Histopathologic and Preneoplastic Changes in Tubal Ligation Materials.

Background and Objectives: To investigate histopathological changes and serous carcinoma precursors such as secretory cell outgrowths (SCOUTs) and p53 signature in the bilateral tubal ligation (BTL) materials used during cesarean section (S/C). Materials and Methods: In total, 138 patients underwent S/C and tubal sterilization (TS) between October 2020 and May 2021 at Konya City Hospital. Patients' data were obtained from the hospital's system. All data and findings were investigated and statistically evaluated. Results: The mean age was 34.62 years (22-44), the mean gravity was 4.89 (2-15) and the mean parity was 3.46 (1-10). In total, 5.79% SCOUT, 7.24% atypia and 9.42% p53 signatures were observed. Significant correlations were shown between the epithelial cell lineage and age between Ki-67, SCOUT, and gravity; between the Ki-67 results and gravity and parity; and between the p53 score and age. Conclusions: TS is a common, safe, and effective method worldwide. Today, BTL is increasing along with increasing S/C ratios. In addition to the reduced risk of ovarian cancers with ligation alone, precursor lesions such as hyperplasia, SCOUT, p53 signature, and STIL/Serous tubal intraepithelial carcinoma (STIC) are encountered in the ampulla materials obtained. Considering the low rates of re-anastomosis, tubal excision may be recommended instead of ligation in women of relatively higher gravity and age.

Expression of laminin-1 and matrix metalloproteinase-9 in benign and malignant endometrium.

BACKGROUND: Laminin-1 and matrix metalloproteinase (MMP)-9 may play roles in the progression from benign to malignant endometrium, so we aimed to investigate their levels of expression in these tissues. METHODS: This case-control study was conducted at a tertiary care center between January 2014 and December 2016. Paraffin blocks of 50 specimens of benign endometrium with proliferative (n = 20), secretory (n = 11), and atrophic (n = 5) endometrium; simple endometrial hyperplasia without atypia (n = 12); and endometrial polyp (n = 2) histology and 49 specimens of malignant endometrium with endometrioid (n = 40), serous (n = 7), clear cell (n = 1), and undifferentiated (n = 1) types were immunostained with laminin-1 and MMP-9 antibodies and assessed for basement membrane continuity for laminin-1 and the percentage and intensity of MMP-9 expression in epithelial cytoplasm. RESULTS: : Laminin-1 continuity in the basement membrane was higher in benign (92%) compared to malignant (16.3%) endometrium (p < 0.0001) without any difference between the subgroups within each group (p > 0.05). All atrophic endometria and endometrial polyps and 23.5% of low grade endometrioid and none of the other endometrial cancers showed uninterrupted basement membrane staining with laminin-1. All cases in malignant endometrium expressed MMP-9 with either low or high immunoreactivity while none of the cases in benign endometrium showed a high staining with MMP-9 (p < 0.01). Proliferative and hyperplastic endometrium together with grade 1 endometrioid cancer expressed MMP-9 better than the atrophic endometrium (p < 0.05). The immunoreactivity with MMP-9 increased gradually from secretory to hyperplastic endometrium and serous carcinoma (p < 0.05). MMP-9 expression in all types of cancers except grade 1 endometrioid and clear cell compared to proliferative endometrium was significantly higher (p < 0.05) and increased from proliferative to grade 2 endometrioid, grade 3 endometrioid, serous and undifferentiated endometrial carcinoma. DISCUSSION: Gradual increments in MMP-9 expression and basement membrane laminin-1 discontinuity may indicate progression from normal to hyperplastic and to low- and high-grade cancerous endometrium.

Early-onset basal cell carcinoma; wide case series at a single tertiary center in middle Anatolia.

OBJECTIVE: Although basal cell carcinoma (BCC) is prevalent in the older population, it can be rarely seen in younger people. This study aims to investigate the risk factors and characteristics of BCC in young patients. METHODS: Pathology reports in a single tertiary care institution between 2010 and 2020 were retrospectively reviewed. Patients under the age of 35 who were diagnosed with BCC were included for the analysis. Data were gathered from medical records and pathology reports. Demographic characteristics, accompanying pathologies, and clinical findings of these patients were analyzed. RESULTS: There were a total of 32 patients in our cohort. Out of 32 patients, 20 were female and 12 were male. One male patient and five female patients were younger than 18. An accompanying risk factor (Gorlin syndrome, XP, renal transplantation, etc.) was present in six patients. There were no known additional diseases or risk factors in 26 patients. Metastasis and recurrence were not reported in any of our patients. Contrary to the information in the literature, the patients with BCC at a young age were not found more aggressive in our study. CONCLUSION: Contrary to the information in the literature, the patients with BCC at a young age were not found more aggressive in our study. Understanding the risk factors associated with BCC is essential for designing prevention strategies and favoring early diagnosis. Awareness of early-onset BCC aids in early diagnosis and treatment of the disease. Therefore, BCC should be in the differential diagnosis of skin lesions in the young population. In addition, when we encounter early-onset BCC, we should not forget the accompanying risk factors and syndromes.

