Can near-infrared imaging distinguish a gelatin-based matrix granuloma from a malignancy in a kidney?

Aim: Differentiating granulomas from cancerous tissue poses a significant challenge in upper urinary tract surgery. We present the case of a 62-year-old male with a gelatin-based matrix (SurgifloTM) granuloma in the kidney following renal cyst decortication eight years earlier.Methods: Contrast-enhanced abdominal tomography revealed a Bosniak type-4 cyst at the previous operation site. The patient underwent laparoscopic partial nephrectomy with near-infrared imaging.Results: The lesion presented as hypofluorescent relative to normal kidney tissue. Histopathological examination revealed a foreign body granuloma due to unabsorbed Surgiflo.Conclusion: The fluorescence pattern could not distinguish a Surgiflo granuloma from a malignant lesion of the kidney.

Neuroprotective effects of topical coenzyme Q10 + vitamin E in mechanic optic nerve injury model.

PURPOSE: We aimed to create mechanic optic nerve injury model in rats and investigate the neuroprotective effects of topical Coenzyme Q10 + Vitamin E (CoQ + Vit.E) molecules on retinal ganglion cells. METHODS: Mechanic optic nerve injury model was created in the right eyes of rats (n = 12). Rats were divided into two groups: glaucoma model with sham treatment and topical CoQ + Vit.E treatment. Treatment was applied for 4 weeks. Glial fibrillary acidic protein, Brn-3a antibody, and anti-Iba1 were examined by immunohistochemistry. Glial fibrillary acidic protein, Bax, Bcl-xL, and Tfam protein expression were measured by Western blot analysis. RESULTS: The number of Brn-3a-positive retinal ganglion cell was 15.0 ± 1.0 (min: 14, max: 16) in sham treatment group and 22.2 ± 4.8 (min: 18, max: 29) in topical CoQ10 + Vit.E treatment group. The protection of Brn-3a in CoQ10 + Vit.E was statistically significant (p < 0.05). Glial fibrillary acidic protein-positive astroglial counts were recorded as 11.7 ± 2.1 (min: 10, max: 14) in sham treatment and 2.5 ± 1.5 (min: 1, max: 4) in topical CoQ10 + Vit.E treatment group (p < 0.05). Topical CoQ10 + Vit.E treatment also decreased Iba1 expression in the retina of mechanic optic nerve injury groups. CoQ10 + Vit.E treatment prevented apoptotic cell death by increasing Bcl-xL protein expression. Also, CoQ10 + Vit.E preserved Tfam protein expression in the retina. CONCLUSION: This study has shown that in glaucoma treatment the neuron protecting effect of topical CoQ10 + Vit.E molecules can be valuable.

Gastric adenocarcinoma with neuroendocrine differentiation: Clinicopathological features and efficacy of modified DCF chemotherapy.

PURPOSE: The aim of this study was to investigate the clinicopathological characteristics of patients with gastric carcinoma with neuroendocrine differentiation (NEDGC) and the efficacy of the modified DCF (mDCF) chemotherapy regimen. METHODS: Patients with NEDGC and non-NEDGC (pure adenocarcinoma) were evaluated comparatively in terms of pathological parameters, clinical parameters and treatment efficacy. Patients received treatment with mDCF (docetaxel, cisplatin and 5-fluorouracil). RESULTS: In total, 391 patients (35 with NEDGC and 356 with non-NEDGC) were included in this study. In particular, in the NEDGC group, the presence of lymphovascular invasion (LVI), presence of perineural invasion (PNI), median tumor size, and metastasis at the time of diagnosis were significantly higher than in the non-NEDGC group. mDCF was used as first-line chemotherapy regimen in 16 patients in the NEDGC group, and in 151 patients in the non-NEDGC group. In NEDGC and non-NEDGC groups overall disease control rate was 87.5% [partial response (PR) (50.0%), stable disease (SD) (37.5%)] and 80.8% [complete response (CR) (2.6%), PR (38.4%), SD (39.8%)], respectively. In the advanced-stage patients who had first-line mDCF, the median overall survival (OS) was 10.6 months (95% CI: 5.9-15.4) and 12.2 months (95% CI: 10.3-14.2) in NEDGC and non-NEDGC groups, respectively (p=0.88). The median progression-free survival (PFS) in the NEDGC and the non-NEDGC groups were 7.6 months (95% CI: 5.5-9.7) and 7.5 months (95% confidence interval/CI: 6.8-8.1), respectively (p=0.82). CONCLUSION: NEDGC patients usually have higher LVI and PNI rates, and they present with advanced disease. In this group of patients, mDCF regimen may be an effective treatment option. However this statement needs to be verified by further prospective and multi-centered studies including a larger patient cohort.

