Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item A Rare Epididymal Mass: Leiomyoma(2014) Cicek, Tufan; Coskunoglu, Esra Zeynep; Demir, Canan Cicek; Akbaba, Kaan; Uzunkopru, Resit; JBF-7113-2023; AAK-4857-2021Leiomyoma is a benign smooth muscle tumor. It rarely rises from epididymal structures and usually is encountred in adults. The patient, who had undergone total epididymectomy for right scrotal mass at another center, was diagnosed with Epididymal Leiomyoma. He was admitted to our clinic for further evaluation and follow up. The previous eididymectomy specimens obtained and refered to our pathology department for confirmation of diagnosis. Microscopy revealed a benign neoplastic lesion, consisting of spindle cells. Which form interlacing bundels. Mitotic figures and tumor necrosis was not. Observed. The previous diagnosis is confirmed as the tumor showed immunohistochemical smooth muscule actin and Desmin posivity Whereas S-100 was not expressed with in the tumoral cells. This case report also overviews epididymal leiomyoma with recent literature findings.Item Expression of A Disintegrin and Metalloproteinase-33 Protein in Vocal Fold Polyps(2015) Akdogan, M. V.; Erinanc, H.; Topal, O.; Erbek, S. S.; 0000-0003-4825-3499; 0000-0001-9710-9974; 0000-0003-1401-6356; 0000-0001-6305-5023; 26153837; B-7604-2019; AAJ-4584-2021; AAL-1268-2021; ABI-6777-2020Background: This study aimed to evaluate the association of a disintegrin and metalloproteinase-33 protein ('ADAM-33') expression in vocal polyp formation and to determine its correlation with clinical characteristics. Methods: Medical charts and histological sections of 32 patients diagnosed with vocal polyps who underwent surgery were analysed. Controls were histopathologically normal vocal fold tissues obtained from 36 patients who underwent surgery for laryngeal squamous cell carcinoma. Immunohistochemical staining was performed to detect ADAM-33 expression in epithelial cells, stroma and vessels. Results: All epithelial, stromal and vascular staining scores were significantly greater in polyp tissue than in controls (p < 0.001). Stromal ADAM-33 staining scores were higher in vocal polyp patients with a symptom duration of less than six months (p < 0.05). Vocal overuse or the presence of reflux symptoms, sinonasal symptoms or allergy did not affect ADAM-33 immunostaining scores (p = 0.05). Conclusion: In this study, ADAM-33 immunostaining was significantly increased in vocal polyps. Therefore, over-expression of this protein may be associated with vocal polyp pathogenesis.Item Human Epidermal Growth Factor Receptor 2 Overexpression in Micropapillary and Other Variants of Urothelial Carcinoma(2018) Behzatoglu, Kemal; Yorukoglu, Kutsal; Demir, Hale; Bal, Nebil; 28753766Background: Human epidermal growth factor receptor 2 (HER2) protein overexpression or gene amplification has been shown in urothelial bladder cancer. This could be helpful when using targeted anti-HER2 therapy on these tumors. Objective: To evaluate HER2 immunohistochemical expression in conventional urothelial carcinoma (UC), in situ UC, and UC variants primarily in micropapillary urothelial carcinoma (MPUC). Design, setting, and participants: The study evaluated 60 MPUC cases; 25 invasive, 20 low-grade noninvasive, and 10 high-grade noninvasive UC cases; 8 in situ UC cases; and 69 UC variant cases. The immunohistochemistry staining was scored according to recommendations of the American Society of Clinical Oncology/College of American Pathologists 2013 HER2 test guideline established for breast cancer and only 3+ staining was considered HER2 overexpression. Outcome measurements and statistical analysis: HER2 overexpression was determined by 3+ staining. Results and limitations: 34 of 60 MPUC cases (56%) showed HER2 overexpression (3+ staining). We observed 3+ staining HER2 overexpression in nine of 25 conventional invasive UC cases (36%), four of eight in situ UC cases (50%), and three of six lipid cell variant cases (50%). 