Histomorphological features of atypical small acinar proliferations (ASAP) that favor malignancy

Objective: Cases diagnosed as atypical small acinar proliferation (ASAP) in prostate transrectal ultrasound (TRUS) biopsies typically require rebiopsies, which are invasiveand associated with increased risk of complications. Therefore, reduction in the rates of ASAP diagnoses during initial biopsy interpretation will decrease the need forrebiopsy and limit the burden of new diagnostic procedures. The current study aimed to investigate patient demographics, serum PSA levels, and histopathological features of cases identified as “ASAP” during initial prostate biopsies and as “benign” or “malignant” in the rebiopsies. Methods: This retrospective study included 187 cases and 257 core biopsies with a diagnosis of ASAP. Initial age and serum PSA levels were recorded, and the cores were analyzed histopathologically. The presence of nuclear enlargement, prominence of nucleoli, cytoplasmic amphophilia, luminal acellular secretions, cristalloids, infiltrative growth pattern, atrophy, inflammation, and number of the suspicious acini were recorded. Adenocarcinomas were identified using the Gleason score. Results: The mean age and serum PSA levels were significantly higher in the intermediate- high grade malignant group compared to the other groups, while nuclear enlargement (>2 times) and prominent nucleoli were more frequently observed in the malignant group compared to the benign group. Amphophilic cytoplasm and luminal acellular amorphous eosinophilic secretions were more frequently observed in malignant groups, while the benign group exhibited higher rates of inflammation. Conclusion: The findings of the current study showed enlargement of the nuclei (≥2 times), nucleolar prominence, amphophilic cytoplasm, luminal amorphous acellular secretion, and absence of inflammation were associated with malignancy. Moreover, higher mean age and serum PSA level were related with intermediate-high grade malignancy, and consideration of these factors during evaluation of initial TRUS biopsies may decrease the prevalence of ASAP diagnoses and prevent unnecessary interventions

Clinical and pathological features of adrenal myelolipoma and myelolipomatous metaplasia cases in our hospital over 13 years

BACKGROUND/AIMS: The development and widespread use of abdominal imaging techniques has increased the incidence of unexpected adrenal tumors called adrenal incidentaloma. Adrenal myelolipomas are the second most common incidentalomas. Similar myelolipomatous morphology appears as a secondary degenerative change in other adrenal lesions and is called myelolipomatous metaplasia. This study investigated the adrenal entities of the last 13 years which had myelolipomatous components.MATERIALS AND METHODS: In this retrospective observational study, cases diagnosed as adrenal myelolipoma or myelolipomatous metaplasia between January, 2009 and January, 2022 were re-examined regarding their age, gender, localization, lesion size, and secondary histopathological changes, accompanying pathological diagnoses as well as clinical and radiological data.RESULTS: Eleven adrenal myelolipoma cases and 6 myelolipomatous metaplasia cases were detected. In myelolipomas, the mean age was 55.45 years, 73% were female and 82% were located on the right side. The lesions were encapsulated and their mean size was 7 cm. One case had a diagnosis of subclinical Cushing's syndrome and the others were hormonally inactive. Some cases were accompanied with hypertension (27%), type 2 diabetes (18%), and asthma (18%). All myelolipomatous metaplasias, which are non-encapsulated, were detected in adrenocortical adenomas. The mean age was 58 years; nonencapsulated and 67% were located on the right side with no gender predilection. Concomitant hypertension (50%), diabetes /33%, and asthma (33%) were frequent.CONCLUSION: Adrenal myelolipoma and myelolipomatous metaplasia both contain adipose and myeloid components. Myelolipoma is a benign and encapsulated neoplasia which is usually detected incidentally. They frequently coexist with chronic diseases such as hypertension, diabetes and asthma

Histological Subgroups in Classic Kaposi Sarcoma: A Preliminary Study

Background and Design: Kaposi sarcomas (KS) are vascular tumors with a low malignant potential which include overlapping infectious, immunologic, and neoplastic processes. Recently, many histological subtypes have been defined. Material and Method: In the present study, 151 cutaneous classic KS lesions in 56 patients were retrospectively evaluated with regard to histological subtypes. Determination of the subtypes was based on the predominant histopathological component in the lesion. We examined changes in epidermis and dermis along with intratumoral inflammatory response characteristics in the lesions. By defining histopathological variants of the cases, differences regarding subtypes were investigated. Results: Cases that bear the ordinary characteristics of KS and those that can not be classified otherwise, comprised 82..8% of the study group. Twenty-six cases showed consistency with the subtypes outlined in the literature in terms of their histopathological properties. The most common histological subtype was the lymphangiectatic variant in 7.3% of the cases. Bullous (2.6%), lymphangioma like (2.6%), intravascular (2%), and pyogenic granuloma like (2%) variants were less common. The most uncommon histological subtype was micronodular (0.6%) type. Lymphangiectatic, bullous, intravascular, and pyogenic granuloma like variants were frequently observed in the nodular stage of KSs. Lympangioma like changes were seen to be present in the early KS lesions. Lymphangiectatic type was oftenly associated with bullous component, whereas pyogenic granuloma like type demonstrated superficial ulceration and intense inflammatory response. Lymphangioma like and intravascular types exhibited a characteristic appearance, while other variants were accompanied by components belonging to different subtypes. Conclusion: In KS, histopathological subtypes can develop as a result of different pathological processes. The next stage of the current study, which is one of the largest case series in the literature, will be investigation of the clinical and prognostic characteristics of the variants

