Pelin Yildiz | Bezmialem Vakif University (original) (raw)

Papers by Pelin Yildiz

Research paper thumbnail of Dermatoscopic findings of pigmented purpuric dermatosis

Anais Brasileiros de Dermatologia, 2016

Research paper thumbnail of New Markers in Atherosclerosis: Thrombospondin-2 (THBS-2) and Leukocyte Cell-Derived Chemotaxin-2 (LECT-2); An Immunohistochemical Study

Medical Science Monitor, Dec 31, 2016

BACKGROUND Current research investigating the role of THBS2 and LECT-2 in atherogenesis is very l... more BACKGROUND Current research investigating the role of THBS2 and LECT-2 in atherogenesis is very limited. Therefore, we designed this study to demonstrate the role of THBS-2 and LECT-2 in atherosclerosis at the tissue level in fresh specimens. MATERIAL AND METHODS A total of 32 patients who underwent coronary bypass surgery were enrolled. Aortic wall punch biopsies were obtained at the site of proximal aortosaphenous bypass graft anastomosis. A specimen of left internal mammarian artery (LiMA) was taken from the segment just proximal to its anastomosis. The aortic tissue is representive of the atherosclerotic tisue, and LiMA tissue is representative of the non-atherosclerotic area. The specimens were painted with CD68 for macrophage, and THBS-2 and LECT-2 antibodies for immunohistochemical staining. RESULTS Aortic THBS-2 levels were significantly lower, whereas aortic LECT-2 levels were significantly higher when compare to LiMA (14.4±9.9 (5-30) and 36.9±13.0 (5-60) p: 0.0001 and 20.3...

Research paper thumbnail of A Rare Confusing Nevus Variant: Meyerson Nevus

Bezmialem Science

Meyerson nevus is a rare benign entity described by Meyerson et al in 1971 as a melanocytic nevus... more Meyerson nevus is a rare benign entity described by Meyerson et al in 1971 as a melanocytic nevus surrounded by inflammatory, eczematous eruption that resolves spontaneously or by topical steriod therapy (fluticasone propionate, Abdi İbrahim İlaç San. ve Tic. A.Ş., İstanbul), but the nevus persists. This entity is not well known and there is limited information in the literature. Since the lesion may develop suspicion for malignancy, it is important to keep this entity in mind. In this article we present three Meyerson nevi, two of which belong to one patient.

Research paper thumbnail of Correlation of clinical, dermoscopical and histopathological features of all subtypes of basal cell carcinoma

Research paper thumbnail of Evolution of Spitz Nevi. Pediatr Dermatol

Research paper thumbnail of Akciğer Dişindaki Tümörlerde İmmunhistokimyasal TTF-1 Ekspresyonu

Objective: Thyroid transcription factor-1 (TTF-1) immunoexpression is frequently determined in sm... more Objective: Thyroid transcription factor-1 (TTF-1) immunoexpression is frequently determined in small-cell lung carcinomas, as well as primary lung adenocarcinomas. While dealing with metastatic carcinomas, TTF-1 immunoexpression is a significant indicator of primary lung carcinomas. Recent studies have revealed that TTF1 immunoexpression is also defined in non-lung cancers, such as squamous cell carcinomas of different sites and certain neuroendocrine tumors. The verified data obtained from these studies indicate that a straightforward diagnosis of primary lung carcinoma in cases with positive TTF-1 immunoexpression can cause diagnostic contradictions. The aim of our study is to investigate the immunoexpression status of TTF-1 in common non-lung tumors. Methods: A total of 85 cases that were diagnosed in our institute between the years 2011-2012 were included in our study. After a review of the pathological slides prepared from these tumors [colon adenocarcinoma (n: 15), renal cell ...

Research paper thumbnail of Galectin-3 Expression in Human Endometrium and Decidua During The Menstrual Cycle and in Gestation

OBJECTIVE: G3 is one of the members of the lectin family that may be involved in the establishmen... more OBJECTIVE: G3 is one of the members of the lectin family that may be involved in the establishment of endometrial receptivity by regulating the proliferation and adhesion of endometrial cells. STUDY DESIGN: Immunohistochemical expression of G3 was tested in late secretory phase of the endometrium (SPE)(n=30), proliferative phase of the endometrium (PPE)(n=34), and decidua (n=41) and induced abortions in the first trimester. RESULTS: Expression of G3 during the PPE was low; 12 cases were score 1 and 19 cases were score 2 (p<0.001). However, among the late SPE, there were 11 cases at score 2, and 15 cases at score 3. In the decidua expression of G3, 37 cases were score 3 (p<0.001). CONCLUSION: There is a significant progression of G3 expression in SPE and gestation. Although during the PPE expression is considerably lower. This shows that G3 plays an important role in implantation.

Research paper thumbnail of Bladder Neck Involvement in Radical Prostatectomy Specimens is not a pT4 Disease

Journal of Urological Surgery

Research paper thumbnail of Traumatic Avulsion of Upper Eyelid Skin Following Surgery in a Patient With Multiple Myeloma and Amyloid Light-chain Amyloidosis

Wound Management & Prevention

Multiple myeloma (MM) is a common hematologic malignancy. Primary systemic amyloidosis or amyloid... more Multiple myeloma (MM) is a common hematologic malignancy. Primary systemic amyloidosis or amyloid light-chain (AL) amyloidosis is a rare disease. PURPOSE This article presents the case of a patient with MM and AL amyloidosis who experienced a severe case of medical adhesive-related skin injury. CASE STUDY A 64-year-old man with MM, AL amyloidosis, and diabetes presented with a necrotic wound on his left heel that required surgical debridement. The patient experienced a traumatic avulsion of the right upper eyelid skin during the removal of the corneal abrasion preventive tape as well as traumatic avulsion of the left upper eyelid skin while the patient's face was being cleansed. The avulsed right upper eyelid skin above the tarsus was repaired with a full-thickness skin graft. The partly avulsed left upper eyelid skin was repositioned, and an excisional biopsy was taken. Both upper eyelids healed uneventfully. The biopsy specimen revealed increased amyloid deposition in the dermis, subcutaneous tissue, and areas surrounding the veins and sweat glands. CONCLUSION This case illustrates the increased risk of medical adhesive-related skin injury and other skin damage in patients with MM and AL amyloidosis. In these patients, the use of tape should be avoided to prevent intraoperative corneal abrasion.

