The clinical significance of endometrial fluid collection in asymptomatic postmenopausal women.

OBJECTIVE: This study assessed the clinical significance of endometrial fluid collection (EFC) in asymptomatic postmenopausal women. MATERIALS AND METHODS: A total of 564 postmenopausal females were enrolled into this retrospective study, of whom 141, with EFC, comprised the study group; the remaining 423 postmenopausal women (the three consecutive patients) who had been admitted to the menopause outpatient clinic for their routine annual check formed the control group. Data, including age, gravidity, parity, body mass index, hypertension, diabetes mellitus, menopause duration, endometrial thickness and histopathological endometrium results, were compared between groups using the SPSS for Windows software package (version 15.0; SPSS Inc., Chicago, IL, USA). RESULTS: There were no significant group differences in gravidity, parity, body mass index, rates of hypertension and diabetes mellitus, endometrial thickness or histopathological endometrium results. However, there were group differences in age (62.0 ± 7.6 vs. 57.2 ± 8.9 years, p < 0.001) and menopause duration (13.4 ± 7.8 vs. 7.9 ± 5.4 years, p < 0.001). CONCLUSION: The results indicate that EFC in asymptomatic postmenopausal women is a benign condition, influenced by older age and commensurately longer menopause duration due to a lack of hormonal stimulation. The presence of EFC by itself does not affect the decision to provide further evaluation; that is determined by the presence of confirmed risk factors (e.g. thickened endometrial stripe). However, further studies are needed to assess any long-term prognostic impact of this finding.

Severe preeclampsia and fetal virilization in a spontaneous singleton pregnancy complicated by hyperreactio luteinalis.

UNLABELLED: BACKGROUNDr: Hyperreactio luteinalis is a rare condition that stems from theca cell hyperplasia in the ovaries due to a high level of human chorionic gonadotropin during gestation. It occurs commonly in pregnant patients with trophoblastic disease, occasionally in multiple pregnancies, and rarely in normal singleton pregnancy. CASE REPORT: A 24-year-old pregnant woman, G3 P0, who was admitted to the Perinatology Clinic with increasing findings of virilization during pregnancy was presented. The patient had bilaterally enlarged multicystic ovaries on sonographic examination and elevated serum androgen levels She was managed conservatively until 38th week of gestation as a presumptive diagnosis of hyperreactio luteinalis. Elevated blood pressure and prominent proteinuria were detected during the follow-up of the patient and labor was induced. She underwent an emergency caesarean delivery because of fetal distress. During caesarean section, ovarian biopsies were taken and a histopathological diagnosis of hyperreactio luteinalis was determined. The female fetus also presented virilization. CONCLUSION: Although infrequent, hyperreactio luteinalis with both maternal and fetal virilization can occur in women with spontaneous singleton pregnancies. The clinical manifestations in such women may be complicated by severe preeclampsia.

Stability of some quality traits in bread wheat (Triticum aestivum) genotypes.

This study was carried out in order to determine some quality traits such as thousand grain weight (TGW), hectoliter weight (HW), grain protein content (GPC), Zeleny sedimentation volume (ZSV) and stability of quality traits of 25 bread wheat genotypes. The experiment was conducted at seven environmental conditions during 2 growing periods (2003-2004 and 2004-2005) using randomized complete block design with four replicates. The ANOVA showed that out of the total sum of squares, 48.4, 28.0 and 23.6% for TGW, 71.4, 14.9 and 13.7% for HW, 54.4, 23.0 and 22.6% for GPC, 44.7, 41.7 and 13.6% for ZSV was attributable to E, G and G x E interaction effects, respectively. Thousand grain weight, hectoliter weight, grain protein content and Zeleny sedimentasyon volume of genotypes changed from 34.5 to 41.4 g, from 76.5 to 80.4 Kg, from 11.49 to 13.37% and from 22.1 to 46.0 ml, respectively. Seven stability parameters, covering a wide range of statistical approaches, were used so as to predict the genotypes. The study of genotypic stability showed that Bezostaya and advanced lines numbered 11 and 24 had high stability for quality traits and proved to be the best within the pool of the studied genotypes. Also, 8 and 17 numbered genotypes demonstrated high stability for TGW, HW, GPC and HW, GPC and ZSV, respectively.

