Browsing by Author "Kiremitci, Saba"

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    Rapidly Progressive Renal Failure in AA Amyloidosis: A New Clinical and Histopathological Entity for an Old Disease
    (2020) Celebi, Zeynep Kendi; Kiremitci, Saba; Sadioglu, Rezzan Eren; Keven, Kenan; 0000-0003-3279-9796; ABB-9570-2020
    Objective: Secondary renal AA amyloidosis (RAAA) presents with proteinuria and/or as nephrotic syndrome and progresses to end stage renal disease (ESRD) insidiously. However, some patients with secondary amyloidosis show a more rapid renal disease progression than the usual course. In this study, we aimed to investigate the underlying cause of the rapidly progressive renal disease in the patients with secondary amyloidosis. Materials and Methods: Patients with kidney biopsy proven secondary RAAA were divided into 2 groups: the rapidly progressive group (estimated glomerular filtration rate >60 mL/min, who needed renal replacement therapy within one year of diagnosis) and the control group. Biopsy specimens were reevaluated for glomerular-vascular amyloid load, tubular atrophy, interstitial fibrosis, and interstitial inflammation. The biopsy characteristics and biochemical parameters were compared between the groups. Results: Histopathological examination showed global amyloid deposition, vascular pole involvement, peritubular capillary amyloid deposition, and severe interstitial inflammation associated with rapidly progressive disease. Estimated glomerular filtration rate was lower and proteinuria was higher in the rapidly progressive group than in the control group. Vascular pole amyloid deposition was found to be a predictor of ESRD in multivariate analysis. Conclusion: This study shows that higher amyloid deposition and severe inflammation revealed in in kidney biopsy of secondary RAAA cases can be risk factors for rapidly progressive renal failure.
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    Small Cell Carcinomas of the Bladder Highly Express Somatostatin Receptor Type 2A: Impact on Prognosis and Treatment-A Multicenter Study of Urooncology Society, Turkey
    (2016) Nese, Nalan; Kumbaraci, Banu S.; Baydar, Dilek E.; Kilicaslan, Isin; Sari, Aysegul A.; Sen, Sait; Gonul, Ipek I.; Kankaya, Duygu; Ozluk, Yasemin; Ermete, Murat; Ozagari, Aysim; Bal, Nebil; Kiremitci, Saba; Yildiz, Kursat; Tuna, Burcin; Sen, Nilay; Yorukoglu, Kutsal; 25906124
    Small cell carcinoma (SmCC) is a rare and aggressive neuroendocrine carcinoma of the bladder. Neuroendocrine carcinomas expressing somatostatin receptors (SSTR) in other viscera such as lung, pancreas, and gastrointestinal system respond to therapy with somatostatin analogs. In the present study, expressions of SSTRs 1 to 5 including type 2A are investigated by immunohistochemistry (IHC) and their relationship with clinicopathologic factors was evaluated. Hundred primary bladder SmCC cases were collected from 12 centers in Turkey. Forty-three cases were pure SmCC. Other cases had mostly papillary urothelial carcinoma as a second component. The percentage of the SmCC component ranged from 5% to 100%. SSTR-2A expression was membranous, whereas the other receptors showed cytoplasmic staining. The percentages of positive cases for SSTR-1, SSTR-2A, SSTR-3, SSTR-4, and SSTR-5 were 4% (3/75), 61.4% (54/88), 2.4% (2/84), 24.4% (20/82), and 6.25% (5/80), respectively. The percentage of SmCC component was positively correlated with the percentage of SSTR-2A expression (P=0.003) while negatively correlated with patient age (P=0.032). SSTR-2A expression was correlated with survival as a bad prognostic factor (P=0.018). SSTR-1, SSTR-3, SSTR-4, and SSTR-5 expressions did not show any statistical significance with any parameter. In conclusion, although the limited number of cases with adequate term follow-up, SSTR-2A expression could be a prognostic factor and somatostatin analogs therapeutic candidate for SmCCs of the bladder as these tumors show high percentage of SSTR-2A expression.