Correlation of [18F]FDG PET activity with expressions of Ki-67 in non-small-cell lung cancer.

BACKGROUND: Lung carcinoma is the most commonly diagnosed cancer throughout the world and is the leading cause of cancer-related deaths. Non-small cell lung cancer (NSCLC) accounts for up to 80% of newly diagnosed lung cancer cases. This study aimed to investigate the relationship between Ki-67 proliferation index (PI) and the maximum standardized uptake value (SUVmax) obtained from [18F]FDG PET/CT in NSCLCs and whether prognosis was predicted with SUVmax values. MATERIAL AND METHODS: This retrospective study included biopsy and resection materials of 41 patients, who were examined in the pathology laboratory of Konya Training and Research Hospital between January 2010 and December 2019, and diagnosed with NSCLC, and whose [18F]FDG PET/CT images were present. RESULTS: There was no significant difference between histopathological subtypes in terms of age (p = 0.077), Ki-67 PI (p = 0.454), and SUVmax (p = 0.143). No correlation was observed between Ki-67 PI and SUVmax values obtained from [18F]FDG PET/CT (p = 0.338, r = 0.153). There was no significant correlation between Ki-67 PI and tumor diameter (p = 0.531). The SUVmax value was found to be lower (12.78 ± 6.14) in tumors measuring ≤ 2.5 in diameter and higher (18.46 ± 7.81) in tumors measuring > 2.5 cm (p = 0.027). Metastases not proven histopathologically but detected in [18F]FDG PET/CT were found to have no significant correlation with Ki-67 and SUVmax values (p = 0.881, p = 0.837). CONCLUSIONS: This study showed that there was no significant relationship between Ki-67 PI and SUVmax value obtained from [18F]FDG PET/CT in NSCLC tumors.

Can Wideband Tympanometry Predict the Prognosis of Otitis Media With Effusion?

Background and Objectives: This study aims to evaluate the capacity of wideband tympanometry (WBT) in predicting the prognosis of otitis media with effusion (OME). Subjects and Methods: Sixty-one ears with effusion and 30 healthy ears of children were enrolled. The patients were followed up monthly using WBT. After the completion of measurements, the ears were separated into four groups according to the duration of recovery; Group 1: Good prognosis (≤1-month, n=18), Group 2: Worse prognosis (>1-month, n=29), Group 3: Surgical (no recovery, n=14), and Group 4: Control (healthy ears, n=30). Tympanometric peak pressure (TPP), resonance frequency (RF), and absorbance levels were compared within and between the groups. Results: The TPP and RF values of the study group were lower than those of the controls (p<0.001). The ears with OME had lower absorbance measures than the controls at all frequencies; the differences were significant at 250, 500, and 1,000 Hz (p<0.001). However, at 2,000 Hz, the absorbance levels of the ears with OME were similar with those of the control group only in the good prognosis group (p>0.05). The receiver-operating characteristic analysis revealed that absorbance measures over 0.237 and 0.311 at 1,000 Hz and 2,000 Hz, respectively, have sensitivities and specificities over 70% for prediction of good prognosis, and the calculated odd ratio for these measures were 6 (p<0.05). Conclusions: WBT measurement is promising in predicting the recovery of OME in children.

Evaluation of P57, P53 and Ki67 Expression in Meningiomas.

