Biomedical subjects
Publications and source records attributed to Selcuk Bilgi.
Granulomatous hypophysitis (GrHy) is a relatively rare inflammatory disease compared with lymphocytic hypophysitis. Only a few cases with magnetic resonance imaging (MRI) findings have been reported to date. We describe the MRI findings for two patients with GrHy with unusual histories and clinical outcomes.
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An unusual presentation of visceral larva migrans observed in a patient is reported. A 5-year-old boy suffering fever, abdominal pain, tenderness, and rigidity in the right lower and upper quadrant of the abdomen was operated on, with the false diagnosis of acute abdomen, and exploratory surgery was carried out. The pathological examination of the liver biopsy revealed eosinophil-rich necrotizing granulomatous inflammation with Toxocara spp larva. The diagnosis was also confirmed by serologic results. Clinicians should remember that toxocaral visceral larva migrans may rarely mimic an acute abdomen and cause unnecessary operations.
Chest wall hamartomas are extremely rare. Frequently mesenchymal hamartomas are presented as a single mass and contain some primitive mesenchymal elements such as chondroid and trabecular bone structures. A 60-year-old man presented to hospital with chest pain. Thirteen years earlier, his CXR and thoracic CT showed three masses on the right and two masses on the left, but he had not received any treatment thereafter. His CT showed the same masses present 13 years earlier, but they were bigger and right thoracotomy was undertaken. At thoracotomy, two sections of the mass in the right posterior mediastinum and one section of the mass in the right apex were excised. They had an occasional bloody appearance and contained small cystic areas, and some areas were extremely hard. Microscopic examination showed that the lesions consisted of mature adipose tissue, a large number of veins of different diameters and collagen tissue. Besides, primitive mesenchymal elements, lymphoid cell accumulations and trabecular bone structures were seen focally. Bilateral chest wall hamartomas are extremely rare and may be confused with malignancy.
AIM: To evaluate the prognostic significance of HER-2/neu overexpression in hormone receptor and axillary lymph node positive breast cancer patients treated in a single institution. METHODS: Paraffin-embedded primary breast cancers from 40 patients with invasive ductal carcinoma were studied immunohistochemically. HER-2/neu staining was classified as negative (0, 1+), weak/moderate positive (2+), or moderate/strong positive (3+) and was assessed for effectiveness as a predictor of outcome in univariate and Cox model multivariate analyses. RESULTS: 20% of patients were positive for HER-2/neu. Significant associations were observed between HER-2/neu and increasing number of involved nodes (p = 0.014), p53 positivity (p = 0.039), the presence of vascular invasion (p = 0.029) and metastases (p = 0.01). Multivariate analysis demonstrated that HER-2/neu overexpression (p = 0.016) and age (p = 0.005) were independent predictors for disease-free survival (DFS) where the number of involved nodes (p = 0.032) was shown to be independent predictor for overall survival. In the HER-2/neu positively stained tumors, significant number of patients developed distant metastases than the patients with HER-2/neu negatively stained tumors (87.5% vs 34.4%, p = 0.01). CONCLUSION: For node positive patients, HER-2/neu overexpression was a significant predictor of DFS.
The thyroid gland is an endocrine organ composed of stable cells. It is well known that regenerative capacity of the thyroid tissue is minimal. Various degrees of morphologic alterations do occur in chronic lymphocytic thyroiditis (CLT), including Hashimoto's thyroiditis. Eighty-five CLT cases were analyzed for these morphologic alterations. Small, irregular, atrophic or hyperplastic thyroid follicles were seen adjacent to the lymphocytic infiltration. There was nuclear enlargement, loss of nuclear polarity in thyrocytes and intrafollicular thyrocyte proliferation in these follicles. We thought that the morphologic alterations in involved follicles could be due to regenerative hyperplasia with increased proliferative activity and basement membrane abnormalities. To examine this hypothesis we investigated Ki-67 and laminin immunoreactivity in the involved follicles adjacent to lymphocytic infiltration areas. The uninvolved follicles were used as controls. Immunopositivity of Ki-67 in involved follicles was significantly higher than that in uninvolved follicles (2.97% +/- 2.16 versus 0.83% +/- 1.63, P < 0.001). Laminin immunostaining indicated the destruction or irregular distribution of basement membrane in involved follicles. We conclude that the increased cell proliferation activity and basement membrane abnormalities in the follicles with morphologic changes adjacent to CLT occur in conjunction with regenerative hyperplasia.
