The utility of ADC measurement techniques for differentiation of low- and high-grade clear cell RCC

Purpose: To evaluate the diffusion properties of clear cell renal cell carcinoma (ccRCC) on magnetic resonance imaging (MRI) concerning their Fuhrman nuclear grades and sizes, and to compare the diagnostic performance of two ROI placement techniques for apparent diffusion coefficient (ADC) measurement (entire mass vs. only the darkest region of the mass). Material and methods: Fifty-one ccRCC were enrolled in the study and grouped into low-grade ccRCC (Fuhrman grade 1 and 2, n = 37) and high-grade ccRCC (Fuhrman grade 3 and 4, n = 14). Selective ADC (Sel-ADC) measurement was performed by placing a circular ROI that included the darkest region of the tumour on ADC map images. Extensive ADC (Ext-ADC) measurement was performed by drawing an ROI that covered the entire tumour. Results: The Sel-ADC value was lower in high-grade ccRCC (p = 0.019), whereas the Ext-ADC value did not show a statistically significant difference (p = 0.42). Sel-ADC value of a ≤ 1.405 mm2/s has a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy value of 78.6, 72.2, 73.87, 77.13, and 75.4, respectively, to differentiate high-grade from low-grade ccRCC. The size and Fuhrman grade of the ccRCC were inversely correlated with the Sel-ADC value; however, the correlations were weak (r = -0.322, p = 0.021 and r = -0.376, p = 0.006, respectively). There was no difference between ADC values of small (≤ 4 cm) and large (> 4 cm) ccRCCs. Conclusions: The ADC value of the darkest region in solid part of the ccRCC may play a role in predicting the nuclear grade of ccRCC

Uterine Cervix Metastasis of Myxopapillary Ependymoma Originated from the Spinal Cord

Background: Myxopapillary ependymomas are well differentiated low-grade tumors which have been documented to local or distant metastasis. In the literature, this is a unique case of myxopapillary ependymoma with metastasis to the uterine cervix. Here, we present a rare case of extra neural metastasis of spinal ependymoma that developed over a long period. Case Report: A 34-year-old woman was referred to our hospital for pelvic mass. A mass (110x100 mm) localized between the sacrococcygeal region and the uterus was detected by magnetic resonance imaging. In 2004, she had been operated upon for myxopapillary ependymoma seated in the sacrococcygeal region for the first time. She underwent tumor resection eight times due to the recurrence of spinal tumor in the same region in nine years. Under the diagnosis of uterine neoplasm, we carried out radical hysterectomy, omentectomy and pelvic lymphadenectomy as the surgical procedure. The pathological findings were reported as myxopapillary ependymoma. Immunohistochemically, the myxopapillary ependymal cells showed strong positivity for glial fibrillary acidic protein, whereas they were negative for low molecular weight cytokeratin. The Ki-67 labeling index was about 2-3%. The patient had an uneventful postoperative period. She has remained free of symptoms in the year since surgery. Conclusion: Extra-spinal myxopapillary ependymoma is very rare, but it must be considered in the differential diagnosis of pelvic mass lesions

A psoralen and ultraviolet A-aggravated dermatosis: Grover's disease

WOS: 000519583900006Grover's disease (GD) is an acquired dermatosis called transient acantholytic dermatosis. The exact cause is unknown, but the factors blamed for the etiology include ultraviolet (UV), sweating, temperature rise, radiation, medications, and malignancies. Topical corticosteroids, topical retinoids, and topical calcipotriol are usually sufficient for treatment, and systemic retinoids, systemic steroids, phototherapy, and methotrexate are rarely used. The current report describes the case of GD in a female patient, which was aggravated by the psoralen and UVA phototherapy

Morphea secondary to interferon betai B injection: A case and review of the literature

PubMed ID: 31046913Interferon beta (IFNß) is a drug used successfully in the treatment of multiple sclerosis (MS). Although IFNß is a safe and well-tolerated drug, dermatological side effects are common. The most common dermatological adverse effect is a local reaction at the injection site. It may also cause inflammatory and immune-mediated dermatological side effects. However, morphea induced by IFNßlb injection is very rare. © 2019, Dermatology Online Journal. All rights reserved

