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Purpose: This study aims to evaluate the demographic, clinical, and pathologic characteristics and response to immunosuppressive therapy, particularly corticosteroids, in adult patients with primary focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD), which are classified as podocytopathies. Materials and Methods: Between January 1998 and December 2014, this study included 44 patients (27 with primary FSGS and 17 with MCD) aged older than 18 years with a histopathologic diagnosis, symptoms of nephrotic syndrome, and a minimum follow-up of six months. Patients were divided into two groups according to the treatment they received and three groups according to their response to treatment. Patients diagnosed with primary FSGS and MCD were evaluated based on clinical, demographic, and laboratory findings, as well as response to treatment, and a comparison was conducted between the two groups. Results: 59.1% of the patients were male with a mean age of 44.8±17.7 years. At the time of diagnosis, there were no statistically significant differences in clinical and demographic characteristics between MCD and primary FSGS patients. However, in patients with MCD, the mean creatinine clearance (118.0±46.7 ml/min) was higher and the rate of microscopic hematuria (11.8%) was lower at the time of diagnosis. There was an increased need for alternative immunosuppressive treatments besides corticosteroids in patients with primary FSGS to achieve partial or complete remission. At both the third and sixthmonth follow-ups, MCD patients achieved a higher rate of complete remission (proteinuria <0.3 g/day) than FSGS patients. Conclusion: Compared to MCD, primary FSGS is more likely to progress, requires more immunosuppressive therapy beyond corticosteroids to achieve partial or complete remission, and has a lower treatment response rate. [ABSTRACT FROM AUTHOR]

Aim Lupus nephritis (LN) is an important complication of systemic lupus erythematosus (SLE). The aim is to use indication and protocol biopsies to determine clinicopathological findings and outcomes of patients with LN undergoing kidney transplantation (KTx). Methods Patients who underwent KTx due to LN were retrospectively analyzed. Recurrent LN (RLN) was diagnosed by transplant kidney biopsy. Results Among 955 KTx patients, 12 patients with LN as the cause of end-stage renal disease were enrolled. Five patients were male. Mean follow-up time was 63 ± 34 months. At the last follow-up visit, mean levels of serum creatinine and proteinuria were 137.0 ± 69.0 µmol/L and 0.26 ± 0.26 g/day, respectively. Eighteen indication and 22 protocol biopsies were performed; 27 biopsies were additionally evaluated by immunofluorescence. In two recipients, subclinical RLN was confirmed by protocol biopsies. Clinical recurrence occurred in four patients. Among patients with RLN, time from diagnosis of LN to KTx was significantly shorter and use of ATG as induction treatment was significantly lower. Graft loss occurred in two recipients who had clinical RLN. Five-year overall graft survival was 85.7%. Conclusion Kidney transplantation is a reasonable option for patients with ESRD secondary to SLE. However, recurrence of LN is common if protocol biopsies are included in post-transplantation surveillance. [ABSTRACT FROM AUTHOR]

Renal cell carcinomas (RCCs) are heterogeneous group of cancers that arise from the tubuler cells and are responsible for 80-85% of all primary renal neoplasms. Less than 5% of all RCCs are thought to be due to a hereditary syndrome. Family studies and molecular genetics have provided important insights into the molecular pathways underlying the pathogenesis of RCCs as well as new insights into classification of RCC. Morphologically based classification of RCCs has evolved over the last 3 decades with the incorporation of molecular genetics into the diagnostic features RCCs. The most recent 2012 Vancouver classification recognized the newly established entities tubulocystic RCC, acquired cystic disease-associated RCC, clear cell (tubulo) papillary RCC, microphthalmia transcription factor family translocation RCC and hereditary leiomyomatosis RCC syndrome-associated RCC. In this article, the molecular and genetic properties of RCCs were summarized and the mechanisms underlying the development new entities of RCCs were discussed. The use of immunohistochemistry and molecular techniques were also evaluated in establishing an accurate diagnosis in new entities. [ABSTRACT FROM AUTHOR]