Paratesticular rhabdomyosarcoma is a rare but highly malign tumor. We report a case of paratesticular rhabdomyosarcoma and discuss the management of this neoplasm in the light of the literature.
OBJECTIVES: Progression of the cell cycle is regulated by the interactions of cyclins, cyclin dependent kinases (CDKs) and CDK inhibitors (CDKIs). p27 is a member of the universal cyclin-dependent kinase inhibitor family. The level of p27 protein expression decreases during tumor development and progression in some epithelial, lymphoid and endocrine tissues. It has been suggested that p27 is an independent prognostic factor in various human cancers. The prognostic value of p27 protein expression is not completely understood in bladder cancer yet. AIMS: To investigate the immunohistochemical expression of p27 in transitional cell bladder cancers and its relationship with clinicopathological data, proliferating cell nuclear antigen (PCNA) and p53 oncoprotein immunoreactivity. METHODS: The expression of p27 protein was immunohistochemically analyzed in paraffin-embedded specimens of 75 patients with transitional cell carcinoma of the bladder. p27 expression was compared with tumor grade, stage, growth pattern, disease-free survival, progression, PCNA and p53 immunoreactivity. RESULTS: Expression of p27 was not significantly related to clinicopathologic parameters, disease-free survival, progression, PCNA and p53 immunoreactivity. CONCLUSION: The results indicate that p27 is not a good predictor for outcome of transitional cell carcinoma of the bladder.
Primary lung tumors mimicking the salivary gland-type neoplasms are extremely rare. These types of tumors originate from submucosal bronchial glands. Epithelial-myoepithelial carcinoma is an uncommon tumor in this group, and only 7 cases have been reported. It is considered to be a low-grade malignant neoplasm. We report a case of epithelial-myoepithelial carcinoma of bronchial gland origin in a 73-year-old man who presented with coughing and dyspnea. The bronchus of the left lower lobe contained a tumor mass that had a polypoid growth pattern. The tumor also extended into the pulmonary parenchyma, forming a well-circumscribed mass with a pushing margin. The tumor consisted of epithelial and myoepithelial cells. The epithelial cells were positive for cytokeratins and epithelial membrane antigen, while the myoepithelial cells were positive for S100 protein and muscle-specific actin. According to these findings, we diagnosed epithelial-myoepithelial carcinoma. After undergoing pneumonectomy, the patient has been disease free for 34 months.
The exact reason for the development of inguinal hernia has not been completely determined. However, it is known that the fascia transversalis (FT) is one of the structures preventing development of hernias. In the etiology of the inguinal hernia, disorders in collagen metabolism have been proposed, and the role of metalloproteinases in remodeling the collagen has recently been of great importance. We could not encounter any study where the role of metalloproteinase inhibitors was evaluated in inguinal hernia. We obtained samples of FT from patients with direct and indirect hernia and used an immunohistochemical method to determine tissue inhibitor of metalloproteinase-2 (TIMP-2) expression. In the study group, samples of FT were taken during the operation from 45 patients, of which 35 were indirect and 10 were direct inguinal hernias. In the control group, samples of FT from various abdominal incisions were also taken from 45 patients with no hernia and operated upon for another pathology. TIMP-2 scores of a direct inguinal hernia were significantly less than those of the control group. However, no difference has been found between the TIMP-2 scores of an indirect inguinal hernia and those of the control group. Decreased TIMP-2 scores in patients with a direct inguinal hernia, compared with both the indirect inguinal hernia group and the control group, explain the reason for the increase in matrix metalloproteinase-2 (MMP-2) that has been proposed in some studies. Therefore, it can be expressed that a decreased activity of TIMP-2 plays a role in inguinal hernia development.