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Item Pathology, Classification, Clinical Manifestations and Prognosis of Langerhan's Cell Histiocytosis: A Single Center Experience(2022) Hasbay, Bermal; Kocer, Nazim Emrah; Kayaselcuk, Fazilet; Canpolat, Emine Tuba; Buyukkurt, Nurhilal; Erbay, AyseObjective: The aim of the study is to raise awareness about clinical features, histopathological and radiological analyzes and treatment details of this rare disease. Methods: A total of 55 Langerhans cell histiocytosis patients, diagnosed between the year 2006 and October 2020 in our department were included in the study. The patients were evaluated in terms of age, gender, tumor localization, risk groups, treatment modalities, recurrence, and outcome of the disease. Results: Twenty-three out of 55 patients were children and 32 were adults. The ages of the patients were between 7 months and 72 years. Thirty-seven of the cases were male and 18 were female. The most common clinical complaint in both groups was pain and swelling. The duration between the onset of the patient complaints and admission to the hospital varies between 7 days-12 months in children, and 10 days-23 years in adults. Forty-three of the cases had single organ involvement and 12 had multiorgan involvement. The most frequently affected organ in both groups was bone. Forty of the 55 patients had follow-up data and the treatment modalities are as follows: Nine patients radiotherapy, 8 patients chemotherapy+steroid, 7 patients chemotherapy, 2 patients chemotherapy+radiotherapy+steroid, 1 patient steroid, 2 patients chemotherapy+radiotherapy. Eleven patients were followed up without additional treatment after surgery. Median follow-up from the time of biopsy was 45.9 months in children and 41.9 months in adults. Conclusions: As a result, diagnosis requires a high degree of suspicion and final diagnosis is based on the histological examination of the lesions and biopsies.Item The effect of sodium iodide symporter protein on ablation success in patients with differentiated thyroid cancer(2022) Mutevelizade, Gozde; Kocer, Nazim Emrah; Reyhan, Mehmet; https://orcid.org/0000-0001-8550-3368; 36214955; AAJ-5242-2021Objective This study aimed to investigate immunohistochemical staining of sodium iodide symporter (NIS) and its effect on response to I-131 therapy in differentiated thyroid carcinoma patients. Methods We evaluated NIS expression, the intracellular distribution of NIS, iodine-131 uptake in residual tissues on post-ablation I-131 whole body scan, and the ablation status after 100 mCi I-131 therapy. We also investigated NIS expression and localization in tumoral paraffin-embedded tissues. Results In this retrospective study, 35 patients (mean age 44.17 +/- 12.9 years, 27 female, 8 male) were studied. Twenty-one of these patients responded to radioiodine therapy, and 14 did not. NIS expression and iodine-131 uptake in residual tissues post-ablation I-131 whole body scan were not statistically significant. When we compared the patients who responded to radioiodine therapy and the poor responder group, NIS expression and iodine-131 uptake in residual tissues did not demonstrate statistically significant difference [(p = 0.308) (p = 0.985) respectively]. 47.6% of the patients in the successful ablation group and 85.7% in the unsuccessful ablation group had intracellular NIS immunostaining. The difference was not statistically significant (p = 0.139). 52.4% of the patients in the successful ablation group and 7% in the unsuccessful ablation group had NIS immunostaining at the basolateral membrane. The difference was statistically significant (p < 0.05). Conclusions In conclusion, we did not find any significant difference between successful and unsuccessful ablation groups in terms of NIS expression; however, we concluded that the intracellular (cytoplasmic) localization of NIS is one of the leading causes of ablation failure regardless of NIS expression in DTC patients.Item T-Cell Lymphoblastic Lymphoma Showing Aberrant Synaptophysin Expression in a Child(2020) Kocer, Nazim Emrah; Hasbay, Bermal; Kayaselcuk, Fazilet; 0000-0002-1180-3840; 0000-0002-5943-9283; 31852036; AAE-2550-2021; AAM-5436-2021Item Relapsed acute myeloid leukemia presenting with myocardial hypertrophy and constrictive pericardial physiology(2019) Acibuca, Aynur; Yeral, Mahmut; Kocer, Nazim Emrah; Koc, Zafer; Gullu, Hakan; 0000-0002-3444-8845; 31062759; ABG-4047-2020; ABC-4148-2020Item Non-Hematologic Malignancies Metastasing to the Bone Marrow: A Record-Based Descriptive Study From A Tertiary Center(2019) Aytan, Pelin; Kocer, Nazim Emrah; Yeral, Mahmut; Gereklioglu, Cigdem; Kasar, Mutlu; Buyukkurt, Nur Hilal; Asma, Suheyl; Ozdogu, Hakan; Boga, CanThe aim of this study is to assess the cases of nonhematologic maiignancies that had bone marrow (BM) metastasis with respect to hematologic abnormalities, radiologic findings and pathologic findings. All of the patients with BM investigation were retrospectively evaluated. The patients with BM metastasis by a non-hematologic malignancy were assessed. Data regarding patient characteristics including peripheral blood evaluation findings, imaging findings, BM evaluation results and survival were obtained from patient files and computer based electronic database. 30 cases were detected among 1831 BM aspirations and biopsies. The most common malignancies were breast (36.7%), prostate (13.3%), gastric(13.3%) and lung (13.3%) adenocarcinomas. 90.9% and 75% of the cases had positive radiologic findings with PET/CT and CT respectively. 