Invasive micropapillary carcinoma of the breast: high incidence of lymph node metastasis with extranodal extension and its immunohistochemical profile compared with invasive ductal carcinoma.

AIMS: Invasive micropapillary carcinoma of the breast is an aggressive and distinctive variant of breast cancer. These tumours have a characteristic histological appearance and have been associated with a high incidence of axillary lymph node metastases and a poor clinical outcome. The aims of this study were to investigate the immunohistochemical profile of invasive micropapillary carcinoma of the breast, to compare it with invasive ductal carcinoma, and to identify the morphological parameters which predict its poor outcome. METHODS AND RESULTS: Fifty-three (2.6%) invasive micropapillary carcinomas of the breast from 2022 cases of infiltrating breast carcinomas were identified by retrospective review. The patient age at presentation ranged from 33 to 78 years (mean 52.5 years). The tumour size ranged from 5 to 70 mm (mean 27 mm). Eighty-two percent (43 of 53) were of high histological grade; 69% (33 of 48) of cases with axillary lymph node dissections had positive lymph nodes; and 75.5% (40 of 53) had lymphatic invasion: 46% (22 of 48) of cases had extranodal extension. Of lymph node-positive cases, 61% had four or more metastatic lymph nodes. Of tumours with tumour size >10 mm, 77% had positive lymph nodes. The percentages of cases positive for oestrogen receptor (ER) and progesterone receptor (PR) were 68% and 61%, respectively. These values were significantly higher than the values for invasive ductal carcinomas. p53 and c-erbB-2 were detected in 48% and 54% of cases, respectively. The mean value of Ki67 was 26%. Follow-up was available in 36 patients. Eight patients had local recurrences, nine patients had distant metastases, and 10 patients died of disease within a follow-up period of 9 years. CONCLUSION: Lymphotropism and an unfavourable prognosis are the hallmarks of this distinct entity. Prognostic markers such as ER, PR, p53, and c-erbB-2 failed to provide new criteria to allow discrimination of these tumours from other breast cancers.

Infarction after fine needle aspiration biopsy of pleomorphic adenoma of the parotid gland.

BACKGROUND: Fine needle aspiration (FNA) is a well-established and safe method for the rapid diagnosis of pleomorphic adenoma. A few clinically important complications, including bleeding, infection and inflammatory reactions, result from FNA. In a small number of cases FNA has been followed by varying degrees of necrosis in some organs. In the literature there are a few reports associated with necrosis in a pleomorphic adenoma of the parotid gland following FNA. CASE: A 27-year-old female had a two-year history of a right parotid mass. FNA revealed pleomorphic adenoma. A histologic diagnosis of pleomorphic adenoma of the right parotid with infarction was made. CONCLUSION: Necrosis associated with infarction may cause diagnostic problems. It is not a sufficient sign of malignant transformation.

Atypical epithelial changes and mutant p53 gene expression in ovarian endometriosis.

