Santral sinir sistemi tümörlerinde proliferasyon markeri : PCNA ve Ki-67'nin tümör tipi ve histolojik grade ile korelasyonu

TEZ2528Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 1997.Kaynakça (s. 53-59) var.viii, 61 s. ; 30 cm.

Fine needle aspiration biopsy in head and neck lesions

1994-1996 döneminde ince iğne aspirasyonu (İİA) polikliniğinde bizzat patolog tarafından gerçekleştirilen 1000 İİA olgusundan 584'ü baş -boyun lezyonlarına aittir. 560 olguda (% 95,89) İİA ile tanı için yeterli materyal elde edilmiştir. Seride 383 tiroid 115 lenf nodulu, 51 cilt-cilt altı ve 35 tükrük bezi lezyonu yer almaktadır. Hastalarda İİA'na bağlı komplikasyon olmamıştır. İİA'nu takiben biyopsi uygulanan 89 olgu gözönünde bulundurulduğunda sensitivite % 78, spesifite %94'tür.Baş boyun lezyonlarında İİA sitolojisi kolay, hızlı, ekonomik ve güvenilirliği yüksek bir tanı yöntemidir, işlemin patolog tarafından gerçekleştirilmiş olması yeterli tanısal materyal elde edilme oranını, doğru sitolojik yaklaşım ve tanıya varılmasını olumlu yönde etkilemekte; gerek hasta, gereke patolog ve klinisyenler açısından çeşitli avantajlar sağlamaktadır.During a period between 1994-1996,1000 fine needle aspirations ,(FNA) were performed by the pathologist in our FNA policlinic, 584 of these cases were located in, the region of head-neck. In 560 (95,89%) of the cases adequate materials were obtained: The distribution of the cases is 383 thyroid, 115 lymphnode, 51 cutaneus-subcutaneus and 35 salivary gland. There was no complications in any of the patients. In 89 cases, which performed biopsy followed by FNA, the sensitivity is 78% and specifity is 94%. In head-neck lesions FNA cytology is a simple ,rapid, low-costed and highly reliable diagnostic method. The fact procedure is carried on by a pathologist affect the rate of satisfactory diagnostic material, correct histologic intervention and diagnosis positively, provide numerous advantages for the patient, pathologist and clinicians.

Prognostic factors in breast cancer

1990-94 yılları arasında Çukurova Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi Anabilim Dalında 185 meme kanserli olguya mastektomi sonrası adjuvan radyoterapi (RT) verildi. Olgular yaş, menstruel durum, histopatoloji, grade, östrojen reseptörü, tümör büyüklüğü, aksiller lenf nodu durumu ve tedavi şeklinin prognoza etkisi açısından retrospektif olarak değerlendirildi. 49 olgu sitotoksik tedavi görmedi. 136 olguya en az 6 kür kemoterapi (KT) uygulandı. 118 olguya tamoksifen verildi. 67 olgu hormonal tedavi görmedi. Median 27 ay takip sonunda 185 olgunun 5'inde lokal nüks, 13'ünde kemik metastazı, 8'inde organ metastazı, 12'sinde kemik ve organ metastazı tespit edildi. 21 olgu kanser nedeniyle (8 olgu organ metastazı, 12 olgu kemik ve organ metastazı, 1 olgu lokal nüks, kemik ve organ metastazı), 9 olgu kanser dışı nedenle eks. oldu. 138 olgu tümörsüz takiptedir. Lokal rekürrens oranı %2.7, uzak metastaz oranı %18.9, hastalıksız sağkalım oranı %74.5, sağkalım oranı %88.7'dir. İstatistiksel analizlerde tümör büyüklüğü, aksiller lenf nodu sayısı, grade, operasyon tipi, aksillaya verilen RT dozu ile hastalıksız sağkalım ve sağkalım arasında anlamlı bir ilişki tespit edildi. T3-4 tümörler, grade II, 4 ve daha fazla sayıda aksiller lenf nodu metastazlı (aksiller bölgeye uygulanan ilave RT prognozu olumlu yönde etkilemedi.) ve simple mastektomi yapılan olguların prognozu daha kötü bulundu.Adjuvant irradiation (RT) was given to 185 numbers of breast carcinoma case after mastectomy in Çukorova University Medical Faculty Main Science Branch of Radiation Oncology between 1990-94 years. The cases have been evaluated retrospectively according to age, menopausal status, histopatology, grade,estrogen receptors, tumor size, axillary nodal status and the impact of treatment on prognosis. 49 cases haven't got adjuvant chemotherapy. Six cycles chemotherapy have been applied to 136 cases. 118 cases have been given tamoxifen. 67 cases haven't got hormonotherapy. After a median follow-up of 27 months, local recurrence in 5 of 185 cases, bone métastase in 13 of them, organ métastase in 12 of them have been found. 21 cases have been exitus because of cancer (8 cases organ métastase, 12 cases organ and bone métastase, 1 case local recurrence, organ and bone métastase). 9 cases have been exitus because of the reason out of cancer. 138 cases have being followed without tumor. The incidence of local recurrence, distant métastase, disease free survival, overall survival is %2.7, %18.8, %74.5, %88.7 retrospectively. A significant relation has been found between tumor size, axillary nodal status, grade, type of operation, the dose of RT given to axilla and disease free survival and overall survival in statistical analysis. The prognos of T3-4 tumor, grade II, the cases with four or more positive nodes (boost irradiation to axillar area hasn't effected prognosis positively) and the cases treated with simple mastectomy has been found worse

