AimTo describe a group of distinct low‐grade oncocytic renal tumours that demonstrate CD117 negat... more AimTo describe a group of distinct low‐grade oncocytic renal tumours that demonstrate CD117 negative/cytokeratin (CK) 7‐positive immunoprofile.Methods and resultsWe identified 28 such tumours from four large renal tumour archives. We performed immunohistochemistry for: CK7, CD117, PAX8, CD10, AMACR, e‐cadherin, CK20, CA9, AE1/AE3, vimentin, BerEP4, MOC31, CK5/6, p63, HMB45, melan A, CD15 and FH. In 14 cases we performed array CGH, with a successful result in nine cases. Median patient age was 66 years (range 49–78 years) with a male‐to‐female ratio of 1:1.8. Median tumour size was 3 cm (range 1.1–13.5 cm). All were single tumours, solid and tan‐brown, without a syndromic association. On microscopy, all cases showed solid and compact nested growth. There were frequent areas of oedematous stroma with loosely arranged cells. The tumour cells had oncocytic cytoplasm with uniformly round to oval nuclei, but without significant irregularities, and showed only focal perinuclear halos. Nega...
Background: Few larger studies have evaluated the long-term outcome after a diagnosis of papillar... more Background: Few larger studies have evaluated the long-term outcome after a diagnosis of papillary urothelial neoplasm of low malignant potential (PUNLMP), demonstrating a broad range of recurrence and progression rates. Additionally, no study has addressed the outcome of PUNLMP exhibiting inverted growth. We evaluated the long term clinical outcome of primary papillary urothelial neoplasm of low malignant potential (PUNLMP), including PUNLMP with inverted growth in a large single center study. Methods: We evaluated 189 primary PUNLMP (177 exophytic, 12 inverted), diagnosed from January 1, 2000 to December 31, 2009, in a centralized uropathology practice. We excluded PUNLMP diagnosed after a previous or with a concurrent urothelial neoplasm. Recurrence was defined as any subsequent urothelial neoplasm, regardless of the grade. Progression was defined as any subsequent higher-grade or invasive urothelial neoplasm. Recurrence and progression were established only if documented on a subsequent biopsy. Descriptive statistical analysis was performed using Microsof Excel software package. Results: The location of PUNLMP included bladder (187) and renal pelvis and ureter (1 each). After a median follow-up of 61 months (range, 9-128 months), 20.1% patients developed a recurrence. Recurrence with PUNLMP only was found in 9% of patients. Subsequent low-grade urothelial carcinoma was documented in 9.5% of patients. Progression to high-grade urothelial carcinoma was found in 1.6% patients (1% with muscle invasion). No patients with recurrent PUNLMP or subsequent low-grade carcinoma demonstrated invasion. All patients with PUNLMP exhibiting an inverted growth had no recurrence or progression on follow-up. Conclusion: In this study, primary PUNLMP recurred primarily either as PUNLMP or low grade urothelial carcinoma. Primary PUNLMP rarely progressed to high grade or invasive carcinoma on long term follow-up. No recurrence or progression was documented on follow-up for PUNLMP that demonstrated exclusively inverted growth.
Mesothelioma of tunica vaginalis is a rare neoplasm, typically demonstrating frankly malignant mo... more Mesothelioma of tunica vaginalis is a rare neoplasm, typically demonstrating frankly malignant morphology and aggressive behavior. Rare cases of well-differentiated papillary mesotheliomas have also been reported, which, in contrast, demonstrate indolent behavior. There are, however, cases which do not fit into the well-differentiated or diffuse malignant mesothelioma categories and can be considered mesothelioma of tunica vaginalis of "uncertain malignant potential", which is an emerging diagnostic category. A 57-year-old man presented with a neoplasm in a hydrocele sac. The neoplasm was non-invasive, but showed focal complex and solid growth and it was difficult to categorize either as well-differentiated papillary mesotheliomas or malignant mesothelioma. After the initial limited resection, the patient underwent radical orchiectomy with hemiscrotectomy and is alive and without disease progression after 6 years. Documentation of these rare tumors will allow their distinction from true malignant mesotheliomas and will facilitate the development of specific treatment recommendations. Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/ vs/3445715895747607.
