Aim: The purpose of the present study of ours was to examine the relation of Ki67 and PTEN expression with the prognosis in the pathologies of patients who undergo gastrointestinal stromal tumor surgery in our clinic. Gastrointestinal stromal tumors; In addition to being small incidental tumors; can be tumors with large size and malignant behavior. For this reason, the relation of a great number of macroscopic and microscopic parameters with prognosis was examined. The diameter, location and mitotic index of the tumor rank the first among these parameters; however, several pathological parameters like PTEN and Ki67 expression are also important. Material and Methods: The present study was conducted between January 2005 and April 2015 with patients diagnosed with gastrointestinal stromal tumors. The demographic data (age and gender), tumor localizations, tumor sizes, mitotic activities, prognostic risk classification, follow-up times, PTEN expressions, Ki67 proliferation indices, relapse and metastasis status, and survival data of the patients were examined retrospectively. Results: A total of 76 patients were included in the present study. A total of 33 (43.4%) of the participants were women, and the average age was 59.7±11.7 years. The relations of PTEN with risk scores (p=0.330), tumor diameter (p=0.360), location (p=0.169), and mitosis count (p=0.579) were not significant. The relation of PTEN staining rate with relapse (p=0.832), metastasis (p=0.626) and survival (p=0.069) was not found to be statistically significant. The relation of Ki67 expression with risk scoring (p=0.018) and mitosis count (p=0.003) was significant. Although the relation between Ki67 and relapse (p=0.019) and metastasis (p=0.003) was significant, the relation between survival (p=0.655) was not significant at a statistical level. Conclusion: The Ki67 expression was a prognosis-indicating index for relapse and metastasis when the baseline value was taken as 5%; however, no relation was detected between PTEN expression and prognosis.

INTRODUCTION:BRAFV600E activating mutation is the most frequent genetic abnormality in the pathogenesis of papillary thyroid carcinoma. We aimed to evaluate the association between BRAFV600E mutation and well-established prognostic clinicopathological characteristics as well as iodine exposure.MATERIAL AND METHODS:From 2000 to 2012, the data of PTC patients admitted to Dr. Lutfi Kirdar Kartal Education and Research Hospital in Turkey were reviewed retrospectively. Clinicopathological parameters were collected. BRAFV600E mutation was analysed by DNA sequencing method in tumour specimens. We hypothesised thatBRAFV600E mutation prevalence is positively correlated with prolonged iodine exposure and expected to be higher in the second half of the recruitment period due to the increment in time spent from the iodisation process of the table salt in our country. Thus, iodine exposure was categorised as short-term (2000-2006) and long-term (2006-2012).RESULTS:A total of 197 patients were accrued. The study population predominantly consisted of conventional variant. A statistically significant relationship was observed betweenBRAFV600E mutation presence and age (p = 0.03), conventional variant PTC (p = 0.00002), T4 stage (p = 0.002), vascular invasion (p = 0.036), thyroid capsule invasion (p < 0.00001), extrathyroidal tissue invasion (p < 0.00001), and lymph node metastasis (p < 0.00001). When categorised as long-term and short-term, iodine exposure was not statistically significantly related withBRAFV600E mutation; however, there were far more PTC cases in the long-term group (86.3% vs. 13.7%).CONCLUSION:We revealed that BRAFV600E mutation is associated with adverse clinicopathological parameters. There appeared to be no relation between long-term iodine exposure and BRAFV600E.

Tacrolimus exhibits its nephrotoxic effect in relation to its inhibition of one of the antioxidant enzymes named catalase. Glutathione peroxidase catalysesa similar reaction done by catalase. The factor which increases GPx’s activity is Glutathione levels.Subsequently, Glutathione levelsare increased by N-Acetyl cysteine (NAC). Thus, it seems NAC can influence the prevention of Tacrolimus mediated nephrotoxicity. In this study,Sprague-Dawley ratsreceived1 mg/kg/day dose of tacrolimus in the control group while the three treatment groupsreceived 1mg/kg/day of tacrolimuswith NAC in 100,200 and 300 mg/kg/day doses respectivelyfor 28 days. Upon study completion, the biochemical markers of tacrolimus nephrotoxicity (urinary microalbumin,serum creatinine and BUN) showed dramatic increase in both the control group and in the three treatment groups. Urinary microalbumin levels showed significant decrease with 300 mg/kg NAC dosing (p<0.01). Furthermore, serum creatinine levels showed significant decrease in all three doses (p<0.05) while BUN showed significant decrease in NAC 100 and 200 mg/kg doses (p<0.01) and 300 mg/kg dose (p<0.001). In the control group on tacrolimus alone, an increase in interstitial fibrosis and tubular atrophytwo important markers of chronic tacrolimus nephrotoxicitywas observedwhereas in contrastthe NAC treatment groups revealed a significant decrease in interstitial fibrosis (p<0.05 in NAC 200 and 300) and tubular atrophy (p<0.05 for NAC 200 and 300). These findings confirm the nephroprotective effects of N-acetylcysteine in chronic tacrolimus nephrotoxicity which acts in a dose dependent manner.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

