Cihan Comba

Role of inflammatory mediators in patients with recurrent pregnancy loss

OBJECTIVE To examine interleukin-12 (IL-12), IL-18, IFN-γ, intracellular adhesion molecule-1 (ICAM-1), leukemia inhibitory factor (LIF), and migration inhibitory factor (MIF) levels in precisely-timed blood and endometrial tissue samples from women with idiopathic recurrent pregnancy loss (RPL). DESIGN Case-control study. SETTING University hospital. PATIENT(S) Twenty-one women with RPL and 20 women with proven fertility (controls). INTERVENTION(S) Primary endometrial cells and blood samples during the midsecretory phase (days 19-23). MAIN OUTCOME MEASURE(S) Detection of IL-12, IL-18, IFN-γ, ICAM-1, LIF, and MIF via enzyme-linked immunosorbent assay in both blood and endometrial tissue samples. RESULT(S) The blood and tissue levels of IL-12, IL-18, and IFN-γ were statistically significantly higher, and the blood and tissue levels of LIF and MIF were statistically significantly lower in patients with RPL. Only the level of tissue ICAM-1 was higher in patients with RPL. There was a strong correlation between blood and tissue level measurements of IL-12, IL-18, LIF, and MIF. CONCLUSION(S) Our findings support the hypothesis that inflammatory processes may contribute to pregnancy loss, possibly through their role in implantation. We found that blood and tissue levels of IL-18, LIF, and MIF, and tissue levels of IL-12, IFN-γ, and ICAM-1 have statistically significant prognostic relevance.

Extrapulmonary lymphangioleiomyomatosis mimicking lymphoma metastatic to uterus

Lymphangioleiomyomatosis is a very rare disease that primarily affects the lungs. The atypical smooth muscle cells in these tumors stain both with smooth muscle markers and melanocytic markers characteristically like their counterparts in other members of the PEComa family. Extrapulmonary lymphangioleiomyomatosis, especially without pulmonary involvement, is extremely rare. The clinical importance of lymphangioleiomyomatosis lies in the fact that it may mimic other malignant diseases, such as lymphoma or sarcoma. Here, we report a case of extrapulmonary lymphangioleiomyomatosis without involvement of the lungs, in a patient pre‐diagnosed as having lymphoma metastasized to the uterus or uterine sarcoma.

Immediate biopsy of cervical cytology-negative and non-HPV-16/18 oncogenic types positive patients

According to the American Society of Colposcopy and Cervical Pathology (ASCCP), a co‐test is recommended for patients one year after the detection of non‐HPV 16/18 viral types in association with a negative cervical cytology. In this study, we used immediate colposcopy to evaluate the risks to the patient during the one year waiting period.

Diffuse peritoneal leiomyomatosis.

Abdominal CT, ultrasound and magnetic resonance imaging (MRI) are non-invasive means to accurately identify cystic structures. Ultrasound appears to yield the most information for the least expense (Bodai et al. 1983; Miuelstaedt 1975). Our initial diagnosis aft er abdominal ultrasound was of ovarian cyst. Diff erential diagnoses include ovarian cyst, pancreatic pseudocyst within the gastrocolic mesentery, pedunculated uterine fi broid and omental cyst (Caropreso 1974). Mesenteric cysts should be considered in the diff erential diagnosis of women presenting with abdominal masses, especially if the ovaries are well-visualised.