Cyclooxygenase-2 and Vascular Endothelial Growth Factor Expression and Their Correlation with Angiogenesis in Gastric Carcinomas

Amaç: Bu çalışmanın amacı, mide karsinomları ile bunların lenf nodu metastazlarında siklooksijenaz-2 (COX-2) ve vasküler endotelyal büyüme (growth) faktörü (VEGF) immün reaktivitelerini belirlemek, bunların anjiyogenezle ve histopatolojik prognostik parametrelerle olan ilişkisini araştırmaktır.Gereç ve Yöntemler: Otuz üç gastrik karsinom olgusunda immünhistokimyasal yöntemlerle COX-2, VEGF ekspresyonu ve CD34 ile belirlenen mikrodamar dansitesi (MVD) derecesi incelendi.Bulgular: COX-2 ile normal mukoza %96,9, karsinom grubu %87,8 oranında pozitif boyandı. Tümördeki COX-2 boyanma derecesi ile mukozadaki COX-2 boyanma derecesi arasında istatistiksel olarak anlamlı bir fark izlenmedi. Damar invazyonu pozitif olguların COX-2 ile lenf nodu boyanma derecesi anlamlı olarak daha yüksek idi (p<0,01). VEGF ile normal mukoza %100, karsinom grubu %93,9 oranında pozitif boyandı. Normal mukoza karsinom grubuna kıyasla VEGF ile anlamlı olarak daha yüksek oranda pozitiflik gösterdi (p=0,05). MVD derecesi tümöre kıyasla mukozada daha fazla idi (p<0,01). Kötü diferansiye karsinomlar, iyi ve orta derecede diferansiye karsinomlara göre anlamlı olarak daha yüksek MVD derecesine sahipti (p<0,05). Tümörde ve metastatik lenf nodlarında COX-2 ve VEGF ekspresyonu ile MVD derecesi arasında herhangi bir ilişki tespit edilmedi. COX-2, VEGF ve MVD derecesinin klinikopatolojik parametrelerle ilişkisi istatistiksel olarak anlamlı bulunmadı.Sonuç: Bu bulgulara göre gastrik karsinomlarda MVD derecesi artarken, tümör diferansiasyonu azalıyor olabilir, fakat COX-2 ve VEGF'nin gastrik karsinom gelişimindeki rolü henüz tam olarak anlaşılamamıştır. COX-2, VEGF ve MVD derecesinin gastrik karsinogenezis sürecindeki yerini tam olarak açığa kavuşturabilmek için daha geniş serilerle ileri çalışmalara gereksinim vardır.Objective: The aim of this study was to investigate the expression of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) in gastric carcinomas and lymph node metastasis and their relationship with angiogenesis and prognostic histopathological parameters.Materials and Methods: COX-2 and VEGF expression and microvessel density (MVD) grade identified by antibodies against CD34 were investigated immunohistochemically in 33 patients with gastric carcinoma. Results: The expression of COX-2 was 96.9% in normal mucosa and 87.8% in gastric carcinoma. Although COX-2 expression in mucosa was higher than in carcinoma, the difference was not statistically significant. The COX-2 positivity rates in lymph nodes were significantly higher in patients with vascular invasion (p&lt;0.01). The expression of VEGF was 100% in normal mucosa and 93.9% in gastric carcinoma. VEGF levels in mucosa were significantly higher than in carcinoma (p=0.05). MVD grade in mucosa was significantly higher than in gastric carcinoma (p&lt;0.01). MVD values were significantly higher in poorly differentiated carcinomas than in well and moderately differentiated carcinomas (p&lt;0.05). There was no association between COX-2 and VEGF expression and MVD grade in tumor tissues and metastatic lymph nodes. There was no correlation of clinicopathological parameters with COX-2 and VEGF expression and MVD grade.Conclusion: Our results suggest that the MVD in gastric carcinoma may correlate with tumor grade, but the precise roles of COX-2 and VEGF in gastric cancers are not yet fully understood. Further studies with large series are needed to clarify the importance of COX-2, VEGF and MVD in cancer progression

Cyclooxygenase-2 and Vascular Endothelial Growth Factor Expression and Their Correlation with Angiogenesis in Gastric Carcinomas