Clinical staging is a critical step in the management of testicular germ cell tumors. Up to one-t... more Clinical staging is a critical step in the management of testicular germ cell tumors. Up to one-third of nonseminomatous germ cell tumors of the testis present with metastatic disease (clinical stages II and III). We investigated the predictors of metastatic disease at presentation in a cohort of 148 consecutive nonseminomatous germ cell tumors of the testis, over a 10-year period. The following clinical and pathologic features were evaluated: age, tumor size, dominant tumor histology, coagulative necrosis, vascular invasion, rete testis invasion and tumor extension into tunica vaginalis, hilar soft tissue, epididymis, or spermatic cord. Studied parameters were correlated with the clinical stage at presentation. Of the 148 patients with nonseminomatous germ cell tumors of the testis, 94 (63%) were clinical stage I, 26 (18%) were stage II, and 28 (19%) were stage III at presentation. Mean patient age was 31 years (range, 17-83). Mean tumor size was 4.1 cm (range, 0.6-19). On univariate analysis, the following parameters showed statistically significant association with the advanced clinical stage at presentation: vascular invasion (Po0.001), rete testis invasion (Po0.001), hilar soft tissue invasion (Po0.001), epididymis invasion (P ¼ 0.005), spermatic cord invasion (P ¼ 0.005), and coagulative necrosis (P ¼ 0.062). On multivariate analysis, only vascular invasion (P ¼ 0.011) and invasion into the rete testis and the hilar soft tissues (P ¼ 0.007 and P ¼ 0.017, respectively) demonstrated significant association with advanced clinical stage at presentation. We conclude that in addition to vascular invasion, tumor invasion into the hilum (rete testis or hilar soft tissue) is also strongly associated with metastatic disease at presentation and should be part of the routine pathology reporting.
Aims: To investigate the impact of the 2005 International Society of Urological Pathology (ISUP)... more Aims: To investigate the impact of the 2005 International Society of Urological Pathology (ISUP) Gleason grading consensus in contemporary practice.Methods and results: The Gleason scores (GS) were compared in two consecutive patient cohorts with matched biopsies and prostatectomies: (i) 908 patients evaluated before the ISUP consensus (July 2000–June 2004) and (ii) 423 patients evaluated after the ISUP consensus (October 2005–June 2007). All biopsies and prostatectomies were performed and scored in one institution and were sampled and processed identically. There was a higher percentage of biopsy and prostatectomy specimens with GS ≥ 7 after the ISUP consensus (GS ≥ 7 on biopsy in 32% before ISUP versus 46% after ISUP; GS ≥ 7 on prostatectomy in 53% before ISUP versus 68% after ISUP; P < 0.001). No significant difference in the complete and ±1 unit Gleason agreement was found before and after the ISUP consensus. There was a trend towards better complete agreement for GS ≥ 7 af...
Succinate dehydrogenase (SDH)-deficient renal carcinoma has been accepted as a provisional entity... more Succinate dehydrogenase (SDH)-deficient renal carcinoma has been accepted as a provisional entity in the 2013 International Society of Urological Pathology Vancouver Classification. To further define its morphologic and clinical features, we studied a multi-institutional cohort of 36 SDHdeficient renal carcinomas from 27 patients, including 21 previously unreported cases. We estimate that 0.05% to 0.2% of all renal carcinomas are SDH deficient. Mean patient age at presentation was 37 years (range, 14 to 76 y), with a slight male predominance (M:F = 1.7:1). Bilateral tumors were observed in 26% of patients. Thirty-four (94%) tumors demonstrated the previously reported morphology at least focally, which included: solid or focally cystic growth, uniform cytology with eosinophilic flocculent cytoplasm, intracytoplasmic vacuolations and inclusions, and round to oval low-grade nuclei. All 17 patients
Childhood bronchiolitis obliterans (BO) is an uncommon complication that is characterized clinica... more Childhood bronchiolitis obliterans (BO) is an uncommon complication that is characterized clinically by persistent and continuous obstructive respiratory symptoms, and has been described secondary to various etiologic factors, including drugs, exposure to toxic fumes, allergic reactions, collagen vascular disease or infections. BO occurs most commonly in children after an episode of acute bronchiolitis and is considered a long-term sequela of viral infection.Postinfectious Bronchiolitis Obliterans (PIBO) is characterized by persistent airway obstruction with functional and radiological evidence of small airway involvement that is in general unresponsive to bronchodilator treatment.Although the condition is relatively rare, and its exact incidence is unknown, it is important to keep it in mind. PIBO is complication of lower respiratory tract epithelial injury, and is often misdiagnosed, delaying recognition and potential treatment. A PIBO diagnosis is usually based on a few factors, ...
Plasmonic metal nanoparticle (NP)-decorated thin films of biobased and biocompatible polymers pro... more Plasmonic metal nanoparticle (NP)-decorated thin films of biobased and biocompatible polymers provide significant opportunities in various biomedical applications. Inspired from the adhesive proteins of the marine mussels, polydopamine (PDA) serves as a versatile, biocompatible, and simple thin-film material and enhances cell growth and proliferation. Herein, we report the fabrication of the gold NPs (AuNPs) or silver NPs (AgNPs)-deposited thin films of PDA and their employment in cell growth and proliferation. PDA thin film with its numerous functional groups enabled well-controlled adsorption of NPs. The number density of NPs was manipulated simply by tuning the deposition time. Cell viability test for human lung cancer (A549) and human colon cancer (CaCO2) cell lines indicated that a thin layer of PDA film remarkably enhanced the cell growth and proliferation. The lower number density of NPs for the 24 h of the culture time resulted in a higher proliferation rate. However, the in...