Mitotically Active Plexiform Fibrohistiocytic Tumor

Plexiform fibrohistiocytic tumor is an intermediate malignant tumor situated in superficial soft tissues. It affects children and young adults. The tumor is most commonly located on upper extremities, whereas involvement of back region is rare. Mitotic activity is generally low (~3/10 HPF). It is rare, but it can exhibit aggressive behavior, so total excision with clear surgical margins and long-term followup is necessary to detect local recurrence and metastases. We report a child with a solid mass on back region which was found to be a mitotically active plexiform fibrohistiocytic tumor (6/10 HPF) after excision. Plexiform fibrohistiocytic tumor (PFT) is a mesenchymal neoplasm of children, adolescents, and young adults. It is characterized by fibrohistiocytic cytomorphology and multinodular growth pattern. Clinically it is usually a slow-growing mass of upper extremities with frequent local recurrence and rare regional lymphatic and systemic metastasis (Fletcher et al. (2002), Enzinger and Zhang (1988), Remstein et al. (1999))

Alteration of tissue expression of human beta defensin-1 and human beta defensin-2 in psoriasis vulgaris following phototherapy

Uzuncakmak, Tugba Kevser Ustunbas/0000-0001-8057-3463WOS: 000492502600001PubMed: 31650859We compared the expression profiles of antimicrobial peptides (AMPs) in psoriatic skin before and after narrow band ultraviolet B (nb-UVB) phototherapy and compared the levels to healthy controls. We studied 15 male and 12 female patients with psoriasis vulgaris, and 11 female and nine male control individuals. The patient group was treated with 24-36 sessions of nb-UVB phototherapy. Immunohistochemical staining for human beta defensin 1 (hBD-1) and human beta defensin 2 (hBD-2) expression of lesioned and control skin was performed prior to and following phototherapy. After phototherapy, the psoriatic area and severity index (PASI) decreased significantly in the treated patients compared to controls. The hBD-1 level was significantly higher in psoriasis patients than healthy controls. We found no statistically significant difference in hBD-1 and hBD 2 levels before and after phototherapy in the patient group. Although hBD-1 plays a role in psoriasis, levels of human beta defensin 1 and 2 are not affected significantly by phototherapy

Folate receptor alpha expression and significance in endometrioid endometrium carcinoma and endometrial hyperplasia

Akalin, Ibrahim/0000-0002-7487-4603WOS: 000358370300156PubMed: 26191275Endometrioid-type endometrial carcinoma (EEC) developing on the ground of endometrial hyperplasia (EH) is amongst the most commonly observed type of cancer in the world. Folate receptor alpha (FR alpha) is a vitamin molecule that has a role in cell proliferation. the fact that FR alpha, which is known to be needed extremely by the cells of malignancies that proliferate rapidly, is present in limited amounts in normal tissues while it is overexpressed in malignant cells of the same tissues makes folate a candidate for target molecular therapy. in our study, FR alpha expression in 214 cases, with 95 diagnosed within EEC and 119 with EH, was studied immunohistochemically. FR alpha expression in EEC was found significantly high compared to EH and normal endometrium (P<0.01). Similarly, FR alpha expression in EH cases with complex atypia were significantly high compared to other hyperplasia subgroups (P<0.01). the findings of our results make us think that FR alpha overexpression may play a role in the EEC carcinogenesis and carcinoma progression from EH. Furthermore, we suggest that it can be helpful in the treatment of EEC and/or transition from hyperplasia stage to EEC as a molecular therapy targeting receptors labeled with antibody-based props containing FR alpha. Finally, we suggest that FR alpha may be used, based on the expression intensity, as a supplemental option to determine the patients that shall be directed to radical therapy amongst patients with complex atypical EH.Istanbul Medeniyet UniversityIstanbul Medeniyet University [TSA-2013-401]This study was supported by Research Fund of Istanbul Medeniyet University (Project Number: TSA-2013-401)

Serum ve idrar fraktalkine düzeyinin primer kas invaziv olmayan mesane kanserinde klinik önemi

