Symptomatic Solid Ectopic Cervical Thymus in a 2-Month-Old Infant: Case Report

Ectopic cervical thymus (ECT) is a rare pediatric pathology usually with an asymptomatic course. In fewer cases, the patient may present with dyspnea, hoarseness, stridor, dysphagia and pain. The mass may present in cystic or solid forms. Solid forms are rare, constituting only 10% of all ECT cases and these are mostly symptomatic. We aimed to present the case of an infant with ECT in the submandibular region that led to shortness of breath. ECTs in the submandibular region are mostly solid and larger in size, and therefore, likely to result in compressive symptoms. In this case report, we tried to cover the important aspects of the diagnosis of ECT, its treatment, and discussed the results with a literature review. We additionally aimed to emphasize the importance of considering pediatric ECT in the differential diagnosis of pediatric neck mass as well as considering surgical excision to prevent serious consequences

Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision

Bir servikal travma olgusunda ilginç direkt grafi ve bilgisayarlı tomografi görüntüleri

WOS:000369324400017PubMed ID: 27135086Acil servise düşme veya motorlu taşıt kazası sonrası bilinç kaybıyla gelen olguların yaklaşık %5-10'unda servikal vertebra kırığı ve kord hasarlanması vardır. Tanıda görüntüleme yöntemleri özellikle bilgisayarlı tomografi (BT) ve direkt grafi önemli role sahiptir. Amacımız C3-4 dislokasyonu ve dist-raksiyonu olan ve shearing hasarlanma olarak adlandırılan servikal travma olgusunda ilginç BT ve direkt grafi bulgularını tanımlamaktır. C3-4 vertebra korpusları arasında hematom nedeniyle belirgin genişleme görülmüştür fakat kırık hattı ve majör vasküler yaralanma saptanmamıştır. Görüntüler oldukça ilginçti. Ayrıca klinik değerlendirmede NEXUS ve Kanada kuralları dikkate alınmıştır. Görüntüleme yöntemleri özellikle de reformat BT görüntüleri hasarın ne olduğu ve nerede olduğunu bulmada kolaylık sağlar.Patients admitted to emergency departments with loss of consciousness following trauma often have cervical vertebrae fractures and spinal cord injuries with a ratio of 5-10%. Computed tomography (CT) and radiography are important for diagnosis. The aim of this study was to describe the interesting CT and radiography findings of a patient who had C3-4 dislocation anddistraction that was called shearing injury. C3 and C4 were seperated, but there was no fracture or major vascular injuries. Images were interesting. NEXUS and Canadian Rules were also referred to for clinical evaluation. Imaging modalities, espacially reformatted CT images, make it easier to diagnose where and what the problem is

