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Our purpose was to comparatively investigate the expressions of nidogen-1 (NID1) and legumain (LGMN) in patients with endometrial cancer, endometrial intraepithelial neoplasia, and proliferative endometrium.A cross-sectional, single-center study was performed by the obstetrics and gynecology and pathology departments of our institution. The relationships between descriptive data, clinicopathologic information, and immunohistochemical expressions of NID1 and LGMN were investigated.The histological grades of endometrial cancers (n = 124) as classified by FIGO included 1 (41, 21.1%), 2 (48, 24.7%), and 3 (35, 18.0%). The medians and ranges of deep and superficial NID1 expressions were 50.00 (0-285) and 5.00 (0-100), respectively. The intensity of legumain expression was noted as negative (30, 24.2%), mild (16, 12.9%), moderate (27, 21.8%), or strong (51, 41.1%). Median disease-free survival and overall survival were 75.00 (range: 1 to 170) months and 77.00 (range: 1 to 170) months, respectively. Patients with more intense expression of NID1 and LGMN displayed a higher histological grade. These patients were more likely to have a positive peritoneal cytology, larger tumor size, higher tendency for myometrial or lymphovascular invasion, involvement of ovaries, cervix, omentum, as well as lymph node metastasis, and recurrence.Our data indicated that the expressions of NID1 and LGMN may have important diagnostic implications in endometrial pathologies. Further studies should be performed to understand the significance of NID1 and LGMN in the pathogenesis of endometrial tumors.

BACKGROUND Chronic viral B hepatitis (CHB) is a potentially life-threatening liver disease that may progress to liver failure and cirrhosis. Currently, although combinations of different laboratory methods are used in the follow-up and treatment of CHB, the failure of these procedures in some cases has led to the necessity of developing new approaches. In CHB, the intrahepatic expression pattern of viral antigens, including hepatitis B surface antigen (HBsAg), is related to different phases of inflammation. However, many studies have focused on the intracytoplasmic properties of HBsAg staining, and HBsAg positivity in liver tissue has not been evaluated by objective quantitative methods. AIM To investigate the relationship of image analysis-based quantitative HBsAg expression and its staining patterns with clinicopathological factors and treatment in CHB. METHODS A total of 140 liver biopsies from treatment-naïve cases with CHB infection were included in this study. Following diagnosis, all patients were treated with entecavir (0.5 mg) and followed up at three-month intervals. The percentage of immunohistochemical HBsAg (p-HBsAg) expression in the liver was determined in whole tissue sections of biopsies from each case by image analysis. The immunohistochemical staining pattern was also evaluated separately according to 3 different previously defined classifications. RESULTS A positive correlation between p-HBsAg and serum levels of hepatitis B virus (HBV) DNA and HBsAg was observed (P < 0.001). The p-HBsAg value was significantly higher in younger patients than in older patients. When the groups were categorized according to the hepatitis B e antigen (HBeAg) status in HBeAg-positive cases, p-HBsAg was correlated with HBV DNA, hepatitis activity index (HAI) and fibrosis scores (P < 0.001). In this group, p-HBsAg and HBsAg expression patterns were also correlated with the viral response (VR) and the serological response (SR) (P < 0.001). Multivariate analysis revealed that p-HBsAg was an independent predictor of either VR or SR (P < 0.001). In HBeAg-negative patients, although HBsAg expression patterns were correlated with both HAI and fibrosis, no relationship was observed among p-HBsAg, clinicopathological factors and VR. CONCLUSION In pretreatment liver biopsies, the immunohistochemical determination of HBsAg expression by quantitative methods, beyond its distribution within the cell, may be a good predictor of the treatment response, especially in HBeAg-positive cases.

AMAC: Kaposi sarkomu (KS) HHV-8 ile iliskili vaskuler bir proliferasyondur. KS icin Turkiye’de epidemiyolojik veriler hakkinda cok fazla calisma yoktur. Biz bu calismada 78 KS olgusunun klinik, patolojik ve immunohistokimyasal ozelliklerinin literatur bilgileri esliginde degerlendirmeyi amacladik. GEREC VE YONTEM: Klinik ve histopatolojik olarak KS tanisi alan 78 hastanin lezyonun klinik ve histopatolojik ozelliklerini retrospektif olarak inceledik. BULGULAR: Olgularimizin yas araligi 46-93 yil arasinda olup ortalama yas 74,06’idi. Olgularimizin 59’u erkek 19’u kadin saptanmistir. Lezyonlar daha cok alt ekstremitede yerlesim gostermekteydi. Hastalarimizin 54’unde KS erken donemini yansitan yama ve plak evresinde iken, 24 hastamiz noduler evrede oldugu saptandi. Hastalarimizdan 23 tanesinden punch biyopsi, 55 tanesinden eksizyonel biyopsi yapilmistir. Eksizyonel biyopsi yapilan hastalarimizin en kucuk tumor capi 0,35 en buyuk tumor capi 2,8 cm olup ortalama tumor capi 0.98’dir. TARTISMA: Bizim calismamizda Konya’da gorulen KS’larinin gec yas baslangicli oldugu ve erkeklerde daha sik goruldugu izlenmistir. Retrospektif olarak degerlendirdigimiz olgularin demografik bilgileri ve histopatolojik tipler acisindan literaturde sunulan calismalarla benzerlikler gosterdigi gorulmektedir.