Objective: Systemic amyloidosis is a rare disorder, characterized by extracellular accumulation of Congo red positive fibrillar amyloid protein deposits that have an amorphous, eosinophilic appearance on hematoxylin-eosin stained preparations. The kidney is the most commonly affected organ by systemic amyloidosis. Congo red staining increases the positive birefringence of the weakly birefringent unstained amyloid. In this study, we investigated the potential diagnostic power of digitally reinforced birefringence of routine hematoxylin-eosin stained slides from renal biopsies. Material and Method: We reviewed 130 hematoxylin-eosin stained slides for polarization. Sixty-five new amyloidosis cases were diagnosed by renal biopsy. All renal biopsies were evaluated by light microscopy and immunofluorescence. Slides were reevaluated blindly using a microscope (Olympus BX51) that was attached polarization filters and connected to a digital camera (Olympus DP21, SAL). Deposits that showed green birefringence on hematoxylin-eosin preparations with digitalized microscopy were considered positive and the results were confirmed using Congo red. Results: Of the 65 Congo red confirmed amyloid positive biopsies, 61 showed green birefringence with hematoxylin-eosin. Of the 65 Congo-red confirmed amyloid negative biopsies, two were considered to be false positive. The sensitivity, specificity, and positive and negative predictive values were estimated as 94%, 97%, 97% and 94% respectively. Conclusion: We concluded that polarized hematoxylin-eosin sections can be used digitally as a fast and first step diagnostic method for renal amyloidosis. [ABSTRACT FROM AUTHOR]

Context.—A disease associated with amyloid deposits, called amyloidosis, is associated with characteristic electron microscopic appearance, typical x-ray pattern, and specific staining. Renal involvement mainly occurs in AA amyloidosis and AL amyloidosis and usually progresses to renal failure. Objective.—The renal histopathologic changes with amyloidosis comprise a spectrum. Clear relationships between the extent of amyloid deposition and the severity of clinical manifestations have not been demonstrated. Whether there is a lack of clinicopathologic correlation is not clear, but studies have revealed the need for standardization of the renal amyloid biopsy report. With these objectives in mind, we proposed a histopathologic classification, scoring, and grading system. Renal amyloidosis was divided into 6 classes, similar to the classification of systemic lupus erythematosus.Amyloid depositions and other histopathologic lesions were scored. The sum of these scores was termed the renal amyloid prognostic score and was divided into 3 grades. Data Sources.—AA amyloidosis was detected in 90% of cases, mostly related to familial Mediterranean fever. Positive correlations between class I and grade I, class VI and grade III, and class III and grade II were observed. Also, a positive correlation was identified between severity of glomerular amyloid depositions, interstitial fibrosis, and inflammation. Because of the inadequacy of the patients' records and outcomes, different therapy regimes, and etiologies, clinical validation of this study has not been completed. Conclusions.—Standardization of the renal amyloid pathology report might be critical for patients' medication and comparison of outcome and therapeutic trials between different clinics. Because of our AA to AL amyloidosis ratio and the predisposition of familial Mediterranean fever-related AA amyloidosis, there is a need for further international collaborative studies. [ABSTRACT FROM AUTHOR]

Objective: Amyloidosis represents extracellular deposition of congophilic fibrils of similar morphology but different chemical composition. The types frequently involving the kidney are AA (serum amyloid A) and AL (light chain amyloid). Hereditary amyloidoses, which can also affect the kidney, are being described with increasing frequency. Distinguishing the type of amyloid is important because of the different treatments and outcomes. Typing of amyloidosis by immunohistochemistry (IHC) is believed to be unreliable, except for AA amyloid. We reevaluated our cases in this study to draw attention to the nonAA amyloid deposits in renal biopsies with amyloidosis. Material and Method: Renal biopsies diagnosed as amyloidosis between 1997 and 2008 were stained for amyloid A with IHC. Cases with negative amyloid A staining were included in the study. Results: We found 190 cases of renal amyloidosis (198 biopsies) during the study period. Thirty cases (33 biopsies) with negative antiAA staining were studied. Among those 30 cases with nonAA amyloidosis, secondary AL amyloidosis was due to multiple myeloma in 8 cases and plasma cell dyscrasia in 2 cases. Hereditary renal amyloidosis was suspected in some cases. Conclusion: Using amyloid A IHC on a routine basis and the clinical history are essential to diagnose AA amyloidosis. The differential diagnosis of nonAA amyloidosis may be inconclusive on IHC. The diagnostic approach should be multidisciplinary and requires careful clinical and pathological evaluation. The limitation of IHC may necessitate direct typing of the amyloid protein extracted from paraffin-embedded specimens in some cases. [ABSTRACT FROM AUTHOR]