Massive Calcified Cerebellar Pilocytic Astrocytoma with Rapid Recurrence : A Rare Case

Pilocytic astrocytomas (PAs) are World Heath Organization Grade I tumors and are most common in children. PA calcification is not a common finding and has been reported more frequently in the optic nerve, hypothalamic/thalamus and superficially located cerebral tumors. We present a cerebellar PA in a 3-year-old male patient with cystic components and massive calcification areas. The residual tumor grew rapidly after the first operation, and the patient was operated on again. A histopathological examination revealed polar spongioblastoma-like cells. Massive calcification is not a common feature in PAs and can lead to difficulties in radiological and pathological differential diagnoses

Gastrointestinal stromal tumors: A multicenter study of 1160 Turkish cases

Background/aims: The aim of this multicenter study was to determine the histopathological features and immunohistochemical profiles of gastrointestinal stromal tumors diagnosed in Turkish patients. Material and Methods: Twenty-eight participating centers registered their gastrointestinal stromal tumor cases on a nationwide database. The diagnosis of gastrointestinal stromal tumor relied upon hematoxylin & eosin features and the results of antibody panel including CD117, CD34, desmin, smooth muscle actin, S-100 protein, and Ki67. The database consisted of parameters including age, gender, location, and all other histopathological and immunohistochemical findings. Statistical analysis was performed using Pearson, Kruskal-Wallis, Mann-Whitney U, and Spearman tests. Results: From all of the gastrointestinal stromal tumors in the database, 1160 cases with a male to female ratio of 1.22 and a mean age of 56.75 years were included in the study. The most common location was the stomach (45.0%), followed by the small intestine, omentum-peritoneum, large intestine, and esophagus (32.0%, 12.6%, 9.3%, 1.1%, respectively). The risk groups were distributed as: 6.1% very low, 21.7% low, 19.3% intermediate, and 53% high-risk cases. Many histopathologic findings were correlated with risk groups. CD117 was positive in 95.3% of gastrointestinal stromal tumors, whereas CD34 was positive in 74.9%, smooth muscle actin in 45.9%, desmin in 9.2%, and S-100 in 19.1.%. Though no significant relation was found between CD117 expression and tumor location, CD34, smooth muscle actin and Ki67 expressions significantly varied in different locations (p=0.001) and risk groups. Conclusions: The results of this multicenter study demonstrated that features other than tumor size and mitosis and immune markers other than CD117 and Ki67 included in the antibody panel seem to be useful as predictive risk factors