Eosinophilic colitis under etanercept.

Eosinophilic colitis (EC) is a rare manifestation of eosinophilic gastrointestinal disorder. Even though the cut-off value of eosinophils per HPF for the diagnosis of EC is not clear, histopathological examination is still a cornerstone. Corticosteroids are the main drugs for EC treatment today. Here, we aim to report a woman with EC who showed clinical remission with budesonide and was maintained with adalimumab alone.

Coexistence of immunoglobulin M nephropathy and autoimmune hemolytic anemia: 2 rare entities.

Immunoglobulin M (IgM) nephropathy is described as mesengial proliferative glomerulonephritis with diffuse mesengial IgM deposition. We report a patient diagnosed with IgM nephropathy and concomitant autoimmune hemolytic anemia syndrome associated with cold-reacting autoantibodies. Complete remission was achieved with systemic corticosteroid and plasmapheresesis.

Adenoid cystic carcinoma of the accessory parotid gland.

Accessory parotid gland is a small salivary gland tissue separated from main part of parotid gland. It is located on the masseter muscle anterior to the Stensen's duct. Tumors of accessory parotid gland are rare. In this article, we report an unusual case of adenoid cystic carcinoma involving accessory parotid gland. The patient presented with a progressively growing mass in the middle portion of her cheek. She underwent a partial parotidectomy including both the superficial and accessory lobes. The histopathologic diagnosis was adenoid cystic carcinoma of cribriform type.

Two cases of unilateral lichen planus following the lines of blaschko.

A 50-year-old man and 71-year-old woman presented to our clinic with unilateral, linear, erythematous, pruritic lesions along the lines of Blaschko. On the basis of clinical and histopathological findings, the lesions were diagnosed as lichen planus with a Blaschkoian distribution, which is a rare form of lichen planus. The patients were treated with topical corticosteroids and antihistamines.

Topical and subconjunctival bevacizumab for corneal neovascularization in an experimental rat model.

AIMS: To evaluate and compare the inhibitory effects of topical and subconjunctival bevacizumab on corneal neovascularization in a rat model. METHODS: Twenty corneas of 20 rats were chemically cauterized with silver nitrate sticks. Animals were randomized into four groups: a control group that received only topical artificial tear drops twice daily, a subconjunctival injection group that received 1.25 mg (0.05 ml) of bevacizumab on the 1st, 4th, and 7th day, and two topical bevacizumab groups that received instillation of 4 or 12.5 mg/ml bevacizumab twice daily. Digital photographs of the cornea were taken and analyzed using an image analysis software program. On the 10th day, corneas were excised and examined histologically. RESULTS: The mean percentage of the vascularized corneal area (%) in the control group was 63.32 ± 13.10 (mean ± SD), compared with 30.22 ± 15.73 in the subconjunctival injection group, 26.76 ± 10.23 in the 4-mg/ml topical group, and 25.52 ± 12.45 in the 12.5-mg/ml group. The differences between the control and each treatment group were significant (all p < 0.01). Further, histological examination revealed that each treatment group had fewer vessels than the control group (all p < 0.01). CONCLUSIONS: Both subconjunctival injection and topical use of bevacizumab are effective and safe in controlling corneal neovascularization.

Chondroid syringoma of the hand.

Chondroid syringoma is a rare cutaneous tumour that usually arises in the head and neck region and is rarely seen on the hands; it is rarely malignant at sites other than the head and neck. However, it should be included in the differential diagnosis of tumours of the hand. We present a 56-year-old man with a chondroid syringoma of the hand that clinically resembled a vascular tumour.

Retroperitoneal fibrosis and obstructive uropathy due to actinomycosis: case report of a treatment approach.

An actinomycotic retroperitoneal infection usually occurs in the presence of an intrauterine device (IUD). It can result in pelvic inflammatory disease and diffuse retroperitoneal fibrosis. A 39-year-old patient was admitted to the emergency unit with left flank pain. A computed tomography scan of the abdomen showed bilateral hydroureteronephrosis and a retroperitoneal malignant mass. Other tumors were excluded with a colonoscopy and an upper gastrointestinal endoscopy. Results of a fine needle aspiration biopsy showed fibrosis compatible with retroperitoneal mesenteritis. Double-J stents were placed in both ureters, and immunosuppressive therapy was started. The patient had clinical and radiologic responses to the therapy. A bilateral ureterolysis and sigmoid colon resection were done. The pathology report showed fibrosis and Actinomyces israelii infection. Parenteral and oral penicillins were administered. The probability of an Actinomyces infection in patients with retroperitoneal fibrosis should be kept in mind, especially in cases in which the patient has an intrauterine device.