A huge ovarian mucinous cystadenoma causing virilization, preterm labor, and persistent supine hypotensive syndrome during pregnancy

Mucinous cystadenoma (MC) of the ovary is an unilateral, multilocular cystic benign epithelial tumor. Supposed to be hormone responsive, MC reaches huge sizes during pregnancy. Aortocaval compression is common during pregnancy, especially when the pregnant woman is in the supine position. However, the compression recovers with a change in position. The authors report the first case of a huge mucinous cystadenoma of the ovary complicating pregnancy and causing virilization, premature labor, and persistent supine hypotensive syndrom

A huge ovarian mucinous cystadenoma causing virilization, preterm labor, and persistent supine hypotensive syndrome during pregnancy

Mucinous cystadenoma (MC) of the ovary is an unilateral, multilocular cystic benign epithelial tumor. Supposed to be hormone responsive, MC reaches huge sizes during pregnancy. Aortocaval compression is common during pregnancy, especially when the pregnant woman is in the supine position. However, the compression recovers with a change in position. The authors report the first case of a huge mucinous cystadenoma of the ovary complicating pregnancy and causing virilization, premature labor, and persistent supine hypotensive syndrom

Comparison of cortico-medullary phase contrast-enhanced MDCT and T2-weighted MR imaging in the histological subtype differentiation of renal cell carcinoma : radiology-pathology correlation

Purpose: Renal cell carcinoma (RCC) subtype differentiation is of crucial importance in the management and prognosis of these patients. In this study, we investigated the usefulness of unenhanced and cortico-medullary phase contrastenhanced multidetector-row computed tomography (MDCT) and T2-weighted fast spin-echo (FSE) magnetic resonance imaging (MRI) modalities in the discrimination of the 3 main subtype RCC patients in correlation with their histopathological findings. Material and methods: A total of 80 pathologically proven RCC patients who had undergone either partial or total nephrectomy were retrospectively investigated in this study. Their histological subtypes were 54 clear cell renal cell carcinoma (ccRCC), 15 papillary renal cell carcinoma (pRCC), and 11 chromophobe renal cell carcinoma (cRCC), based on pathological evaluation. There were 62 male (77.5%) and 18 female (22.5%) patients. Among the 54 ccRCC patients, 29 patients had both non-contrast and cortico-medullary phase CT, 1 had only non-contrast CT, 5 only had cortico-medullary phase CT, and 38 had MRI examination. In the pRCC group, 10 patients had both non-contrast and cortico-medullary phase CT, 1 had only non-contrast CT, 1 had only cortico-medullary phase CT, and 12 had MRI. Finally, in the remaining 11 cRCC patients, 9 had both non-contrast and cortico-medullary phase CT, and only 5 had MRI. We calculated both tumour attenuation values as HU (Hounsfield units) on unenhanced and cortico-medullary phase MDCT images and also tumour mean signal intensity values on FSE T2-weighted MRI images by using the region of interest (ROI) including normal renal cortex measurements. Besides quantitative evaluation, we also performed qualitative visual assessment of tumours on contrast-enhanced MDCT and FSE T2-weighted MRI. Results: There was no statistically significant difference among the attenuation values of the 3 tumour subtypes on pre-contrast CT images. ccRCC demonstrated a prominent degree of contrast enhancement compared to the chromophobe and papillary ones on cortico-medullary phase MDCT. We found no statistically significant difference between chromophobe and papillary subtypes, although chromophobe tumours showed slightly higher attenuation values compared to papillary ones. ccRCCs usually demonstrated a heterogenous contrast enhancement on corticomedullary phase CT images, while the papillary subtype usually had a homogenous appearance on visual assessment. On FSE T2-weighted MR images, the signal intensity values of ccRCC patients were found to be significantly higher than both chromophobe and papillary subtypes. Although cRCC patients had a prominently lower T2 signal intensity than clear cell subtype, there was no statistically significant signal intensity difference between chromophobe and papillary subtypes. Regarding visual assessment, papillary subtype tumours showed a mostly homogenous appearance on T2-weighted images and a statistically significant difference was present. On the other hand, there was no significant difference of visual assessment of the clear cell and chromophobe subtypes

