Browsing by Publisher "FEDERATION TURKISH PATHOLOGY SOC"

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    The Role of Immunohistochemistry in Differential Diagnosis of Follicular Patterned Lesions of Thyroid
    (FEDERATION TURKISH PATHOLOGY SOC) Yegen, G; Demir, MA; Ertan, Y; Nalbant, OAK; Tunçyürek, M
    Objective: In the present study we aimed to assess the role of galectin3, cytokeratin 19, thyroid peroxidase and CD44v6 in distinguishing benign from malignant follicular lesions. Material and Method: Fifty-four malignant and 50 benign lesions were evaluated and classified according to World Health Organization 2004 histological classification. Galectin-3, cytokeratin 19, thyroid peroxidase and CD44v6 were performed immunohistochemically and the slides were evaluated by two independent investigators. Sensitivity, specificity and diagnostic accuracy were assessed for each antibody tested. Results: Sensitivity, specificity and diagnostic accuracy were as follows respectively: Galectin-3: 59,25%, 84% and 71,15%; Cytokeratin 19: 70%, 82% and 75,4%; Thyroid peroxidase: 61%, 70% and 65,4%; CD44v6: 20,4%, 88% and 52,9%. Conclusion: The negativity for Galectin-3 and Cytokeratin 19 can not exclude malignancy but positivity can be thought as a sign of malignant feature or potential for lesions in which there is strong suspect of malignancy. Thyroid peroxidase immunostaining failed to differantiate benign from malignant oxyphilic tumors but decreased expression can be used as a malignancy marker together with Galectin-3 and/or Cytokeratin19 positivity in suspicious cases. CD44v6 does not seem to be reliable in distinguishing benign from malignant follicular patterned thyroid lesions. In conclusion, our approach is to take as much new samples or serial sections as possible in cases without clear-cut evidence of malignancy but with histological and immunohistochemical suspicion. Follicular variant papillary carcinoma has different criteria for malignancy and it should be always kept in mind while evaluating a benign-looking lesion with immunohistochemical signs that favor malignancy.
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    Relationship of Tumor-Associated Macrophage Population Detected by CD68 PG-M1, CD68 KP1, and CD163 with Latent EBV Infection and Prognosis in Classical Hodgkin Lymphoma
    (FEDERATION TURKISH PATHOLOGY SOC) Mavili, HS; Isisag, A; Tan, A; Miskioglu, M; Saka Baraz, L; Nese, N
    Objective: To evaluate the quantity of tumor-associated macrophages (TAMs) in cases of Hodgkin Lymphoma of classical type (cHL), and to reveal possible associations between TAM intensity and latent Epstein-Barr virus (EBV) infection, overall survival, progression-free survival, prognostic indices, and clinicopathological parameters. Materials and Methods: A total 46 cases of cHL with complete clinical records were selected and re-evaluated histopathologically. Staining for CD68 (PG-M1; KP1 clones) and CD163 was evaluated and the cut-off values were defined. Also, all cases were evaluated using the chromogen in situ hybridization (CISH) method with EBER (Epstein-Barr virus-encoded RNA) probes for the presence of possible EBV infection. Results: It was found that high expression levels of PG-M1 and high International Prognostic Scores (IPS) were associated with shortened overall survival (p=0.047, p=0.013). Cases with 2 or less areas of nodal region involvement were observed to have longer progression-free survival period (p=0.043). Higher expression levels of CD68 PG-M1, CD68 KP1, and CD163 were found to show significant associations with the presence of some clinical parameters such as the presence of B symptoms, spleen involvement, and the presence of EBV infection. Conclusions: Our findings suggest that increase of PG-M1+ TAM is associated with shortened overall survival, while higher expressions of all immunohistochemical markers are statistically significantly associated with the presence of EBV infection and clinical parameters mentioned above. These findings indicate that highlighting the TAM rate via macrophage markers in cases of cHL could be helpful in determining the prognostic risk groups and the relevant results should be mentioned in pathology reports.
