Leukemia Cutis and Second Primary Malignant Melanoma: An Extraordinary Case Report

Introduction: Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is the most common leukemia of adult. Patients with CLL/SLL are at higher risk for secondary malignancies such as skin, breast or lung tumours. Cutaneous infiltrates of CLL/SLL have been reported in association with squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and actinic keratosis.Case Presentation: We present a patient with a previous history of CLL/SLL who developed a primary skin melanoma in the same area of leukemic infiltration, with the histological and immunohistochemical features.An 80-year-old man presented with an 3 cm nonpigmented, erythematous and ulcerated plaque on the abdomen. Microscopically, a primary melanoma with an ulcer and skin infiltration of CLL/SLL at the ulcer base was seen.Conclusion: Secondary cutaneous neoplasms can develop in patients with CLL/SLL and CLL/SLL infiltration can be associated with melanoma as in our case. The finding of a dense infiltrate of lymphocytes in cutaneous tumors should raise possibility of CLL/SLL and lead to a detailed examination

Evaluation of case series of delayed tularaemia

Tularemia is a zoonotic disease caused by the gram-negative bacterium Francisella tularensis. Clinical suspicion is extremely important and serology is the gold standard for diagnosis. The oropharyngeal form of tularemia in Turkey takes the form of outbreaks or sporadic cases. Delay in diagnosis is the major factor in complications. Five delayed cases of tularemia in the Marmara region of Turkey are described in this paper between 2009-2015 years. All patients’ diagnoses were confirmed with serology, and all had LAP on their neck regions. The lymphadenopathies persisted despite medical treatment four being excised by Ear Nose and Throat Clinic (ENT). Tularemia must be considered in the evaluation of masses on the neck, particularly in endemic areas. The most important factor in the successful management of tularemia is early initiation of treatment. The risk of suppuration and surgical interventions increases in delayed cases

Clinical Approach to Ocular Cicatricial Pemphigoid

Objectives:To evaluate the demographic data, ocular and systemic findings, clinical management, and outcomes of patients with ocular cicatricial pemphigoid (OCP).Materials and Methods:The medical records of 11 patients diagnosed as having OCP in the ophthalmology department of Ege University between 2008 and 2021 were evaluated retrospectively.Results:The patients’ mean follow-up time was 14±5.76 months. All eyes (100%) had conjunctival involvement and 18 (81.81%) had corneal involvement. According to the Tauber staging system, 7 (31.81%), 8 (36.36%), and 7 (31.81%) of the eyes were stage 2, 3, and 4, respectively. The diagnosis was confirmed in 6 (66.66%) of 9 patients who underwent biopsy. Amniotic membrane transplantation was performed in 7 eyes, entropion surgery in 2 eyes, and electrocauterization for trichiasis in 5 eyes. Systemic involvement was observed in 45.45% (5/11) of patients, most commonly oral mucosal involvement (18.18%). Review of medical records showed that alkylating agents, steroids, and dapsone were used in patients treated before 2020. Mycophenolate mofetil was preferred to be used in combination with corticosteroids. Although treatment responses before mycophenolate mofetil usage could not be evaluated well because of loss to follow-up, 4 (66.66%) of 6 patients who received steroid treatment combined with mycophenolate mofetil showed partial or complete clinical remission. No serious side effects and drug withdrawal were observed.Conclusion:OCP is a sight-threatening autoimmune disease that affects older adults. Although positive biopsy results are valuable for diagnosis, negative results do not exclude the diagnosis. The main treatment is systemic immunosuppressives. Disease activity can be suppressed, especially with early initiation of drug therapy. These patients require a multidisciplinary approach. Especially in the presence of isolated ocular findings, ophthalmologists should be able to make the decision to start immunosuppressive treatment, and systemic treatment should not be delayed

İğsi ve / veya epiteloid hücreli nevus (spitz nevus)

1959-1995 yıllan arasında E.Ü. Tıp Fakültesi Patoloji Anabilim Dalı'na gelen melanositik lezyonlar arasında 18 Spitz nevus, Spitz nevus ile kıyaslanabilir özellikte 18 MM ve Spitz nevusa aykırı bazı yönleri olan 8 ara olgu histopatolojik parametreler ışığında karşılaştırıldı. Spitz nevus olgularının dokuzu kadın, dokuzu erkek idi. Yaş dağılımı 5 ile 51 arasında değişiyordu ve ortalama 21.3 bulundu. En sık yerleşim yeri %41 ile yüz ve %24 ile alt ekstremite idi. Tümör çapı 3 mm ile 11 mm arasında değişiyordu ve ortalama çap 5.5 mm bulundu. Dizilim özellikleri, hücresel özellikler ve çevre doku değişiklikleri olmak üzere üç ana grup altında toplanan bir grup histopatolojik parametre kırkdört olgunun tümünde araştırıldı. Bu parametreler arasında ekspansiv nodul, poliklonalite, belirgin pajetoid yayım, derin veya atipik mitoz ve kaba kromatin MM lehine, matürasyon ve Kamino cismi Spitz nevus lehine öne çıkan bulgulardır. Yedi Spitz nevus, altı ara olgu ve sekiz MM olgusuna AgNOR yöntemi uygulandı ve Spitz nevus ile ara olguların değerleri birbirine yakındı ve bu iki grup ile MM arasındaki fark istatistiksel olarak anlamlı bulundu (p = 0.0036). öne çıkan histopatolojik parametreler ve AgNOR değerleri ışığında I, II, III, IV, VI ve VII no'lu ara olguların spektrumun Spitz nevus bölümüne yakın olduğu, V ve VIII no'lu ara olguların özellikle poliklonal ortak paydası nedeniyle MM'a yakın olduğu görüldü. 7

