RESUMO
INTRODUCTION: To evaluate the effects of consistency in preoperative and postoperative Gleason scores to the operation outcomes in patients who underwent laparoscopic radical prostatectomy. MATERIALS AND METHODS: 204 of 347 patients were included the study. 143 patients whose preoperative prostate biopsies were evaluated in the other Institute were not included into the study. The preoperative data of patients and operation outcomes were investigated from institute's files of patients. Patients were divided to three groups by using consistence of pre and postoperative Gleason scores. The tumor, node and metastasis classification were used for staging prostate cancer. RESULTS: Mean age was 63 and the mean PSA level was 11 ng/dl overall. In statistical analysis PSA levels, Gleason score and rate of positive score were significantly low in Group I (p < 0.05). As in operative data, nerve sparing surgical technique was performed statistical significance higher in Group 1 than other Groups. External bleeding rate of Group II was significantly lower than the other Groups. In univariate and multivariate analysis, postoperative pathologic stage was statistical significant for consistency of pre and postoperative Gleason scores. CONCLUSIONS: The modified Gleason scoring system is safe and usable for evaluating prostate biopsies and operative specimens. The consistency in pre and postoperative Gleason score effect the operation technique and also operation outcomes. Working with an experienced uro-pathologist provides to inform patients more accurate and better.
Assuntos
Laparoscopia , Prostatectomia , Neoplasias da Próstata/cirurgia , Idoso , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/patologia , Estudos RetrospectivosRESUMO
BACKGROUND: Unilateral nevoid telangiectasia (UNT) is a unique vascular dermatosis of ambiguous aetiology. OBJECTIVE: To investigate the role of neurological disorder in pathogenesis of the UNT. METHODS: We investigated eight consecutive patients with unilateral nevoid telangiectasia. Detailed dermatological and neurological examinations, and magnetic resonance imaging were performed on each patient. In case of presence of dysesthesia over the skin lesion, electroneuromyography was performed to determine any relationships between lesions and peripheral neuropathy. RESULTS: All the patients had hypoesthesia over the skin lesion. The cranial magnetic resonance imaging showed subcortical hamartomatous lesions in one patient and demyelinized plaques on the corpus of the caudate nucleus and the pontin area in another. Electroneuromyography evaluation was nonspecific. CONCLUSION: In our study, neurological disorders were associated with UNT. Thus, it can be speculated that neurological disorders might contribute to the development and/or progression of UNT. Patients with UNT should be encouraged for neurological investigation.
Assuntos
Doenças do Sistema Nervoso/complicações , Nevo/complicações , Telangiectasia/complicações , Adolescente , Adulto , Criança , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Familial Mediterranean fever (FMF) is an inherited, recurrent, inflammatory disease. Of its various cutaneous features, erysipelas-like erythema is the best known and most common skin lesion. We present a new case of FMF with recurrent bullous lesions. A 41-year-old woman was admitted to our clinic with tense bullae, 20 x 20 mm in diameter on the left shin. The patient had a history of fever, abdominal pain, peritonitis attacks and infertility. A lesional skin biopsy revealed subepidermal bullae and neutrophilic infiltration around dermal vessels. Direct immunofluorescence analysis was negative. Over the period of investigation, the lesion regressed spontaneously; 1 month later, a similar lesion appeared on the right wrist. Diagnosis of FMF was made according to the Tel-Hashomer criteria. Recognition of this peculiar skin lesion may lead to an earlier diagnosis of the disease.
Assuntos
Vesícula/patologia , Febre Familiar do Mediterrâneo/patologia , Dor Abdominal/complicações , Adulto , Vesícula/complicações , Colchicina/uso terapêutico , Febre Familiar do Mediterrâneo/complicações , Febre Familiar do Mediterrâneo/tratamento farmacológico , Feminino , Supressores da Gota/uso terapêutico , Humanos , Recidiva , Resultado do TratamentoRESUMO
We report here the first Turkish patient with progressive symmetric erythrokeratoderma. The patient's skin lesions appeared in the axillae at 3 months of age, and gradually spread to other flexural areas and to the trunk. Dermatological examination of the boy at 3.5 years of age revealed symmetric, hyperkeratotic plaques with erythematous outlines on the neck, wrists, armpits, trunk and posterior knees. The histopathological changes were nonspecific, including marked hyperkeratosis, irregular acanthosis, focal papillomatosis and perivascular lymphocytic infiltrates. Molecular studies of the loricrin (LOR), connexin 31 (GJB3) and connexin 30.3 (GJB4) genes did not identify a disease-causing mutation. These results further underline the genetic heterogeneity of the erythrokeratodermas.