We aimed to evaluate the effects of nasal functions for the integrity of grafts after myringoplas... more We aimed to evaluate the effects of nasal functions for the integrity of grafts after myringoplasty. In our study 78 patients who underwent myringoplasty operation between 2011-2013 were included. Group I was defined as the group with an intact tympanic membrane following surgery. Group II was defined as the group with a tympanic membrane perforation following surgery. Group I consisted of 44 and Group II consisted of 34 patients. Subjective and objective measurements of nasal functions, Eustachian tube function (ETF), and allergic status were performed using nasal obstruction symptom evaluation (NOSE) scale, visual analog scale (VAS), and the score for allergic rhinitis (SFAR) questionnaires and acoustic rhinometry and saccharin test. It was investigated whether there was any difference between these two groups in terms of these parameters. There was statistically no significant difference between groups according to the age, sex and the presence of tubal dysfunction and allergic r...
We undertook a systematic evaluation of the prognostic value of numerous histologic factors in 16... more We undertook a systematic evaluation of the prognostic value of numerous histologic factors in 165 radical cystectomies (RC) of patients with invasive urothelial carcinoma who underwent surgery after neoadjuvant chemotherapy (NAC). Tumor regression grade (TRG) and therapy-related stromal and epithelial changes were also recorded. Locally advanced disease (≥pT2 and/or pN+) was present in 64% of patients, 22% had no evidence of residual carcinoma (pT0+pN0) and 28% had no evidence of residual muscle invasive carcinoma (≤pT1+N0). TRG 1, 2, and 3 were found in 32%, 15%, and 50% of patients, respectively. Histologic variants of UC were reported in 25% of cases. The most common therapy-related stromal change was fibroblastic reaction (78%) and the most common epithelial change in residual UC was smudgy and poorly preserved chromatin (28%). Prominent stromal and epithelial changes were noted in 41% and 5% of RC, respectively. Progression was found in 45% of patients and cancer-related death...
The aim of this study is to retrospectively analyze the data of the patients who underwent paroti... more The aim of this study is to retrospectively analyze the data of the patients who underwent parotidectomy in our clinic, review the characteristics of parotid gland masses in the light of the literature and compare the preoperative fine needle aspiration biopsy (FNAB) results with postoperative histopathologic results. The medical files of 71 male and 50 (total n=121) female patients who underwent parotidectomy in our clinic between January 2008 and August 2015 were examined. Ages, gender, the surgical procedures, preoperative FNAB, and postoperative histopathologic results of all the patients were recorded. According to definitive postoperative histopathologic results 101 (%85.8) patients had benign and 20 (%16.2) patients had malignant parotid masses. The most common benign parotid gland masses were pleomorphic adenomas in 53 and Whartin tumors in 33 patients. Based on postoperative histopathology results the most frequent malignant tumor was squamous cell carcinoma which was encountered in 6 patients. We performed 106 superficial, 12 total and 3 radical parotidectomies in 121 patients with parotid masses. We did not observe recurrent tumors during follow-ups. Preoperative FNAB results had a diagnostic 80% sensitivity our study. Physical examination, USG, MR imaging and FNAB are important procedures in the preoperative evaluation of parotid gland masses. FNAB results are quite reliable as a guiding tool for the surgical procedures to be selected. Together with IFNB Superficial parotidectomy still maintains its distinguished place among the therapeutical armamentorium for benign tumors of the parotid gland. For malignant tumors total parotidectomy must be performed as far as possible. Neck dissection must be peformed for patients with nodal metastasis. Elective neck dissection for N0 patients is still a challenging subject because of various types ofparotid tumors, and lack of adequate number of case series in each group.