The differential diagnosis of facial granulomas can be challenging in some cases, as multiple diseases have similar histopathological findings.Herein we describe a 36-year-old male with granulomatous rosacea that was initially diagnosed as papulonecrotic tuberculid based on the initial histopathological sections analyzed.This case presentation aimed to highlight both the need for re-evaluation of clinical findings and that examination of new histopathologic sections may be necessary for a definitive diagnosis of facial granulomas.

BACKGROUND:Prosthetic valve dysfunction due to pannus formation is a rare but serious complication. Currently, limited data are available concerning the pathogenesis and immunohistochemical properties of pannus. The study aim was to investigate the morphological, histopathological and immunohistochemical characteristics of pannus formation in patients with prosthetic valve dysfunction.METHODS:A total of 35 patients (10 males, 25 females; mean age 44 ± 16 years) who had undergone re-do valve surgery due to prosthetic valve obstruction was enrolled in the study. Immunohistochemical studies were aimed at evaluating the expression of alphasmooth muscle actin (α-SMA) and desmin in myofibroblasts and smooth muscle cells; epithelial membrane antigen (EMA) in epithelial cells; and CD34, Factor VIII and vascular endothelial growth factor (VEGF) in endothelial cells. Matrix metalloproteinases (MMPs) -2 and -9, and transforming growth factor-beta (TGF-β) were used to demonstrate cytokine release from macrophages, leukocytes, fibroblasts and myofibroblasts.RESULTS:Pannus appeared as a tough and thick tissue hyperplasia which began from outside the suture ring in the periannular region and extended to the inflow and outflow surfaces of the prosthetic valves. Histopathological analysis showed the pannus tissue to consist of chronic inflammatory cells (lymphocytes, plasma cells, macrophages and foreign body giant cells), spindle cells such as myofibroblasts, capillary blood vessels and endothelial cells laying down the lumens. Calcification was present in the pannus tissue of 19 explanted prostheses. Immunohistochemical studies revealed positive α-SMA expression in all patients, whereas 60.5% of patients were positive for desmin, 50% for EMA, 42.1% for VEGF, 39.5% for TBF-β, 42.1% for MMP-2, 86.8% for CD34, and 97.4% for Factor VIII. MMP-9 was negative in all patients.CONCLUSIONS:Pannus tissue appears to be formed as the result of a neointimal response in periannular regions of prosthetic valves that consist of periannular tissue migration, myofibroblast and extracellular matrix proliferation with vascular components. It is a chronic active process in which mediators such as TGF-β, VEGF and MMP-2 play roles in both matrix formation and degradation.

OBJECTIVE:Ovarian metasteses are often mistaken for primary adenocarcinoma. Studies conducted in recent years have focused on a search for an immunohistochemical marker to aid the differential diagnosis primary and metastatic ovarian carcinoma. Our study objective was to study the usefulness of Wilms tumor 1 (WT 1) antigen in this context.MATERIALS AND METHODS:The study was conducted at the pathology clinic of Lütfi Kırdar Training and Research Hospital. Deparaffinated blocks of 40 epithelial ovarian tumors, 40 colon adenocarcinomas, and 35 cases of omentum metastases were studied. Cytokeratin 7 (CK 7), cytokeratin 20 (CK 20), and WT 1 were applied to all specimens.RESULTS:All ovarian adenocarcinomas were stained with CK 7 (100%). Colorectal adenocarcinomas were stained positive with CK 20 in 87.5% of cases. Primary ovarian adenocarcinomas stained positive with WT 1 in 82.5% of the cases and none of the colorectal adenocarcinomas showed staining with WT 1 (0%).CONCLUSION:WT 1 can be used in conjuction with CK 7 in the differential diagnosis of ovarian carcinomas.