High-grade endometrial carcinomas (HGEC) are difficult to classify. With the current use of HER2-based therapy in serous carcinoma, a diagnosis of clear cell carcinoma (CCC) has the potential to exclude patients from receiving therapy. Therefore, we examined HER2 expression in our CCC patients. The preparations of 8 patients with CCC who underwent hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection were re-evaluated. Patients did not have any prior treatment. Histopathologic parameters that were evaluated include cytoplasmic clearing, nuclear atypia, mitotic activity, hobnail architecture, hyalinized cores, hyaline globules, stratification of epithelial lining papillae, or glandular structures, and highly atypical cell layers. Immunohistochemically, HER2, ER, PR, HNF1β, Napsin A, MLH1, MSH2, MSH6 and PMS2 were applied. HER2 staining pattern, ASCO/CAP protocol used for endometrial carcinom was used. HER2 was positive in 3 of our 8 CCC patients (37.5%). While all of our HER2 + cases were Napsin A and HNF1β positive, MMR proteins were intact and ER and PR were negative. Two patients had wild type p53 and 1 patient had aberrant p53 staining. Considering that there is not always a consensus between SC and CCC, even among gynecopathologists, tumor heterogeneity and different tumor components may exist, and while patients may be diagnosed with CCC and benefit from HER2 therapy, there is also a possibility that they may not benefit from the treatment. The fact that 37.5% of our CCC cases were HER2 + is a finding with strong implications for the therapeutic approach. As a result of our study, in patients with CCC, if MMR is intact and ER-PR is negative, regardless of the p53 staining pattern, HER2 testing may be an objective screening method for patients who are likely to benefit from HER-targeted therapy. Consequently, patients with a diagnosis of CCC can be candidates for future clinical trials of HER2-targeted therapy.

Background: Digital mammography (DM) and digital breast tomosynthesis (DBT) are important radiological modalities, which increase the survival of breast cancer patients. Breast cancer is a morphologically heterogeneous disease with various histopathological parameters and multiple receptors in its biological profile. Objectives: This study aimed to analyze the morphological features of invasive breast cancer on DM and DBT, to investigate the contribution of DBT to DM, to examine the association of DBT findings with pathological molecular subtypes, Bloom-Richardson grade, and Ki-67 index, and to determine the effect of breast parenchyma density on the relationship between DBT findings and hormone receptors. Patients and Methods: A total of 36 patients with malignant lesions were evaluated in this study. According to the American College of Radiology (ACR) classification, the lesion features were divided into subgroups based on DM and DBT, and the findings were compared. The relationships between DBT findings and the hormone receptor status, molecular classification, and Bloom-Richardson grade were also investigated, and the effect of density on these relationships was assessed. Results: The mean age of the patients (n = 36) was 53 years. Based on the comparison of DM and DBT findings, spiculated margins, mass density, architectural distortion, and microcalcifications were significantly more frequent in DBT. Lesions with indistinct margins on DM were observed as mass lesions with spiculated margins on DBT (P < 0.001). Regarding the relationship between DBT findings and hormone receptor status and Ki-67 proliferation index, in progesterone receptor (PR)-positive patients, an irregular tumor shape was more common (89.7%). In PR-negative patients, skin changes and nipple retraction were more frequently seen (P = 0.03 for skin changes, and P = 0.049 for nipple retraction). Regarding the association between Bloom-Richardson grade (BRG) and DBT findings, tumors with a higher grade were more likely to be associated with a high tumor density (P = 0.032). Also, considering the relationship between molecular classification and DBT findings, skin changes and nipple retraction were significantly more frequent in triple-negative masses compared to other subtypes (P = 0.011 for skin changes and P = 0.016 for nipple retraction). Conclusion: DBT is superior to DM, as it reveals the lesion margins, density, and architectural distortion more accurately. The majority of PR-positive tumors were irregular, while most PR-negative cases were round. The mass density also increased as the tumor grade increased. Skin change and nipple retraction were frequently seen in triple-negative tumors compared to other subtypes. Therefore, DBT is a promising diagnostic tool for showing molecular subtypes in dense breasts.

