Prognostic value of the morphological features of postperfusion liver biopsies in liver transplantation

Purpose: The aim of this study was to show the potential prognostic effects of morphological findings for the graft function, rejection and survival by evaluating the postperfusion liver biopsies. Materials and Methods: Sixty six cases who underwent cadaveric liver transplantation between 2006-2010 were included. The representative slides of postperfusion subcapsular wedge biopsies were evaluated for intrasinusoidal neutrophilic infiltration, microvesicular steatosis, hepatocyte swelling, hepatocellular necrosis, endothelial swelling, bile duct epithelial changes, cholangiolar proliferation and sinusoidal congestion/hemorrhage. The associations between the histopathological features and early allograft dysfunction, mortality rate and rejection status were statistically analysed. Results: Intrasinusoidal neutrophilic infiltration was grade 1 in 40 (60%), grade 2 in 24 (36%), and grade 3 in 2 cases (4%). The presence of grade 2-3 intrasinusoidal neutrophils was found to be significantly associated with mortality rate. The presence of sinusiodal congestion/hemorrhage was statistically related to the rejection. The presence of sinusiodal congestion/hemorrhage was significantly associated with shorter overall survival. Conclusion: Intrasinusoidal neutrophilic infiltration is promising to be a possible histopathological predictor for mortality. In addition, the presence of sinusoidal congestion can be a candidate as a prognostic factor both for rejection and overall survival based on our study.Amaç: Bu çalışmada, perfüzyon sonrası karaciğer biyopsileri değerlendirilerek morfolojik bulguların greft fonksiyonu, rejeksiyon durumu ve sağkalım üzerindeki potansiyel prognostik etkilerinin gösterilmesi amaçlanmıştır. Gereç ve Yöntem: 2006-2010 yılları arasında kadavradan karaciğer nakli yapılan 66 olgu çalışmaya dahil edildi. Postperfüzyon kama biyopsilerine ait kesitler, intrasinüzoidal nötrofilik infiltrasyon, mikroveziküler steatoz, hepatosit şişmesi, hepatoselüler nekroz, endotelyal şişme, safra kanalı epitel değişiklikleri, kolanjiyolar proliferasyon ve sinüzoidal konjesyon/hemoraji açısından değerlendirildi. Histopatolojik özellikler ile erken allogreft disfonksiyonu, mortalite oranı ve rejeksiyon durumu arasındaki ilişkiler istatistiksel olarak analiz edildi. Bulgular: İntrasinüzoidal nötrofilik infiltrasyon 40 olguda (%60) derece 1, 24 olguda (%36) derece 2 ve 2 olguda (%4) derece 3 idi. Derece 2-3 intrasinüzoidal nötrofil varlığının mortalite oranı ile, sinüzoidal konjesyon/kanama varlığının rejeksiyon ile istatistiksel olarak anlamlı şekilde ilişkili olduğu saptandı. Ayrıca sinüzoidal konjesyon/hemoraji varlığının, daha kısa sağkalım süresi ile istatistiksel olarak anlamlı şekilde ilişkili olduğu bulundu. Sonuç: İntrasinüzoidal nötrofilik infiltrasyon, mortaliteyi öngörmek için olası bir histopatolojik belirleyici olma umudu taşımaktadır. Ayrıca çalışmamıza göre sinüzoidal konjesyon varlığı hem rejeksiyon hem de sağkalım için prognostik faktör olarak aday olabilir

Role of apoptosis, bcl-2 and bax protein expression in premature rupture of fetal membranes

OBJECTIVE: To examine the degree of apoptosis in human fetal membranes associated with premature rupture Of membranes (PROM) as compared with normal pregnancies and to evaluate the expression of proapoptotic bax and antiapoptotic bcl-2 gene products

Stereologically estimated mean nuclear volume and histopathologic malignancy grading as predictors of disease extent in non-small cell lung carcinoma

The aim of this study was to investigate the value of the architectural grade, cytologic atypia, mitotic counts and stereologically estimated mean nuclear volume in predicting the stage of disease in non-small cell lung carcinomas. Hematoxylin-Eosin-stained sections from 53 non-small cell lung carcinomas were evaluated in terms of the morphologic and morphometric features mentioned above. Mean nuclear volume was estimated stereologically. Operable and inoperable tumor stages were compared concerning the parameters examined. There was no significant difference between operable and inoperable tumor stages in terms of the architectural grade in both squamous cell carcinomas and adenocarcinomas, although we found a positive correlation between architectural grades and increasing stages in SCC. Significant differences were found concerning atypia, mitosis grades, and the score combining both variables (C2) when comparing operable with inoperable tumor stages in squamous cell carcinomas but not in adenocarcinomas (Chi square, p = 0.013, p = 0.008 and p = 0.008 for squamous cell carcinomas respectively). The mean nuclear volumes of tumor cells in both squamous cell carcinomas and adenocarcinomas showed statistically significant differences between operable and inoperable stages (p = 0.05 and 0.02 respectively)

Ki-67 immunostaining and stereologic estimation of nuclear volume in melanocytic skin tumors

OBJECTIVE: To investigate the proliferative activity and mean nuclear volume (MNV) of melanocytic skin tumors

Apoptotic and mitotic index in squamous cell carcinomas and premalignant lesions of the uterine cervix

The aim of this study was to determine the frequency of apoptotic and mitotic cells in different grades of premalignant lesions and in different stages of squamous cell carcinoma (SCC) of the uterine cervix. The apoptotic and mitotic indices (AI and MI) of 55 H&E-stained sections of cervical intraepithelial neoplasia (CIN) and 30 SCCs were evaluated in light microscopy by a morphometric method. Twenty, 16, and 19 of 55 CIN cases were classified in CIN I, CIN II, and CIN III group, respectively. No apoptosis was observed in the normal epithelium next to the dysplastic mucosa. There was no statistically significant difference between CIN I and CIN II as well as CIN II and CIN III groups in terms of apoptotic and mitotic cell counts. Mitotic cell counts were found significantly higher in CIN III group when compared with CIN I and CIN II groups together. There was no statistically significant difference in the apoptotic and mitotic cell counts between nonkeratinizing and keratinizing types of SCC. In the SCC group, apoptotic cell counts did not show significant difference between tumor stages. But mitotic counts were significantly higher in advanced stage rumors. The SCC group showed significantly higher mitotic and apoptotic cell counts when compared with preneoplastic lesions. This study suggests that apoptotic function is not altered during progressive stages of dysplastic change in cervical epithelium, while proliferation is triggered only in late stages of dysplasia. Both apoptosis and mitosis are markedly increased in progression to malignancy in cervix epithelium. Mitotic cell counts may be helpful in predicting the extent of the disease in SCC. Resistance of cell death by apoptosis after invasion may accelerate the net growth of the tumor resulting in advanced disease

Combined segmental and focal adenomyomatosis involving the body of the gallbladder

Adenomyomatosis (adenomyomatous hyperplasia) of the gallbladder is a benign process of unknown origin that has been classified into three morphologic types: diffuse, segmental, and focal (fundal). Cases of combined (segmental and focal) forms involving the gallbladder body are very rare. We present the sonographic findings of a case having adenomyomatosis of the gallbladder body with focal as well as segmental forms of the disease. (C) 2005 Wiley Periodicals, Inc