtype could not be determined. However, similar to the literature, tumors rate smaller than 2 cm was also higher in luminal types. Two medullary carcinoma is consistent with the literature found in the basal-like type. In basal-like group, the tumor grade was higher than in other groups. 74

Background : Epidemiologic data indicates that rheumatoid arthritis is an independent risk factor for cardiovascular disease. Epicardial adipose tissue is a novel cardio-metabolic risk factor. Our aim was to evaluate epicardial fat thickness (EFT) using echocardiography in patients with rheumatoid arthritis compared to healthy control subjects. Secondly, we investigated relationship between epicardial fat thickness and clinical and echocardiographic parameters in patients with rheumatoid arthritis. Method : The study population included 76 consecutive patients with rheumatoid arthritis (64 female; mean age, 53 ±11 years, median disease duration, 7.8 years) and 50 healthy subjects as controls (39 female; mean age, 52 ± 6 years). All patients underwent echocardiography to assess left ventricular diastolic dysfunction, left ventricular hypertrophy and EFT. All values were compared between groups. Results : EFT was higher in rheumatoid arthritis patients than in healthy controls (0.66±0.20 vs. 0.54±0.18; p= 0.003). Thickness of Intra Ventricular Septum (IVS) (1.1±0.06 and 9.8±0.08; p=0.001) and posterior wall (PW) (0.98±0.05 and 0.93±0.08; p=0.015) was higher in patients with rheumatoid arthritis compared to healthy controls. Early diastolic myocardiac peak velocity or late diastolic mitral peak velocity (E/A) ratio was lower in rheumatoid arthritis patients compared to healthy patients (1.1 ±0.8 and 1.24±0.1 p=0.001) as well as, E/e’ was higher in Rheumatoid arthritis (RA) patients than healthy patients. (E/e’:8.7±1.6 and 8.0±1.4 p=0.020). In patients with rheumatoid arthritis, EFT was positively correlated with hypertension and duration of disease and E/e’ (r: 0.10, p: 0.010, r: 0.306, p: 0.004 and r: 0.465 p: 0.007 respectively) and EFT was negatively correlated with E/A (r: -.262 p:0.022 ) Conclusion : To our knowledge, this is the first report about epicardial adipose tissue in rheumatoid arthritis patients. Epicardial fat thickness as an indicator of cardiovascular involvement was higher in rheumatoid arthritis patients. Keywords : Rheumatoid arthritis, epicardial fat thickness, cardiac involvement

Objectives: Lung cancer is the leading cause of cancer-related mortality in both men and women worldwide. Small cell lung cancer (SCLC) represents 15-20 % of all lung cancers. The aim of this study was to evaluate the clinical features of small cell lung cancer (NSCLC) cases that were diagnosed in our clinic. Methods: The patients who were diagnosed as SCLC in our clinic were comprised the study group. The files and records of the study group were retrospectively reviewed to identify patients. The study group included 64 patients (59male, 5 female). Results: The mean age was 57.5 ±8.1 years. All patients were current smokers ( 50,3 pack-year). The most frequent symptoms on admission were chest pain, cough and weight loss. The most common radiologic finding was a hilar solid mass and hilar lymphadenopathies. The diagnosis was established by histopathologic examination of biopsy specimens obtained by various means, in which bronchoscopy was the sole means of diagnosis in 92,2 % of the patients. The stages of SCLC were limited disease in 26(29,7 %) and extensive disease in 38 (59,3%) patients. Metastasis was most frequently to the liver followed by bone and brain. Five (7,8%) patient had complete response (CR). forty nine (76,5%) patients had partial response. The median survival was 309 days, 210 days and 270 days for LS, ES and overall patients, respectively. Conclusions: In conclusion, demographic and clinical features of the patients were similar with the literature. Due to the high rates of extensive disease, the median survival rates and responses were lower than the previous series.