Objective: The aim of this study was to investigate the expression of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) in gastric carcinomas and lymph node metastasis and their relationship with angiogenesis and prognostic histopathological parameters. Materials and Methods: COX-2 and VEGF expression and microvessel density (MVD) grade identified by antibodies against CD34 were investigated immunohistochemically in 33 patients with gastric carcinoma. Results: The expression of COX-2 was 96.9% in normal mucosa and 87.8% in gastric carcinoma. Although COX-2 expression in mucosa was higher than in carcinoma, the difference was not statistically significant. The COX-2 positivity rates in lymph nodes were significantly higher in patients with vascular invasion (p<0.01). The expression of VEGF was 100% in normal mucosa and 93.9% in gastric carcinoma. VEGF levels in mucosa were significantly higher than in carcinoma (p=0.05). MVD grade in mucosa was significantly higher than in gastric carcinoma (p<0.01). MVD values were significantly higher in poorly differentiated carcinomas than in well and moderately differentiated carcinomas (p<0.05). There was no association between COX-2 and VEGF expression and MVD grade in tumor tissues and metastatic lymph nodes. There was no correlation of clinicopathological parameters with COX-2 and VEGF expression and MVD grade. Conclusion: Our results suggest that the MVD in gastric carcinoma may correlate with tumor grade, but the precise roles of COX-2 and VEGF in gastric cancers are not yet fully understood. Further studies with large series are needed to clarify the importance of COX-2, VEGF and MVD in cancer progression

Evaluation of amniotic fluid as a skin graft storage media compared with RPMI and saline

We aimed to assess and compare the histological changes of grafts stored in Roswell Park Memorial Institute-1640 solution (RPMI), amniotic fluid (AF), and saline. Amniotic fluid which has abundant nutrients, proteins, and growth factors, and antimicrobial features may be an easily achievable and cheap alternative for the short term preservation of skin grafts. Discarded surgical skin pieces obtained from 15 trauma patients were divided into three groups as RPMI, AF, and saline. The specimens were evaluated at days 7, 14, 21, and 28 for histological alterations by a 3-point scoring scale. Histological scores in the grafts stored in amniotic fluid and RPMI were found significantly lower than those stored in saline (p < 0.01). No significant difference was detected between AF and RPMI stored grafts. AF may be a good alternative for skin graft preservation as demonstrated by histological changes. New studies with multiple AF donators and repeated experiments will be worthwhile. Besides, restrictions of some ethical and legal issues for AF use should be solved. (C) 2010 Elsevier Ltd and ISBI. All rights reserved

Proliferative fasciitis: A case report

Proliferatif fasiitis, fasiaları ve subkutanöz dokuyu tutan, sık görülmeyen benign, bir bağ doku lezyonudur. Genellikle yetişkinlerde, erkek ve kadınlarda eşit oranda, 40-70 yaş arasında sık görülür. Özellikle ön kol ve uyluk olmak üzere ekstremitelerde sık yerleşir. Histopatolojik olarak lezyon fibroblast benzeri hücreler ile ganglion benzeri büyük dev hücrelerden oluşur. Klinik olarak hızlı bü- yümesi, infiltratif büyüme paterni, hücreden zengin olması, mitoz oranının yüksek olabilmesi, dev hücrelerin varlı- ğı nedeniyle malign mezenkimal tümörlerle karışabilmektedir. Kırk beş yaşında erkek hastanın göğüs duvarı üzerinde saptanan bir kitle proliferatif fasiitis tanısı aldı. İmmunhistokimyasal olarak düz kas aktini, CD68, S-100 proteini ve CD34 ile boyanma izlenmedi. Spindle ve dev hücreler vimentin ile pozitif reaksiyon verdi.Proliferative fasciitis is a rare, benign connective tissue lesion arising from fascia and subcutaneus adipose tissue. Proliferative fasciitis is a lesion of adult life, with a peak incidence between ages 40 and 70 years. Males and females are equally affected. The majority of the lesions occurred in the extremities, especially in the forearm and the thigh. Histologically, the characteristic features of lesion are fibroblast-like cells and ganglionlike giant cells. The diffuse infiltrative growth, high cellularity, mitotic activity and presence of ganglion cell-like giant cells have led to the misinterpretation of malignant neoplasms. A 45 year-old man who developed a nodule on the chest wall diagnosed as proliferative fasciitis. The immunohistochemical study showed negativity CD68, S-100 protein, CD34 and smooth muscle actin in the cells. Vimentin immunoreactivity was detected in the spindle and giant cells

