Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Giant Basal Cell Carcinoma Causing Axillary Contracture: A Case Report of an Unusual Localization of an Advanced Case(2023) Albayati, Abbas; Ozkan, Burak; Tepeoglu, Merih; Uysal, Cagri A.; 0000-0003-2806-3006; 0000-0003-3093-8369; 0000-0001-6236-0050; 38061706; AAC-3344-2021Basal cell carcinoma (BCC) is the most common type of non-melanoma skin cancer. Although BCC arises most commonly in sun-exposed areas of the body, such as the head and neck, it infrequently can be seen in sun-protected parts as well. Axilla is one of the least encountered areas of BCC. Delay in the diagnosis or management alongside negligence of the patient can lead to a tumor reaching a giant size. We report a case of giant axillary BCC in a 59-years old female patient with no known risk factors for skin cancers. The tumor was excised with wide margins, and the tissue defect was reconstructed with latissimus dorsi musculocutaneous flap. A 3-year follow-up did not show any sign of recurrence or metastasis.Item Fine-Needle Aspiration Biopsy Findings of the Thyroid Gland in Renal Transplant Patients(2023) Akcay, Eda Yilmaz; Tepeoglu, Merih; Atilgan, Alev Ok; Yagci, Sergen; Ozdemir, Binnaz Handan; Haberal, Mehmet; 37885286Objectives: For patients with end-stage renal disease, thyroid diseases are common due to altered hormone excretion and transport, and for renal transplant recipients this is due to immunosuppressive drugs. We investigated the prevalence of thyroid disorders, including thyroid cancer, by fine-needle aspiration biopsy in kidney transplant candidates and recipients and estimated the outcomes. Materials and Methods: For 305 thyroid fine-needle aspiration biopsies performed from January 2000 to December 2020 in patients with end-stage renal disease, we recorded patient demographics, thyroid ultrasonography, and biopsy findings. Results: Of biopsy results from 305 patients, 272 (89.2%) were benign, 24 (7.9%) showed atypia of undetermined significance/follicular lesion of undetermined significance, 2 (0.7%) had suspicion for malignancy, and 7 (2.3%) were malignant. Thyroid surgery was performed for 13 patients with benign results, 6 with atypia of undetermined significance/follicular lesion of unde-termined significance, 2 with suspicion for malignancy, and 7 with malignancy. In 13 patients with benign cytology, the histopathology finding was also benign in lobectomy specimens. In 6 patients with atypia of undetermined significance/follicular lesion of undetermined significance, the final diagnosis was papillary thyroid carcinoma in 3 patients, adeno-matous hyperplasia in 2 patients, and Hurthle cell adenoma in 1 patient. For all 9 patients for whom fine-needle aspiration biopsy was suspicious for malignancy or malignant, histopathologic examination showed papillary thyroid carcinoma in total thyroidectomy materials. Among 12 papillary thyroid carcinoma patients, 4 underwent renal transplant after thyroidectomy, and survival for these 4 patients was 116.25 +/- 29.30 months after transplant without tumor recurrence or distant metastases. Conclusions: Thyroid diseases are more frequent in patients with end-stage renal disease or renal transplant versus the normal population and also affect morbidity and mortality at higher rates in these patients. Fine-needle aspiration biopsy is a useful diagnostic modality in evaluation and treatment of thyroid nodules in both kidney transplant candidates and recipients.Item Chest Wall Implantation Metastasis Caused by Percutaneous Radiofrequency Ablation for Hepatic Tumor(2015) Kilic, Dalokay; Uysal, Cagri; Akdur, Aydincan; Kayipmaz, Cagri; Tepeoglu, Merih; Boyvat, Fatih; 0000-0002-9894-8005; 0000-0002-8726-3369; 0000-0001-6236-0050; 25742838; H-7700-2019; F-4230-2011; AAK-5222-2021; AAA-3068-2021We report a very rare case of a 55-year-old man with chest wall metastatic tumor caused by seeding of hepatocellular carcinoma after percutaneous radiofrequency ablation (RFA) for hepatic tumor 42 months