Background: Several studies have suggested a possible role of human papillomavirus (HPV) and Epstein-Barr virus in the pathogenesis of oral premalignant lesions. This study aimed to investigate the correlation between squamous dysplasia of the tongue and expression of p16 and Ki67 immunohistochemically as well as HPV genotypes with real-time polymerase chain reaction (PCR). Methods: Twenty-three tongue biopsies were stained immunohistochemically for p16, Epstein-Barr virus and Ki67 and real-time PCR and chromogenic in-situ hybridization for HPV. Results: Dysplasia was diagnosed in 16 of 23 cases without invasive carcinoma and suspicious for dysplasia (n=17) and HPV infection (n=6). These were subjected to chromogenic in-situ hybridization for HPV DNA (HPV-III family 16). There was no immunoreactivity for Epstein-Barr virus. p16 was positive in 4/16 (25%) of dysplastic lesions. One lesion was positive for HPV by chromogenic in-situ hybridization, and one case was positive by real-time PCR for HPV. Conclusion: This evidence suggested that HPV infection but not Epstein-Barr virus infection plays a role in pathogenesis of squamous dysplasia localized tongue.

Objective: The role of the galectin-3 and CD44v6 expression in the differentiation of the thyroid follicular carcinoma and follicular adenoma were investigated in many preoperative cytologic samples and significant results were achieved. In this study, we investigated galectin-3 and CD44v6 as potential supportive markers of histopathologic diagnosis in the differentiation of follicular carcinoma and adenoma of thyroid in conventional tissue sections. Material and Method: A total of 60 thyroidectomy specimens from Kartal Dr. Lutfi Kirdar Training and Research Hospital and Istanbul University Cerrahpasa Medical Faculty Pathology Department were investigated retrospectively. Twenty cases of the 60 thyroidectomy specimens were diagnosed as follicular carcinoma and 40 cases were diagnosed as follicular adenoma. Sections taken adjacent to the capsule of the nodule were stained immunohistochemically by HRP-AEC method for galectin-3 and CD44v6 antibody. Then sections were investigated under light microscope and labeled as no staining (-), focal weak staining (+), moderately intense staining (++), intense staining (+++). Results: Galectin-3 expression was significant in the differentiation of the follicular carcinoma and adenoma (p0.05). Conclusion: Galectin-3 was determined as a potential marker in the diagnosis of follicular carcinoma but CD44v6 expression was not a diagnostic value in the differentiation of follicular carcinoma and adenoma.