18. Yüzyılda Vidin Şehrinin Sosyo-Ekonomik Panoraması (1790-1808)

The object of this study is to analyze the administrative, social and economic structure of the city of Vidin in the 18th century in the light of provincial court registers (şeriye sicilleri). The 18th century represents a period in which the wars against Austria and Russia, and their consequences causing military, fiscal, administrative and social changes the Ottoman Empire faced with. The wars against the European states, seeking to dominate the Ottoman Balkans with colonial aims, constitute a factor that enforced the Ottoman military system into a transformation. Making the military system effective in warfare and training its actors in a similar manner as their European counterparts did was one of the crucial problems for the Ottoman statesmen. Nevertheless the efforts for modernization of military system entailed some measures first in fiscal and then provincial administrations as well as the social structure of the Empire.Bu çalışma 18. Yüzyıl sonunda Vidin şehrinin idari, sosyal ve ekonomik yapısını, şeriye sicillerinin sağladığı veriler ışığında incelemeyi amaçlamaktadır. 18. Yüzyıl Osmanlı İmparatorluğu nun Avusturya ve Rusya ile yaptığı savaşlar ve bu savaşların yol açtığı askeri, mali, idari ve sosyal değişimlerle yüzleştiği bir dönemi ifade eder. Emperyal hedeflerle Osmanlı Balkanlarında egemen olmaya çalışan Avrupalı devletlerle yürütülen savaşlar, Osmanlı askeri nizamını dönüşüme zorlayan bir unsur teşkil etmiştir. Askeri nizamın ve aktörlerinin, savaş uğraşısında daha etkin hale getirilmeleri ve rakipleri ile benzer formasyona sahip olmaları, Osmanlı devlet erkanının en önemli problemlerinden biri halindedir. Ancak askeri nizamın modernleştirilmesi çabaları, öncelikle mali alanda olmak üzere imparatorluğun taşra idaresinde ve sosyal yapısında da bazı tedbirlerin alınmasını zorunlu kılar

Extranodal Marginal Zone Lymphoma of the Parotid Gland

Non Hodgkin lymphomas correspond to 25 % of all head and neck cancers. These rare tumors only include less than 5 % of malign tumors in parotid region. Differential diagnosis of these tumors cover many malign and benign tumors of the parotid gland. Definite diagnosis depends on sufficient tissue material of parotidectomy specimen. Treatment modality is surgical removal of the lesion with or without additional radiation and chemotherapy depending on the stage of the tumor. Prognosis is better than other forms of the B-cell lymphoma. We present a 54 year old woman who suffered from progressively and slowly growing mass on parotid region, without any inflammatory disease or chronic infection, diagnosed with mucosa associated lymphoid tissue lymphoma of the parotid gland. Parotid gland was totally excised by superficial parotidectomy and there is no recurrence after 5 years postoperative period

Correlation of REG1A, Claudin 7 and Ki67 expressions with tumor recurrence and prognostic factors in superficial urothelial urinary bladder carcinomas

Aım: Superficial urothelial urinary bladder tumors are neoplasms that frequently recur and have a potential for invasion and metastasis. REG gene family is composed of various acute phase reactants, lectins, antiapoptotic factors, and growth factors that are effective on pancreatic island cells, neural cells, and epithelial cells. REG1A and REG1B are two forms of the human REG1 gene. It is reported that they are expressed in several cancers and are correlated with the prognosis of the patient. Claudins are integral transmembrane proteins that interconnect cells. However, their role in human tumorigenesis is extremely controversial. The aim of this study is to evaluate the relationship of REG1A, claudin 7 protein expressions, and Ki67 proliferation index in superficial urothelial urinary bladder tumors with well-known parameters of prognosis and tumor recurrence, and also to clarify whether these parameters are independent prognostic factors or not. Materials and Methods: A hundred and eleven patients diagnosed with superficial urothelial carcinoma between 2011 and 2016 years in our hospital and followed up in our urology clinic were included in this study. The slides prepared from paraffin blocks were immunohistochemically stained with REG1A, claudin 7, and Ki67 antibodies. Results: REG1A showed positive staining in 37 (33%) and negative staining in 74 (67%) of urothelial tumors. Claudin 7 was positive in 24 (22%) and negative in 87 (78%) cases. REG1A expression showed a positive correlation with tumor stage and tumor recurrence; a high Ki67 proliferation index was positively correlated with tumor stage and grade. The loss of claudin 7 expression was related to tumor recurrence. Besides, tumors with REG1A expression and claudin 7 loss had a shorter survival independent of recurrence. Conclusıon: In urothelial tumors, REG1A expression and loss of claudin 7 might be significant markers of prognosis that predict tumor recurrence

Primary Dural Spinal Lymphoma Presentation of a Rare Spinal Tumor Case

Background. Primary spinal dural lymphomas (PSDL) are tumors with characteristic histopathology of a lymphoma, which are completely in the spinal epidural space without any other systemic involvement. Extranodal primary lymphoma involving nervous system prefers thalamus/basal ganglia, periventricular region, cerebellum, eyes, meninges/dura, and cranial nerves or spinal cord. Rare spinal localization with acute spinal cord compression is worth attention. Case Presentation. A 48-year-old male presented with a several-month-long history of upper back pain. Lately, he had numbness and weakness at both lower extremities and was unable to walk for one week. A spinal MRI showed a thoracic lesion with cord compression at T2–T4 levels. The patient underwent surgical decompression, with his final histopathology showing diffuse large B-cell lymphoma. Systemic work-up was negative for nodal disease. Following surgery, he received radiotherapy combined with chemotherapy. He experienced a good outcome after four years. Conclusion. The upper thoracic cord is a rare location for primary spinal lesions/metastases, both of which prefer the lower thoracic and upper lumbar regions. In cases of progressive paraparesis, there should be immediate surgical intervention in the case of denovo disease, followed by combined radiotherapy and chemotherapy procedures