3+ staining HER2 overexpression was not seen in eight glandular, six small cell, and five sarcomatoid variant cases. HER2 overexpression was negative in the 20 low-grade noninvasive UC cases but positive in two of the 10 high-grade noninvasive UC cases (20%). We observed HER2 overexpression most commonly in MPUC cases. We also found HER2 overexpression in conventional invasive and in situ UC cases. Conclusions: Pure in situ UC and conventional invasive UC, especially MPUC, could be candidate tumors for treatment with anti-HER2 antibody (trastuzumab therapy). Patient summary: Targeted therapy has a limited place in treatment of bladder cancer. In this study, human epidermal growth factor receptor 2 (HER2) overexpression in bladder carcinomas was evaluated in a large number of cases. Anti-HER2 therapy could be used in bladder cancers, as in breast and gastric cancers. (C) 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.Item Medulloblastoma: Clinicopathological Correlates of SHH, WNT, and Non-WNT/SHH Molecular Subgroups Analysis and Prognostic Significance: Mono-Institutional Series(2022) Hasbay, Bermal; Kayaselcuk, Fazilet; Suner, Halil Ibrahim; Sarialioglu, Faik; https://orcid.org/0000-0002-5957-8611; 000832603900001; AAJ-5381-2021AIM: To reevaluate the medulloblastoma cases according to histomorphological and molecular features, and to investigate the relationship between the prognostic factors of the new WHO classification by applying Beta-catenin, YAP1, GAP1, p53, and INI1 antibodies immunohistochemically. MATERIAL and METHODS: This study includes 41 patients who have been diagnosed with medulloblastoma between 2007-2019 in pathology department. Immunohistochemically, p53, beta-catenin, YAP1, GAP1, and INI1 immune markers were applied, and the relationship between the results and the prognostic parameters was evaluated statistically. RESULTS: When 41 patients were classified into WHO medulloblastoma histological subtype groups according to histomorphological features, 22 (53.7%) patients were classified as classical type, 11 (26.8%) patients as desmoplastic nodular type, and 8 (19.5%) patients as large cell/anaplastic type medulloblastoma. According to their molecular characteristics, 14 (34.1%) patients were in the Non-WNT/SHH group, 5 (12.2%) patients were SHH mutant, 17 (41.5%) patients were SHH wild, and 5 (12.2%) patients were in the WNT active group. There was no statistically significant correlation between age, gender, tumor size, recurrence, Ki67 proliferation index with molecular types and histopathological types. CONCLUSION: In our study, metastasis at the time of diagnosis, histological large cell anaplastic type, immunohistochemical p53 positivity, molecular SHH mutant type were the statistically significant indicators of worse prognosis and shorter survival time.Item Metaplastic Carcinoma of the Breast: Analysis of 38 Cases from a Single Institute(2020) Hasbay, Bermal; Aka Bolat, Filiz; Aytac, Huseyin Ozgur; Aslan, Hulya; Purbager, Aysin; 0000-0002-7138-246X; 0000-0002-3583-9282; 31769499; AAK-9104-2021; AAJ-7913-2021Objective: To evaluate the pathological and radiological features, hormone profiles, surgery and treatment methods of metaplastic breast carcinoma cases diagnosed at our center in the light of current literature. Material and Method: A total of 38 metaplastic breast cancer cases diagnosed between 2006-2018 at our center were included in the study. The patients were evaluated in terms of age, tumor size, localization, histological grade, hormone profiles (ER, PR, Her2-neu), American Joint Committee on Cancer (AJCC) Tumor, Lymph node status, Metastases (TNM) stage, progression, survival, radiological features, types of surgery and therapy modalities (chemotherapy and / or radiotherapy). Results: The age of the patients ranged between 32 and 95 years. Pathological evaluation of cases showed that 14 were pure epithelial (IC-NST + squamous cell carcinoma) and 24 were metaplastic carcinomas with mesenchymal differentiation. Ductal carcinoma in situ (DCIS) was accompanying an invasive component in twenty cases. Seventeen patients had lymph node metastasis. Twelve patients developed distant metastasis. Thirty patients were triple negative for hormone