Vocal fold polyps usually arise as a result of acute submucosal bleeding, followed by the formati... more Vocal fold polyps usually arise as a result of acute submucosal bleeding, followed by the formation of a locally organized hematoma. [1] Their morphology may range from a simple edematous mass arising from the true vocal fold to a mass with a gelatinous, hemorrhagic or hyalinized appearance. [2] Most of them are small lesions with hoarseness as the presenting symptom. Giant polyps in rare occurrence may present with stridor and dyspnea. [3] Case Report We report five rare cases of giant polyps presenting with dyspnea (Fig. 1). Case 1 A 56-year-old woman presented to our emergency clinic with stridor and severe dyspnea. She had a 4-year history of hoarseness and was treated previously for her asthma symptoms. She smoked 40 cigarettes daily for 40 years. Endoscopic examination indicated a huge pedunculated mass occupying almost the whole glottic space. The patient was taken to the operating room. Microlaryngoscopic excision of the mass under general anesthesia was performed without complication. The histopathological diagnosis confirmed a diagnosis of vocal fold polyp. Case 2 A 27-year-old man with progressive hoarseness and dyspnea presented to our clinic. He smoked 10 cigarettes daily for 7 years. Endoscopy revealed a huge pedunculated mass originating from right vocal fold. Suspension microlaryngoscopy was performed under general anesthesia. The polyp was totally excised with no complication. Histopathology report indicated a benign laryngeal polyp. Case 3 A 51-year-old woman admitted to our clinic with dysphonia and dyspnea with exercise. She had a smoking history of 20
When minimal prostate cancer is detected in the initial transurethral resection of the prostate (... more When minimal prostate cancer is detected in the initial transurethral resection of the prostate (TURP) sample, it is uncertain how extensively the remaining tissue should be sampled for accurate grading and staging. To identify whether additional partial or complete sampling is required to accurately evaluate TURP samples with minimal cancer (stage T1a). We prospectively examined all TURP samples in our institution during 1 year. All specimens were sampled randomly in 6 cassettes. When minimal cancer was found, we performed additional partial sampling (1 block per 5 g of remaining tissue), followed by complete submission of all remaining tissue. All samples were evaluated separately to identify possible changes in Gleason score and tumor volume. We performed a cost analysis for the additional tissue sampling. Of 747 TURP samples evaluated on the initial 6 cassettes, 125 (16.7%) contained prostate cancer. Minimal cancer involving less than 5% of sampled tissue was found in the initia...
In contrast to the common tumors of the prostate, seminal vesicle demonstrates low potential for ... more In contrast to the common tumors of the prostate, seminal vesicle demonstrates low potential for neoplastic proliferation. Of the rare primary seminal vesicle tumors, adenocarcinoma is the most common, but there are also rare seminal vesicle neoplasms which demonstrate epithelial and stromal components. These neoplasms have been described in the literature under various names, including "epithelial-stromal tumor," "cystic epithelial-stromal tumor," "cystadenoma," "cystomyoma," "mesenchymoma," "Müllerian adenosarcoma-like tumor," "phyllodes tumor," and "cystosarcoma phyllodes." The spectrum of reported mixed epithelial-stromal tumors (MEST) of seminal vesicle encompasses low, intermediate and high-grade tumors, but the precise distinction and nomenclature for these tumors remain unsettled. We propose a common nomenclature for these tumors, based on the review of published cases and 2 index cases from our ...
We have investigated the evolution of chronic glomerular changes in the absence of the recurrence... more We have investigated the evolution of chronic glomerular changes in the absence of the recurrence of original disease in an experimental rat model of chronic renal allograft rejection. Using serial graft needle biopsies and serum creatinine levels, we were able to focus on early glomerular changes that are associated with good graft function. The recipient rats were divided into 5 groups, 2 with allogeneic (DA to WF) transplants and 3 with syngeneic (DA to DA) transplants. In the first 2 allogeneic groups, one group received cyclosporine (CsA) for 2 weeks (n = 7) and the other received CsA for 12 weeks (n = 5). In the 2-week treatment group, all allografts developed chronic rejection, compared with none in the 12-week group. Syngeneic controls received CsA for 2 (n = 3) and 12 weeks (n = 3), or no immunosuppression (n = 2) in order to exclude the effects of CsA. The first detectable ultrastructural event was slight deposition of electron lucent material in the glomerular basement membrane. Contrary to previous morphological studies, the initial deposition was not subendothelial, but was within the lamina densa itself. Examination of allogeneic grafts with good graft function and syngeneic grafts showed glomerular alterations that were similar to the early changes preceding chronic rejection. The intensity of changes in optimally immunosuppressed allografts was mild, and they were arrested early in the evolving stage of glomerular basement membrane changes. In the suboptimally immunosuppressed allografts with chronic rejection, the glomerular basement membrane changes became more pronounced and extensive in subsequent biopsies. Thus, all recipients in different groups showed similar glomerular alterations, but to different intensities. These results suggest a common pathogenetic mechanism which might be endothelial damage. In chronic rejection, the endothelial damage might be immunologically mediated by rejection episodes and progressive, whereas in syngeneic grafts and in allografts without chronic rejection, perioperative trauma, ischemia, and graft reperfusion may be responsible for the self-limiting glomerular changes.
Arias-Stella reaction is a hormone-induced atypical endometrial change that may involve endometri... more Arias-Stella reaction is a hormone-induced atypical endometrial change that may involve endometrial, extraendometrial, or endometriotic sites. Establishing a correct diagnosis of Arias-Stella reaction may sometimes be problematic when seen outside of the uterine corpus, particularly in a limited biopsy sample when the pathologist is not aware of the clinical history. We report an Arias-Stella reaction in bladder endometriosis, which presented as a bladder mass in a 25-year-old pregnant woman. Clinical information of intrauterine pregnancy (week 16) was not initially provided when the biopsy was performed. We also discuss endometriosis, endocervicosis, and müllerianosis of the bladder, which are benign glandular lesions that may mimic tumors within the bladder wall.