Research paper thumbnail of The role of diffusion-weighted MRI and contrast-enhanced MRI for differentiation between solid renal masses and renal cell carcinoma subtypes

Abdominal Radiology

To assess the value of diffusion-weighted magnetic resonance imaging (DW-MRI) and contrast-enhanc... more To assess the value of diffusion-weighted magnetic resonance imaging (DW-MRI) and contrast-enhanced MRI (CE-MRI) for differentiation between benign and malignant solid renal masses, renal cell carcinoma (RCC) subtypes, oncocytomas, and lipid-poor angiomyolipomas (LP-AML). Minimum or lowest ‘apparent diffusion coefficient’ (ADC1) and representative ADC values (ADC2) of 112 renal masses (n: 46 benign renal mass, n: 66 malignant renal mass) were measured on DW-MRI images (b 50, 400, 800 s/mm2). Signal intensity (SI) measurements were performed in normal renal parenchyma and most avid enhanced area of the renal masses at precontrast, corticomedullary, and nephrographic phases on CE-MRI. Contrast enhancement rate (CER) and contrast enhancement index (CEI) values of renal masses were compared between benign-malignant renal masses and RCC subtypes, oncocytomas, and LP-AMLs. There was no significant difference between ADC1, ADC2 values, and SI of benign and malignant renal masses (p = 0.721, p = 0.255, p = 0.872). Mean ADC1 and ADC2 values of clear cell RCCs were significantly higher than nonclear cell RCCs (p = 0.005 p = 0.002). Mean CER value of clear cell RCCs was significantly higher than nonclear cell RCCs in nephrographic phase (p = 0.003). Mean CEI values of clear cell RCCs were significantly higher than nonclear cell RCCs in the corticomedullary and nephrographic phase (p = 0.027 vs. 0.008). LP-AMLs were differentiated from other renal masses with wash-out phenomenon. Combined usage of ADC, SI, CER, and CEI values may be useful for discrimination between RCC subtypes, oncocytomas, and lipid-poor AMLs.

Research paper thumbnail of Current Approach to the Prognostic Parameters of Testicular Germ Cell Tumors Accompanied by Our Cases

Düzce Tıp Fakültesi Dergisi

Aim: Testicular germ cell tumors (TGCT) are solid neoplasms common in young adult men and an impo... more Aim: Testicular germ cell tumors (TGCT) are solid neoplasms common in young adult men and an important cause of cancer-related deaths during this period. Revisions in histopathological classification and staging affect prognosis and treatment. The aim of this study was to analyze our TGCT cases, to review prognostic parameters, and their relationship between germ cell neoplasia in situ (GCNIS), intratubular and intertubular tumors. Material and Methods: In this study, Hematoxylin&Eosin-stained sections of 77 TGCTs were re-evaluated. The presence of GCNIS, intratubular and intertubular germ cell tumors were recorded. Histopathological classification and staging were revised based on the changes in the 8th edition of American Joint Committee on Cancer (AJCC). Results: The majority of the patients were diagnosed as seminoma (n=42), followed by mixed germ cell tumors (n=33) and spermatocytic tumors (n=2). Rete testis invasion in 30 cases, epididymal invasion in 6 cases, hilar soft tissue invasion in 10 cases, tunica vaginalis invasion in 1 case, spermatic cord invasion in 4 cases, and lymphovascular invasion in 22 cases were detected. Intertubular seminoma in 25 cases, intratubular carcinoma in 16 cases, and GCNIS in 73 cases were detected. Conclusion: The major criteria to determine treatment choices are histopathological diagnosis, pathological tumor stage, serum tumor markers and presence of metastasis. According to AJCC 8th edition, addition of hilar soft tissue invasion to staging has increased the number of our pT2 cases. Moreover, assuming discontinuous tumor invasion of spermatic cord by vascular invasion as pM1 has also increased the number of metastatic testis tumors.

Research paper thumbnail of Oral liken planus ve skuamöz hücreli karsinom olgularında Langerhans hücre yoğunluğunun değerlendirilmesi

Konuralp Tıp Dergisi

Amac: Oral mukoza pek cok etken tarafindan hasara ugratilabilmektedir. Oral patolojilerin hucre a... more Amac: Oral mukoza pek cok etken tarafindan hasara ugratilabilmektedir. Oral patolojilerin hucre aracili immunite ile iliski olabilecegi one surulmus ve bu konuda cok cesitli arastirmalar yapilmistir. Dendritik hucreler, adaptif hucresel cevabi baslatan antijen sunucu hucrelerdir. Bu grubun onemli bir uyesi olan Langerhans hucreleri(LH), tum stratifiye epitellerde ozellikle de skuamoz epitelin orta ve ust kisminda yerlesir. Oral liken planus(OLP) sik gorulen, etyolojisi net bilinmeyen kronik mukokutanoz inflamatuar bir hastaliktir. Oral kavitede en sik rastlanan malignite oral skuamoz hucreli karsinomdur(OSHK). Calismamizda mukozal savunmada onemli rolu olan Langerhans hucrelerinin OLP ve OSHK’da dagilimini inceleyerek lokal immun cevaptaki rolu hakkinda fikir sahibi olmayi amacladik Yontem: 2013-2016 yillari arasinda Dis Hekimligi Fakultesi tarafindan gonderilen, 36 adet OLP, 28 adet OSHK ve kontrol grubu olarak 10 adet normal mukoza olmak uzere toplam 74 hasta retrospektif olarak yeniden degerlendirilmis, uygun bloklar secilerek immunhistokimyasal olarak Langerin antikoru uygulanmistir. Her olguda 1mm2’lik alanlarda bazal ve suprabazal yerlesimli LH’leri sayilmistir. Bulgular: Calismamizda OLP olgularinda kadin(%60),OSHK olgularinda erkek hakimiyeti(%58) izlendi. Yas dagilimi OLP’larda 53±12 iken OSHK’da 61±21 idi. OLP hastalarin %86’sinda yanak mukozasinda yerlesimli iken OSHK olgularinda bu oran sadece %11’di. Langerhans hucre yogunlugu kontrol grubunda 87(57-105), OLP’da 104(84-143), OSHK’da 82(48-128)’du. Sonuc: Calismamizda LH’lerinde sayisal olarak OLP’lerde kontrol ve OSHK olgularina gore istatiksel olarak anlamli artis izlenmistir. Literaturde bu durumlarla ilgili cesitli farkli sonuclara rastlamak mumkundur. Langerhans hucrelerinin bu hastaliklardaki yogunlugunun belirlenmesi, hastaligin patogenezi ve tedavi seceneklerinin gelistirilebilmesi acisindan yol gosterici olabilir.