Assuntos
Eritema/genética , Hiperceratose Epidermolítica/genética , Mutação/genética , Pré-Escolar , Conexinas/genética , Consanguinidade , Diagnóstico Diferencial , Eritema/patologia , Heterogeneidade Genética , Humanos , Hiperceratose Epidermolítica/patologia , Masculino , Proteínas de Membrana/genética , LinhagemRESUMO
Alternaria species are common saprophytic fungi that naturally subsist on decaying plant materials, and occasionally may cause diseases in human beings and domestic animals. They can be a potential opportunistic pathogen in immunocompromized hosts or those with significant underlying disease. However, rarely they are also pathogen in otherwise healthy hosts. We report here the first case of cutaneous alternariosis in a 30-year-old woman who was on systemic steroid therapy for active systemic lupus erythematosus. The patient was referred to our department with purple papules and ulcerated nodules on the dorsum of the hands, wrists and ankles. Skin biopsy showed granulomatous reaction with fungal elements that were subsequently identified as Alternaria species. Individual lesions were successfully treated with oral itracanozole 200mg daily for six weeks. Besides the patient's own disease, the use of systemic steroid use might be a possible predisposing factor for the development of cutaneous alternariosis.
Assuntos
Alternaria/patogenicidade , Dermatomicoses/etiologia , Lúpus Eritematoso Sistêmico/complicações , Corticosteroides/efeitos adversos , Corticosteroides/uso terapêutico , Adulto , Alternaria/efeitos dos fármacos , Antifúngicos/uso terapêutico , Dermatomicoses/tratamento farmacológico , Feminino , Humanos , Hospedeiro Imunocomprometido , Itraconazol/uso terapêutico , Lúpus Eritematoso Sistêmico/tratamento farmacológicoAssuntos
Síndrome do Nevo Basocelular/radioterapia , Carcinoma Basocelular/diagnóstico , Nefropatias/complicações , Neoplasias Induzidas por Radiação/diagnóstico , Radioterapia/efeitos adversos , Neoplasias Cutâneas/diagnóstico , Adulto , Síndrome do Nevo Basocelular/complicações , Síndrome do Nevo Basocelular/patologia , Carcinoma Basocelular/patologia , Diagnóstico Diferencial , Humanos , Masculino , Neoplasias Induzidas por Radiação/patologia , Neoplasias Cutâneas/patologiaRESUMO
We describe a 25-year-old man with epidermodysplasia verruciformis (EV) associated with neurofibromatosis type 1 (NF1). The lesions, persisting for more than 15 years, consisted of widespread planar warts on the backs of the hands and wrists, and reddish-brown macules on the trunk, neck and face. During the last 5 years, our patient developed several epithelial tumours, namely solar keratoses, plaques of Bowen's disease and squamous cell carcinomas (SCCs). He also presented with NF1 lesions with neurofibromas, café-au-lait macules, axillary freckling and Lisch nodules. He had left tibial bowing. Polymerase chain reaction analysis of the skin lesions demonstrated the presence of human papillomavirus (HPV) 15 in a flat wart, HPV 20 in a plaque of Bowen's disease, and HPV 15 and HPV 20 in an SCC lesion. Both EV and NF1 show an inherited predisposition to malignancy but the molecular mechanism underlying tumour development is not fully understood. The appearance of both diseases in our patient may be a coincidental association but may also contribute to the identification of loci for susceptibility to NF1 and EV on chromosome 17.
Assuntos
Epidermodisplasia Verruciforme/complicações , Neurofibromatose 1/complicações , Adulto , Doença de Bowen/complicações , Doença de Bowen/genética , Doença de Bowen/virologia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/virologia , Cromossomos Humanos Par 17 , Consanguinidade , DNA Viral/análise , Epidermodisplasia Verruciforme/genética , Epidermodisplasia Verruciforme/virologia , Predisposição Genética para Doença , Humanos , Masculino , Neurofibromatose 1/genética , Neurofibromatose 1/virologia , Papillomaviridae/genética , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/virologiaRESUMO
A case of lobular carcinoma in a male breast is described. Because the structure of the male breast does not have lobules and acini, lobular carcinoma cases are seen infrequently. The pathological diagnosis was invasive lobular carcinoma of the breast. The karyotype of the patient revealed a 46 XY/46 XY, dmin (double minutes) chromosomal structure. Although 28% of the examined metaphases showed 46 XY, 1-5 dmin, the others were normal. We reviewed the English literature and found 20 reported cases of lobular carcinoma of the male breast. Our case represents lobular carcinoma in a proven genotypic male patient showing no exogenous or endogenous estrogens.