Proliferative fasciitis: A case report

Proliferatif fasiitis, fasiaları ve subkutanöz dokuyu tutan, sık görülmeyen benign, bir bağ doku lezyonudur. Genellikle yetişkinlerde, erkek ve kadınlarda eşit oranda, 40-70 yaş arasında sık görülür. Özellikle ön kol ve uyluk olmak üzere ekstremitelerde sık yerleşir. Histopatolojik olarak lezyon fibroblast benzeri hücreler ile ganglion benzeri büyük dev hücrelerden oluşur. Klinik olarak hızlı bü- yümesi, infiltratif büyüme paterni, hücreden zengin olması, mitoz oranının yüksek olabilmesi, dev hücrelerin varlı- ğı nedeniyle malign mezenkimal tümörlerle karışabilmektedir. Kırk beş yaşında erkek hastanın göğüs duvarı üzerinde saptanan bir kitle proliferatif fasiitis tanısı aldı. İmmunhistokimyasal olarak düz kas aktini, CD68, S-100 proteini ve CD34 ile boyanma izlenmedi. Spindle ve dev hücreler vimentin ile pozitif reaksiyon verdi.Proliferative fasciitis is a rare, benign connective tissue lesion arising from fascia and subcutaneus adipose tissue. Proliferative fasciitis is a lesion of adult life, with a peak incidence between ages 40 and 70 years. Males and females are equally affected. The majority of the lesions occurred in the extremities, especially in the forearm and the thigh. Histologically, the characteristic features of lesion are fibroblast-like cells and ganglionlike giant cells. The diffuse infiltrative growth, high cellularity, mitotic activity and presence of ganglion cell-like giant cells have led to the misinterpretation of malignant neoplasms. A 45 year-old man who developed a nodule on the chest wall diagnosed as proliferative fasciitis. The immunohistochemical study showed negativity CD68, S-100 protein, CD34 and smooth muscle actin in the cells. Vimentin immunoreactivity was detected in the spindle and giant cells

Secretory carcinoma: A case report

Onaltı yaşında bir kız çocuğun sağ memesinde bulunan 4,5x3,5x3 cm boyutlarda kitle eksizyonel olarak çıkarıldı. Kitlenin makroskopik incelemesinde; çevreden çok iyi sınırlı, fakat kapsülsüz tümöral doku izlendi. Tü- mörün mikroskopik görüntüsü belirleyici olup, eozinofilik sekresyonla dolu lümen oluşturan eozinofilik, granüler veya berrak sitoplazmalı hücrelerle döşeli tubuloalveolar ve fokal papiller yapılar vardı. Hücrelerin bazılarında nukleus belirgin nukleol içermekteydi, mitoz nadir olarak izlendi. S-100 protein, östrojen ve progesteron reseptörü, poliklonal karsinoembriyojenik antijen (CEA) antikorları ile yapılan immunhistokimyasal boyamalarda S-100 ile pozitif reaktivite görüldü. Östrojen ve progesteron reseptörü, CEA ile pozitif reaktivite saptanmadı. Bu bulgularla olguya sekretuar karsinom tanısı verildi. Meme tümörlerinin nadir görülen tipi olan sekretuar karsinom, meme kanserlerinin %1’inden azını oluşturur. Prognozu çok iyidir ve bir çok seride 5 yıllık yaşam %100’e yakın olarak bildirilmektedir.16 year-old girl with a mass measuring 4,5x3,5x3 cms, in the right breast was presented. The patient underwent surgical resection. Grossly, it was a noncapsulated, well circumscribed neoplasm. The microscopic apparence was distinctive. Tubuloalveolar and focally papilary formations, lined by cells with eosinophilic, granular or clear cytoplasm were seen forming lumina filled by an eosinophilic secretion. Some nucleus had prominent nucleoli, but mitoses were very scant. Immunohistochemistry was performed by using the following antibodies: S-100 protein, oestrogen and progesterone receptor and polyclonal carcinoembryonic antigen (CEA). The tumor cells were positive for S-100 protein and negative for, oestrogen and progesterone receptor and CEA. Clinical and morphological findings were consisted with a secretory carcinoma. Secretory carcinoma of the breast is a rare varyant of the breast carcinoma. It is accounting less than 1% of all breast neoplasms. The overall prognosis is excellent, most series quoting a 5-year survival rate close to 100%

Pancreatic tumor metastasis to the navel in a case with three primary tumors – case report and review of the literature

Introduction. Sister Mary Joseph nodule (SMJN) is a metastasis that can occur in the umbilical region due to many tumors in the abdomen. Most of the cases are of gastrointestinal system origin and are often an indicator of poor prognosis. It can be seen in 1-3% of intraabdominal and pelvic malignancies. In the literature, around 300 studies are presented, mostly in the form of case reports. Very few (7-9%) of the cases with SMJN are from pancreatic origin. In our literature review, we found that in the majority (>90%) of SMJN cases due to pancreatic tumors, the lesions originated from the pancreatic tail and/or body, and tumor marker Ca-19.9 was very high in most cases (>90%). Aim. Here, the case of SMJN seen in a patient with three different primary tumors was discussed in the light of the literature data. Description of the case. Here, our case, whose third primary malignancy was detected in the pancreas in the PET/CT examination performed to investigate the origin of SMJN in a 68-year-old female patient who had undergone surgery due to breast in 2011 and endometrium cancers in 2018 and came with umbilical metastasis, is presented in the light of the literature data. Conclusion. As a result, in our case, which was followed up due to two primary tumors, it became important to know the origin of the SMJN that occurred due to the third primary tumor detected during the CT and PET/CT examination due to the newly emerging SMJN. It is important to know the origin and histopathological features of the SMJN in order to determine the treatment to the patien