Objective: Fractalkine is a chemotactic agent that shows both tumorogenic and anti-tumorogenic activity in some cancer types. In this study, we investigated the role of fractalkine in the diagnosis, progression and recurrence of primer non-muscle-invasive bladder cancer (NMIBC) and compared it with the healthy population. Methods: Overall, 84 people that consisted of 44 cases with primary NMIBC and 40 healthy controls enrolled for this study. Blood and urine samples were collected and fractalkine levels were measured by the ELISA method. Urinary creatinine levels were calculated and urinary fractalkine levels were optimized. Demographic data, tumor stage (Ta, T1), grade (low and high), number of tumors, tumor size, recurrence and progression status of patients were recorded. NMP22 test was performed on the patient group and urine cytology was sent from the patients. Fractalkine levels and subgroup analyses were compared between two groups. Results: The mean age of patients was 63.9±11.1 and 62.3±9.6 in the control group. The mean urinary fractalkine level was7.8±0.9 ng/ml in the study group and 7.7±0.6 ng/ml in the control group; there was no statistically significant difference between the two groups (p=0.426). Mean urinary fractalkine/creatinine level was similar between the study group and control group (16.0±32.2 ng/mgCr and 11.1±7.0 ng/mgCr, respectively, p=0.781). Mean serum fractalkine level was 2.9±1.2 ng/ml in the study group and 2.9±0.7 ng/ml in the control group; there was not a statistically significant difference (p=0.183). Also, we could not find any relation of fractalkine levels with tumor size, number, recurrence and progression. NMP 22 test was positive in half of the study group and Fractalkine levels were higher in the patients that NMP22 tests were negative that was statistically significantly. Cytology was positive for 45.5% of patients, but there was not any statistical correlation between fractalkine levels and cytology. Conclusion: In this study, we did not find a significant difference concerning serum and urinary fractalkine level between the two groups. These findings do not support the use of fractalkine as a biomarker for bladder cancer diagnosis and follow-up.Amaç: Fraktalkine, bazı kanser tiplerinde hem tümörojenik hem de anti-tümoörojenik aktivite gösteren bir kemotaktik ajandır. Bu çalışmada, fraktalkinenin primer kas invaziv olmayan mesane kanserinde tanı, nüks ve progresyondaki rolünü araştırdık. Gereç ve Yöntem: Çalışmaya primer kas invaziv olmayan mesane kanseri tanısı konulan 44 hasta ve sağlıklı kontrol grubu olan 40 kişi olmak üzere toplam 84 kişi alındı. Kan ve idrar örnekleri toplandı ve fraktalkine düzeyi ELISA yöntemi ile değerlendirildi. İdrar kreatinin düzeyleri hesaplanıp idrar fractalkine düzeyi optimize edildi. Demografik veriler, tümör evresi (Ta, T1), derecesi (düşük, yüksek), sayısı, boyutu ve rekürrens, progresyon durumu kaydedildi. Fraktalkine düzeyleri ve alt grup analizleri her iki grup arasında karşılaştırıldı. Hasta grubuna NMP22 test yapıldı ve hastalardan idrar sitolojisi gönderildi. Bulgular: Hasta grubun ortalama yaşı, 63.9±11.1, kontrol grubunda ise 62.3±9.6 idi. Ortalama idrar fraktalkine düzeyi hastalarda 7.8±0.9 ng/ ml ve kontrol grubunda 7.7±0.6 ng/ml olup iki grup arasında istatistiksel anlamlı fark izlenmedi (p=0.426). Ortalama idrar fraktalkine/kreatinin değeri iki grup arasında benzerdi (sırasıyla, 16.0±32.2 ng/mgCr ve 11.1±7.0 ng/mgCr, p=0.781). Ortalama serum fraktalkine düzeyi hasta grubunda 2.9±1.2 ng/ml ve sağlıklı kontrol grubunda 2.9±0.7 ng/ml olup, iki grup arasında istatistiksel anlamlı fark izlenmedi (p=0.183). Aynı zamanda, fraktalkine düzeyi ile tümör boyutu, sayısı, nüks ve progresyon durumu arasında ilişki tespit edilmedi. Fraktalkine düzeyi NMP22 test pozitif hastalarda negatif olanlara göre istatiksel anlamlı olarak daha yüksekti. Sitoloji hastaların %45.5’inde pozitifti fakat fraktalkine değerleriyle istatiksel anlamlı bir ilişki görülmedi. Sonuç: Bu çalışmada, her iki grup arasında serum ve idrar fraktalkine düzeyi benzer bulunmuş olup, fraktalkinenin primer mesane kanserli hastalarda biomarker olarak kullanılamayacağı gösterilmiştir

Pseudoherpetiform Presentation of Grover&apos;s Disease: A Rare Presentation

Abstract Observation: Grover&apos;s disease is a common pruritic skin disease which is also known as persistent and transient achantolytic dermatosis. It is characterised by crusted, pruritic, erythematous papulovesicular eruption and more common in Caucasians, males and usually seen after fourth decade. Lesions may persist for years. Differential diagnosis is made by numerous prurutic papulovesicular diseases. We want to present a 28-year-old female patient with relapsing, crusted, reddish to brown 3-5 mm papulovesicular lesions on her chest and back. She was misdiagnosed as recurrent herpes simplex infection before and systemic acyclovir was precribed but she was resistant to this therapy. Histopathological examination was consistent with Grover&apos;s disease. We want to remind Grover&apos;s disease in differential diagnosis of relapsing papulovesicular eruptions