OBJECTIVE: We conducted this study with the aim of predicting the biological behavior of meningiomas, and determining the benefits of associating histological subtype and grade with the expression of proliferative markers and tumor suppressor proteins. METHODS: The study included 29 patients with primary intracranial and intraspinal meningioma diagnosed in the pathology laboratory of Konya City Hospital between January 2014 and December 2020. Clinicopathological characteristics of the patients including parameters such as age and gender were obtained from the hospital records. Histopathological findings were obtained by re-evaluating the preparations stained with Hematoxylin-Eosin, which were extracted from the archive, and by evaluating new sections obtained from paraffin blocks of patients stained with Ki67, p53, and p57 immunohistochemical stains. RESULTS: A moderate correlation was found between tumor size and Ki67 proliferation index (PI) (p=0.003, r=0.530). There was no significant difference between grade I and grade II tumors in terms of p53 (p=0.184) and p57 (p=0.487) expressions. There were higher levels of Ki67 PI in grade II tumors. The histological subtypes of the tumor had no significant difference with Ki67 PI (p=0.018), p53 (p=0.662), and p57 (p=0.368) expressions. CONCLUSION: In order to obtain more definitive results, there is a need for studies, which are conducted with a greater number of patients and in multiple centers, and in which a long prospective follow-up is planned. The combination of histological, surgical, and imaging markers could make a more sensitive tool for predicting recurrence, and this could also be tested in future studies.

Expression of extracellular matrix proteins nidogen-1 and legumain in endometrial carcinomas.

PURPOSE: Our purpose was to comparatively investigate the expressions of nidogen-1 (NID1) and legumain (LGMN) in patients with endometrial cancer, endometrial intraepithelial neoplasia, and proliferative endometrium. METHODS: A cross-sectional, single-center study was performed by the obstetrics and gynecology and pathology departments of our institution. The relationships between descriptive data, clinicopathologic information, and immunohistochemical expressions of NID1 and LGMN were investigated. RESULTS: The histological grades of endometrial cancers (n = 124) as classified by FIGO included 1 (41, 21.1%), 2 (48, 24.7%), and 3 (35, 18.0%). The medians and ranges of deep and superficial NID1 expressions were 50.00 (0-285) and 5.00 (0-100), respectively. The intensity of legumain expression was noted as negative (30, 24.2%), mild (16, 12.9%), moderate (27, 21.8%), or strong (51, 41.1%). Median disease-free survival and overall survival were 75.00 (range: 1 to 170) months and 77.00 (range: 1 to 170) months, respectively. Patients with more intense expression of NID1 and LGMN displayed a higher histological grade. These patients were more likely to have a positive peritoneal cytology, larger tumor size, higher tendency for myometrial or lymphovascular invasion, involvement of ovaries, cervix, omentum, as well as lymph node metastasis, and recurrence. CONCLUSION: Our data indicated that the expressions of NID1 and LGMN may have important diagnostic implications in endometrial pathologies. Further studies should be performed to understand the significance of NID1 and LGMN in the pathogenesis of endometrial tumors.

Increased expression of ASRGL1 in invasive ductal carcinoma and its association with estrogen-progesterone receptor status of tumors.

AIMS: Human asparaginase-like protein 1 (ASRGL1) is closely related to tumor growth. ASRGL1 can significantly promote cell proliferation and suppress apoptosis. To date, high levels of expression of ASRGL1 have been reported in various tumors, but the function of ASRGL1 in carcinogenesis is still not well understood. In this study, we aimed to immunohistochemically investigate the expression of ASRGL1 in non-neoplastic breast tissue and invasive ductal carcinoma. METHODS AND RESULTS: ASRGL1 was evaluated immunohistochemically in 148 invasive ductal carcinomas and 105 nonneoplastic breast tissue samples to assess the impact on breast cancer development and its association with clinicopathologic features. ASRGL1 was observed positive in 63 (42.6%) and negative in 85 (57.4%) invasive ductal carcinoma. In nonneoplastic breast tissue, 24 (22.9%) cases were ASRGL1 positive and 81 (77.1%) were negative. A significant difference was observed between invasive ductal carcinoma and nonneoplastic breast tissue in terms of ASRGL1 expression, and ASRGL1 expression was increased in invasive ductal carcinoma (P = .001). Most estrogen receptor-negative tumors and progesterone receptor-negative tumors were also negative with ASRGL1 and the difference was significant (P = .006 and P = .001, respectively). The correlation between the ASRGL1 expression of the tumors and event-free survival or overall survival was not significant (P>.05). CONCLUSIONS: ASRGL1 may play a role in increasing cell proliferation and breast cancer development. ASRGL-1 expression in breast cancer closely correlates with the hormone receptor status of the tumor. In breast cancer, ASRGL-1 expression does not contribute to predicting tumor behavior.

Results of Excision of Unknown Papillary Neoplasms Detected on Core Biopsy.