after the initial operation. The patient was managed with aggressive full-thickness chest wall resection and reconstruction with a Prolene (Ethicon, Somerville, NJ) and methyl methacrylate sandwich graft and subsequent musculocutaneous free-flap transposition. (C) 2015 by The Society of Thoracic SurgeonsItem Synchronous Posttransplant Lymphoproliferative Disorder and Inflammatory Myofibroblastic Tumor of the Lung in a 2-Year-Old Liver Transplanted Boy: A Case Report(2015) Tepeoglu, Merih; Atilgan, Alev Ok; Ozdemir, B. Handan; Haberal, Mehmet; 0000-0001-8595-8880; 0000-0002-7528-3557; 0000-0002-9894-8005; 0000-0002-3462-7632; 25184247; AAK-3333-2021; X-8540-2019; AAK-5222-2021; AAJ-8097-2021Inflammatory myofibroblastic tumor is a rare benign lesion found mostly in children and young adults. It originates from the lung, abdominopelvic region, and retroperitoneum. The tumor is composed of myofibroblasts and inflammatory cell infiltration in the tissue. The cause and pathogenesis of this tumor are not completely understood. Epstein-Barr virus has been held responsible in some reported cases of inflammatory myofibroblastic tumors. Another tumor (which is known to be related to the Epstein-Barr virus) is posttransplant lymphoproliferative disorder. We report the case of a 2-year-old boy who underwent a liver transplant at the age of 9 months (the donor was his mother) because of biliary atresia. At 11 months after transplant, we detected posttransplant lymphoproliferative disorder and inflammatory myofibroblastic tumor concurrently. This entity is presented to highlight possible Epstein-Barr virus involvement in inflammatory myofibroblastic tumor of lung.Item Pathological Findings of Liver Allografts Evaluated at Autopsy(2014) Ayva, E. Sebnem; Ozdemir, B. Handan; Tepeoglu, Merih; Haberal, Mehmet; https://orcid.org/0000-0002-2280-8778; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0002-9894-8005; https://orcid.org/0000-0002-3462-7632; 24635808; AAK-1967-2021; X-8540-2019; AAK-5222-2021; AAJ-8097-2021Objectives: We review the pathological findings as determined by autopsy of the liver allografts. Materials and Methods: We retrospectively analyzed 408 patients who had a liver transplant between January 1990 and December 2012. Thirteen of the 408 patients underwent postmortem examination. Clinicopathologic findings including the age at death, causes of death, and main pathological findings were evaluated. Results: The study group of 13 patients who underwent a liver transplant had a mean age of 29 years at the time of death. Mean survival was 6 1 months (range, 10-72 mo). Ten of 13 patients (76.9%) died 90 days after the liver transplant. The remaining 3 patients died, 1 case in 1 year, in 2 cases after 1 year. Causes of the deaths were infection (9 cases), respiratory distress (1 cases), multiorgan failure (1 cases), primary graft failure (1 cases), and massive intra-abdominal bleeding (1 cases). The causes of the infection were bacterial infection in 6 cases (67%) and invasive fungal infection in other 3 cases (33%). The main pathological finding was hepatic infarction in 9 cases (69%). Bridging fibrosis (3 cases) and hematoma (1 case) were obtained in the remaining cases. Conclusions: Our results emphasize that infections are the main cause of death and hepatic infarction is the main histopathologic findings among these 13 patients within the first year of transplant. We consider postmortem examination to have important role in determining the primary graft failure and other causes that increased mortality in liver transplant recipients. An autopsy can provide understanding of the main causes and cause of death.Item Lung Metastasis of Fatty Hepatocellular Carcinoma After Liver Transplant: A Case Report(2014) Tepeoglu, Merih; Ozdemir, B. Handan; Atilgan, Alev Ok; Akdur, Aydincan; Haberal, Mehmet; https://orcid.org/0000-0002-9894-8005; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0001-8595-8880; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0002-3462-7632; 