AimTo describe a group of distinct low‐grade oncocytic renal tumours that demonstrate CD117 negat... more AimTo describe a group of distinct low‐grade oncocytic renal tumours that demonstrate CD117 negative/cytokeratin (CK) 7‐positive immunoprofile.Methods and resultsWe identified 28 such tumours from four large renal tumour archives. We performed immunohistochemistry for: CK7, CD117, PAX8, CD10, AMACR, e‐cadherin, CK20, CA9, AE1/AE3, vimentin, BerEP4, MOC31, CK5/6, p63, HMB45, melan A, CD15 and FH. In 14 cases we performed array CGH, with a successful result in nine cases. Median patient age was 66 years (range 49–78 years) with a male‐to‐female ratio of 1:1.8. Median tumour size was 3 cm (range 1.1–13.5 cm). All were single tumours, solid and tan‐brown, without a syndromic association. On microscopy, all cases showed solid and compact nested growth. There were frequent areas of oedematous stroma with loosely arranged cells. The tumour cells had oncocytic cytoplasm with uniformly round to oval nuclei, but without significant irregularities, and showed only focal perinuclear halos. Nega...
Background: Few larger studies have evaluated the long-term outcome after a diagnosis of papillar... more Background: Few larger studies have evaluated the long-term outcome after a diagnosis of papillary urothelial neoplasm of low malignant potential (PUNLMP), demonstrating a broad range of recurrence and progression rates. Additionally, no study has addressed the outcome of PUNLMP exhibiting inverted growth. We evaluated the long term clinical outcome of primary papillary urothelial neoplasm of low malignant potential (PUNLMP), including PUNLMP with inverted growth in a large single center study. Methods: We evaluated 189 primary PUNLMP (177 exophytic, 12 inverted), diagnosed from January 1, 2000 to December 31, 2009, in a centralized uropathology practice. We excluded PUNLMP diagnosed after a previous or with a concurrent urothelial neoplasm. Recurrence was defined as any subsequent urothelial neoplasm, regardless of the grade. Progression was defined as any subsequent higher-grade or invasive urothelial neoplasm. Recurrence and progression were established only if documented on a subsequent biopsy. Descriptive statistical analysis was performed using Microsof Excel software package. Results: The location of PUNLMP included bladder (187) and renal pelvis and ureter (1 each). After a median follow-up of 61 months (range, 9-128 months), 20.1% patients developed a recurrence. Recurrence with PUNLMP only was found in 9% of patients. Subsequent low-grade urothelial carcinoma was documented in 9.5% of patients. Progression to high-grade urothelial carcinoma was found in 1.6% patients (1% with muscle invasion). No patients with recurrent PUNLMP or subsequent low-grade carcinoma demonstrated invasion. All patients with PUNLMP exhibiting an inverted growth had no recurrence or progression on follow-up. Conclusion: In this study, primary PUNLMP recurred primarily either as PUNLMP or low grade urothelial carcinoma. Primary PUNLMP rarely progressed to high grade or invasive carcinoma on long term follow-up. No recurrence or progression was documented on follow-up for PUNLMP that demonstrated exclusively inverted growth.
Mesothelioma of tunica vaginalis is a rare neoplasm, typically demonstrating frankly malignant mo... more Mesothelioma of tunica vaginalis is a rare neoplasm, typically demonstrating frankly malignant morphology and aggressive behavior. Rare cases of well-differentiated papillary mesotheliomas have also been reported, which, in contrast, demonstrate indolent behavior. There are, however, cases which do not fit into the well-differentiated or diffuse malignant mesothelioma categories and can be considered mesothelioma of tunica vaginalis of "uncertain malignant potential", which is an emerging diagnostic category. A 57-year-old man presented with a neoplasm in a hydrocele sac. The neoplasm was non-invasive, but showed focal complex and solid growth and it was difficult to categorize either as well-differentiated papillary mesotheliomas or malignant mesothelioma. After the initial limited resection, the patient underwent radical orchiectomy with hemiscrotectomy and is alive and without disease progression after 6 years. Documentation of these rare tumors will allow their distinction from true malignant mesotheliomas and will facilitate the development of specific treatment recommendations. Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/ vs/3445715895747607.