Research paper thumbnail of Histopathological Features of Paratesticular Solid Tumors: 5 Years Experience

İstanbul Kanuni Sultan Süleyman Tıp Dergisi

Research paper thumbnail of A case of multiple familial trichoepitelioma with malignant transformation successfully treated with Vismodegib

Dermatologic Therapy

Dear Editor A 62-year-old woman consulted from plastic surgery clinic to the dermatoveneorology c... more Dear Editor A 62-year-old woman consulted from plastic surgery clinic to the dermatoveneorology clinic with multiple firm, flesh colored papules localized to the face and erythematous nodules on the scalp (Figure 1). The patient had total left auriculectomy due to the color changes of the lesions, and increasing in size on her auricula, the histopathological examination revealed basal cell carcinoma (BCC), with positive surgical margin on the tragus, and suspicious lesion was extended to the external ear way, the biopsy from this lesion was consistent with BCC, again. A purulent discharge from left auricula was accompanying the complaints of patients (Figure 2). On dermoscopic examination, there were arborizing vessels, black clods on the papules of right medial cantus similar to the dermoscopic features of BCC (Figure 3). Multiple punch biopsies were performed from the papules of the face and nodules of the scalp. Histopathological examinations revealed trichoepitelioma for all of the biopsies. Patient stated that she had had these lesions since she was a teenager; her mother, sister, and all of her children showed similar eruptions on their faces (Figure 4). Because of clinical and histological manifestations, the patient and her relatives were suspected to have multiple familial trichoepitelioma (MFT). To confirm our suspected diagnosis, genetic analysis was carried out. Heterozygous missense germline mutation was detected on the CYLD tumor suppressor gene. Since the positive surgical margin, purulent discharge, and the complications of recurrent radical surgery, Vismodegib 150 mg/day was started to the patient. After 3 months of treatment, the purulent discharge was stopped, the

Research paper thumbnail of Surgical treatment of adult‐onset xanthogranuloma

Dermatologic Therapy

Dear Editor, The adult orbital xanthogranulomatous disease (AOXD) is a rare group of orbital and ... more Dear Editor, The adult orbital xanthogranulomatous disease (AOXD) is a rare group of orbital and ocular heterogeneous disorders. It is characterized by the proliferation of non-Langerhans (type II) histiocytes. According to the severity of systemic involvement, it is classified into four subgroups as adult-onset xanthogranuloma (AOX), adultonset asthma with periocular xanthogranuloma, Erdheim-Chester disease, and necrobiotic xanthogranuloma (Table 1). While the most common subtype is reported as necrobiotic xanthogranuloma, the least common type is reported as AOX, as seen in our case. Although there are some histological differences and distinctive systemic associations in these four subgroups, each of them is characterized by the infiltration of foamy histiocytes and giant cells of the Touton type, which are usually negative for S100 protein and CD1a, and positive for CD68. A 39-year-old male patient admitted to our clinic with bilateral periorbital yellowish plaques and papulonodules that had been present for 5 years. Although they were removed twice, the lesions recurred in a short period. The examination revealed 4 × 1 cm yellowish plaques and papulonodules extending from the right medial canthus to the nasojugal crease and 2.5 × 0.75 cm yellowish plaques and papulonodules extending from the medial part of the left lower eyelid crease to the nasojugal crease. The lesions were non-tender and firm on palpation (Figure 1A-C). Two-step surgical excision was planned on the right side due to the large size of the lesion. In the first session, crescentic partial excision was performed. With a careful exploration, the entire yellowish lesion was removed from and around the medial canthal ligament, and the skin was sutured. Histopathologic examination revealed diffuse dermal infiltrate of histiocytes extending through the periorbital soft tissue, forming nodules (Figure 1D). The histiocytes were the dominant cells containing lipid and were characterized by their appearance of finely vacuolated, foamy cytoplasm (xanthomatous cytoplasm). The xanthomatous cells were intermingled aggregates of lymphocytes, plasma cells, eosinophils, and scattered Touton giant cells. The collection of these cells formed granulomas (Figure 1E). The histopathological diagnosis was reported as xanthogranuloma. With the absence of paraproteinemia, hematologic abnormalities, asthma, lymphadenopathies, and internal organ involvement, our patient was diagnosed as AOX. After 11 months, all lesions on the right and left sides were excised totally by performing crescentic excisions. No recurrence was observed in a 4-years follow-up (Figure 1F-H). AOX does not show any gender discrimination. It is seen in the 38 to 79 age group as isolated xanthogranuloma without systemic involvement. AOX manifests itself as bilateral, yellowish, puffy, indurated, non-ulcerated masses in the eyelids, and/or periorbital region. Involvement may also occur in the anterior orbital fat compartment, extraocular muscles, and/or lacrimal glands. Although the presence of Touton giant cells with xanthoma cells is typical, it is difficult to subclassify the disease based on histomorphology alone. Since patients often have varying combinations of periocular xanthogranuloma and other blood dyscrasias such as thrombocytopenia, paraproteinemia, and/or monoclonal gammopathy, histomorphologic evaluation often requires correlation with the patterns of systemic involvement. Many treatment modalities such as corticosteroids, chemotherapy, radiotherapy, or surgery have been used with varying success rates in AOXD, however, there is no consensus on the most effective treatment option yet. AOX usually does not require aggressive treatment unlike the other subtypes of the disease. For that reason, even in the recurrent

Research paper thumbnail of A Rare Confusing Nevus Variant: Meyerson Nevus

Bezmialem Science, May 31, 2018

Meyerson nevus is a rare benign entity described by Meyerson et al in 1971 as a melanocytic nevus... more Meyerson nevus is a rare benign entity described by Meyerson et al in 1971 as a melanocytic nevus surrounded by inflammatory, eczematous eruption that resolves spontaneously or by topical steriod therapy (fluticasone propionate, Abdi İbrahim İlaç San. ve Tic. A.Ş., İstanbul), but the nevus persists. This entity is not well known and there is limited information in the literature. Since the lesion may develop suspicion for malignancy, it is important to keep this entity in mind. In this article we present three Meyerson nevi, two of which belong to one patient.