Breast Lesions Detected on Computed Thorax Tomography

Amaç: Mamografi memenin primer görüntüleme yöntemi olmasına kar- şılık, değişik patolojileri saptamak amacıyla çekilen bilgisayarlı tomografilerde insidental (rastlantısal) benin ya da malin meme lezyonlarıyla giderek daha sık karşılaşılmaktadır. Dolayısıyla bu lezyonların saptanması ve doğru tanımlanması önem kazanmıştır. Bu çalışmada meme dışı patolojiler için çekilen bilgisayarlı tomografilerde saptanan insidental meme lezyonlarının sıklığını, morfolojik özelliklerini ve sonuçlarını değerlendirmeyi amaçladık. Yöntem ve Gereçler: Bölümümüzde 2011-2013 tarihleri arasında çekilen bilgisayarlı tomografilerde insidental saptanan meme lezyonları de- ğerlendirildi. Daha önce tanı konmuş meme lezyonu olan hastalar çalışma dışında bırakıldı. Histopatolojik tanısı olan ya da en az 2 yıl boyunca takip edilmiş hastalar çalışmaya alındı. Bulgular: Çalışma grubunu oluşturan ortalama 551,38 yaşındaki (aralık 37-78 yıl) toplam 33 kadının 12sinde (%36) malin, 21inde (%64) benin ya da normal bulgular saptandı. En sık saptanan patoloji malin lezyonlar arasında invaziv duktal karsinom, benin lezyonlarda ise fibroadenomdu. En önemli bilgisayarlı tomografi bulgusu, malin lezyonlarda düzensiz kontur yapısı ve lenfadenopati varlığı, benin lezyonlarda ise düzgün kontur yapısıydı. Sonuç: Bilgisayarlı tomografi incelemelerde kesite girdiğinde meme mutlaka dikkatli bir şekilde değerlendirilmelidir. Meme lezyonlarının uygun şekilde raporlanması erken tanı ve tedaviye olanak sağlayacaktır.Objective: Although mammography is the primary imaging method of the breast, incidental benign and malignant breast lesions are increasingly being detected on computed tomographies (CTs) performed to detect different pathologies. Therefore, the detection and accurate identification of these lesions is important. In this study, we aimed to evaluate the frequency, morphological features, and results of incidental breast lesions on CTs performed for the detection of extramammarian pathologies. Materials and Methods: Incidental breast lesions on CTs performed in our department between 2011 and 2013 were evaluated. Patients who had previously diagnosed breast lesions were excluded from the study. The inclusion criteria were histopathologic diagnose and being followed -up for at least 2 years. Results: The study population consisted of 33 women whose mean age was 55±1.38 (3778) years. Of the 33 women, 12 (36%) had malignant and 21 (64%) had benign or normal findings. The most common malignant lesion was invasive ductal carcinoma, and the most common benign lesion was fibroadenoma. Ill-defined contour and lymphadenopathy in malignant lesions and well-defined contour in benign lesions were the most important CT findings. Conclusion: Breasts must be carefully evaluated if it is included in the scans. An accurate report of breast lesions gives an opportunity for early diagnosis and treatment

Detection of microcalcification in digitized mammograms with multistable cellular neural networks using a new image enhancement method: automated lesion intensity enhancer (ALIE)

WOS:000352476800017Abstract: Microcalcification detection is a very important issue in early diagnosis of breast cancer. Generally physicians use mammogram images for this task; however, sometimes analyzing these images become a hard task because of problems in images such as high brightness values, dense tissues, noise, and insufficient contrast level. In this paper, we present a novel technique for the task of microcalcification detection. This technique consists of three steps. The first step is focused on removing pectoral muscle and unnecessary parts from the mammogram images by using cellular neural networks (CNNs), which makes this a novel process. In the second step, we present a novel image enhancement technique focused on enhancing lesion intensities called the automated lesion intensity enhancer (ALIE). In the third step, we use a special CNN structure, named multistable CNNs. After applying the combination of these methods on the MIAS database, we achieve 82.0% accuracy, 90.9% sensitivity, and 52.2% specificity values