Early diagnosis and classification of amyloid deposition and differentiation from other glomerular fibrillar deposits relies on routine Congo red (CR) histochemistry. Congo red fluorescence (CRF) is an alternative method based on examination of the CR-stained section by ultraviolet (UV) light. The aim of this study is to investigate the usefulness of CRF, especially when applied to frozen kidney sections. Congo red fluorescence was applied to sections of frozen kid-ney biopsies prospectively and to paraffin sections retrospectively. The findings of CRF were compared to CR staining in bright light. Prospectively, 15 cases of amyloidosis were diagnosed on frozen sections and identical CR staining was found in all of the paraffin-stained sections. There were no false positives or negatives. Retrospectively, 146 renal biopsies previously stained with CR were re-evaluated with CRF. Eighty-seven CR positive cases were confirmed by CRF, and one new case was identified. Congo red fluorescence is simple to perform and more pronounced, therefore easier to evaluate than CR in bright light. Congo red, when combined with immunohistochemistry, is still visible under UV whereas CR is masked in bright light. Although not widely used, the CRF method for detecting amyloid is simple to use with a high specificity and sensitivity, and may be applied successfully to frozen sections. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "A proposed histopathologic classification, scoring, and grading system for renal amyloidosis: standardization of renal amyloid biopsy report" by S. Sen and B. Sarsık in the April 2010 issue.

Significant improvements in patient and graft survival and reductions in the frequency of acute rejection were obtained in the early period after renal transplantation, but this success was not sufficiently reflected in the long term. Allograft kidney losses in the long term remain a significant problem. In this study, we investigated the specific causes of graft losses in patients who had a good clinical course in the first year but developed graft loss in the long term. A total of 118 patients who underwent kidney transplantation in 2005 and 2006 in the Organ Transplantation Center of Ege University Medical Faculty Hospital were evaluated. The inclusion criteria were to be older than 18 years and have a serum creatinine value of <2 mg/dL at the 12th month after transplantation. Sixty-one percent of the recipients were male, and the mean age at the time of transplantation was 34 ± 11 years (18 to 61). We observed 29 graft losses during the mean follow-up period of 129 ± 35 months (27 to 162). Three of the graft losses were death by functional graft. Of the 26 patients with graft loss, 16 had chronic rejection, and 8 had recurrent glomerulonephritis. The relationship between nonimmune causes and graft loss was not detected. In conclusion, nonimmune factors may not be as important as we think in relatively young and healthier recipients. Chronic rejection and recurrent glomerulonephritis are the main causes of long-term graft loss of patients with good graft function at the end of the first year. Improvement of long-term survival will be possible with the prevention and effective treatment of these 2 problems. • The effect of nonimmunologic events on allograft kidney survey should not be ignored, but these factors may not be as important as we think in young and relatively healthier recipients. • Chronic rejection and recurrent glomerulonephritis are the main causes of long-term graft loss of patients with good graft function at the end of the first year. Improvement of long-term survival will be possible with the prevention and effective treatment of these 2 problems. [ABSTRACT FROM AUTHOR]