Tipik ve atipik hipofiz adenomlarında hormon immünreaktivite dağılımı

Objective: We aimed to assess the spectrum of hormone immunoreactivity in our pituitary adenoma cases and discuss the diagnostic parameters of atypical pituitary adenomas. Material and Methods: A total of 166 pituitary adenoma cases diagnosed from 2005 to 2008 in our department were included in the present study. Hematoxylin-eosin stained and immunohistochemistry performed slides (ACTH, PRL, GH, TSH, FSH, LH, Ki-67, and p53) were evaluated. Cases having more than two mitoses on 10 high power fields besides more than 3% Ki-67 index were accepted in the atypical group. Results: Histologically, 159 cases were typical pituitary adenoma and 7 were atypical pituitary adenoma. Of the atypical pituitary adenoma cases, one case was ACTH, one GH and one both GH and prolactin hormone immunoreactive pituitary adenomas. Four cases were hormone immunonegative adenomas. Of the typical pituitary adenoma cases, 39 cases were GH, 19 ACTH, 17 prolactin, 10 FSH, 8 LH and one TSH immunreactive pituitary adenomas. Fourty-seven cases were hormone immunonegative adenomas.Twenty-two of the all pitutary adenoma cases had recurrence. Of these cases, 18 were typical adenoma and four were atypical adenoma. Conclusion: The ratio of prolactin immunoreactive pituitary adenoma cases in the surgical material of neuropathology is decreasing due to medical therapy. Atypical pituitary adenomas are not the sole factor affecting the recurrence mechanism but these tumors have higher recurrence rate compared with typical pituitary adenomas and we think the proliferation index might be the principal approach in the diagnosis of these lesions.Amaç: Hipofiz adenomu olgularımızın hormon immünreaktivite dağılımını ve atipik hipofiz adenomu tanı kriterlerinin tartışılmasını amaçladık. Gereç ve Yöntem: Bu çalışmaya 2005-2008 yılları arasında Anabilim Dalımızda hipofiz adenomu tanısı alan 166 olgu dahil edildi. Olguların hematoksilen-eozin ve immünhistokimya uygulanan preperatları (ACTH, PRL, GH, TSH, FSH, LH, Ki-67 ve p53) tekrar gözden geçirildi. 10 büyük büyütme alanında ikinin üzerinde mitoz yanı sıra Ki-67 indeksi %3'ün üzerinde olan olgular atipik grupta ele alındı. Bulgular: Histolojik olarak 159 olgu tipik hipofiz adenomu, 7 olgu atipik hipofiz adenomu idi. Tipik hipofiz adenomu olgularının 39'u GH, 19'u ACTH, 17'si prolaktin, 10'u FSH, 8'i LH ve biri TSH immünreaktivitesi gösteren hipofiz adenomuydu. On sekiz olgu multihormonal adenomdu. Hormon immünreaktivite göstermeyen 47 olgu bulunmaktaydı. Atipik hipofiz adenomlarının ikisi ACTH, biri GH immünreaktivitesi gösteren hipofiz adenomuydu. Dört olgu da hormon immünreaktivitesi göstermeyen hipofiz adenomuydu. Tüm hipofiz adenomu olgularımızın 22'sinde nüks saptandı. Nüks eden olgularımızın 18'i tipik adenom, 4'ü atipik adenom idi. Sonuç: Medikal tedaviye bağlı olarak nöropatoloji cerrahi materyali içinde prolaktin reaktivitesi gösteren hipofiz adenomlarının oranı düşmektedir. Atipik hipofiz adenomları, rekürrens mekanizmasını etkileyen tek faktör değildir ancak bu tümörler tipik hipofiz adenomları ile kıyaslandığında yüksek rekürens oranına sahiptir ve biz bu lezyonların tanısında proliferasyon indeksinin temel yaklaşım olacağını düşünüyoruz

The preparation, characterization and antibacterial properties of chitosan/pectin silver nanoparticle films

Edible film production from natural biodegradable polymers that will not cause environmental waste problems has been increasing in recent years. Antibacterial materials can be added to these films to increase the shelf life and quality of products. In this work, chitosan-based and chitosan/pectin-based silver nanoparticle films which has eco-friendly and antibacterial properties were synthesized. The morphological test of the prepared films was performed by scanning electron microscope and transmission electron microscope. The presence of silver element was detected by energy-dispersive X-ray. Thermal analysis was tested with thermogravimetric analysis and differential scanning calorimeter analyzer. The crystallinity (%) of films was determined with X-ray diffraction analyzer. The presence of pectin increased the thermal stability and crystallinity%. The mechanical tests were examined with Zwick universal testing machine and the content of pectin improved the mechanical properties of film. The antibacterial test was done toward Gram-negative bacteria (Escherichia coli). Chitosan/pectin-based films compared with chitosan-based film displayed long-lasting antibacterial activity against E.coli