OBJECTIVE: This study aimed to find out valuable parameters that predict the nature of breast papillary lesions before excision, and we compared our results with those in the literature. MATERIALS AND METHODS: We reviewed the medical records and pathology slides of patients diagnosed with papillary neoplasm after undergoing a core-needle biopsy between 2010 and 2020, who, subsequently, underwent surgical excision in a single tertiary care institution. The core biopsy results and pathology results of excision materials were compared with the radiological, pathological, and demographic findings. RESULTS: A total of 51 patients were included in the study. According to the excision results, the patients were divided into two groups: the atypical group, which included 20 patients (39.3%), and the benign group, which included 31 patients (61.7%). The results of the core biopsy showed that the loss of myoepithelial cell layer was identified in 18 patients in the atypical group, while it was present in all patients in the benign group. Tumor sizes were larger and patient ages were older in the atypical group compared with the benign group. No significant difference was found between atypical and benign groups in terms of breast imaging-reporting and data system (BI-RADS) classification and location (right vs left; central vs peripheral). The upgrade rate was between 0% and 16% in literature, while it was 4% in our study. CONCLUSION: There is no consensus on whether patients diagnosed with papillary neoplasia as a result of core biopsy will undergo excision. According to our results, patients with following criteria should have their lesions excised: those who are advanced in age, those who are diagnosed with a papillary lesion as a result of core biopsies with loss of myoepithelial cell layer, and those who are diagnosed with large-sized lesions without loss of myoepithelial cell layer. Patients diagnosed with small-sized lesions without loss of myoepithelial cell layer and who are young in age are to be followed up without the need for lesion excision. The lesions should be adequately sampled.

Incidental ectopic adrenal cortical tissue: Retrospective analysis of 16 patients.

OBJECTIVE: To evaluate ectopic adrenal cortical tissue (EACT) and identify clinical, pathological and radiological aspects. STUDY DESIGN: Retrospective review of pathology reports in a single tertiary institution between 2010 and 2020 was conducted. Patients diagnosed with EACT were included for analysis. Demographic characteristics, accompanying pathologies and clinicopathological and radiological findings of these patients were analyzed. RESULTS: There was a total of 17 patients in the cohort. Fifteen were boys and 2 were adults (1 male). The mean diameter of the EACT nodule was 0.25 cm (range 0.2-0.5 cm). All EACTs were incidentally diagnosed. Seven EACTs were diagnosed during an inguinal hernia repair, 6 during orchidopexy, 1 during partial orchiectomy, 2 during orchiectomy and 1 during hysterectomy and bilateral salpingoophorectomy due to uterine prolapse. DISCUSSION: EACT is a rare entity that is mostly found incidentally during inguinoscrotal interventions. Radiological discrimination of EACT may not be easy and thus, not detected prior to surgery. Clinical significance of EACT is not very well understood, however it tends to be a benign pathology. Although it is more commonly found in children, adults may present with EACT, as well. CONCLUSION: A tiny yellowish nodule detected in the inguinoscrotal region should be suspected for EACT by pediatric urologists, surgeons, and pathologists.

Laryngeal Oncocytic Cystadenoma with Rare Location and Clinicopathological Aspects.

Laryngeal oncocytic cysts and cystadenomas are uncommon and observed in 0.1-1% of laryngeal biopsy specimens. A 66-year-old male was admitted to the hospital with a hoarse voice of 6 months duration. On laryngoscopic examination, a lesion of the left anterior vocal cord was present. It was excised by direct laryngoscopy and histopathologic examination revealed a cystic cavity with papillary projections into the lumen. The epithelial lining comprised bland oncocytic epithelium. These findings are characteristic of laryngeal oncocytic cystadenoma. Endoscopic excision is curative in these lesions. Oncocytic cystadenoma is a rare, cystic neoplasm that occurs in late adulthood. It may be considered in the clinicopathologic differential diagnosis of laryngeal lesions.

The Bibliometric Analysis of the Studies Presented at the Turkish National Otorhinolaryngology Congresses in the Period 2009-2018.