Aim: Nephrotic syndrome (NS) is the most common childhood glomerular disease manifested by proteinuria, edema and hypoalbuminemia. The aim of this study was to examine children with primary NS in terms of their clinical laboratory and histopathological features, and to evaluate their treatment responses. Materials and Methods: Thirty-eight (21 boys/17 girls) patients followed up with primary NS were included in this study. Results: The mean age at diagnosis was 6.4 years. The histopathological diagnoses were focal segmental glomerulosclerosis (FSGS) in 17 patients, minimal change disease (MCD) in 8, membranoproliferative glomerulonephritis (MPGN) in 3, and membranous glomerulonephritis in 1 patient. Those patients with MPGN were older than those with MCD and FSGS (p=0.035). Twenty-four patients were steroid sensitive. Steroid response rates were 88% in those patients with MCD, 41% in patients with FSGS and 33% in those with MPGN. At their last visit, three patients (7.9%) were diagnosed with chronic kidney disease. Conclusion: NS is the most common glomerular disease of childhood. Early diagnosis and the histopathological features of this disease have an important place in its prognosis. Knowing the demographic, clinical and pathological features of the disease is helpful in monitoring its progress and its prognosis. [ABSTRACT FROM AUTHOR]

BK virus nephropathy is a serious complication that can lead to allograft kidney loss. Excessive immunosuppression increases the risk. We aimed to evaluate whether there is an increased risk of BK viremia and nephropathy in patients who underwent high-dose immunosuppression because of the development of acute rejection in the early period after kidney transplantation. This retrospective cohort study was performed between April 2015 and March 2016. Twenty-nine patients who had biopsy-proven acute rejection in the first 3 months were evaluated for BK viremia and nephropathy. Thirty patients who had transplantations at the same period were the control group. Plasma BK-DNA values were examined at 1, 2, 3, 6, 9, and 12 months after the rejection treatment and at 3, 6, 9, and 12 months in the control group. Presence of polyoma nephropathy was examined with surveillance biopsies at the 6 and 12 months. Acute rejection treatment was started on the 12th day after transplantation (2–37 days). Seventeen cellular rejections and 12 humoral rejections were reported by biopsy. Two of the 12 humoral rejections were suspicious. Only pulse steroid (PS) (n = 18); PS, plasmapheresis, and intravenous immunoglobulin (n = 8); PS and intravenous immunoglobulin (n = 2); and PS and plasmapheresis (n = 1) treatments were performed. In 21 patients in the rejection group and 25 patients in the control group, BK-DNA was not positive at all. Two patients had graft loss at 11 and 36 months in the rejection group. Graft losses were secondary to rejection. Treatment with antithymocyte globulin-free regimens after acute rejection episodes did not lead to an increase in BK viremia. • Treatment with antithymocyte globulin–free regimens after acute rejection episodes does not lead to an increase in BK viremia in renal transplant recpients. • With BK-DNA monitoring and appropriate treatment changes, it is possible to deal with BK viremia. [ABSTRACT FROM AUTHOR]

Objective: Amyloidosis represents a group of diseases with deposition of amyloid fibrils. Clinical and histopathological features of renal amyloidosis vary according to the type of precursor protein. Histopathological diagnosis of amyloidosis relies on routine Congo red histochemistry. Thioflavin T may be an alternative method based on examination on ultraviolet light, but is believed to give inconsistent and inaccurate results. Materials and Method: The sensitivity and specivity of Thioflavin T and Congo red fluorescence that can be applied to the diagnosis of amyloid were compared in order to find how best to diagnose amyloid deposits on fluorescence microscopy. Results: Frozen tissue sections available from 120 native and transplant renal biopsy patients were stained with Tioflavin T. Prospectively, 10 cases of amyloidosis (8 with AA and 2 with nonAA) were diagnosed on frozen Tioflavin T sections and identical Congo red fluorescence staining was found in all the cases. There were no false positives or negatives. Conclusion: The Tioflavin T method is simple to perform and easier to evaluate. It can therefore be utilized to track down even minute amyloid deposits, which might be missed by the Congo red fluorescence. In conclusion, Tioflavin T was demonstrated to be a sensitive and specific method for diagnosis of amyloid even in small frozen renal tissue sections. This method can, therefore, allow the easiest diagnosis of renal amyloidosis on fluorescence microscopy. [ABSTRACT FROM AUTHOR]