Abstract Objective: Head and neck cancers account for 17.6% of all malignant neoplasms. Data on the incidence of head and neck cancers and histological subtypes in Turkey are limited. This study aimed to provide an overview of statistics for head and neck cancers. Material and Method: This retrospective and descriptive study included 1973 cases of in-situ carcinomas, malignant and borderline neoplasia from the head and neck region in a period of 5 years, diagnosed at Dr.Lütfi Kırdar Kartal Education and Research Hospital’s Department of Pathology. Demographic data of patients and data from histopathological report were recorded. The topography of all tumours was coded according to the International Classification of Diseases for Oncology, 2nd and 3rd edition and histological and behavioral codes were given according to ICD-O-3. Data was entered and analyzed using Microsoft Excel™, version 2010. Results: Male and female ratio was 1.03 for head and neck cancers. The most common sites for males were described as the ratio in head and neck cancers and all malignant tumours as follows: the skin (non-melanoma) (48.4%-8.2%), the larynx (12.6%-2.3%), the thyroid (11.1%-1.2%), the lips (7.8%-1.3%), and the nasopharynx (3.1%-0.5%). The most common sites for females were as follows: the thyroid (45.3%-8.3%), the skin (non-melanoma) (39.6%-7.3%), the lips (3.6%-0.6%), the nasopharynx (2.2%-0.4%) and the eye (1.7%-0.3%). The male: female ratio was 25.2 for larynx cancers. The most common histological types and rates for males and females were also given. Conclusion: This descriptive epidemiological pathology-based cancer incidence study has relative value for describing head and neck cancer incidences in the İstanbul region and shown that pathology report-based descriptive epidemiological studies are still valuable for determination of the regional distribution of cancer incidence out of the active cancer registration regions. Öz Amaç: Baş boyun tümörleri tüm malign neoplazmların %17,6’sını oluşturmaktadır. Türkiye’deki baş boyun kanserleri insidansları ve histolojik alt tiplerine ait bilgiler sınırlıdır. Bu çalışma baş boyun kanserleri istatistiklerine genel bakışı amaçlamaktadır. Gereç ve Yöntem: Retrospektif ve deskriptif olan çalışma, Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi Patoloji Kliniği’nde 5 yıllık zaman diliminde tanı alan, baş boyun bölgesine ait 1973 in-situ karsinom, malign ve borderline neoplazi olgusunu içermektedir. Hastalara ait nüfus bilgileri ve histopatoloji raporlarındaki bilgiler kaydedildi. Tüm tümörlere ait topoğrafikodlaması Uluslararası Hastalıkların Sınıflandırılması-Onkoloji 2. ve 3. baskılara göre, histoloji ve davranış kodlaması 3. baskıya göre yapılmıştır. Veri kayıtları ve analizi Microsoft Excel™, 2010 versiyonu ile yapılmıştır. Bulgular: Erkek ve kadın oranı 1,03’dür. Erkeklerde en sık görülen lokalizasyonların, baş boyun tümörleri içinde ve tüm tümörler içinde dağılımı şu şekildedir; deri (melanom dışı) (%48,4-%8,2), larinks (%12,6-%2,3), tiroid (%11,1-%1,2), dudak (%7,8-%1,3) ve nazofarinks (%3,1-%0,5). Kadınlarda en sık görülen lokalizasyonların, baş boyun tümörleri içinde ve tüm tümörler içinde dağılımı şu şekildedir; tiroid (%45,3-%8,3), deri (melanom dışı) (%39,6-%7,3), dudak (%3,6-%0,6), nazofarinks (%2,2-%0,4) ve göz (%1,7-%0,3). Larinks kanserleri için erkek kadın oranı 25,2 dir. Erkeklerde ve kadınlarda en çok görülen histolojik tip ve oranları da ayrıca verildi. Sonuç: Patoloji rapor tabanlı retrospektif deskriptif epidemiyolojik çalışmamız İstanbul bölgesi baş boyun kanserleri oranlarını belirlemede göreceli değer taşımakta ve patoloji rapor-tabanlı deskriptif epidemiyolojik çalışmaların, aktif kanser kayıt bölgelerinin dışında kanser insidansı bölgesel dağılımının belirlenmesi için değerli olduğunu göstermektedir.

The aim of this study evaluation of diagnostic accuracy of preoperative FNAC in salivary gland lesions.

Lipomatous lesions of the salivary glands are rare, accounting for less than 0.5% of all parotid gland tumours. Distinct microscopic variants of lipoma of the salivary glands, e.g. angiolipoma, fibrolipoma, pleomorphic lipoma and spindle-cell lipoma have been reported. A 45 year-old male patient with mass on uvula was presented. Specimen was capsulated, yellow coloured, soft tissue with 1,3 cm in greatest diameter. Whole-mount section showed tumor composed by mature adipocytes, salivary gland parenchymal tissue and lymphoid follicles surrounded by fibrous capsule. Salivary gland component consist acinar and ductal elements. In some areas, glandular components were atrophic. Lymphoid follicles and focal fibrosis were seen. Oncocytic, sebaceous, and squamous metaplasia were not observed. Sialolipomas were composed predominantly of adipose tissue and showed expansive growth with fibrous capsule. Sialolipomas were reported at parotid gland, submandibular gland, hard and soft palate. To our knowledge, such a case in uvula localization was not previously presented.

Several studies have suggested a possible role of human papillomavirus (HPV) in the pathogenesis of oral carcinoma and presence of HPV in oral premalignant lesions (OPL).