24635803; AAK-5222-2021; X-8540-2019; AAK-3333-2021; AAA-3068-2021; AAJ-8097-2021Hepatocellular carcinoma with prominent fatty change is rare, and to date only a few cases have been reported. In this article, we present a 57-year-old woman who underwent a liver transplant for hepatocellular carcinoma. Ten months after liver transplant, she presented with a persistent cough. Computed tomography of the chest was performed, revealing a solid lung mass that measured 1 Chi 0.9 cm in the right inferior lobe. Right inferior lobectomy was performed, and the final diagnosis was noted as hepatocellular carcinoma with prominent fatty change. Fatty change was extensive in the tumor; therefore, lipoid pneumonia was the first condition that was considered in the differential diagnosis during examination of the lobectomy material. For the differential diagnosis, the immunohistochemistry panel was studied to show the hepatocellular nature of the tumor. Although metastasis of hepatocellular carcinoma to the lungs is expected, hepatocellular carcinoma with prominent fatty change can cause diagnostic difficulties, such as lipoid pneumonia, especially in small lung biopsies.Item Nonmelanoma Skin Cancer After Kidney Transplant(2014) Tepeoglu, Merih; Ayva, Sebnem; Atilgan, Alev Ok; Tunca, M. Zeyneb; Ozdemir, B. Handan; Moray, Gokhan; Yildirim, Sedat; Arslan, Gulnaz; Haberal, Mehmet; https://orcid.org/0000-0002-9894-8005; https://orcid.org/0000-0002-2280-8778; https://orcid.org/0000-0001-8595-8880; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-5735-4315; https://orcid.org/0000-0002-3462-7632; 24907724; AAK-5222-2021; AAK-1967-2021; AAK-3333-2021; X-8540-2019; AAE-1041-2021; AAF-4610-2019; AAJ-8097-2021Objectives: Solid-organ transplant recipients have a high risk of developing nonmelanoma skin cancers. This study sought to determine the incidence of skin cancer and identify possible risk factors for skin cancer in kidney transplant recipients. Materials and Methods: Nonmelanoma skin cancer was diagnosed and confirmed with histology in 33 of 1275 kidney transplant recipients (2.6%). Demographic and clinical findings were reviewed retrospectively. Results: Nonmelanoma skin cancers included squamous cell carcinoma in 10 patients (30%), basal cell carcinoma in 9 patients (27%), Kaposi sarcoma in 9 patients (27%), squamous cell carcinoma in situ in 3 patients (9%), and cutaneous lymphoma in 2 patients (6%). The ratio of squamous cell carcinoma to basal cell carcinoma was 1.1:1. The mean time from transplant to skin cancer diagnosis was 65 +/- 55 months (range, 0-180 mo). Immunosuppressive therapy was based on cyclosporine in 22 patients (67%), tacrolimus in 8 patients (24%), and combination therapy (cyclosporine and azathioprine) in 3 patients (9%). Conclusions: Nonmelanoma skin cancer is an important clinical problem in kidney transplant recipients. Interventions that may benefit kidney transplant recipients may include intensive patient education, protection against sun exposure, and dermatologic screening programs.Item Role of Bronchoalveolar Lavage in Diagnosis of Fungal Infections in Liver Transplant Recipients(2015) Tepeoglu, Merih; Atilgan, Alev Ok; Ozdemir, B. Handan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0001-8595-8880; 0000-0002-7528-3557; 0000-0002-9894-8005; 25894185; AAJ-8097-2021; AAK-3333-2021; X-8540-2019; AAK-5222-2021Objectives: Pulmonary fungal infections remain the most important cause of morbidity and mortality in liver transplant recipients. Fast and accurate causative diagnoses are essential for a good outcome. Bronchoscopy with bronchoalveolar lavage frequently is performed to diagnose pulmonary infections in immunocompromised patients. The aim of this study was to evaluate the diagnostic use of bronchoalveolar lavage in liver transplant recipients with pulmonary infections. Materials and Methods: We retrospectively analyzed the data of 408 patients who underwent liver transplant from January 1990 to December 2012. Patients who underwent