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PURPOSE: The present study aimed to assess Lipocalin-2 (LCN2) expression in patients with papillary thyroid cancer (PTC) and to compare it with multinodular goitre (MNG). We also investigated the correlation between LCN2 expression and clinicopathologic characteristics. METHODS: This retrospective study included 63 surgically treated adult patients with papillary carcinoma and 65 adult patients with a MNG. Age, gender, physical, radiological and histopathological examinations, and surgical data of the patients were extracted from the hospital records. Size, histological subtype, capsule invasion, multifocality, extrathyroidal extension (ETE), lymph node metastasis (LNM), and immunohistochemical (IHC) studies of the tumour were recorded from the final histopathological reports of patients with PTC. The patient groups were compared in terms of LCN2 expression. The relationships between LCN2 expression and clinicopathological and other IHC parameters were also evaluated in patients with PTC. RESULTS: LCN2 expression was significantly higher in the PTC group than in the control group. No significant correlation was demonstrated between LCN2 expression and the presence of multifocal disease, capsular invasion, vascular invasion, ETE, and LNM. There was a moderate positive correlation between LCN2 and human bone marrow endothelial cell marker-1 (HBME-1) expressions, however, no correlation was found between LCN2 and cytokeratin-19 (CK19), CD56, and galectin-3. CONCLUSION: LCN2 expression may be a useful biomarker in differentiating benign and malignant lesions of the thyroid gland; however, its expression pattern may not be associated with clinicopathologic characteristics of the PTC and should be investigated in further studies with larger clinical samples.
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BACKGROUND: Intrapancreatic accessory spleen (IPAS) is a congenital entity that can be confused with malignant distal pancreatic masses. Radiologic imaging and radionuclide imaging have an important place in the diagnosis of IPAS. CASE REPORT: Blood tests were performed on a 36-year-old female patient who presented with tachypnea, tachycardia, pain in the joints, and pain in the left abdominal quadrant. Laboratory test results were as follows: hemoglobin value 6.0 mg/dl, sedimentation 120, aspartate transaminase (AST) 150U/L, and alanine transaminase level (ALT) 110U/ L. Additional laboratory tests and ultrasonography were performed. The anti-double-stranded DNA (dsDNA) level was 800 IU/ml. C3 and C4 values were both 0.64 IU/ml, with anti-Ro-52 +++(three positive) and anti-Ro-60 ++ (two positive). A clinical diagnosis of systemic lupus erythematosus (SLE) was made. Ultrasonography and dynamic contrast-enhanced upper abdominal MRI showed lesions suggestive of multiple hemangiomas in the liver and a 29x18 mm lesion in the tail of the pancreas with a similar appearance as the spleen. SLE treatment was started. Scintigraphy was recommended for the diagnosis of IPAS. Scintigraphy was performed in the third week of the treatment. Uptake was not observed. In the second month of the treatment, a control upper abdominal MRI was performed, and a decrease in the size of the lesion was observed. CONCLUSION: IPAS can be confused with pancreatic masses. Lack of uptake in scintigraphy may be due to treatment protocols that produce low phagocytic activity. If radiological imaging findings are compatible, a reduction in lesion size after immunosuppressive therapy can be accepted as evidence for the diagnosis of IPAS.
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Osteopoikilosis is an inherited condition with autosomal dominant trait resulting in sclerotic foci throughout the skeleton. It has been suggested that loss-of-function mutations of LEMD3 gene located on 12q14.3 result in osetopoikilosis. A bp heterozygote deletion was detected in our patient at the cytosine nucleotide at position 1105 with molecular genetic analysis. Although this mutation has not been previously described, it was considered to be the most likely cause of the disease in our patient due to frame shift and premature stop codon formation. As in our case, three phase bone scintigraphy and whole body imaging did not reflect the true extent of lesion sites and lesion activity. SPECT/CT images could reflect lesion location and activity more accurately, and could be a good alternative for differential diagnosis of unexplained bone pain and sclerotic lesions in one examination.