Pulmoner epithelioid hemangioendothelioma is a rare and multifocal malignant tumor of vascular origin.

Objective This study aimed to find out valuable parameters that predict the nature of breast papillary lesions before excision, and we compared our results with those in the literature. Materials and methods We reviewed the medical records and pathology slides of patients diagnosed with papillary neoplasm after undergoing a core-needle biopsy between 2010 and 2020, who, subsequently, underwent surgical excision in a single tertiary care institution. The core biopsy results and pathology results of excision materials were compared with the radiological, pathological, and demographic findings. Results A total of 51 patients were included in the study. According to the excision results, the patients were divided into two groups: the atypical group, which included 20 patients (39.3%), and the benign group, which included 31 patients (61.7%). The results of the core biopsy showed that the loss of myoepithelial cell layer was identified in 18 patients in the atypical group, while it was present in all patients in the benign group. Tumor sizes were larger and patient ages were older in the atypical group compared with the benign group. No significant difference was found between atypical and benign groups in terms of breast imaging-reporting and data system (BI-RADS) classification and location (right vs left; central vs peripheral). The upgrade rate was between 0% and 16% in literature, while it was 4% in our study. Conclusion There is no consensus on whether patients diagnosed with papillary neoplasia as a result of core biopsy will undergo excision. According to our results, patients with following criteria should have their lesions excised: those who are advanced in age, those who are diagnosed with a papillary lesion as a result of core biopsies with loss of myoepithelial cell layer, and those who are diagnosed with large-sized lesions without loss of myoepithelial cell layer. Patients diagnosed with small-sized lesions without loss of myoepithelial cell layer and who are young in age are to be followed up without the need for lesion excision. The lesions should be adequately sampled.

OBJECTIVE: In this prospective study, the diagnostic performance of the new version of superb microvascular imaging (SMI) in differentiating malignant from benign lesions was evaluated. MATERIAL AND METHODS: Ninety breast lesions were included. During color SMI examination, both free-hand region of interest (ROI) and box ROI were used. Vascular index (VI) values were obtained from the lesion using both types of ROI and from normal breast tissue via box ROI. VI values, monochrome SMI grading and histopathological results were compared. The efficacy of color SMI and monochrome SMI was investigated in differentiating between benign and malignant breast lesions. RESULTS: The cut-off value, in the differentiation of benign and malignant lesions with color SMI was 0.50 for box ROI, while it was 0.30 for free-hand ROI. The specificity of VI values obtained with box ROI was higher than that of free-hand ROI when differentiating malignant lesions from benign. Comparison of VI values from a lesion and from normal breast tissue showed that VI values in malignant lesions were significantly higher (p

Although basal cell carcinoma (BCC) is prevalent in the older population, it can be rarely seen in younger people. This study aims to investigate the risk factors and characteristics of BCC in young patients.Pathology reports in a single tertiary care institution between 2010 and 2020 were retrospectively reviewed. Patients under the age of 35 who were diagnosed with BCC were included for the analysis. Data were gathered from medical records and pathology reports. Demographic characteristics, accompanying pathologies, and clinical findings of these patients were analyzed.There were a total of 32 patients in our cohort. Out of 32 patients, 20 were female and 12 were male. One male patient and five female patients were younger than 18. An accompanying risk factor (Gorlin syndrome, XP, renal transplantation, etc.) was present in six patients. There were no known additional diseases or risk factors in 26 patients. Metastasis and recurrence were not reported in any of our patients. Contrary to the information in the literature, the patients with BCC at a young age were not found more aggressive in our study.Contrary to the information in the literature, the patients with BCC at a young age were not found more aggressive in our study. Understanding the risk factors associated with BCC is essential for designing prevention strategies and favoring early diagnosis. Awareness of early-onset BCC aids in early diagnosis and treatment of the disease. Therefore, BCC should be in the differential diagnosis of skin lesions in the young population. In addition, when we encounter early-onset BCC, we should not forget the accompanying risk factors and syndromes.

A broad survey of the fall webworm (Lepidoptera: Erebidae) populations in agricultural and forested areas in the Central Black Sea Region of Turkey led to the detection of a granulovirus (G...