Assuntos
Neoplasias da Mama Masculina/patologia , Carcinoma Lobular/patologia , Neoplasias da Mama Masculina/genética , Carcinoma Lobular/genética , Humanos , Cariotipagem , Masculino , Pessoa de Meia-IdadeRESUMO
Hyper-IgM syndrome is a rare immunodeficiency disease characterized by markedly decreased serum IgG, IgA, and IgE levels but normal or elevated IgM levels. The most common clinical signs are infections, cirrhosis, arthritis, malignancies, and mucosal ulcers. Approximately two-thirds of patients have chronic neutropenia associated with oral and perirectal ulcers. We report a 14-month-old girl with hyper-IgM syndrome who has recurrent cutaneous ulcers restricted to the diaper area.
Assuntos
Disgamaglobulinemia/diagnóstico , Imunoglobulina M/sangue , Úlcera Cutânea/etiologia , Nádegas , Diagnóstico Diferencial , Disgamaglobulinemia/complicações , Feminino , Humanos , Hospedeiro Imunocomprometido , Lactente , Úlcera Cutânea/patologia , gama-Globulinas/uso terapêuticoRESUMO
Paragangliomas can arise from virtually any site in the body containing embryonic neural crest tissue. We present a female patient with an extra-adrenal retroperitoneal paraganglioma, and a review of the literature.
Assuntos
Paraganglioma Extrassuprarrenal/patologia , Neoplasias Retroperitoneais/patologia , Criança , Feminino , Humanos , Paraganglioma Extrassuprarrenal/cirurgia , Neoplasias Retroperitoneais/cirurgiaRESUMO
An adenomatoid tumour was found in the anterior maxillary region of a 15 year old female patient. Two impacted teeth were found in the tumour. The lateral incisor found in the tumour was dilacerated, and the roots of the first premolar were resorbed. A review of the English literature indicated that 294 similar cases have been reported.
Assuntos
Neoplasias Maxilares/patologia , Tumores Odontogênicos/patologia , Adolescente , Dente Pré-Molar/diagnóstico por imagem , Dente Pré-Molar/patologia , Calcinose/patologia , Dente Canino/diagnóstico por imagem , Dente Canino/patologia , Feminino , Humanos , Incisivo/diagnóstico por imagem , Incisivo/patologia , Neoplasias Maxilares/diagnóstico por imagem , Tumores Odontogênicos/diagnóstico por imagem , Radiografia , Reabsorção da Raiz/diagnóstico por imagem , Reabsorção da Raiz/patologia , Raiz Dentária/anormalidades , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/patologia , Dente Impactado/diagnóstico por imagem , Dente Impactado/patologiaRESUMO
OBJECTIVE: To determine the fine needle aspiration biopsy (FNAB) findings in hepatic Echinococcus multilocularis. STUDY DESIGN: FNAB and tru-cut liver needle biopsy were applied in 14 hepatic E multilocularis cases. Cytologic smears were stained with May-Grünwald-Giemsa and periodic acid-Schiff (PAS) stain. Tissue sections were stained with hematoxylin-eosin (HE) and PAS stain. RESULTS: In tissue sections, homogeneous, thin, cystic structures of various dimensions strongly stained with PAS. Mucoid material was stained with PAS in the cystic structures. Wide, coagulative necrosis was observed in all cases. In some cases there were foreign body-type giant cells at the periphery of the lesion. In all the cytologic smears there were an intense necrotic ground, PAS-positive hyaline cuticular structures and mucoid globules; in some cases there were foreign body-type giant cells. CONCLUSION: The above cytologic characteristics are basic diagnostic criteria for FNAB of E multilocularis.
Assuntos
Biópsia por Agulha/métodos , Biópsia/métodos , Equinococose Hepática/patologia , Técnicas Histológicas , HumanosRESUMO
A 67-year-old man with an enlarged left tonsil underwent a tonsillectomy for the suspicion of malignancy. He had had a dental extraction six months earlier. Clinical and histopathological investigations established the diagnosis of primary tonsillar tuberculosis.