Clinical staging is a critical step in the management of testicular germ cell tumors. Up to one-t... more Clinical staging is a critical step in the management of testicular germ cell tumors. Up to one-third of nonseminomatous germ cell tumors of the testis present with metastatic disease (clinical stages II and III). We investigated the predictors of metastatic disease at presentation in a cohort of 148 consecutive nonseminomatous germ cell tumors of the testis, over a 10-year period. The following clinical and pathologic features were evaluated: age, tumor size, dominant tumor histology, coagulative necrosis, vascular invasion, rete testis invasion and tumor extension into tunica vaginalis, hilar soft tissue, epididymis, or spermatic cord. Studied parameters were correlated with the clinical stage at presentation. Of the 148 patients with nonseminomatous germ cell tumors of the testis, 94 (63%) were clinical stage I, 26 (18%) were stage II, and 28 (19%) were stage III at presentation. Mean patient age was 31 years (range, 17-83). Mean tumor size was 4.1 cm (range, 0.6-19). On univariate analysis, the following parameters showed statistically significant association with the advanced clinical stage at presentation: vascular invasion (Po0.001), rete testis invasion (Po0.001), hilar soft tissue invasion (Po0.001), epididymis invasion (P ¼ 0.005), spermatic cord invasion (P ¼ 0.005), and coagulative necrosis (P ¼ 0.062). On multivariate analysis, only vascular invasion (P ¼ 0.011) and invasion into the rete testis and the hilar soft tissues (P ¼ 0.007 and P ¼ 0.017, respectively) demonstrated significant association with advanced clinical stage at presentation. We conclude that in addition to vascular invasion, tumor invasion into the hilum (rete testis or hilar soft tissue) is also strongly associated with metastatic disease at presentation and should be part of the routine pathology reporting.
Aims: To investigate the impact of the 2005 International Society of Urological Pathology (ISUP)... more Aims: To investigate the impact of the 2005 International Society of Urological Pathology (ISUP) Gleason grading consensus in contemporary practice.Methods and results: The Gleason scores (GS) were compared in two consecutive patient cohorts with matched biopsies and prostatectomies: (i) 908 patients evaluated before the ISUP consensus (July 2000–June 2004) and (ii) 423 patients evaluated after the ISUP consensus (October 2005–June 2007). All biopsies and prostatectomies were performed and scored in one institution and were sampled and processed identically. There was a higher percentage of biopsy and prostatectomy specimens with GS ≥ 7 after the ISUP consensus (GS ≥ 7 on biopsy in 32% before ISUP versus 46% after ISUP; GS ≥ 7 on prostatectomy in 53% before ISUP versus 68% after ISUP; P < 0.001). No significant difference in the complete and ±1 unit Gleason agreement was found before and after the ISUP consensus. There was a trend towards better complete agreement for GS ≥ 7 af...
Succinate dehydrogenase (SDH)-deficient renal carcinoma has been accepted as a provisional entity... more Succinate dehydrogenase (SDH)-deficient renal carcinoma has been accepted as a provisional entity in the 2013 International Society of Urological Pathology Vancouver Classification. To further define its morphologic and clinical features, we studied a multi-institutional cohort of 36 SDHdeficient renal carcinomas from 27 patients, including 21 previously unreported cases. We estimate that 0.05% to 0.2% of all renal carcinomas are SDH deficient. Mean patient age at presentation was 37 years (range, 14 to 76 y), with a slight male predominance (M:F = 1.7:1). Bilateral tumors were observed in 26% of patients. Thirty-four (94%) tumors demonstrated the previously reported morphology at least focally, which included: solid or focally cystic growth, uniform cytology with eosinophilic flocculent cytoplasm, intracytoplasmic vacuolations and inclusions, and round to oval low-grade nuclei. All 17 patients
Childhood bronchiolitis obliterans (BO) is an uncommon complication that is characterized clinica... more Childhood bronchiolitis obliterans (BO) is an uncommon complication that is characterized clinically by persistent and continuous obstructive respiratory symptoms, and has been described secondary to various etiologic factors, including drugs, exposure to toxic fumes, allergic reactions, collagen vascular disease or infections. BO occurs most commonly in children after an episode of acute bronchiolitis and is considered a long-term sequela of viral infection.Postinfectious Bronchiolitis Obliterans (PIBO) is characterized by persistent airway obstruction with functional and radiological evidence of small airway involvement that is in general unresponsive to bronchodilator treatment.Although the condition is relatively rare, and its exact incidence is unknown, it is important to keep it in mind. PIBO is complication of lower respiratory tract epithelial injury, and is often misdiagnosed, delaying recognition and potential treatment. A PIBO diagnosis is usually based on a few factors, ...
Plasmonic metal nanoparticle (NP)-decorated thin films of biobased and biocompatible polymers pro... more Plasmonic metal nanoparticle (NP)-decorated thin films of biobased and biocompatible polymers provide significant opportunities in various biomedical applications. Inspired from the adhesive proteins of the marine mussels, polydopamine (PDA) serves as a versatile, biocompatible, and simple thin-film material and enhances cell growth and proliferation. Herein, we report the fabrication of the gold NPs (AuNPs) or silver NPs (AgNPs)-deposited thin films of PDA and their employment in cell growth and proliferation. PDA thin film with its numerous functional groups enabled well-controlled adsorption of NPs. The number density of NPs was manipulated simply by tuning the deposition time. Cell viability test for human lung cancer (A549) and human colon cancer (CaCO2) cell lines indicated that a thin layer of PDA film remarkably enhanced the cell growth and proliferation. The lower number density of NPs for the 24 h of the culture time resulted in a higher proliferation rate. However, the in...