Research paper thumbnail of Bladder Neck Involvement in Radical Prostatectomy Specimens is not a pT4 Disease

Journal of Urological Surgery, Dec 27, 2017

Research paper thumbnail of The Effects of Micronized Progesterone and Cabergoline On a Rat Autotransplantation Endometriosis Model: A Placebo Controlled Randomized Trial

Journal of Investigative Surgery

Abstract Aim The etiology of endometriosis is complex and various theories have been postulated. ... more Abstract Aim The etiology of endometriosis is complex and various theories have been postulated. Endometriosis pathogenesis involves genetic susceptibility, immunologic alterations and inflammatory prerequisite pathways. In this pilot experimental animal study we wanted to investigate the effects of cabergoline and micronized progesterone on a rat endometriosis model. Material and methods All rats were provided and housed in the animal laboratory of the Experimental Research Center of Bezmialem Vakif University. This was a placebo controlled randomized trial. The endometriosis model consisted of autotransplantation of endometrial tissue on 21 adult Sprague-Dawley rats. Endometriosis formation by second-look laparotomy was confirmed 8 weeks later. After measuring the endometriosis implant area the rats were randomized into three intervention groups: cabergoline treatment group, micronized progesterone treatment group and the control group. Four weeks after treatment, a third laparotomy was performed to remeasure implant volumes. Endometriotic implants were obtained for histopathological and immunohistochemical analysis. Results After 4 weeks of treatment endometriosis implant sizes diminished in all groups. There was no statistically significant difference regarding implant size volume before and after treatment among the groups. The peritoneal histopathology and immunohistochemistry showed no difference with regards to IL-6 and TNF-α staining among groups. Conclusion We conclude that oral treatment of cabergoline and micronized progesterone for 4 weeks was not statistically effective in endometriotic implant regression. However, we believe further studies are warranted. Treatment for longer durations or via different routes may be investigated in further studies. When ethically applicable other mammals may be considered such as baboons.

Research paper thumbnail of Effects of Orally Consumed Rosa damascena Mill. Hydrosol on Hematology, Clinical Chemistry, Lens Enzymatic Activity, and Lens Pathology in Streptozotocin-Induced Diabetic Rats

Molecules

Diabetes mellitus is a multisystemic metabolic disorder that may affect the eyes, kidneys, vessel... more Diabetes mellitus is a multisystemic metabolic disorder that may affect the eyes, kidneys, vessels, and heart. Chronic hyperglycemia causes non-enzymatic glycation of proteins and elevation of the polyol pathway resulting in oxidative stress that damages organs. The current study aimed to investigate the dose-dependent effects of orally consumed Rosa damascena Mill. hydrosol on hematology, clinical biochemistry, lens enzymatic activity, and lens pathology in streptozotocin (STZ)-induced diabetic rats. Diabetes was induced into male Sprague–Dawley rats by intraperitoneal administration of STZ (40 mg/kg body weight). Rose hydrosols containing 1515 mg/L and 500 mg/L total volatiles (expressed as citronellol) were introduced to rats orally for 45 days. Consumption of 1515 mg/L volatile containing rose hydrosol successfully ameliorated hematologic, hepatic, and renal functions. Hydrosols also attenuated hyperglycemia and decreased the advanced glycation end-product formation in a dose-de...

Research paper thumbnail of Measurement of Tumor Thickness in Cutaneous Squamous Cell Carcinomas

The American Journal of Dermatopathology

Cutaneous squamous cell carcinoma (cSCC) is the second most common cause of nonmelanoma skin canc... more Cutaneous squamous cell carcinoma (cSCC) is the second most common cause of nonmelanoma skin cancers. Although it has a relatively low mortality rate, it may be locally destructive and potentially metastasize. Tumor thickness of the primary lesion is one important parameter associated with biologic behavior. Such measurement is currently performed in different ways depending on the anatomic location and subspecialty (eg, skin vs. head and neck vs. gynecologic pathology). Furthermore, the new The American Joint Committee on Cancer eighth edition has changed the previously recommended method of measurement of cSCC of head and neck from a modified Breslow thickness to measuring from the granular layer of adjacent, normal-appearing skin to the deepest invasive tumor cell. This study evaluated the clinical significance on patient outcome by measuring tumor thickness using 4 common, currently available methods (measurement from: A. uninvolved dermoepidermal junction; B. top of granular cell layer of the epidermis overlying the tumor, that is, similar to Breslow thickness; C. dermoepidermal junction with in situ cSCC; D. top of granular layer of uninvolved skin) in 85 specimens from nongenital areas of 78 patients with cSCC. Thirty-five percent of them were from the head and neck area. Measurements were performed in millimeters using the digital ruler of image analysis software (Olympus cellSens Standard) on whole-slide scanned images. Associations between recurrence-free survival (RFS) and each method were assessed. When thickness was considered as a continuous measure, there was no statistically significant association between any of the 4 measurement techniques and RFS. When using the currently recommended 6.0-mm cutoff, methods B and C were significantly associated with RFS. Similarly, when optimal cutoff values were selected, all 4 methods were significantly associated with RFS in univariable analysis. However, in a multivariable model that included the techniques and location of lesion, only method B, using the optimal cutoff value of 8.7 mm, was independently associated with RFS. In summary, in our series of cSCC, measurement of thickness using a Breslow method (method B) was significantly associated with RFS using the optimal cutoff and the currently recommended 6.0 mm in univariable analyses and the optimal cutoff in a multivariable assessment. Therefore, our data indicate that measurement of tumor thickness in a manner similar to Breslow thickness may be used to help predict recurrence in patients with cSCC.