Hemolytic Uremic Syndrome (HUS) is characterized by the clinical triad of microangiopathic non-immune hemolytic anemia, thrombocytopenia, and acute renal failure. There are infections, genetic causes, malignancies, autoimmune diseases, drugs, and many unexplained causes in the etiology of HUS. The most common cause of HUS in children is Shiga toxin-producing Escherichia coli (STEC). In the literature, few influenza A (H1N1) pdm09 virus-related HUS cases are reported. In this case report, a case with hemolytic uremic syndrome associated with influenza A (H1N1) pdm09 virus infection is presented. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the relationship between prognostic factors and cancer-specific survival (CSS) in renal tumors larger than ten centimeters. Materials and Methods: We evaluated the data of 126 patients who underwent open radical nephrectomy due to a renal mass larger than 10 cm between January 2010 and June 2016. Kaplan-Meier analysis or Cox regression was used to analyze the relationship between CSS and variables. Pairwise group comparisons were also evaluated with the Log-Rank test. A p-value <0.05 was considered statistically significant. Results: Mean follow-up was 68.5 months and mean survival was 39.2 months. The relationships between tumor histopathology, stage and CSS were significant. Tumor size negatively affected CSS, but the relationship was not significant. Tumor stage (T2b, T3b), tumor thrombus, lymph node metastasis and adjuvant therapy were the most effective independent factors affecting CSS according to Cox regression analysis results. Conclusion: Although tumor size is an important prognostic factor for T2b and lower stage kidney tumors, this effect is less in larger tumors and other clinicopathological features should be considered further to predict prognosis. [ABSTRACT FROM AUTHOR]

Objective: Bone metastasis is common in advanced prostate cancer (PCa). Recently, there has been a growing interest in the potential role of inflammatory markers, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and neutrophil-to-monocyte ratio (NMR), in predicting advanced disease in patients with solid tumors. In the current study, we aimed to assess the relationship of bone metastasis detected on bone scintigraphy (BS) with NLR, PLR, and NMR in patients with Pca. Materials and Methods: The study group included 85 PCa patients. Patient characteristics, prostate-specific antigen (PSA) values, Gleason score, histopathological features, presence of metastatic focus on BS and complete blood count values were retrospectively evaluated. The relationship of the presence of bone metastasis on BS with clinicopathological features such as PSA, Gleason score, histopathological findings and NLR, PLR and NMR values were investigated. Results: Median NLR, PLR and NMR were 2.90, 125.69 and 8.38, respectively. Thirty-six patients had metastatic disease on BS. Our findings showed a statistically significant relationship between high NLR value and the presence of bone metastasis (p=0.018) and high Gleason score (p=0.034). However, no significant statistical relationship was found between clinicopathological features and PLR and NMR values (p>0.05). Conclusion: Despite the limited number of patients, a significant relationship between high NLR and metastatic bone disease was found. While high NLR has been generally considered an independent risk factor for poor PCa prognosis, we assume that larger scale studies are warranted to assess its value as a prognostic indicator in PCa patients. [ABSTRACT FROM AUTHOR]