OBJECTIVE: The aim of this study was to quantitatively and qualitatively analyze the abstracts presented at Turkish National Otorhinolaryngology Congresses in the years from 2009 to 2018. METHODS: Abstracts were defined and grouped according to their field of study, design, level of evidence, number of authors, the main institution in which they were held, and whether they were uni- or multi-centric. Frequency and percentage tables were prepared. RESULTS: In total, 5,463 studies, of which 1,431 (26.2%) were oral presentations and 4,032 (73.8%) were poster presentations were reviewed. The highest number of studies was in the field of otology and in the form of oral presentations (32%), and in the field of head and neck surgery in the form of poster presentations (37%). Fifty-seven percent of all studies were conducted in university hospitals, and 34% in Training and Research Hospitals. Eighty-three percent of oral presentations and 99% of poster presentations were clinical studies. The rate of experimental animal studies was 16% in oral presentations. The most commonly used design of orally presented clinical studies was descriptive (31%), whereas prospective randomized controlled design was the least common (3%). No study with a level 1 of evidence was found. The rate of oral papers presented with evidence levels 2, 3, 4, and 5 among all oral presentations were 22%, 13%, 11%, and 54%, respectively. CONCLUSION: The findings indicated that the abstracts were satisfactory in quantity, but overall scientific quality was not sufficient. The data obtained may serve as a basis for future studies, and follow-up studies may guide individuals and institutions that steer the Turkish ENT community.

Comparison of Ankaferd Blood Stopper and silver sulfadiazine use in burn wounds: An experimental study.

BACKGROUND: The present study was designed to compare the effectiveness of topical silver sulfadiazine (SSD) and Ankaferd Blood Stopper® (ABS) usage in experimental partial-thickness burns in rats. METHODS: Twenty-one male Wistar albino rats weighing 250-290 (range: 270+-19) g were used in the present study. A round brass probe that was specifically designed (3×3 cm diameter) was used to induce the burns in rats. After the presence of partial-thickness burns was confirmed, the rats were divided into three groups: Group 1 (ABS group) Ankaferd Blood Stopper® pad, Group 2 (SSD group) silver sulfadiazine (Silverdin®), and Group 3 (Control group) 1% isotonic saline solution-impregnated pad. The healing period was followed up clinically and histopathologically. The day on which 50% and 80% of re-epithelization at first were detected for each rat was also recorded. RESULTS: The mean times of 50% and 80% of re-epithelization at first were 10.8 days, 13.8 days, and 16.8 days in Groups 1, 2, and 3, respectively (p<0.001), and 16.4 days, 19.7 days, and 25.2 days, respectively (p<0.001). The mean inflammatory scores were also found to be better in the ABS group than in other groups (p<0.05). CONCLUSION: Our study showed that ABS has better results for the healing of the burn wound than SSD in experimental partial-thickness burns in rats.

Mucociliary clearance in patients with continuous ambulatory peritoneal dialysis.

INTRODUCTION: Mucociliary clearance (MC) is a critical defense mechanism for the protection of the entire respiratory system. Nasal colonization of some pathogens and chronical nasal infections are important risk factors for peritonitis. Any disturbance in the MC causes stasis of secretions and secondary infections. OBJECTIVE: The aim of the study was to evaluate the patients with chronic kidney disease (CKD) receiving continuous ambulatory peritoneal dialysis (CAPD) in terms of nasal MC. More specifically, the goal is to investigate the possible correlation between the nasal MC and peritonitis. METHODS: Forty CAPD patients and 39 healthy volunteers were involved in the study. The nasal MC was evaluated with the saccharin test, in which a 1mm diameter saccharin particle was carefully placed on the antero-medial surface of inferior nasal concha. The time taken by the subjects from the placement of particle to the perception of the sweet taste was taken as mucociliary clearance time (MCT). The groups were compared in terms of MCT. The patient group was evaluated in terms of a peritonitis history, and the correlations with MC were analyzed. RESULTS: Patient group with CKD consisted of 16 females and 24 males with a mean age of 32.4 years; healthy individuals in the control group consisted of 17 women and 22 men with a mean age of 33.3 years. There was not a significant difference in terms of mean MC time in patients with CKD when compared with the individuals in the control group. The comparison between the mean MCT in the patients who had a history of peritonitis and patients without peritonitis was statistically significant (p<0.05). CONCLUSIONS: Unique for being conducted with patients in continuous ambulatory peritoneal dialysis, the current study shows that although the MC of CKD patients and healthy individuals is similar, patients with low rates of MC appear to present an increased incidence of peritoneal infection. Considering the small sample investigated, an invitation to future confirmatory studies would be appropriate.

Effects of Dexmedetomidine Infusion During Sevoflurane Anesthesia on Otoacoustic Emissions.