Research paper thumbnail of Dermatoscopic findings of pigmented purpuric dermatosis

Anais Brasileiros de Dermatologia, 2016

Research paper thumbnail of New Markers in Atherosclerosis: Thrombospondin-2 (THBS-2) and Leukocyte Cell-Derived Chemotaxin-2 (LECT-2); An Immunohistochemical Study

Medical Science Monitor, Dec 31, 2016

BACKGROUND Current research investigating the role of THBS2 and LECT-2 in atherogenesis is very l... more BACKGROUND Current research investigating the role of THBS2 and LECT-2 in atherogenesis is very limited. Therefore, we designed this study to demonstrate the role of THBS-2 and LECT-2 in atherosclerosis at the tissue level in fresh specimens. MATERIAL AND METHODS A total of 32 patients who underwent coronary bypass surgery were enrolled. Aortic wall punch biopsies were obtained at the site of proximal aortosaphenous bypass graft anastomosis. A specimen of left internal mammarian artery (LiMA) was taken from the segment just proximal to its anastomosis. The aortic tissue is representive of the atherosclerotic tisue, and LiMA tissue is representative of the non-atherosclerotic area. The specimens were painted with CD68 for macrophage, and THBS-2 and LECT-2 antibodies for immunohistochemical staining. RESULTS Aortic THBS-2 levels were significantly lower, whereas aortic LECT-2 levels were significantly higher when compare to LiMA (14.4±9.9 (5-30) and 36.9±13.0 (5-60) p: 0.0001 and 20.3...

Research paper thumbnail of A Rare Confusing Nevus Variant: Meyerson Nevus

Bezmialem Science

Meyerson nevus is a rare benign entity described by Meyerson et al in 1971 as a melanocytic nevus... more Meyerson nevus is a rare benign entity described by Meyerson et al in 1971 as a melanocytic nevus surrounded by inflammatory, eczematous eruption that resolves spontaneously or by topical steriod therapy (fluticasone propionate, Abdi İbrahim İlaç San. ve Tic. A.Ş., İstanbul), but the nevus persists. This entity is not well known and there is limited information in the literature. Since the lesion may develop suspicion for malignancy, it is important to keep this entity in mind. In this article we present three Meyerson nevi, two of which belong to one patient.

Research paper thumbnail of Correlation of clinical, dermoscopical and histopathological features of all subtypes of basal cell carcinoma

Research paper thumbnail of Evolution of Spitz Nevi. Pediatr Dermatol

Research paper thumbnail of Akciğer Dişindaki Tümörlerde İmmunhistokimyasal TTF-1 Ekspresyonu

Objective: Thyroid transcription factor-1 (TTF-1) immunoexpression is frequently determined in sm... more Objective: Thyroid transcription factor-1 (TTF-1) immunoexpression is frequently determined in small-cell lung carcinomas, as well as primary lung adenocarcinomas. While dealing with metastatic carcinomas, TTF-1 immunoexpression is a significant indicator of primary lung carcinomas. Recent studies have revealed that TTF1 immunoexpression is also defined in non-lung cancers, such as squamous cell carcinomas of different sites and certain neuroendocrine tumors. The verified data obtained from these studies indicate that a straightforward diagnosis of primary lung carcinoma in cases with positive TTF-1 immunoexpression can cause diagnostic contradictions. The aim of our study is to investigate the immunoexpression status of TTF-1 in common non-lung tumors. Methods: A total of 85 cases that were diagnosed in our institute between the years 2011-2012 were included in our study. After a review of the pathological slides prepared from these tumors [colon adenocarcinoma (n: 15), renal cell ...

Research paper thumbnail of Galectin-3 Expression in Human Endometrium and Decidua During The Menstrual Cycle and in Gestation

OBJECTIVE: G3 is one of the members of the lectin family that may be involved in the establishmen... more OBJECTIVE: G3 is one of the members of the lectin family that may be involved in the establishment of endometrial receptivity by regulating the proliferation and adhesion of endometrial cells. STUDY DESIGN: Immunohistochemical expression of G3 was tested in late secretory phase of the endometrium (SPE)(n=30), proliferative phase of the endometrium (PPE)(n=34), and decidua (n=41) and induced abortions in the first trimester. RESULTS: Expression of G3 during the PPE was low; 12 cases were score 1 and 19 cases were score 2 (p<0.001). However, among the late SPE, there were 11 cases at score 2, and 15 cases at score 3. In the decidua expression of G3, 37 cases were score 3 (p<0.001). CONCLUSION: There is a significant progression of G3 expression in SPE and gestation. Although during the PPE expression is considerably lower. This shows that G3 plays an important role in implantation.

Research paper thumbnail of Bladder Neck Involvement in Radical Prostatectomy Specimens is not a pT4 Disease

Journal of Urological Surgery

Research paper thumbnail of Traumatic Avulsion of Upper Eyelid Skin Following Surgery in a Patient With Multiple Myeloma and Amyloid Light-chain Amyloidosis

Wound Management & Prevention

Multiple myeloma (MM) is a common hematologic malignancy. Primary systemic amyloidosis or amyloid... more Multiple myeloma (MM) is a common hematologic malignancy. Primary systemic amyloidosis or amyloid light-chain (AL) amyloidosis is a rare disease. PURPOSE This article presents the case of a patient with MM and AL amyloidosis who experienced a severe case of medical adhesive-related skin injury. CASE STUDY A 64-year-old man with MM, AL amyloidosis, and diabetes presented with a necrotic wound on his left heel that required surgical debridement. The patient experienced a traumatic avulsion of the right upper eyelid skin during the removal of the corneal abrasion preventive tape as well as traumatic avulsion of the left upper eyelid skin while the patient's face was being cleansed. The avulsed right upper eyelid skin above the tarsus was repaired with a full-thickness skin graft. The partly avulsed left upper eyelid skin was repositioned, and an excisional biopsy was taken. Both upper eyelids healed uneventfully. The biopsy specimen revealed increased amyloid deposition in the dermis, subcutaneous tissue, and areas surrounding the veins and sweat glands. CONCLUSION This case illustrates the increased risk of medical adhesive-related skin injury and other skin damage in patients with MM and AL amyloidosis. In these patients, the use of tape should be avoided to prevent intraoperative corneal abrasion.

