The clinicopathologic observation, c-KIT gene mutation and clonal status of gastrointestinal stromal tumor in the sacrum

<p>Abstract</p> <p>Background</p> <p>It is very rare that gastrointestinal stromal tumor (GIST) occurs in the sacrum. Only one case of GIST occuring in the sacral region, with intracranial metastasis, has been reported in the literature. Moreover, only few cases have been published in literature about its clonal origin.</p> <p>Case presentation</p> <p>In this report, we present a rare case of GIST occuring in the sacrum and describe its clinicopathologic features, c-KIT gene mutation and clonal status. Microscopically, the lesion was composed of spindle cells arranged in cords, knitted and whirlpool patterns. Trabecula of bone were found in the lesion. The cytoplasm of tumor cells were abundant, and the nuclei were fusiform. Mitotic figures were rare. Immunohistochemically, the tumor cells showed positive reactivity for CD117 and CD34. On mutation analysis, a c-KIT gene mutation was found in exon 11. The result of clonal analysis demonstrated that the GIST was monoclonal.</p> <p>Conclusion</p> <p>In summary, we showed that tumor material, phenotypically identical with GISTs was found in the sacrum. It is difficult to differentiate GISTs from other spindle cell tumors, hence the need for immunohistochemistry, the examination of c-KIT gene amplification and sequencing.</p

Enthesitis and its relationship with disease activity, functional status, and quality of life in psoriatic arthritis: a multi-center study

PMID = 3177339

patients with axial psoriatic arthritis

Objectives In this study, we aimed to evaluate the effect of gender on clinical findings, disease activity, functional status and quality of life in patients with axial involvement in Turkey. Methods Patients with PsA who met the CASPAR classification criteria were enrolled consequently in this cohort. Turkish League Against Rheumatism (TLAR)-Network was formed with the participation of 25 centres. The demographic variables, fatigue, diagnostic delay, the beginning of peripheral arthritis, enthesitis, dactylitis and spine involvement, inflammatory low back pain, BASFI, HAQ, HAQ-s, visual analogue scale-pain (VAS-pain), anxiety, depression and disease activity parameters (ESR, DAS28, BASDAI) were recorded. Axial involvement was assessed according to clinical and radiological data according to modified New York (MNYC) or Assessment of SpondyloArthritis international Society (ASAS) criteria. Results A total of 1018 patients with PsA were included in this study. Of the 373 patients with axial involvement, 150 were male (40.2%) and 223 (59.8%) were female. Spondylitis was detected in 14,7% of men and 21,9% of women in all patients. Pain score (VAS) (p < .002), fatigue (p < .001), ESR (p < .001), DAS28 (p < .001), BASDAI score (p < .001), PsAQoL (p < .001), HAQ score (p < ,01), HAQ-S score (p < .001), anxiety (p < .001), depression (p < .024), FACIT (p < .001) and FiRST (p < .001) scores were statistically significantly worse in women than males with axial PsA. However, quality of life was better (p < .001) and PASI score (p < .005) were statistically worse in male patients than in female patients with axial involvement. Conclusion This study has shown that the burden of disease in axial PsA has significant difference between genders. Disease activity, physical disability, functional limitation, depression and anxiety scores were higher in female patients, while quality of life were better and PASI score were higher in male patients. Therefore, we suggest that new strategies should be developed for more effective treatment of axial PsA in female patients.C1 [Nas, Kemal; Tekeoglu, Ibrahim; Baykul, Merve; Kamanli, Ayhan] Sakarya Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol & Immunol, Sakarya, Turkey.[Kilic, Erkan] Kanuni Training & Res Hosp, Rheumatol Clin, Trabzon, Turkey.[Keskin, Yasar; Kucukakkas, Okan; Yurdakul, Ozan Volkan] Bezmialem Fdn Univ, Dept Phys Med & Rehabil, Istanbul, Turkey.[cevik, Remzi] Dicle Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Diyarbakir, Turkey.[Sargin, Betul; Sendur, Omer Faruk] Adnan Menderes Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Aydin, Turkey.[Acer Kasman, Sevtap; Duruoz, Mehmet Tuncay] Marmara Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Istanbul, Turkey.[Alkan, Hakan] Pamukkale Univ, Sch Med, Dept Phys Med & Rehabil, Denizli, Turkey.[Sahin, Nilay] Balikesir Univ, Sch Med, Dept Phys Med & Rehabil, Balikesir, Turkey.[Cengiz, Gizem] Univ Hlth Sci, Van Training & Res Hosp, Rheumatol Clin, Van, Turkey.[Cuzdan, Nihan] Balikesir Ataturk City Hosp, Rheumatol Clin, Balikesir, Turkey.[Albayrak Gezer, Ilknur] Selcuk Univ, Sch Med, Dept Phys Med & Rehabil, Konya, Turkey.[Keskin, Dilek] Kirikkale Univ, Sch Med, Dept Phys Med & Rehabil, Kirikkale, Turkey.[Mulkoglu, Cevriye] Ankara Numune Training & Res Hosp, Dept Phys Med & Rehabil, Ankara, Turkey.[Resorlu, Hatice] Canakkale Onsekiz Mart Univ, Sch Med, Dept Phys Med & Rehabil, Canakkale, Turkey.[Ataman, Sebnem] Ankara Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Ankara, Turkey.[Bal, Ajda] Univ Hlth Sci, Diskapi Yildirim Beyazit Training & Res Ho, Dept Phys Med & Rehabil, Ankara, Turkey.[Alkan Melikoglu, Meltem] Ataturk Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Erzurum, Turkey.[Ayhan, Fikriye Figen] Atilim Univ, Med Sch, Dept Phys Med & Rehabil, Ankara, Turkey.[Bodur, Hatice] Yildirim Beyazit Univ, Sch Med, Dept Phys Med & Rehabil, Ankara, Turkey.[Calis, Mustafa] Erciyes Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Kayseri, Turkey.[Capkin, Erhan] Karadeniz Tech Univ, Sch Med, Dept Phys Med & Rehabil, Trabzon, Turkey.[Devrimsel, Gul] Recep Tayyip Erdogan Univ, Sch Med, Dept Phys Med & Rehabil, Rize, Turkey.[Gok, Kevser] Ankara City Hosp, Rheumatol Clin, Ankara, Turkey.[Hizmetli, Sami] Cumhuriyet Univ Sivas, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Sivas, Turkey.[Kocabas, Hilal] Necmettin Erbakan Univ, Meram Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Konya, Turkey.[Kutluk, Oznur; Tuncer, Tiraje] Akdeniz Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Antalya, Turkey.[Sen, Nesrin] Kartal Dr Lutfi Kirdar Training & Res Hosp, Dept Rheumatol, Istanbul, Turkey.[Toprak, Murat] Yuzuncu Yil Univ, Sch Med, Dept Phys Med & Rehabil, Van, Turkey.[Tolu, Sena] Medipol Univ, Sch Med, Dept Phys Med & Rehabil, Istanbul, Turkey