receptors. The mean follow-up period of the patients was 34 months. The estimated life expectancy was 116 months. All of the patients received chemotherapy and 28 patients received adjuvant radiotherapy. There was no correlation between tumor size and lymph node or distant metastasis in our series. Our findings are consistent with the literature. Conclusion: Metaplastic breast carcinoma is a rare entity among breast carcinomas. Metaplastic carcinomas of the breast draw attention with the differences in their clinical course and the radiological and pathological heterogeneity.Item Implications for thymus growth in childhood: histogenesis of cortex and medulla(2019) Fidan, Pinar Ayran; Kaymaz, F. Figen; Dagdeviren, Atilla; 0000-0003-3047-0305; 0000-0001-8990-8282; 30155680; ABG-5365-2020; P-2877-2014The increase in autoimmune diseases in recent years has drawn attention back to the thymus, with new approaches to improve and/or restore immune function being investigated. As the primary lymphoid organ responsible for functional T cell development, studies on the pre-/post-natal development of this organ and T lymphocytes in human and other species are of special interest. During our screening studies we observed structures that had not been described or mentioned previously, and named them epitheliostromal sheaths. Associated with these unique structures were also small attached lobules (possibly reflecting the maturational stages of thymic lobules), which the authors consider as markers of histogenesis and the growth of the organ during early childhood; these findings are thus presented to researchers in this field. Approximately 1000 sections prepared from infantile thymic tissues of partial biopsy specimens were immunostained and examined. Specimens were taken from ten patients (with informed consent) in the age range of 4-9years who underwent surgery due to congenital cardiovascular anomalies but were otherwise normal. Digital images of interest were captured to describe them in detail. Determining the immunophenotype of the compartments in these newly developing lobules assisted us greatly in defining compartments and their growth order. In summary, our findings suggest a niche-based thymus growth mechanism during childhood. We presented our findings, hoping to provide additional insight to researchers aiming to restore thymus function in adulthood and improve its immunological functions.Item SEROUS VERSUS HIGH-GRADE ENDOMETRIOID ENDOMETRIAL CARCINOMA: IMMUNOHISTOCHEMISTRY OF RFP IS NOT USEFUL FOR DIFFERENTIATION(2016) Ussakli, Cigdem; Usubutun, Alp; Dicner, Nazmiye; Dolgun, Anil; Bulbul, Dilek; Isikdogan, Zuhal; Haberal, Nihan; Ozen, Ozlem; Tezel, Gaye Guler; 0000-0001-9852-9911; 28155970; AAK-4587-2021We evaluated the immunohistochemical expression of ret finger protein (RFP) along with conventional immunohistochemical markers in endometrioid and serous carcinomas of the endometrium. A total of 124 endometrial carcinoma cases (24 grade 1 endometrioid, 60 grade 3 endometrioid, 40 serous) were retrieved from pathology archives. Tissue microarrays were constructed. The expression of RFP, WT1, ER., PR, p53 and p16 was examined immunohistochemically. Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve, kappa statistic for interobserver reproducibility, Kruskal-Wallis test, Mann-Whitney U test and Fisher's exact tests were performed for statistical analyses. The mean RFP score was 1.54 in grade 1 endometrioid, 4.31 in grade 3 endometrioid, and 6.31 in serous carcinomas (p < 0.001). Overall, RFP scores were higher both in serous and grade 3 endometrioid carcinoma (p > 0.05), and significantly lower in grade 1 endometrioid carcinoma (p < 0.05). p16 and p53 staining patterns were able to differentiate between high-grade endometrioid and serous carcinoma (p < 0.001). ER, PR and WT-1 did not reach statistical significance for subtyping. The kappa values of the general agreement between the observers were 0.737 and 0.727 for endometrioid and serous carcinomas respectively (p < 0.001). Diffuse p53 and p16 staining provides the most sensitive and specific immunomarkers for