Research paper thumbnail of The role of diffusion-weighted MRI and contrast-enhanced MRI for differentiation between solid renal masses and renal cell carcinoma subtypes

Abdominal Radiology

To assess the value of diffusion-weighted magnetic resonance imaging (DW-MRI) and contrast-enhanc... more To assess the value of diffusion-weighted magnetic resonance imaging (DW-MRI) and contrast-enhanced MRI (CE-MRI) for differentiation between benign and malignant solid renal masses, renal cell carcinoma (RCC) subtypes, oncocytomas, and lipid-poor angiomyolipomas (LP-AML). Minimum or lowest ‘apparent diffusion coefficient’ (ADC1) and representative ADC values (ADC2) of 112 renal masses (n: 46 benign renal mass, n: 66 malignant renal mass) were measured on DW-MRI images (b 50, 400, 800 s/mm2). Signal intensity (SI) measurements were performed in normal renal parenchyma and most avid enhanced area of the renal masses at precontrast, corticomedullary, and nephrographic phases on CE-MRI. Contrast enhancement rate (CER) and contrast enhancement index (CEI) values of renal masses were compared between benign-malignant renal masses and RCC subtypes, oncocytomas, and LP-AMLs. There was no significant difference between ADC1, ADC2 values, and SI of benign and malignant renal masses (p = 0.721, p = 0.255, p = 0.872). Mean ADC1 and ADC2 values of clear cell RCCs were significantly higher than nonclear cell RCCs (p = 0.005 p = 0.002). Mean CER value of clear cell RCCs was significantly higher than nonclear cell RCCs in nephrographic phase (p = 0.003). Mean CEI values of clear cell RCCs were significantly higher than nonclear cell RCCs in the corticomedullary and nephrographic phase (p = 0.027 vs. 0.008). LP-AMLs were differentiated from other renal masses with wash-out phenomenon. Combined usage of ADC, SI, CER, and CEI values may be useful for discrimination between RCC subtypes, oncocytomas, and lipid-poor AMLs.

Research paper thumbnail of Current Approach to the Prognostic Parameters of Testicular Germ Cell Tumors Accompanied by Our Cases

Düzce Tıp Fakültesi Dergisi

Aim: Testicular germ cell tumors (TGCT) are solid neoplasms common in young adult men and an impo... more Aim: Testicular germ cell tumors (TGCT) are solid neoplasms common in young adult men and an important cause of cancer-related deaths during this period. Revisions in histopathological classification and staging affect prognosis and treatment. The aim of this study was to analyze our TGCT cases, to review prognostic parameters, and their relationship between germ cell neoplasia in situ (GCNIS), intratubular and intertubular tumors. Material and Methods: In this study, Hematoxylin&Eosin-stained sections of 77 TGCTs were re-evaluated. The presence of GCNIS, intratubular and intertubular germ cell tumors were recorded. Histopathological classification and staging were revised based on the changes in the 8th edition of American Joint Committee on Cancer (AJCC). Results: The majority of the patients were diagnosed as seminoma (n=42), followed by mixed germ cell tumors (n=33) and spermatocytic tumors (n=2). Rete testis invasion in 30 cases, epididymal invasion in 6 cases, hilar soft tissue invasion in 10 cases, tunica vaginalis invasion in 1 case, spermatic cord invasion in 4 cases, and lymphovascular invasion in 22 cases were detected. Intertubular seminoma in 25 cases, intratubular carcinoma in 16 cases, and GCNIS in 73 cases were detected. Conclusion: The major criteria to determine treatment choices are histopathological diagnosis, pathological tumor stage, serum tumor markers and presence of metastasis. According to AJCC 8th edition, addition of hilar soft tissue invasion to staging has increased the number of our pT2 cases. Moreover, assuming discontinuous tumor invasion of spermatic cord by vascular invasion as pM1 has also increased the number of metastatic testis tumors.

Research paper thumbnail of Oral liken planus ve skuamöz hücreli karsinom olgularında Langerhans hücre yoğunluğunun değerlendirilmesi

Konuralp Tıp Dergisi

Amac: Oral mukoza pek cok etken tarafindan hasara ugratilabilmektedir. Oral patolojilerin hucre a... more Amac: Oral mukoza pek cok etken tarafindan hasara ugratilabilmektedir. Oral patolojilerin hucre aracili immunite ile iliski olabilecegi one surulmus ve bu konuda cok cesitli arastirmalar yapilmistir. Dendritik hucreler, adaptif hucresel cevabi baslatan antijen sunucu hucrelerdir. Bu grubun onemli bir uyesi olan Langerhans hucreleri(LH), tum stratifiye epitellerde ozellikle de skuamoz epitelin orta ve ust kisminda yerlesir. Oral liken planus(OLP) sik gorulen, etyolojisi net bilinmeyen kronik mukokutanoz inflamatuar bir hastaliktir. Oral kavitede en sik rastlanan malignite oral skuamoz hucreli karsinomdur(OSHK). Calismamizda mukozal savunmada onemli rolu olan Langerhans hucrelerinin OLP ve OSHK’da dagilimini inceleyerek lokal immun cevaptaki rolu hakkinda fikir sahibi olmayi amacladik Yontem: 2013-2016 yillari arasinda Dis Hekimligi Fakultesi tarafindan gonderilen, 36 adet OLP, 28 adet OSHK ve kontrol grubu olarak 10 adet normal mukoza olmak uzere toplam 74 hasta retrospektif olarak yeniden degerlendirilmis, uygun bloklar secilerek immunhistokimyasal olarak Langerin antikoru uygulanmistir. Her olguda 1mm2’lik alanlarda bazal ve suprabazal yerlesimli LH’leri sayilmistir. Bulgular: Calismamizda OLP olgularinda kadin(%60),OSHK olgularinda erkek hakimiyeti(%58) izlendi. Yas dagilimi OLP’larda 53±12 iken OSHK’da 61±21 idi. OLP hastalarin %86’sinda yanak mukozasinda yerlesimli iken OSHK olgularinda bu oran sadece %11’di. Langerhans hucre yogunlugu kontrol grubunda 87(57-105), OLP’da 104(84-143), OSHK’da 82(48-128)’du. Sonuc: Calismamizda LH’lerinde sayisal olarak OLP’lerde kontrol ve OSHK olgularina gore istatiksel olarak anlamli artis izlenmistir. Literaturde bu durumlarla ilgili cesitli farkli sonuclara rastlamak mumkundur. Langerhans hucrelerinin bu hastaliklardaki yogunlugunun belirlenmesi, hastaligin patogenezi ve tedavi seceneklerinin gelistirilebilmesi acisindan yol gosterici olabilir.