The gypsy moth (Lymantria dispar L., Lepidoptera: Lymantriidae) is one of the most serious pest of various forestal, food and industrial crops worldwide. We have characterized a new Lymantria dispar nucleopolyhedrovirus (LdMNPV-T4) variant, which was isolated from dead L. dispar larvae in Turkey. Scanning electron microscope observations showed that the polyhedral occlusion bodies (OBs) of the LdMNPV-T4 were irregularly shaped. Transmission electron microscopy revealed that OBs of LdMNPV-T4 were occupied with several virions in which multiple nucleocapsids packaged by viral envelope. Restriction analysis of the LdMNPV-T4 DNA purified from the viral inclusion bodies yielded BamHI, BglII, EcoRI and HindIII fragments. The mean size estimated for the complete LdMNPV-T4 genome was calculated to be 163.3 kb. Phylogenetic analysis of amplified polh, lef-8 and lef-9 sequences showed its relation to the other NPVs from Lymantria species. Mortality values of the LdMNPV-T4 at four different concentrations ag...

In recent years, with the increase in computer support, image processing and machine learning methods have become effective on these high resolution histopathological images. The aim of this study is to classify histopathological images with high accuracy to help diagnosis process by reducing the workload of specialists. By using two different data sets in the experimental studies, the images in one of them were classified by conventional feature extractions based method and the images in the other by deep learning methods. In the feature extraction based approach, when pixel densities and image histograms were added to the features obtained with Haralick textural descriptor, the highest classification accuracy was obtained with random forest classifier as 87.3%. In order to overcome the many challenges of feature extraction -based approaches, deep learning methods become as important alternatives. DenseNet121, DenseNet169 and SqueezeNet 1.0 models obtained 88.75%, 92.5% and 88.75% accuracies respectively, by retraining the models trained with the ImageNet dataset provided by PyTorch with the BACH ICIAR dataset and testing them with 20% of the images. With forming an ensemble model, the class which is the majority of the estimation results of the models is counted as the final prediction and 97.5% accuracy is obtained.

Aim: Along with the increased availability of radiologic imaging methods, early identification of tumor tissue, and patient surveillance programs; ductal carcinoma in situ (DCIS) and microinvasive DCIS became more commonly identified in the tru-cut biopsy specimens and resected samples of patients. Pathological examinations of the excision materials from these patients reveal invasive tumors, microinvasions or DCIS alone. Recently, it has become debatable whether to perform a sentinel lymph node biopsy (SLNB) in patients diagnosed with DCIS or microinvasive DCIS. In this present study, we evaluated the diagnosis made by examining the excision material, any presence of lymph node metastases, and the relationship of hormone profile to the presence of metastases in the patients diagnosed with DCIS or microinvasive DCIS by the examination of tru-cut biopsy specimens. Based on our study results, we discussed the requirement for SLNB in patients with a tru-cut diagnosis of DCIS or microinvasive DCIS.Materials and Methods: The study included 172 patients, who underwent surgical excision and SLNB after receiving a tru-cut biopsy diagnosis of DCIS and microinvasive DCIS in our hospital from the year 2010 to 2018.Results: Tru-cut biopsy diagnoses were DCIS and microinvasive DCIS in 69.8% (120 patients) and 30.2% (52 patients) respectively. SLNB metastases were identified in 35.8% (n=43) of the DCIS positive patients and 44.2% (n=23) in the microinvasive DCIS positive patients. The diagnosis of invasive ductal carcinoma after mastectomy was made at a rate of 90.0% (n=108) among the DCIS positive patients and 92.3% (n=48) among the microinvasive DCIS positive patients. Conclusion: SLNB metastases were found in 35.8% (n=43) and 44.2% (n=23) of the DCIS positive patients and microinvasive DCIS positive patients, respectively. We conclude that SLNB should be favorably proper to perform in the patients with tru-cut diagnoses of DCIS and microinvasive DCIS because a high rate of SLNB metastases was detected in our DCIS and microinvasive DCIS patients and a high rate of invasive ductal carcinoma diagnosis was made after examining the excision material of these patients.