43.3% of the patients died during the study period and the median time from BM assessment to death was 2 months. Anemia, thrombocytopenia and leukopenia were present in 90%, 73.3% and 20% respectively. Lactate dehydrogenase and alkaline phosphatase were elevated in 90% and 80% respectively. In 76.2% a leukoerythroblastic blood picture was present. All the cases were diagnosed with biopsy and aspiration detected infiltration in 40% and in 4 metastatic patients (13.3%) the aspiration was false negative. In 46.7% the aspiration resulted with dry tap. Grade 3 fibrosis was present in 76.7%. BM assessment is a minimally invasive technique and provides very beneficial clinical data, however, because the survival is very short after BM assessment and the PET/CT has a considerable sensitivity it is not necessary to confirm BM metastasis in patients whose tumor stage is already known.Item Variations in apparent diffusion coefficient values following chemotherapy in pediatric neuroblastoma(2015) Demir, Senay; Altinkaya, Naime; Kocer, Nazim Emrah; Erbay, Ayse; Oguzkurt, Pelin; 25519453PURPOSE In children the assessment of solid tumors' response to chemotherapy is based primarily on size reduction, which can be unreliable and a late marker, in the presence of necrosis. We aimed to establish whether apparent diffusion coefficient (ADC) values of childhood neuroblastomas show proportional changes in relation to chemotherapy response. METHODS We evaluated 15 pediatric patients with abdominopelvic neuroblastomas, who had undergone MRI before and after chemotherapy. Two radiologists retrospectively analyzed all images by drawing a round uniform region-of-interest in the solid/contrast-enhancing portion of the lesions in consensus. The ADC values from pre- and postchemotherapy images were compared. RESULTS Postchemotherapy ADC values were significantly higher than those obtained before treatment (P < 0.05, for minimum, maximum, and median ADC values). CONCLUSION Our results support diffusion-weighted MRI as a promising noninvasive biomarker of therapeutic responses. To the best of our knowledge, this is the first report to compare diffusion-weighted imaging findings before and after chemotherapy in childhood neuroblastic tumors.Item A Rare Complication of Brucellosis: Testicular Abscess(2015) Gul, Umit; Demiroglu, Yusuf Ziya; Erbay, Gurcan; Kocer, Nazim EmrahBrucellosis is a zoonosis caused by Brucella species. Brucella epididymo-orchitis had been reported in up to 20% of patients with brucellosis. This case was a male patient who developed Brucella epidiymo-orchitis and testicular abscess. He had fever, arthralgia and his right epididymis and right testicle were enlarged and tender. Ultrasound evaluation showed hypertrophy of the right epididymis and testis and moreover hypoechoic area within the testis. Brucella serology was positive and the patient did not respond completely to treatment with streptomycin, doxycycline, and rifampicina. Unilateral orchidectomy was decided. In areas where brucella infection is endemic brucella epididymo-orchitis should be considered in the differential diagnosis. Effective and rapid treatment is important. It should be noted that these patients may develop testicular abscess.Item Inflammatory Myofibroblastic Tumor of the Prostate(2016) Kocer, Nazim Emrah; Bal, Nebil; Gul, Umit; Aydin, HakanInflammatory myofibroblastic tumors (IMT) of the prostate are very rare lesions that may mimic sarcomas and spindle carcinomas both clinically and histopathologically. The case presented here is a 63-year-old patient, with normal prostate specific antigen levels and a chronic history of complaints, who underwent to suprapubic prostatectomy due to the infravesical obstruction symptoms that are resistant to medical therapy. Histopathological examination of the excision material revealed a well demarcated spindle cell lesion with focal nuclear polymorphism, hyperchromasia, mononuclear inflammatory infiltration and myxoid areas. Mitosis was rare. Immunohistochemically smooth muscle actin and vimentin were positive, anaplastic lymphoma kinase-1 was focal positive, S-100 and pancytokeratin were negative. The lesion was diagnosed as an inflammatory pseudotumor. Differential diagnosis of the IMT from malignant spindle cell tumors of the prostate is crucial to prevent overtreatment.Item Spleen Salvaging Treatment Approaches in Non-parasitic Splenic Cysts in Childhood(2016) Gezer, Hasan Ozkan; Oguzkurt, Pelin; Temiz, Abdulkerim; Ince, Emine; Ezer, Semire Serin; Kocer, Nazim Emrah; Demir, Senay; Hicsonmez, Akgün; 27574347The aim of this study was to evaluate our experience with primary non-parasitic splenic cysts (NPSC) which are relatively rare in children and consist almost exclusively of single case reports or small case series in the literature. The medical records of all patients who presented to our clinic with NPSC between 2005 and 2015 were evaluated retrospectively. There were 22 children whose ages ranged from 2 months to 14 years (mean 9.2 +/- 4.7 years). The size of the cysts was in the range of 5 to 200 mm (mean 55.4 +/- 48.2 mm). Ten patients underwent surgery for splenic cysts. Partial splenectomy (n = 2), total cyst excision (either open n = 4 or laparoscopically n = 1), and total splenectomy (n = 3) were performed. The non-operated patients were asymptomatic and followed with ultrasound (US). The follow-up period in non-operated patients ranged from 6 months to 5 years (mean 2.27 +/- 1.29 years). Complete regression was observed in four (33 %) non-operated patients. The regressed cyst measurements were 10, 16, 30, and 40 mm, respectively. Approximately half of the NPSC is diagnosed incidentally. Small (< 5 cm) asymptomatic cysts should be under regular follow-up with US/physical examination for regression. If surgery is required, we prefer open cyst excision as it gives excellent results and preserves splenic immune function.Item Re: Lambda light chain myeloma presenting as nodular hepatic lesion: A clinical rarity(2015) Ulusan, Serife; Kocer, Nazim Emrah; 0000-0002-5943-9283; 26881682; AAM-5436-2021