Research paper thumbnail of Histopathological Features of Paratesticular Solid Tumors: 5 Years Experience

İstanbul Kanuni Sultan Süleyman Tıp Dergisi

Research paper thumbnail of A case of multiple familial trichoepitelioma with malignant transformation successfully treated with Vismodegib

Dermatologic Therapy

Dear Editor A 62-year-old woman consulted from plastic surgery clinic to the dermatoveneorology c... more Dear Editor A 62-year-old woman consulted from plastic surgery clinic to the dermatoveneorology clinic with multiple firm, flesh colored papules localized to the face and erythematous nodules on the scalp (Figure 1). The patient had total left auriculectomy due to the color changes of the lesions, and increasing in size on her auricula, the histopathological examination revealed basal cell carcinoma (BCC), with positive surgical margin on the tragus, and suspicious lesion was extended to the external ear way, the biopsy from this lesion was consistent with BCC, again. A purulent discharge from left auricula was accompanying the complaints of patients (Figure 2). On dermoscopic examination, there were arborizing vessels, black clods on the papules of right medial cantus similar to the dermoscopic features of BCC (Figure 3). Multiple punch biopsies were performed from the papules of the face and nodules of the scalp. Histopathological examinations revealed trichoepitelioma for all of the biopsies. Patient stated that she had had these lesions since she was a teenager; her mother, sister, and all of her children showed similar eruptions on their faces (Figure 4). Because of clinical and histological manifestations, the patient and her relatives were suspected to have multiple familial trichoepitelioma (MFT). To confirm our suspected diagnosis, genetic analysis was carried out. Heterozygous missense germline mutation was detected on the CYLD tumor suppressor gene. Since the positive surgical margin, purulent discharge, and the complications of recurrent radical surgery, Vismodegib 150 mg/day was started to the patient. After 3 months of treatment, the purulent discharge was stopped, the

Research paper thumbnail of Surgical treatment of adult‐onset xanthogranuloma

Dermatologic Therapy

Dear Editor, The adult orbital xanthogranulomatous disease (AOXD) is a rare group of orbital and ... more Dear Editor, The adult orbital xanthogranulomatous disease (AOXD) is a rare group of orbital and ocular heterogeneous disorders. It is characterized by the proliferation of non-Langerhans (type II) histiocytes. According to the severity of systemic involvement, it is classified into four subgroups as adult-onset xanthogranuloma (AOX), adultonset asthma with periocular xanthogranuloma, Erdheim-Chester disease, and necrobiotic xanthogranuloma (Table 1). While the most common subtype is reported as necrobiotic xanthogranuloma, the least common type is reported as AOX, as seen in our case. Although there are some histological differences and distinctive systemic associations in these four subgroups, each of them is characterized by the infiltration of foamy histiocytes and giant cells of the Touton type, which are usually negative for S100 protein and CD1a, and positive for CD68. A 39-year-old male patient admitted to our clinic with bilateral periorbital yellowish plaques and papulonodules that had been present for 5 years. Although they were removed twice, the lesions recurred in a short period. The examination revealed 4 × 1 cm yellowish plaques and papulonodules extending from the right medial canthus to the nasojugal crease and 2.5 × 0.75 cm yellowish plaques and papulonodules extending from the medial part of the left lower eyelid crease to the nasojugal crease. The lesions were non-tender and firm on palpation (Figure 1A-C). Two-step surgical excision was planned on the right side due to the large size of the lesion. In the first session, crescentic partial excision was performed. With a careful exploration, the entire yellowish lesion was removed from and around the medial canthal ligament, and the skin was sutured. Histopathologic examination revealed diffuse dermal infiltrate of histiocytes extending through the periorbital soft tissue, forming nodules (Figure 1D). The histiocytes were the dominant cells containing lipid and were characterized by their appearance of finely vacuolated, foamy cytoplasm (xanthomatous cytoplasm). The xanthomatous cells were intermingled aggregates of lymphocytes, plasma cells, eosinophils, and scattered Touton giant cells. The collection of these cells formed granulomas (Figure 1E). The histopathological diagnosis was reported as xanthogranuloma. With the absence of paraproteinemia, hematologic abnormalities, asthma, lymphadenopathies, and internal organ involvement, our patient was diagnosed as AOX. After 11 months, all lesions on the right and left sides were excised totally by performing crescentic excisions. No recurrence was observed in a 4-years follow-up (Figure 1F-H). AOX does not show any gender discrimination. It is seen in the 38 to 79 age group as isolated xanthogranuloma without systemic involvement. AOX manifests itself as bilateral, yellowish, puffy, indurated, non-ulcerated masses in the eyelids, and/or periorbital region. Involvement may also occur in the anterior orbital fat compartment, extraocular muscles, and/or lacrimal glands. Although the presence of Touton giant cells with xanthoma cells is typical, it is difficult to subclassify the disease based on histomorphology alone. Since patients often have varying combinations of periocular xanthogranuloma and other blood dyscrasias such as thrombocytopenia, paraproteinemia, and/or monoclonal gammopathy, histomorphologic evaluation often requires correlation with the patterns of systemic involvement. Many treatment modalities such as corticosteroids, chemotherapy, radiotherapy, or surgery have been used with varying success rates in AOXD, however, there is no consensus on the most effective treatment option yet. AOX usually does not require aggressive treatment unlike the other subtypes of the disease. For that reason, even in the recurrent

Research paper thumbnail of A Rare Confusing Nevus Variant: Meyerson Nevus

Bezmialem Science, May 31, 2018

Meyerson nevus is a rare benign entity described by Meyerson et al in 1971 as a melanocytic nevus... more Meyerson nevus is a rare benign entity described by Meyerson et al in 1971 as a melanocytic nevus surrounded by inflammatory, eczematous eruption that resolves spontaneously or by topical steriod therapy (fluticasone propionate, Abdi İbrahim İlaç San. ve Tic. A.Ş., İstanbul), but the nevus persists. This entity is not well known and there is limited information in the literature. Since the lesion may develop suspicion for malignancy, it is important to keep this entity in mind. In this article we present three Meyerson nevi, two of which belong to one patient.