BACKGROUND AND OBJECTIVES: Knowing the ototoxic potential of the agents used in medical treatments is important for the protection of hearing. Although we have knowledge regarding some effects of dexmedetomidine, which is an anesthetic-sparing drug, its influence over the hearing system has never been studied and is obscure yet. The aim of this study is to determine the effects of intravenous dexmedetomidine application during sevoflurane anesthesia on otoacoustic emissions (OAEs). SUBJECT AND METHODS: This prospective randomized study was performed on 60 patients (34 male, 26 female, mean age: 30.6±9.2 years) who were scheduled for an elective surgery under general anesthesia and the patients were enrolled and randomly divided into 2 groups. They received dexmedetomidine (Group D) or Saline (Group S) infusion during a standardized Sevoflurane anesthesia. Transient and distortion product OAEs were measured preoperatively and postoperatively (24th hour). OAE results were compared within and between groups. RESULTS: In group D postoperative OAEs were lower than preoperative OAEs and postoperative levels of group S, especially at low frequencies (p<0.05). CONCLUSIONS: Dexmedetomidine infusion affects the micromechanical function of cochlea especially in the low-frequency region. Dexmedetomidine should be carefully used during general anesthesia to avoid its probable harmful effects on cochlear micromechanics.

Investigation of Human Papillomavirus (HPV) and Epstein-Barr Virus (EBV) in antrochoanal polyps.

OBJECTIVES/HYPOTHESES: This study aimed to investigate the presence of HPV (HPV types 11 and 16) and EBV in antrochoanal polyps and to contribute to the current literature in this regard. STUDY DESIGN: A case-control study. METHODS: A total of 100 patients (including 43 patients undergoing surgery for antrochoanal polyp, 27 patients undergoing surgery for nasal polyp, and 30 patients undergoing surgery for hypertrophic inferior turbinate) were included in this study. DNA was isolated from formalin-fixed, paraffin-embedded samples with the aid of the Bioneer's AccuPrep Genomic DNA Extraction Kit. In the obtained genomic DNAs, while the detection of HPV DNA was performed using the nested-PCR method, the detection of HPV types 11/16 and EBV DNA was performed using the RT-PCR method. RESULTS: The mean age of the patients with antrochoanal polyp was 26.7 ±â€¯15.4 years (range 7-70). There were 20 (46.5%) women and 23 (53.5%) men in the antrochoanal polyp group. HPV DNA was positively detected using the nested-PCR method in 14 (32.6%) of the patients with antrochoanal polyp and in 3 (11.1%) of the patients with nasal polyp. HPV DNA was not detected in the hypertrophic inferior turbinate group (control group). There was a statistically significant difference between all groups in terms of HPV DNA positivity. In the antrochoanal polyp group, 2 patients had HPV 11 positivity and 12 patients had HPV 16 positivity. In the nasal polyp group, 1 patient had HPV 11 positivity and 2 patients had HPV 16 positivity. EBV DNA was positively detected in 16 (37.2%) of the patients with antrochoanal polyp, in 11 (40.7%) of the patients with nasal polyp and in 8 (26.7%) of the patients with hypertrophic inferior turbinate, respectively. There was no statistically significant difference between the groups in terms of EBV DNA positivity. CONCLUSIONS: This study demonstrates that there is a need for further studies investigating the presence of viruses in antrochoanal polyps.

Expression of Laminin Receptor 1 in Normal, Hyperplastic, and Malignant Endometrium.

Laminin receptor 1 may have a role in the progression from endometrial hyperplasia with or without atypia to endometrial cancer. Therefore, we aimed to investigate the pattern, percentage, and intensity of laminin receptor 1 expression in normal, hyperplastic, and neoplastic endometrium. Paraffin blocks of 131 specimens with the diagnoses of normal endometrium (n=25), endometrial hyperplasia with atypia (n=21) or without atypia (n=55), and endometrial cancer (n=30) were immunostained with laminin receptor 1 antibody, and its expression percentage, pattern, and intensity in the epithelial cytoplasm, basement membrane, and endometrial stroma of these tissues were assessed. When compared with hyperplasia with or without atypia and endometrial cancer, the percentage of nonstaining with laminin receptor 1 in the epithelial basement membrane was higher (96%), and the percentage of <50% staining with laminin receptor 1 was lower (4%) in the normal endometrium (P=0.001). While a progressive increment in staining percentage and density of epithelial cytoplasm and basement membrane was noted through an orderly progression from normal endometrium to endometrial hyperplasia without atypia, endometrial hyperplasia with atypia, and cancer of endometrium (P<0.001), such a relationship was not found for the staining percentage and density of endometrial stroma (P>0.05). Disease progression-related gradual increment in laminin receptor 1 expression in the epithelial basement membranes of hyperplastic endometrium with or without atypia and cancer of endometrium reveals that it may play a substantial role in the transition from premalignant to the malignant state of endometrial lesions.