OBJECTIVE:Head and neck cancers account for 17.6% of all malignant neoplasms. Data on the incidence of head and neck cancers and histological subtypes in Turkey are limited. This study aimed to provide an overview of statistics for head and neck cancers.MATERIAL AND METHOD:This retrospective and descriptive study included 1973 cases of in-situ carcinomas, malignant and borderline neoplasia from the head and neck region in a period of 5 years, diagnosed at Dr.Lütfi Kırdar Kartal Education and Research Hospital's Department of Pathology. Demographic data of patients and data from histopathological report were recorded. The topography of all tumours was coded according to the International Classification of Diseases for Oncology, 2nd and 3rd edition and histological and behavioral codes were given according to ICD-O-3. Data was entered and analyzed using Microsoft Excel™, version 2010.RESULTS:Male and female ratio was 1.03 for head and neck cancers. The most common sites for males were described as the ratio in head and neck cancers and all malignant tumours as follows: the skin (non-melanoma) (48.4%-8.2%), the larynx (12.6%-2.3%), the thyroid (11.1%-1.2%), the lips (7.8%-1.3%), and the nasopharynx (3.1%-0.5%). The most common sites for females were as follows: the thyroid (45.3%-8.3%), the skin (non-melanoma) (39.6%-7.3%), the lips (3.6%-0.6%), the nasopharynx (2.2%-0.4%) and the eye (1.7%-0.3%). The male: female ratio was 25.2 for larynx cancers. The most common histological types and rates for males and females were also given.CONCLUSION:This descriptive epidemiological pathology-based cancer incidence study has relative value for describing head and neck cancer incidences in the İstanbul region and shown that pathology report-based descriptive epidemiological studies are still valuable for determination of the regional distribution of cancer incidence out of the active cancer registration regions.

OBJECTIVE The aim of the study was a retrospective evaluation of 299 cases that were histopathologically diagnosed as cystic echinococcosis (CE) in the pathology laboratory of our hospital in a seven years period. METHODS All specimens sent to the laboratory were examined microscopically following macroscopic and hematoxylin eosin (H-E) staining. 299 cases were reviewed according to age, gender and organ affected by the cyst, more than one specimen of the same organ was evaluated once. RESULTS Of the 299 cases, 44.5% (133) were male whereas 55.5% (166) of them were female. Additionally, %5 (15) of the cases were between 0-15 ages, %31.8 (95) of them were between 16-30 ages, %29.4 (88) of them were between 31-45 ages, % 24.4 (73) of them were between 46-60 ages and %9.4 (28) of them were older than 61. Cysts were mostly localized in liver, lungs and peritoneal cavity, %71.9 (215), %11.4 (34) and %4.7 (14) respectively. CONCLUSION Demographic features of our cases were mostly in line with the previous literature. Because of the presence of atypical localized cases, during pathologic evaluation of all surgical cystic specimens, elements of this parasite should be searched and evaluated carefully.

OBJECTIVE:To describe a case of epithelioid trophoblastic tumor (ETT) in a postmenopausal woman, which had several peculiar features that differentiate it from previously reported ETTs.CASE REPORT:ETT of the uterus is a rare form of trophoblastic tumor with only 100 cases distinguished until now. Our case differs from the previously reported ones due to its several exceptional features. Our patient had no history of trophoblastic or gynecological disease; is postmenopausal; had endocervical extension from the beginning; recurrences and metastasis at follow up; and had a high Ki-67 index and a normal beta-human chorionic gonadotropin value.CONCLUSION:Because precise differential diagnosis will alter the therapeutic approach and prognosis, it is necessary for treating physicians to be aware of these unusual presentations.

Cemento-osseous dysplasias are non-neoplastic, reactive fibro-osseous lesions of tooth-bearing areas. Lesions in anterior mandible and localised only a few adjacent teeth termed as periapical cemento-osseous dysplasia or limited lesion occurring in a posterior jaw quadrant called focal cemento-osseous dysplasia are the same lesions. A 47-year-old male patient was complaining of flux after extraction of a tooth. A panoramic radiograph displayed lobular, irregularly shaped radiopacities involving right maxilla extending from the maxillary alveolus to the inferior orbital border and right maxillary tuberosity. Microscopic examination showed unencapsulated, extensive irregularly shaped cementum-like calcifications continious with normal bone lamella and in fibrous tissue.

The aim of this study was to detect the presence of H. pylori in the salivary gland neoplasms for investigating the possible role of H. pylori in the aetiology of salivary gland neoplasms.