It has been reported that cases of ovarian endometriosis those with epithelial cytological atypia have potential for malignant transformation. This study was planned to determine the incidence of atypical endometriosis and its cytological criteria, to evaluate the malignant potential of atypical endometriosis via immunohistochemical methods (p53). In this study we evaluated 140 samples obtained from 120 cases of ovarian endometriosis and 10 ovarian endometrioid carcinomas that have been previously diagnosed histopathologically. We re-evaluated endometriosis cases with respect to their epithelial and stromal features, existence of acute or chronic inflammatory cells in endometriotic epithelium or stroma and other accompanying histological findings. We observed atypia in 7 (5.8%) cases; reactive atypia in 37 (30.8%) cases, no atypia in 76 (63.4%) cases. We evaluated immunohistochemical p53 expression in 7 atypical cases, 37 reactive atypical cases, and in 10 of those without atypia and in 10 endometrioid carcinoma cases. We noted no staining in cases with atypia, reactive atypia and without atypia while 3 cases of endometrioid carcinoma had positive staining for p53. We concluded that prominent nucleolus and angulation of nuclear contour could be added to criteria of atypia that were mentioned before in the literature. In our study, even though p53 expression could not be shown with immunohistochemical methods in atypical endometriotic cases; it can not be determined that atypical endometriosis lesions are not premalignant. Still, endometriosis cases should be evaluated carefully by the pathologist for foci of cytological atypia and it should be kept in mind that malignant transformation might occur in these atypical endometriosis cases.

Cytoprotective effect of trimetazidine on 60 minutes of intestinal ischemia-reperfusion injury in rats.

Trimetazidine (TMZ), a potent antioxidant agent, has been used to protect the myocardium, liver and kidney from ischemia reperfusion (IR) injury. We investigated the effect of TMZ, a cellular anti-ischemic agent and a free radical scavenger, on 60 min of warm intestinal IR injury in rats. Sprague-Dawley rats were divided into three groups: a sham-operated group (no IR injury, n = 8), an ischemic control group (control, n = 8), and a TMZ-treated group (3 mg/kg, n = 8). Malondialdehyde (MDA) levels, myeloperoxidase (MPO) activity, and mucosal damage were investigated after 120 min of reperfusion. MDA levels and MPO activity were more elevated and histopathological damage more severe in the control group than in the sham group (P < 0.05). MDA levels and MPO activity were lower and there was less histopathological damage in the TMZ group than in the control group (P < 0.05). Accumulation of lipid peroxidation products and neutrophils in mucosal tissues were significantly inhibited by TMZ treatment. We conclude that pretreatment of rats with TMZ before intestinal ischemia attenuates but does not prevent, histological damage.

Cystic lymphangioma of the spleen mimicking hydatid disease.

Cystic lymphangioma is a very rare condition generally accepted to be the result of a developmental malformation of the lymphatic system. Usually seen in children, it occurs infrequently in adults. The neck (75%) and axillary regions (20%) are the most common locations of lymphangioma, but it can occur in the retroperitoneum, mediastinum, mesentery, omentum, colon, pelvis, groin, bone, skin, scrotum, and spleen. We present a cystic lymphangioma of the spleen with emphasis on its rarity in this site and problems of differential diagnosis with hydatid disease.

Intramedullary spinal tuberculoma presenting as a conus tumor: a case report and review of the literature.

Intramedullary spinal tuberculoma is a rare form of central nervous system tuberculosis. Although tuberculosis is unusual in the west, it is still prevalent in Asia and Africa. We report a case in which the diagnosis was made histologically without evidence of symptoms of systemic tuberculosis. The lesion, located in the conus medullaris, mimicked a conus tumor. The patient was a 20-year-old man who presented with a history of progressive leg weakness, urinary urgency, and impotence. There was no history of, or recent contact with, tuberculosis. A diagnosis of an intramedullary tumor in the conus medullaris was made by MRI. The patient underwent a T11-L1 laminectomy and total resection of the lesion with microsurgical technique. Histologic examination revealed a granulomatous lesion containing Langhans' giant cells, inflammatory cells, and caseating necrosis. Antituberculous medication was instituted as soon as the diagnosis was made. Neurologic symptoms and signs slowly improved postoperatively. A combination of microsurgical resection and antituberculous chemotherapy should be the choice of treatment for intramedullary tuberculomas.

Mature cystic teratoma in round ligament: case report.

Our report describes an unusual presentation of mature cystic teratoma. In this case, 3 mature cystic teratomas were encountered during cesarean section, one in each round ligament and the other in the left ovary. According to the literature, round ligament is one of the rarest sites for the presentation of mature cystic teratoma.