differentiating high-grade endometrioid and serous carcinomas.Item Enhancer of zeste homologue 2 (EZH2) expression in synovial sarcomas as a promising indicator of prognosis(2017) Ozgun, Gonca; Yalcinkaya, Ulviye; Ugras, Nesrin; Ocakoglu, Gokhan; Deligonul, Adem; Cetintas, Sibel Kahraman; Bilgen, Muhammed Sadik; 28738014Synovial sarcoma (SS) is a type of soft-tissue sarcoma, often linked to poor survival. Although overexpression of enhancer of zeste homologue 2 (EZH2) has been associated with poor prognosis in different tumors, a few studies investigated this link in SS. Here, we analyzed the relationship between EZH2 expression and prognostic factors in SS. We included 29 patients with SS. Immunostaining of EZH2 was performed with (D2C9) XP (TM) Rabbit mAb antibody, and the results were classified as low EZH2 expression (negative or weak expression) and high EZH2 expression category (moderate or strong expression). Analysis of survival in relation to prognostic factors was performed with Kaplan-Meier survival curves and Cox proportional hazard regression analysis. Our sample included 19/29 female and 10/29 male patients, with age range 16-63 years. The tumor diameter ranged from 2 to 15 cm. Necrosis was observed in 15/29 cases. Sixteen cases had > 10 mitoses per 50 high-power fields (HPFs). Out of 29 cases, 14 showed low and 15 had high EZH(2) expression. Statistically significant results were obtained for the association between the presence of metastasis and necrosis (p = 0.042), high EZH2 expression and distant metastasis (p = 0.018), high EZH2 expression and necrosis (p = 0.016), and high EZH2 expression and the tumor size > 5 cm versus tumor size <= 5 cm (p = 0.014). Patients with all of the following: the tumor size <= 5 cm, low EZH2 expression, and without necrosis and distant metastasis had significantly longer survival time. Our results are consistent with previous studies, suggesting that EZH(2) overexpression is an indicator of poor prognosis in SS.Item Robust diagnosis of Ewing sarcoma by immunohistochemical detection of super-enhancer-driven EWSR1-ETS targets(2018) Ozen, Ozlem; Baldauf, Michaela C.; Orth, Martin F.; Dallmayer, Marlene; Marchetto, Aruna; Gerke, Julia S.; Rubio, Rebeca Alba; Kiran, Merve M.; Musa, Julian; Knott, Maximilian M. L; Ohmura, Shunya; Li, Jing; Akpolat, Nusret; Akatli, Ayse N.; Dirksen, Uta; Hartmann, Wolfgang; de Alava, Enrique; Baumhoer, Daniel; Sannino, Giuseppina; Kirchner, Thomas; Gruenewald, Thomas G. P.; 0000-0002-9082-1317; 29416716; AAK-4468-2021Ewing sarcoma is an undifferentiated small-round-cell sarcoma. Although molecular detection of pathognomonic EWSR1-ETS fusions such as EWSR1-FLI1 enables definitive diagnosis, substantial confusion can arise if molecular diagnostics are unavailable. Diagnosis based on the conventional immunohistochemical marker CD99 is unreliable due to its abundant expression in morphological mimics. To identify novel diagnostic immunohistochemical markers for Ewing sarcoma, we performed comparative expression analyses in 768 tumors representing 21 entities including Ewing-like sarcomas, which confirmed that CIC-DUX4-, BCOR-CCNB3-, EWSR1-NFATc2-, and EWSR1-ETS-translocated sarcomas are distinct entities, and revealed that ATP1A1, BCL11B, and GLG1 constitute specific markers for Ewing sarcoma. Their high expression was validated by immunohistochemistry and proved to depend on EWSR1-FLI1-binding to highly active proximal super-enhancers. Automated cut-off-finding and combination-testing in a tissue-microarray comprising 174 samples demonstrated that detection of high BCL11B and/or GLG1 expression is sufficient to reach 96% specificity for Ewing sarcoma. While 88% of tested Ewing-like sarcomas displayed strong CD99-immunoreactivity, none displayed combined strong BCL11B-and GLG1-immunoreactivity. Collectively, we show that ATP1A1, BCL11B, and GLG1 are EWSR1-FLI1 targets, of which BCL11B and GLG1 offer a fast, simple, and cost-efficient way to diagnose Ewing sarcoma by immunohistochemistry. These markers may significantly reduce the number of misdiagnosed patients, and thus improve patient care.