Amaç: İleri evre prostat kanserinde kemik metastazı sık görülmekte olup, hastaların yaşam kalitesini etkilemektedir. Son yıllarda nötrofil-lenfosit oranı (NLO), trombosit-lenfosit oranı (TLO) ve nötrofil monosit oranı (NMO) gibi enflamasyon belirteçlerinin solid tümörlerde prognostik bir biyomarker olabileceğine dikkat çekilmektedir. Prostat kanser tanılı olgularda sintigrafide saptanan kemik metastazlarıyla NLO, TLO ve NMO arasındaki ilişkiyi değerlendirmek. Yöntem: Çalışmamıza Mart 2015 ve Ocak 2017 tarihleri arasında prostat kanseri nedeniyle kemik sintigrafisi çekilen 85 hasta dahil edildi. Hastanın yaşı, PSA değerleri, Gleason skoru, histopatolojik özellikleri, kemik sintigrafisinde metastatik odak varlığı, odakların lokalizasyonu ile tam kan sayımı retrospektif olarak incelendi. Kemik sintigrafi görüntüleri çift başlı gama kamerayla (İnfinia II GP&Hawkeye 4) tüm vücut statik görüntüleri elde edilerek gerçekleştirildi. Nötrofil, lenfosit, trombosit sayıları otomatik kan sayım cihazı (Dyn Ruby Cell, ABBOTT, USA) ile ölçüldü. Hastalar NLO, PLO ve NMO medyan değerlerine göre iki gruba ayrıldı. Kemik sintigrafisinde metastatik bulgu olan/olmayan olgular ve PSA, Gleason skoru, periprostatik yayılım, cerrahi sınır pozitifliği, seminal vezikül invazyonu, perinöral invazyon gibi klinikopatolojik özellikler ile medyan NLO, TLO, NMO arasındaki ilişki değerlendirildi. İstatistiksel analizde ki-kare testi kullanıldı (p<0,05; anlamlı). Bulgular: Çalışma kriterlerine uyan 85 hastanın yaşları 52-86 arasındaydı. Hasta yaş ortalaması 68,5±8,58 idi. Medyan NLO, PLO ve NMO değerleri sırasıyla 2,92, 125,69 ve 8,38 idi. NLO, PLO, NMO ile kemik sintigrafi bulguları, PSA, Gleason skoru, ekstraprostatik yayılım, seminal vezikül invazyonu, cerrahi sınır pozitifliği, perinöral invazyon gibi klinikopatolojik özellikler arasındaki ilişki analiz edildiğinde yüksek NLO değeri ile sintigrafide kemik metastaz varlığı (p=0,018, Tablo 1) ve yüksek Gleason skoru (p=0,034) arasında istatiksel ilişki saptandı. PLO ve NMO ile klinikopatolojik özellikler arasında ise anlamlı istatiksel ilişki gösterilemedi (p>0,05). Sonuç: Çalışmamız prostat kanser tanılı hastalarda yüksek NLO ile kemik metastazı arasında anlamlı ilişki bulunduğunu göstermektedir. NLO'nun prostat kanser prognozunda bağımsız risk faktörü olduğu yönünde çalışmalar mevcut olmakla birlikte; bu hasta grubunda daha geniş kapsamlı çalışmaların yapılmasıyla olası prognostik katkısının belirlenebileceğini düşünmekteyiz. [ABSTRACT FROM AUTHOR]

Intraductal carcinoma of prostate has been previously described in radical prostatectomies. It’s rarely encountered in needle biopsies in the absence of infiltrative carcinoma. But, both histogenesis and nomenclature of the lesion is still controversial. Among the pure intraductal carcinoma of prostate cases, a different solid patern was described with smaller nuclei at the center of the ducts. However, there is a lack of information about the association of those cases with acinar prostate adenocarcinoma. Herein, we describe a case of acinar adenocarcinoma with predominant non-neuroendocrine TTF-1 positive small cell intraductal component. [ABSTRACT FROM AUTHOR]

Monitoring of allograft function entails methods more accurate than serum creatinine and creatinine-based GFR equations ( eGFR). This prospective trial aimed at investigating the diagnostic accuracy of creatinine- and cystatin C-based eGFR with measured GFR ( mGFR) and compared them with graft fibrosis detected by protocol biopsies ( PBx). Forty-four kidney transplant recipients were enrolled. PBx were obtained postengraftment and at 6th and 12th months. GFR was measured by Tc-99m DTPA at 3th, 6th, and 12th months after transplantation. Significant correlation existed between eGFR and mGFR at 3, 6, and 12 months ( P < 0.0001). Cystatin C-based Hoek and Larsson equations had the lowest bias and highest accuracy. The sum of interstitial fibrosis and tubular atrophy score increased from implantation to 6th and 12th months (0.52 ± 0.79, 0.84 ± 0.88, 1.50 ± 1.35). This was accompanied by reduction of mGFR from 54.1 ± 15.2 to 49.9 ± 15.2 and 46.8 ± 16.5 ml/min/1.73 m2, while serum creatinine, cystatin C, and eGFR remained stable. Neither creatinine- nor cystatin C-based GFR equations are reliable for detecting insidious graft fibrosis. In the first year after transplantation, mGFR, with its best proximity to histopathology, can be used to monitor allograft function and insidious graft fibrosis. [ABSTRACT FROM AUTHOR]