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    Pleural Giant Solitary Fibrous Tumor and Immunohistochemical Profile
    (FEDERATION TURKISH PATHOLOGY SOC) Nese, N; Yaldiz, S; Ovali, G; Isisag, A
    Pleural solitary brous tumor is a rare and slow growing intrathoracic neoplasm. It originates from submesenchymal cells of parietal or, more commonly, visceral pleura. Although most cases follow a benign clinical course, it has been reported that a malignant outcome is seen in 7,5-37% of cases. We present here a case considered as pleural solitary brous tumor with malignant potential. A 74-yearold woman presented with dyspnea and computerized tomography showed a mediastinal mass connected to the pleura. The tumor was removed by surgery. Grossly, the tumor was lobulated, welldemarcated and mostly encapsulated. Its weight was 754 gr. and it measured 17x12x5.5 cm. The cut surface had a whorled appearance. Focal necrosis and myxoid degenerative areas were noted. Histopathologically, hypocellular areas characterized by uniform, small spindle cells in a collagen rich stroma and hypercellular areas were seen. The tumor had a prominent branching vascular network. Although mitosis was infrequent, necrosis was common. Tumoral cells were strongly immunoreactive for CD34, bcl-2 and vimentin by immunohistochemistry. Cytokeratin, actin, S100, CD117 and desmin were negative. The ratio of Ki-67 positive cells was 10%. the patient was diagnosed as pleural solitary brous tumor with malignant potential because of hypercellularity and presence of large necrotic areas although increased mitosis and pleomorphism were almost absent. : ere was no recurrence or metastasis 15 months after the surgery.
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    A Retrospective Evaluation of the Epithelial Changes/Lesions and Neoplasms of the Gallbladder in Turkey and a Review of the Existing Sampling Methods: A Multicentre Study
    (FEDERATION TURKISH PATHOLOGY SOC) Esendagli, G; Akarca, FG; Balci, S; Argon, A; Sengiz Erhan, S; Turhan, N; Ince Zengin, N; Hallaç Keser, S; Çelik, B; Bulut, T; Abdullazade, S; Erden, E; Savas, B; Bostan, T; Sagol, O; Aysal Agalar, A; Kepil, N; Karslioglu, Y; Günal, A; Markoç, F; Saka, B; Özgün, G; Özdamar, SO; Bahadir, B; Kaymaz, E; Isik, E; Ayhan, S; Tunçel, D; Özguven Yilmaz, B; Çelik, S; Karabacak, T; Erbarut Seven, I; Ataizi Çelikel, C; Gücin, Z; Ekinci, Ö; Akyol, G
    Objective: As there is continuing disagreement among the observers on the differential diagnosis between the epithelial changes/lesions and neoplasms of the gallbladder, this multicentre study was planned in order to assess the rate of the epithelial gallbladder lesions in Turkey and to propose microscopy and macroscopy protocols. Material and Method: With the participation of 22 institutions around Turkey that were included in the Hepato-Pancreato-Biliary Study Group, 89,324 cholecystectomy specimens sampled from 2003 to 2016 were retrospectively evaluated. The numbers of adenocarcinomas, dysplasias, intracholecystic neoplasms/adenomas, intestinal metaplasias and reactive atypia were identified with the review of pathology reports and the regional and countrywide incidence rates were presented in percentages. Results: Epithelial changes/lesions were reported in 6% of cholecystectomy materials. Of these epithelial lesions, 7% were reported as adenocarcinoma, 0.9% as high-grade dysplasia, 4% as low-grade dysplasia, 7.8% as reactive/regenerative atypia, 1.7% as neoplastic polyp, and 15.6% as intestinal metaplasia. The remaining lesions (63%) primarily included non-neoplastic polypoids/hyperplastic lesions and antral/pyloric metaplasia. There were also differences between pathology laboratories. Conclusion: The major causes of the difference in reporting these epithelial changes/lesions and neoplasms include the differences related to the institute's oncological surgery frequency, sampling protocols, geographical dissimilarities, and differences in the diagnoses/interpretations of the pathologists. It seems that the diagnosis may change if new sections are taken from the specimen when any epithelial abnormality is seen during microscopic examination of the cholecystectomy materials.
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    Splenic Hamartoma
    (FEDERATION TURKISH PATHOLOGY SOC) Nalbant, OAK; Nese, N; Kahya, M; Isisag, A
    Splenic hamartoma is a rare, benign lesion of the spleen requiring differential diagnosis. A 60-year-old male patient referred to the hospital with epigastric pain. Abdominal computed tomography revealed a mass in the spleen and multiple lymphadenopathies at the posterior wall of the stomach. The patient underwent splenectomy for diagnostic purposes. A pink to red, solid, well circumscribed tumoral lesion with a greatest diameter of 4.5 cm was observed on the cut surface of the splenectomy specimen in addition to ten other, not well circumscribed, dark red, solid tumoral lesions measuring between 0,3-1 cm in greatest diameter. All of the lesions were diagnosed as splenic hamartoma. As splenic hamartoma is a rare lesion and needs to be di + erentiated from other benign tumoral lesions of the spleen, this case is found worth to be presented.