We aimed to evaluate the effects of nasal functions for the integrity of grafts after myringoplas... more We aimed to evaluate the effects of nasal functions for the integrity of grafts after myringoplasty. In our study 78 patients who underwent myringoplasty operation between 2011-2013 were included. Group I was defined as the group with an intact tympanic membrane following surgery. Group II was defined as the group with a tympanic membrane perforation following surgery. Group I consisted of 44 and Group II consisted of 34 patients. Subjective and objective measurements of nasal functions, Eustachian tube function (ETF), and allergic status were performed using nasal obstruction symptom evaluation (NOSE) scale, visual analog scale (VAS), and the score for allergic rhinitis (SFAR) questionnaires and acoustic rhinometry and saccharin test. It was investigated whether there was any difference between these two groups in terms of these parameters. There was statistically no significant difference between groups according to the age, sex and the presence of tubal dysfunction and allergic r...
We undertook a systematic evaluation of the prognostic value of numerous histologic factors in 16... more We undertook a systematic evaluation of the prognostic value of numerous histologic factors in 165 radical cystectomies (RC) of patients with invasive urothelial carcinoma who underwent surgery after neoadjuvant chemotherapy (NAC). Tumor regression grade (TRG) and therapy-related stromal and epithelial changes were also recorded. Locally advanced disease (≥pT2 and/or pN+) was present in 64% of patients, 22% had no evidence of residual carcinoma (pT0+pN0) and 28% had no evidence of residual muscle invasive carcinoma (≤pT1+N0). TRG 1, 2, and 3 were found in 32%, 15%, and 50% of patients, respectively. Histologic variants of UC were reported in 25% of cases. The most common therapy-related stromal change was fibroblastic reaction (78%) and the most common epithelial change in residual UC was smudgy and poorly preserved chromatin (28%). Prominent stromal and epithelial changes were noted in 41% and 5% of RC, respectively. Progression was found in 45% of patients and cancer-related death...
The aim of this study is to retrospectively analyze the data of the patients who underwent paroti... more The aim of this study is to retrospectively analyze the data of the patients who underwent parotidectomy in our clinic, review the characteristics of parotid gland masses in the light of the literature and compare the preoperative fine needle aspiration biopsy (FNAB) results with postoperative histopathologic results. The medical files of 71 male and 50 (total n=121) female patients who underwent parotidectomy in our clinic between January 2008 and August 2015 were examined. Ages, gender, the surgical procedures, preoperative FNAB, and postoperative histopathologic results of all the patients were recorded. According to definitive postoperative histopathologic results 101 (%85.8) patients had benign and 20 (%16.2) patients had malignant parotid masses. The most common benign parotid gland masses were pleomorphic adenomas in 53 and Whartin tumors in 33 patients. Based on postoperative histopathology results the most frequent malignant tumor was squamous cell carcinoma which was encountered in 6 patients. We performed 106 superficial, 12 total and 3 radical parotidectomies in 121 patients with parotid masses. We did not observe recurrent tumors during follow-ups. Preoperative FNAB results had a diagnostic 80% sensitivity our study. Physical examination, USG, MR imaging and FNAB are important procedures in the preoperative evaluation of parotid gland masses. FNAB results are quite reliable as a guiding tool for the surgical procedures to be selected. Together with IFNB Superficial parotidectomy still maintains its distinguished place among the therapeutical armamentorium for benign tumors of the parotid gland. For malignant tumors total parotidectomy must be performed as far as possible. Neck dissection must be peformed for patients with nodal metastasis. Elective neck dissection for N0 patients is still a challenging subject because of various types ofparotid tumors, and lack of adequate number of case series in each group.