Persistent Müllerian duct syndrome is the result of either anti-Müllerian hormone (AMH) deficiency or AMH receptor resistance. A long tubular structure was palpated during the physical examination of a 13-month-old male patient who had presented with bilateral undescended testes. At physical examination, the testes were not palpable. The patient's karyotype was XY, SRY (+), and his AMH level was 22 ng/mol. Structures suggestive of ovaries, a uterus, and fallopian tubes were observed during the laparoscopic examination of the ectopic testis. AMHR2 gene sequence analysis performed with a preliminary diagnosis of AMH receptor resistance revealed a previously unreported homozygous c.24G>A (p.W8X) mutation. The patient was assessed as a case of AMH receptor resistance. Orchiopexy was performed. [ABSTRACT FROM AUTHOR]

Objective: Amyloidosis is a rare disease with various etiologies with extracellular amyloid protein depositions. At present, at least 26 distinctive amyloid forms have been detected with different clinical importance and treatment. They have characteristic staning fetaures with Congo red. Amyloid may be detected in 2-10% of prostates that have been removed because of hyperplasia or carcinoma. Amyloidosis of seminal vesicles is accepted as senil amyloidosis and it is not accompanied by systemic amyloidosis or clinical symptoms. This condition is the most common form of localized amyloidosis. In this study we aimed to investigate incidence and histologic characteristics of amyloidosis of seminal vesicles in radical prostatectomy materials of the patients whose prostate carcinomas were treated surgically. Material and Method: Amyloid depositions in seminal vesicles of 207 radical prostatectomy materials that prostates had been removed due to localized prostate carcinoma. Amyloid depositions were confirmed with Congo red staining and polarization microscope. Results: Amyloidosis of seminal vesicles was detected in 10 (4.8%) of cases. Mean age of the patients is 66.2 years. Amyloid depositions tend to be nodular and bilateral in subepithelial region of affected seminal vesicles. Amyloid depositions were not detected in blood vessels in seminal vesicles or prostate parenchyma. Conclusion: Localized amyloidosis of seminal vesicles is not an unusual finding. amyloidosis of seminal vesicles incidence in Turkish patients included in this study and histopathologic characteristics of these patients are not different from the other studies. Systemic AA amyloidosis is the most common form of amyloidosis in our country. To be aware of amyloidosis of seminal vesicles is of importance in discrimination from the other forms of amyloidosis. [ABSTRACT FROM AUTHOR]

Introduction: Determination of the frequency and prevalence of biopsy proven nephropat-hies in older adults and adults is important for epidemiological studies. Materials and Method: Predominant glomerulonephritis (GN) in native renal biopsies of adults and older adults (a65 years) were evaluated. Results: Among a total of 1702 renal biopsies (males 52%, ages 16-82, mean 40±15 years), 121 (7%) were performed in persons a65 years old. The mean age at the time of renal biopsy increased from 37.3±16.8 in 1996 to 44±16.1 years in 2009. The leading indications for biopsy in older and younger age groups were nephrotic syndrome (NS) (46.5% vs. 39.8% respectively), asymptomatic urinary abnormalities (20.9% vs. 33.4% respectively) acute renal failure (15.1% vs. 7.4% respectively) and hematuria (4.7% vs. 10.9% respectively ). The etiologies of NS were amyloidosis, membranous GN and focal segmental glomerulosclerosis (FSGS) in both age groups. Primary GN was the predominant etiology in both age groups. Above 65 years, membranous (14.8%) and crescentic (9.9%) GNs were predominant while below 65 years IgA nephropathy (9%) was predominant. Among secondary GNs, amyloidosis (19%) and lupus nephritis (11.7%) were also predominant in the elderly and the younger persons respectively. Conclusion: The current data represents the experience of a single center. Such registries will allow epidemiologic studies to answer several open questions regarding both prevention and treatment of nephropathies in different age groups. [ABSTRACT FROM AUTHOR]