Surgical treatment and outcome of pulmonary hamartoma: a retrospective study of 10-year experience.

BACKGROUND: The present retrospective study was designed to review the clinicopathological features and outcome of surgical treatment of pulmonary hamartoma who underwent surgical operation between January 2008 and January 2018. METHODS: The information about the age and gender of patients, symptoms, history of tobacco consumption, the presence of malignancies, radiological and imaging findings, calcification in the hamartoma, location and size of the lesions, findings of preoperative diagnostic investigations, operative procedures, operative time, tube drainage duration, surgical complication, hospital stay after tumor resection, duration of follow-up, and outcome were recorded. RESULTS: The average size of the neoplasms was 2.72 cm. Five patients (20.8%) had malignancies, which occurred previously in two patients, and concomitantly in three patients. Twenty-four patients underwent surgical treatment which included enucleation in 14 (four cases had thoracoscopic surgery), wedge resection in 8 (six cases had thoracoscopic surgery), and lobectomy in 2 patients. A total of four postoperative complications were noted. The patients were followed up for 2-98 months. CONCLUSION: Enucleation was the main choice in our series. The follow-up for a long period revealed no malignant transformation and recurrence. Due to lack of the malignance after operation in our series, we presumed that the enucleation for pulmonary hamartoma was safe enough.

Effectiveness of Superb Microvascular Imaging for the differentiation of intraductal breast lesions.

AIMS: The aim of this study was to compare the diagnostic performance of superb microvascular imaging (SMI) and power Doppler imaging (PDI) for the differentiation of intraductal breast lesions. MATERIALS AND METHODS: A total of 54 intraductal breast lesions (39 benign, 10 atypical, and 5 malignant) in 53 patients were examined using B-mode ultrasonography, PDI, and SMI. Vascularity grading, distribution of microvessels, and penetrating vessels were evaluated using each Doppler technique. The diagnostic performances of both methods were compared. RESULTS: SMI was more efficient in detecting flow signals than PDI (p=0.004). The highest diagnostic accuracy rates were achieved with SMI using vascular grading. When hypervascularity was used as a cut-off value to differentiate malignant and atypical lesions from benign lesions, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 66.6%, 80.7%, 66.6%, 80.7%, and 75.6%for PDI, and 86.6%, 76.9%, 68.4%, 90.9%, and 80.4% for SMI, respectively. CONCLUSIONS: SMI is more sensitive than PDI for detecting subtle blood flow in intraductal breast lesions with statistical significance. This novel and promising vascular imaging technique may be helpful in B-mode ultrasonography to distinguish intraductal breast lesions.

Advantages of b-mode ultrasound combined with strain elastography in differentiation of idiopathic granulomatous mastitis from malignant breast lesions

Background/aim: To evaluate the diagnostic performance of strain elastography (SE) combined with B-mode ultrasound in distinguishing between idiopathic granulomatous mastitis (IGM) and malignant breast lesions. Materials and methods: Seventy-seven malignant breast lesions and 36 IGM were assessed using B-mode ultrasound and SE. Ultrasonographic findings for all the breast lesions were classified based on the 2013 American College of Radiology Breast Imaging Reporting and Data System (BI-RADS-US), and the SE findings were evaluated based on the strain ratio and a five-point scale. The diagnostic performances of B-mode ultrasonography, SE, and the combination of both methods were compared. Results: Significant differences in strain ratio and elastography scores were found between IGM and malignant breast lesions. When the lesions were assessed with B-mode ultrasound alone, in order to distinguish between IGM and malignant breast lesions, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 94.8%, 66.7%, 85.9%, 85.7%, and 85.8%, respectively. However, when assessed with a combination of B-mode ultrasonography and SE, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 96.1%, 100%, 100%, 92.3%, and 97.3%, respectively. Conclusion: The combination of SE and B-mode ultrasound has better diagnostic performance in the differentiation of IGM and malignant breast lesions than B-mode ultrasonography alone.