Vocal fold polyps usually arise as a result of acute submucosal bleeding, followed by the formati... more Vocal fold polyps usually arise as a result of acute submucosal bleeding, followed by the formation of a locally organized hematoma. [1] Their morphology may range from a simple edematous mass arising from the true vocal fold to a mass with a gelatinous, hemorrhagic or hyalinized appearance. [2] Most of them are small lesions with hoarseness as the presenting symptom. Giant polyps in rare occurrence may present with stridor and dyspnea. [3] Case Report We report five rare cases of giant polyps presenting with dyspnea (Fig. 1). Case 1 A 56-year-old woman presented to our emergency clinic with stridor and severe dyspnea. She had a 4-year history of hoarseness and was treated previously for her asthma symptoms. She smoked 40 cigarettes daily for 40 years. Endoscopic examination indicated a huge pedunculated mass occupying almost the whole glottic space. The patient was taken to the operating room. Microlaryngoscopic excision of the mass under general anesthesia was performed without complication. The histopathological diagnosis confirmed a diagnosis of vocal fold polyp. Case 2 A 27-year-old man with progressive hoarseness and dyspnea presented to our clinic. He smoked 10 cigarettes daily for 7 years. Endoscopy revealed a huge pedunculated mass originating from right vocal fold. Suspension microlaryngoscopy was performed under general anesthesia. The polyp was totally excised with no complication. Histopathology report indicated a benign laryngeal polyp. Case 3 A 51-year-old woman admitted to our clinic with dysphonia and dyspnea with exercise. She had a smoking history of 20
When minimal prostate cancer is detected in the initial transurethral resection of the prostate (... more When minimal prostate cancer is detected in the initial transurethral resection of the prostate (TURP) sample, it is uncertain how extensively the remaining tissue should be sampled for accurate grading and staging. To identify whether additional partial or complete sampling is required to accurately evaluate TURP samples with minimal cancer (stage T1a). We prospectively examined all TURP samples in our institution during 1 year. All specimens were sampled randomly in 6 cassettes. When minimal cancer was found, we performed additional partial sampling (1 block per 5 g of remaining tissue), followed by complete submission of all remaining tissue. All samples were evaluated separately to identify possible changes in Gleason score and tumor volume. We performed a cost analysis for the additional tissue sampling. Of 747 TURP samples evaluated on the initial 6 cassettes, 125 (16.7%) contained prostate cancer. Minimal cancer involving less than 5% of sampled tissue was found in the initia...
In contrast to the common tumors of the prostate, seminal vesicle demonstrates low potential for ... more In contrast to the common tumors of the prostate, seminal vesicle demonstrates low potential for neoplastic proliferation. Of the rare primary seminal vesicle tumors, adenocarcinoma is the most common, but there are also rare seminal vesicle neoplasms which demonstrate epithelial and stromal components. These neoplasms have been described in the literature under various names, including "epithelial-stromal tumor," "cystic epithelial-stromal tumor," "cystadenoma," "cystomyoma," "mesenchymoma," "Müllerian adenosarcoma-like tumor," "phyllodes tumor," and "cystosarcoma phyllodes." The spectrum of reported mixed epithelial-stromal tumors (MEST) of seminal vesicle encompasses low, intermediate and high-grade tumors, but the precise distinction and nomenclature for these tumors remain unsettled. We propose a common nomenclature for these tumors, based on the review of published cases and 2 index cases from our ...
We have investigated the evolution of chronic glomerular changes in the absence of the recurrence... more We have investigated the evolution of chronic glomerular changes in the absence of the recurrence of original disease in an experimental rat model of chronic renal allograft rejection. Using serial graft needle biopsies and serum creatinine levels, we were able to focus on early glomerular changes that are associated with good graft function. The recipient rats were divided into 5 groups, 2 with allogeneic (DA to WF) transplants and 3 with syngeneic (DA to DA) transplants. In the first 2 allogeneic groups, one group received cyclosporine (CsA) for 2 weeks (n = 7) and the other received CsA for 12 weeks (n = 5). In the 2-week treatment group, all allografts developed chronic rejection, compared with none in the 12-week group. Syngeneic controls received CsA for 2 (n = 3) and 12 weeks (n = 3), or no immunosuppression (n = 2) in order to exclude the effects of CsA. The first detectable ultrastructural event was slight deposition of electron lucent material in the glomerular basement membrane. Contrary to previous morphological studies, the initial deposition was not subendothelial, but was within the lamina densa itself. Examination of allogeneic grafts with good graft function and syngeneic grafts showed glomerular alterations that were similar to the early changes preceding chronic rejection. The intensity of changes in optimally immunosuppressed allografts was mild, and they were arrested early in the evolving stage of glomerular basement membrane changes. In the suboptimally immunosuppressed allografts with chronic rejection, the glomerular basement membrane changes became more pronounced and extensive in subsequent biopsies. Thus, all recipients in different groups showed similar glomerular alterations, but to different intensities. These results suggest a common pathogenetic mechanism which might be endothelial damage. In chronic rejection, the endothelial damage might be immunologically mediated by rejection episodes and progressive, whereas in syngeneic grafts and in allografts without chronic rejection, perioperative trauma, ischemia, and graft reperfusion may be responsible for the self-limiting glomerular changes.
Arias-Stella reaction is a hormone-induced atypical endometrial change that may involve endometri... more Arias-Stella reaction is a hormone-induced atypical endometrial change that may involve endometrial, extraendometrial, or endometriotic sites. Establishing a correct diagnosis of Arias-Stella reaction may sometimes be problematic when seen outside of the uterine corpus, particularly in a limited biopsy sample when the pathologist is not aware of the clinical history. We report an Arias-Stella reaction in bladder endometriosis, which presented as a bladder mass in a 25-year-old pregnant woman. Clinical information of intrauterine pregnancy (week 16) was not initially provided when the biopsy was performed. We also discuss endometriosis, endocervicosis, and müllerianosis of the bladder, which are benign glandular lesions that may mimic tumors within the bladder wall.
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