Objective: Mucinous tubular and spindle cell carcinomas (MTSCC’s) are recently described rare type of renal cell carcinoma (RCC). MTSCC’s are characterized by small, elongated tubules lined by cuboidal cells and/or cords of spindled cells separated by pale mucinous stroma. They have morphological similarities to papillary RCC (papRCC). We evaluated the importance of the immunohistochemical features in the differential diagnosis of MTSCC and papRCC. Material and Method: We re-evaluated 9 cases of MTSCC diagnosed between 2004 and 2010 and compared 10 cases of papRCC. All tumorswere stained with alpha methylacyl-CoA racemase (AMACR), cytokeratin 7 (CK7), CK19, renal cell carcinoma marker (RCC Ma), CD10 and kidney specific cadherin (KspCad). Results: A total of 6/9 cases were considered classical. Two of 9 MTSCC’s were classified as “mucin-poor”. Foamy macrophages were identified in 4 cases. The immunoreactivity in MTSCC was AMACR 100%, CK7 100%, CK19 100%, RCC Ma 50%, CD10 11%,and KspCad 38% while the values for papRCC were AMACR 100%, CK7 90%, CK19 100%, RCC Ma 100%, CD10 80%, and KspCad 0%.Conclusion: MTSCCs may include little mucin and show a markedpredominance of either of its principal morphological components. They may mimic other forms of RCC. Pathologists should be aware of the histological spectrum of MTSCCs to ensure an accurate diagnosis. Careful attention to the presence of a spindle cell population may be helpful in the differential diagnosis in tumors with predominant compact tubular growth. Immuno histochemical stains for papRCC are also expressed in MTSCC, but strong CD10 expression may not favor MTSCC. [ABSTRACT FROM AUTHOR]

With a widely usage of prostate specific antigen (PSA) testing as a screening tool, number of prostate biopsy procedures and number of biopsy cores are increased because of the negative pathology results. As a result of this condition, incidental pathological findings including the prostate and/or the seminal vesicles were encountered. Seminal vesicle amyloidosis is one of these incidental results. In this study we aimed to present a patient with amyloidosis of the seminal vesicles which was found on transrectal ultrasound guided prostatic biopsy. [ABSTRACT FROM AUTHOR]

Objective: To determine the clinicopathologic and oncologic outcomes of testis-sparing surgery (TSS) by evaluating the data of patients who underwent TSS in our clinic. Materials and Methods: A total of 24 patients (27 testes) who underwent TSS in the last 16 years were included in the study. All the patients presented with a solitary testicular mass or bilateral testicular mass. Preoperative tumor markers were investigated and scrotal ultrasonography was performed in all patients. Surgery was performed with inguinal incision, temporary clamping of the spermatic cord and frozen section analysis (FSA) of the lesion. Intraoperative data, histopathological findings, and recurrence status were analyzed. Results: The mean follow-up period was 96 months. The mean age of the patients was 29.7 (18-66) years. The mean tumor diameter was 11 mm (2-18). TSS was performed bilaterally in 3 patients and unilaterally in 24 patients. According to the final pathology report, 18 (66.7%) of the masses were benign and 9 (33.3%) were malignant. Intraoperative FSA was performed in 17 patients (70.8%). FSA revealed malign histopathology in 6 patients and complementary orchiectomy was performed in 4 of these patients. 14 patients (51.9%) were detected to have positive surgical margins. Two of these patients had seminoma diagnosis and radical orchiectomy was performed due to recurrence on follow-up in these patients. TSS was performed in all patients without any significant intra-postoperative complications. Conclusion: TSS may have significant functional and cosmetic benefits without worsening oncologic results in appropriately selected patients. [ABSTRACT FROM AUTHOR]