Tissue Reaction of the Rat Urinary Bladder to Synthetic Mesh Materials

The aim of this study was to assess urinary bladder histopathology induced by the sling materials tension-free vaginal tape (TVT), vypro mesh, and intravaginal slingplasty (IVS). Thirty rats were studied: sham-operated controls, TVT, vypro, and IVS groups. After laparotomy, a 0.5- x 1-cm piece of mesh was implanted on the anterior bladder wall. The bladder was examined histopathologically after 12 weeks. Inflammation, foreign-body reaction, subserosal fibrosis, necrosis, and collagen deposition were graded. The Kruskal-Wallis and posthoc Dunn tests were used. The sham-operated rats showed no tissue reactions. The TVT, vypro, and IVS groups showed increased inflammation (p = 0.006, p = 0.031, p = 0.001), subserosal fibrosis (p = 0.0001), foreign-body reaction (p = 0.0001), and collagen deposition (p = 0.0001) as compared to sham. Inflammation was more intense in the IVS group as compared to the TVT and vypro groups (p = 0.041, p = 0.028). The bladder presented more increased inflammatory response to IVS than the other meshs. This may play a role in the ultimate outcomes or complications from slings

Amyloidosis in a Patient With Congenital Neutropenia Because of G6PC3 Deficiency

Glucose-6-phosphatase catalytic subunit 3 (G6PC3) deficiency is a recently identified form of congenital neutropenia associated with developmental anomalies. The severity of neutropenia and the clinical spectrum are highly variable. Aside from infectious complications and extrahematologic features, inflammatory bowel disease and autoinflammatory complications are less frequently observed manifestations. However, amyloidosis has never been reported in G6PC3 deficiency. Here, we present a 12-year-old patient with incidentally discovered neutropenia because of the p.E65A (c.194A>C) variant of the G6PC3 gene. He had recurrent aphthae and abdominal pain episodes, and developed nephrotic-range proteinuria, amyloidosis, and end-stage renal failure during follow-up

EVALUATION OF CLINICOPATHOLOGICAL FINDINGS OF 513 KIDNEY BIOPSIES

Objective: Kidney biopsy is performed for the diagnosis and the decision of treatment of renal parenchymal diseases. The aim of this study was to evaluate the clinicopathological findings of kidney biopsies

Renal Involvement in AA Amyloidosis: Clinical Outcomes and Survival

Background: The natural history of AA amyloidosis is typically progressive, leading to multiple organ failure and death. We analyzed the etiology as well as clinical and laboratory features of patients with biopsy-proven AA amyloidosis and evaluated the ultimate outcome. Methods: Seventy-three patients (24 female; mean age 41.85±15.89 years) were analyzed retrospectively. Demographic, clinical and laboratory features were studied and the outcome was assessed. Results: Familial Mediterranean Fever and tuberculosis were the most frequent causes of amyloidosis. Mean serum creatinine and proteinuria at diagnosis were 4.65±4.89 mg/dl and 8.04±6.09 g/day, respectively; and stage I, II, III, IV and V renal disease were present in 19.2%, 13.7%, 16.4%, 11%, and 39.7% of the patients, respectively. ESRD developed in 16 patients during the follow-up period. All of the ESRD patients started a dialysis programme. Thirty patients (41%) died during the follow-up period; median patient survival was 35.9±6.12 months. Old age, tuberculosis etiology, advanced renal disease and low serum albumin levels were associated with a worse prognosis. Serum albumin was a predictor of mortality in logistic regression analysis. Conclusion: The ultimate outcome of the patients with AA amyloidosis is poor, possibly due to the late referral to the nephrology clinics. Early referral may be helpful to improve prognosis

Polypoid Lesions of Gallbladder: Retrospective Analysis of 99 Cases.

Purpose: Polypoid lesions of gallbladder are originated from gallbladder mucosa. In the current study, it has been aimed to evaluate clinically and histopathologically the polypoid lesions of cholecystectomy cases in ten years. Materials and Methods: In our clinic 4479 cholecystectomy cases between June 2004 and June 2014 have been retrospectively investigated for the polypoid lesions clinically and histopathologically. Results: In 4479 cholecystectomy cases, 99 (2.2%) included polypoid lesions. Abdominal pain has been the major symptom. In the histopathologic evaluation, 42 cholesterol polyps, 2 inflamatuar polyps, 2 hyper plastic polyps, 2 intestinal type adenoma, 18 adenomyoma, 29 adenomyomatous hyperplasia 1 pyloric gland adenoma, 1 musinous cyst adenoma, 1 tubular adenoma, 1 well-differentiated papillary adenocarcinoma have been determined. Conclusion: A retrospective analysis has been performed for the polypoid lesions of the cholecystectomy clinically and histopathologically. [Cukurova Med J 2015; 40(3.000): 452-456

Serum Heat Shock Protein Levels in IgA Nephropathy

Background: The family of heat shock proteins (HSPs) contains several members that regulate the cell response to any hazardous factors to protect protein structure. The aim of the study was to determine whether serum levels of HSPs increase in children with IgA nephropathy/Immunoglobulin A-associated vasculitis nephritis (IgAN/IgAVN) and to assess their relationship with the prognostic factors