bronchoalveolar lavage after transplant were included in this study. Results: There were 18 of 408 liver transplant recipients (4.41%) who underwent bronchoalveolar lavage after transplant. The mean age was 49.5 +/- 18 years. In 5 patients (27.8%), fungal microorganisms were observed in the cytology of bronchoalveolar lavage specimens, including Aspergillus fumigatus in 3 patients and Candida albicans in 2 patients. Death occurred in 4 of 5 patients (80%) with fungal infections. No association was observed between the presence of fungal infection and clinical and radiographic findings of the patients. Conclusions: Bronchoscopy with bronchoalveolar lavage is a useful, noninvasive diagnostic tool for the rapid diagnosis of infections in solid-organ transplant recipients.Item Papanicolaou Smear Findings in Solid-Organ Transplant Recipients Compared With Normal Subjects According to the Bethesda 2001 System(2015) Atilgan, Alev Ok; Tepeoglu, Merih; Haberal, A. Nihan; Durukan, Elif; Kuscu, Esra; Haberal, Mehmet; 0000-0002-9894-8005; 0000-0002-3462-7632; 0000-0001-9852-9911; 0000-0001-8595-8880; 0000-0002-0992-6980; 0000-0002-8579-5564; 25894158; AAK-5222-2021; AAJ-8097-2021; AAK-4587-2021; AAK-3333-2021; AAI-8792-2021; AAJ-8621-2021Objectives: Solid-organ transplant recipients are at increased risk of developing cancer including cervical cancer compared with woman in the general population, mostly due to long-term immunosuppressive therapy. The Papanicolaou smear remains the primary method of screening cervical pathology including preinvasive and invasive lesions. The objective of this study was to evaluate Pap smear findings in solid-organ transplant recipients, determine the prevalence of abnormal smears, and compare these patients with the general population. Materials and Methods: We retrospectively examined 111 women patients who received liver or kidney transplant between January 1990 to December 2012 at Baskent University Ankara Hospital. Pap smear findings were compared with normal control patients matched for same age and technical procedure of cervical cytology. To selection of control patients, propensity score matching program was performed. All Pap smears were re-examined according to Bethesda 2001 criteria. Results: In 111 transplant patients, 2 patients (1.8%) had atypical squamous cells of undetermined significance, 8 patients (7.2%) had low-grade squamous intraepithelial lesion, 15 patients (13.5%) had Candida infection, 2 patients (1.8%) had Trichomonas vaginalis, 1 patient (0.9%) had herpes simplex infection, 13 patients (11.7%) had bacterial vaginosis, 15 patients (13.5%) had reactive changes due to inflammation, and 18 patients (16.2%) had atrophy. When we compared our results with the control group, there were statistically significant differences (P <= .05) between the 2 groups in epithelial cell abnormalities (low-grade squamous intraepithelial lesion), Candida infection, bacterial vaginosis, and atrophy. Conclusions: Pap smear screening potentially may help recognize cervical preinvasive and invasive lesions. The risk of developing cervical intraepithelial neoplasia is greater in transplant recipients because of immunosuppressive therapy. The incidence of low-grade squamous intraepithelial lesion was significantly greater in transplant recipients than the general population. Intensive follow-up with Pap smear in transplant recipients is important in the early detection of these lesions.Item Divergent Role of Programmed Death -Ligand 1 (PD-L1) in Renal Allografts with Antibody-Mediated Rejection (AMR)(2018) Ozdemir, B. Handan; Akcay, Eda; Atilgan, Alev Ok; Borcek, Pelin; Tepeoglu, Merih; Polat, Aysegul Yucel; Deniz, Melis; Haberal, Mehmet; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0001-6831-9585; https://orcid.org/0000-0001-8595-8880; https://orcid.org/0000-0002-9894-8005; https://orcid.org/0000-0002-3590-9375; AAJ-8097-2021; X-8540-2019; AAK-1960-2021; AAK-3333-2021; AAK-5222-2021; AAP-3975-2021; https://orcid.org/0000-0002-3462-7632