Research paper thumbnail of Bladder Neck Involvement in Radical Prostatectomy Specimens is not a pT4 Disease

Journal of Urological Surgery, Dec 27, 2017

Research paper thumbnail of The Effects of Micronized Progesterone and Cabergoline On a Rat Autotransplantation Endometriosis Model: A Placebo Controlled Randomized Trial

Journal of Investigative Surgery

Abstract Aim The etiology of endometriosis is complex and various theories have been postulated. ... more Abstract Aim The etiology of endometriosis is complex and various theories have been postulated. Endometriosis pathogenesis involves genetic susceptibility, immunologic alterations and inflammatory prerequisite pathways. In this pilot experimental animal study we wanted to investigate the effects of cabergoline and micronized progesterone on a rat endometriosis model. Material and methods All rats were provided and housed in the animal laboratory of the Experimental Research Center of Bezmialem Vakif University. This was a placebo controlled randomized trial. The endometriosis model consisted of autotransplantation of endometrial tissue on 21 adult Sprague-Dawley rats. Endometriosis formation by second-look laparotomy was confirmed 8 weeks later. After measuring the endometriosis implant area the rats were randomized into three intervention groups: cabergoline treatment group, micronized progesterone treatment group and the control group. Four weeks after treatment, a third laparotomy was performed to remeasure implant volumes. Endometriotic implants were obtained for histopathological and immunohistochemical analysis. Results After 4 weeks of treatment endometriosis implant sizes diminished in all groups. There was no statistically significant difference regarding implant size volume before and after treatment among the groups. The peritoneal histopathology and immunohistochemistry showed no difference with regards to IL-6 and TNF-α staining among groups. Conclusion We conclude that oral treatment of cabergoline and micronized progesterone for 4 weeks was not statistically effective in endometriotic implant regression. However, we believe further studies are warranted. Treatment for longer durations or via different routes may be investigated in further studies. When ethically applicable other mammals may be considered such as baboons.

Research paper thumbnail of Effects of Orally Consumed Rosa damascena Mill. Hydrosol on Hematology, Clinical Chemistry, Lens Enzymatic Activity, and Lens Pathology in Streptozotocin-Induced Diabetic Rats

Molecules

Diabetes mellitus is a multisystemic metabolic disorder that may affect the eyes, kidneys, vessel... more Diabetes mellitus is a multisystemic metabolic disorder that may affect the eyes, kidneys, vessels, and heart. Chronic hyperglycemia causes non-enzymatic glycation of proteins and elevation of the polyol pathway resulting in oxidative stress that damages organs. The current study aimed to investigate the dose-dependent effects of orally consumed Rosa damascena Mill. hydrosol on hematology, clinical biochemistry, lens enzymatic activity, and lens pathology in streptozotocin (STZ)-induced diabetic rats. Diabetes was induced into male Sprague–Dawley rats by intraperitoneal administration of STZ (40 mg/kg body weight). Rose hydrosols containing 1515 mg/L and 500 mg/L total volatiles (expressed as citronellol) were introduced to rats orally for 45 days. Consumption of 1515 mg/L volatile containing rose hydrosol successfully ameliorated hematologic, hepatic, and renal functions. Hydrosols also attenuated hyperglycemia and decreased the advanced glycation end-product formation in a dose-de...

Research paper thumbnail of Measurement of Tumor Thickness in Cutaneous Squamous Cell Carcinomas

The American Journal of Dermatopathology

Cutaneous squamous cell carcinoma (cSCC) is the second most common cause of nonmelanoma skin canc... more Cutaneous squamous cell carcinoma (cSCC) is the second most common cause of nonmelanoma skin cancers. Although it has a relatively low mortality rate, it may be locally destructive and potentially metastasize. Tumor thickness of the primary lesion is one important parameter associated with biologic behavior. Such measurement is currently performed in different ways depending on the anatomic location and subspecialty (eg, skin vs. head and neck vs. gynecologic pathology). Furthermore, the new The American Joint Committee on Cancer eighth edition has changed the previously recommended method of measurement of cSCC of head and neck from a modified Breslow thickness to measuring from the granular layer of adjacent, normal-appearing skin to the deepest invasive tumor cell. This study evaluated the clinical significance on patient outcome by measuring tumor thickness using 4 common, currently available methods (measurement from: A. uninvolved dermoepidermal junction; B. top of granular cell layer of the epidermis overlying the tumor, that is, similar to Breslow thickness; C. dermoepidermal junction with in situ cSCC; D. top of granular layer of uninvolved skin) in 85 specimens from nongenital areas of 78 patients with cSCC. Thirty-five percent of them were from the head and neck area. Measurements were performed in millimeters using the digital ruler of image analysis software (Olympus cellSens Standard) on whole-slide scanned images. Associations between recurrence-free survival (RFS) and each method were assessed. When thickness was considered as a continuous measure, there was no statistically significant association between any of the 4 measurement techniques and RFS. When using the currently recommended 6.0-mm cutoff, methods B and C were significantly associated with RFS. Similarly, when optimal cutoff values were selected, all 4 methods were significantly associated with RFS in univariable analysis. However, in a multivariable model that included the techniques and location of lesion, only method B, using the optimal cutoff value of 8.7 mm, was independently associated with RFS. In summary, in our series of cSCC, measurement of thickness using a Breslow method (method B) was significantly associated with RFS using the optimal cutoff and the currently recommended 6.0 mm in univariable analyses and the optimal cutoff in a multivariable assessment. Therefore, our data indicate that measurement of tumor thickness in a manner similar to Breslow thickness may be used to help predict recurrence in patients with cSCC.