Memenin fillodes tümörlerinde cerrahi tedavi: tek merkez deneyimi

Amaç: Memenin fillodes tümörü nadir görülen fibroepitelyal bir tümördür. Bu çalışmada memenin fillodes tümörü tanılı hastalarımızın klinikopatolojik bul- gularını ve tedavi yaklaşımımızı sunmayı amaçladık. Yöntem ve Gereçler: Kliniğimizde 2003-2011 yılları arasında memenin fillodes tümörü nedeniyle tedavi gören 9 hastanın tıbbi kayıtları geriye dönük olarak incelendi. Bulgular: Hastaların ortanca yaşı 38 (20-70) yaş olarak saptanmıştır. Hastala- rın tümünün başvuru şikayeti memede ele gelen kitle idi. Hastalardan altısına kalın-iğne biyopsi, ikisine eksizyonel biyopsi, birine de ince iğne aspirasyon bi- yopsisi (İİAB) ile tanı konuldu. Ortalama tümör büyüklüğü 9.3 (4-20) cm olarak hesaplandı. İki hasta dışında tüm olgulara cerrahi sınır negatif olacak şekilde lokal eksizyon uygulandı ve adjuvan ek bir tedavi verilmedi. İki hastadan birine mastektomi, diğerine ise modifiye radikal mastektomi işlemi uygulandı. Has- talar ortalama 43 (5-95) ay takip edildi. Takip süresince hastalarda memede nüks saptanmadı. Sonuç: Bu olgularda preoperatif tanı cerrahi yaklaşımı belirlemek açısından önemlidir. Ayırıcı tanıda yapılan ultrasonografi ve mamografi gibi radyolojik tetkiklerde bu tümörleri fibroadenomdan ayırt etmek zordur. Doku biyopsisi ile tanıya gitmek mümkündür. Sonuç olarak, fillodes tümörler genellikle klinik ve patolojik olarak selim olduğundan tüm hastalarda sınır negatif olacak şekil- de cerrahi yaklaşım düşünülmelidir.Objective: Phyllodes tumor of the breast is a rare fibroepithelial tumor. In this study, our aim is to present the clinicopathological characteristics of our patients diagnosed with phyllodes tumor of the breast and our treatment ap- proach to the cases. Materials and Methods: The medical records of a total of 9 patients who had been treated at our clinic between 2003 and 2011 for phyllodes tumor were analyzed retrospectively. Results: The median age of the patients was 38 (20-70) years. The presenting complaint of all patients was a palpable mass in the breast. Six of the patients were diagnosed by tru-cut biopsy, two were diagnosed through excisional bi- opsy, and one was diagnosed through fine- needle aspiration biopsy (FNAB). Median tumor size was 9.3 (4-20) cm. Local excision was performed on all but two patients so as to have the surgical border negative and no adjuvant addi- tional treatment was initiated. Mastectomy was performed for one of the two patients and modified radical mastectomy was performed for the other. The follow-up period of the patients was an average of 43 (5-95) months. No breast recurrences were seen during the follow-up period. Conclusion: Pre-operative diagnosis is important for these cases in order to determine the surgical approach. It is difficult to differentiate these tumors from fibroadenoma by ultrasonography and mammography. It is possible to diagnose patients through tissue biopsy. In conclusion, a surgical approach with negative margins for all patients should be taken into consideration since phyllodes tumors are generally benign both clinically and pathologically

Primary Neuroendocrine Carcinoma of the Breast: A Report of Three Cases

Primary neuroendocrine carcinoma of the breast is extremely rare. More than 97% of neuroendocrine tumors occur in the gastrointestinal and respiratory tracts. Three cases that have been operated in our clinic and had a diagnosis of primary neuroendocrine carcinoma of the breast were assessed, along with literature data. Histopathological diagnoses were obtained by preoperative core needle biopsy. Breast-conserving surgery was performed in two cases, and modified radical mastectomy in one. In all cases, immunohistochemical studies were positive for neuron-specific enolase and synaptophysin. All patients received adjuvant chemotherapy (CT) and one patient received additional radiotherapy (RT). Recurrence or distant metastasis was not detected during long-term follow-up after surgery.Memenin primer nöroendokrin karsinomları oldukça nadirdir. Nöroendokrin tumorlerin %97’den fazlası gastrointestinal ve solunum sisteminde ortaya çıkar. Kliniğimizde memenin primer nöroendokrin karsinomu nedeniyle opere edilen üç olgu literatür eşliğinde değerlendirildi. Ameliyat öncesi histopatolojik tanılar kalın iğne biyopsisi ile kondu. İki olguya meme koruyucu cerrahi, birine de modifiye radikal mastektomi işlemi uygulandı. Tüm olgularda immünhistokimyasal çalışmalarda nöron spesifik enolaz ve sinaptofizin pozitifliği görüldü. Olguların tümüne adjuvan tedavide kemoterapi (KT) verilmiş olup bir olguda ayrıca radyoterapi (RT) uygulandı. Ameliyat sonrası uzun dönem takiplerinde nüks ya da uzak metastaz saptanmadı