The fall webworm (Hyphantria cunea) impacts a wide variety of crops and cultivated broadleaf plant species. The pest is native to North America, was introduced to Europe and has since spread further as far as central Asia. Despite several attempts to control its distribution, the pest continues to spread causing damage all over the world. A naturally occurring baculovirus, Hyphantria cunea granulovirus (HycuGV-Hc1), isolated from the larvae of H. cunea in Turkey appears to have a potential as microbial control agent against this pest. In this report we describe the complete genome sequence and organization of the granulovirus isolate (HycuGV-Hc1) that infects the larval stages and compare it to other baculovirus genomes. The HycuGV-Hc1 genome is a circular double-stranded DNA of 114,825 bp in size with a nucleotide distribution of 39.3% G + C. Bioinformatics analysis predicted 132 putative open reading frames of (ORFs) ≥ 150 nucleotides. There are 24 ORFs with unknown function. Seven homologous repeated regions (hrs) and two bro genes (bro-1 and bro-2) were identified in the genome. Comparison to other baculovirus genomes, HycuGV-Hc1 revealed some differences in gene content and organization. Gene parity plots and phylogenetics confirmed that HycuGV-Hc1 is a Betabaculovirus and is closely related to Plutella xylostella granulovirus. This study expands our knowledge on the genetic variation of HycuGV isolates and provides further novel knowledge on the nature of granuloviruses.

Thymolipoma is a rare and benign lesion originating from the anterior mediastinum. Thymolipoma is mostly diagnosed incidentally. However, cough, dyspnea and chest pain can be seen. A 35-year-old male patient presented to our hospital with the complaint of shortness of breath lasting for one month. The physical examination revealed a massive pleural effusion on the right. In computed tomography (CT) imaging of the thorax, a soft tissue density of 7.5x5x5 cm in size, containing calcifications were observed in the anterior mediastinum. A right thoracotomy was performed for the treatment and to make a definite diagnosis. The histopathological examination resulted in the diagnosis of a thymolipoma. We presented our case with its differential diagnosis because of its rarity.

In this study, Lymantria dispar dispar larvae, collected from three different localities in Turkey, were examined for the presence of inclusion bodies under phase contrast and electron microscopes. Inclusion bodies from infected larvae were subjected to polymerase chain reaction using the conserved primers for polyhedrin (polh), late expression factor 8 (lef-8) and late expression factor 9 (lef-9) genes. Sequence analysis confirmed that larvae collected from the three different localities contained multiple nucleopolyhedrosis viruses (MNPVs). These isolates were designated LdMNPV-T1, LdMNPV-T2 and LdMNPV-T3. Phylogenetic analyses of these isolates were performed using target genes polh, lef-8 and lef-9. Restriction endonuclease analysis of the three geographic isolates with EcoRI and PstI enzymes demonstrated some differences existed among the isolates. According to the EcoRI profile, the mean estimated size for the complete genome of each isolate (LdMNPV-T1, LdMNPV-T2 and LdMNPV-T3) was calculated to be approximately 170, 153 and 170kb, respectively. Insecticidal activities of each isolate were tested on L.d.dispar larvae using four different viral concentrations between 10(3) and 10(6)OBs/ml. Results showed that the mortalities for LdMNPV-T1, -T2 and -T3 ranged between 13-53%, 47-100% and 46-93%, respectively. The LC50 and LC95 values of LdMNPV-T2 were not significantly different from the respective corresponding values of the other two isolates. However, isolate LdMNPV-T2 killed larvae with a LC50 value that was lower than the other two isolates. Our results suggested there are promising LdMNPV isolates in Turkey that can be used for microbial control of L.d.dispar larvae.

Aim: The purpose of this study is to investigate the relationship between TMJ disc displacement and chondylar degenerative changes.Material and Methods: The MRIs of 182 TMJs belonging to 91 patients with TMD were evaluated. TMJs were distributed into three groups according to the disc positions as normal disc position (Group 1, n=39), disc displacement with reduction (Group 2, n=49) and disc displacement without reduction (Group 3, n=94). Condylar degenerative change is diagnosed according to presence or absence of erosion, sclerosis, flattening and osteophyte encountered in MRI. When more than one type of degenerative change was observed, the joint was determined to have degenerative changes.Results: The results of MRI evaluation of 182 TMJs revealed Group 1, Group 2 and Group 3 in 39 (21.4%), 49 (26.9%) and 94 (51.6%) joints, respectively. No degenerative condyle was found in 107 (58.8%) joints whereas degenerative condylar changes were encountered in 75 (41.2%) of 182 TMJs by the MRI evaluation. Condyle degeneration was detected in 2 (5.1%) of the joints with normal disc position whereas 6 (12.2%) and 67 (71.3%) of the joints with reducing and non-reducing disc displacement revealed condyle degeneration, respectively.Conclusion: A statistically significantly higher rate of condyle degeneration was encountered in the joints with disc displacement without reduction than the joints with disc displacement with reduction and normal disc position. Advancing disc displacement causes condylar degenerative changes.Keywords: Temporomandibular joint disorders; magnetic resonance imaging; disc displacement; degenerative changes.