Hampar Akkaya

Primary Leiomyosarcoma of the Breast: A Case Report

Primary leiomyosarcoma of the breast is an extremely rare tumor, accounting for less than 1% of all breast tumors and only 24 cases have been reported in the English medical journals. It is quite difficult to diagnose leiomyosarcoma preoperatively. Establishing an accurate diagnosis is very important in planning treatment. When preoperative diagnosis can be achieved before or during the operation, wide resection should be performed. There is no need for axillary lymph node dissection. In this case report, we present a case involving primary leiomysarcoma of the breast in a 48-year-old woman and we discuss optimal treatment options.

The value of tartrate resistant acid phosphatase (TRAP) immunoreactivity in diagnosis of hairy cell leukemia

Hairy cell leukemia (HCL) is a rare chronic B‐cell lymphoproliferative disorder characterized by splenomegaly, pancytopenia, and circulating atypical lymphocytes with circumferential cytoplasmic projections. We investigated the specificity and the sensitivity of anti‐TRAP antibody immunoreactivity in 57 cases of HCL. We found that there is a statistically highly significant difference between TRAP immunoreactivities of the study and the control groups, and HCL can be diagnosed by TRAP immunoreactivity in bone marrow trephine biopsy materials with a specificity of 98.27 % and a sensitivity of 100%.

Shrinkage of Nasal Mucosa and Cartilage during Formalin Fixation

Background: After resection, specimens are subjected to formalin fixation during histological processing. This procedure can result in tissue shrinkage, with the amount of shrinkage related to tissue composition and tissue type. Aims: To evaluate the shrinkage of nasal mucosa and cartilage tissue and compare differences in shrinkage after resection, after formalin fixation, and during microscopic examination to understand differences in the rate of shrinkage of different tissue types. Study Design: Animal experimentation. Methods: Fresh nasal septa were excised from sheep (10 mm diameter in 40 sheep and 20 mm diameter in 40 sheep). The mucosa was separated from one side of the cartilage, with the contralateral mucosa remaining attached to the cartilage. Specimen diameters were measured in situ, after resection, after fixation for 6 or 24 hours (10% formalin), and during microscopic examination. Results: There were no differences between the in situ and after resection diameters of any tissue components (free mucosa, mucosa attached to cartilage, and cartilage) of all nasal specimens (10- or 20-mm diameter and 6- or 24-hour fixation). However, significant shrinkage occurred between resection and after-fixation. Regarding tissue specimens that were fixed for different durations (6 or 24 hours), we observed a significantly smaller mean tissue diameter in specimens fixed for 24 hours versus those fixed for 6 hours for mucosa attached to cartilage (in the 10-mm diameter after-fixation samples), free mucosa (in the 20-mm diameter after-fixation samples), mucosa attached to cartilage (in the 20-mm diameter after-fixation and microscopic measurement samples), and cartilage (in the 20-mm diameter after-fixation samples). Tissue shrinkage was greatest in free mucosal tissue and least in cartilage. Conclusion: These results should be considered when evaluating patients undergoing surgical procedures for nasal cavity and paranasal sinus malignancies. Surgical margins should be measured before fixation or evaluated if possible before fixation and shrinkage.

Metachronous Occurrence of Granular Cell Tumor in Breast Skin and Scalp: Diagnostic Challenging Differentiating Benign from Malignant and a Literature Review

Granular cell tumor (GCT) is a Schwann cell related benign neoplasm of soft tissue. GCT is an uncommon entity that occurs in a wide variety of body sites, but it is generally presented in the skin, oral cavity, superficial soft tissue, and respiratory and digestive tracts. Most of the GCTs are benign but clinically and radiologically these may mimic malignancy. Histopathological diagnosis is gold standard for establishing the true nature of the lesion. GCT is most commonly solitary but in about 10% of cases can be multifocal, usually involving various skin and soft tissue sites versus involving various internal sites. Therefore, these can involve skin and soft tissue or submucosa and viscera. GCT is usually benign; however, local recurrence is common due to incomplete removal. Malignant cases are rarely reported in 1-2% of cases. In this study, we report clinical and histopathological findings of a 36-year-old woman with metachronous GCT in breast and scalp. The clinical features raise the question of whether these are metachronous benign GCTs or whether this is establishment of malignant behavior. The aim of this report is to present the histopathological and clinical features of GCT and the diagnostic challenge of differentiating benign from malignant GCT.

C-MYC and BCL2 translocation frequency in diffuse large B-cell lymphomas: A study of 97 patients.

Purpose: Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma with marked biologic heterogeneity. MYC and BCL2 rearrangements have been reported in a proportion of DLBCLs, where they may be associated with an adverse clinical outcome. The aim of this study was to determine the frequency of MYC and BCL2 translocations in DLBCL and assess the prognostic impact in DLBCL patients. Materials and Methods:   In the present study, we evaluated the expression patterns of CD 10, BCL6, and MUM 1 by immunohistochemistry in 121 cases with DLBCL in tissue microarray (TMA): 62 cases in germinal center B-cells (GCBs); and 59 cases in activated B-cells (ABCs) of which 60 were females and 61 were males. MYC and BCL2 rearrangements were investigated by interphase fluorescence in situ hybridization on TMAs in 97 DLBCLs. Result: MYC rearrangements were observed in 11 of 97 cases. There was no association with other clinical features, including age, sex, and nodal/extranodal disease. MYC rearrangement was associated with significantly worse overall survival (P < 0.01). BCL2 rearrangements were observed in 14 of 97 cases. There was no association with other clinical features including age and sex. BCL2 rearrangement had a worse outcome (P < 0.01). MYC and BCL2 rearrangements were observed in 3 of 97 cases with the age of  53 (female), 53, 63 years old, respectively, died in 24, 18, and 35 months after the diagnosis. Two cases had primary nodal and one case primary extranodal presentations. All these patients had stage IV disease. Conclusion: We concluded that C-MYC and BCL2 may contribute to aggressive transformation, and more mechanism-based therapy should be explored. Targeted therapies involving these rearrangements and its associated pathways may change the fate of DLBCLs. Analysis of MYC gene rearrangement along with BCL2 is critical in the identification of high-risk patients with poor prognosis.

Hydatid disease involving some rare sites in the body.

A hydatid cyst is an endemic disease in our country. Clinical manifestation includes cyst formation, most commonly in the liver and lungs. Renal, brain, and subcuteneous localizations are rare. Here we report four cases: two cases of primary renal hydatid disease, one of intracranial hydatid cyst, and one of subcutaneous hydatid cyst. We discuss the prevalence, diagnostic workup, and management of echinococcosis.

Massive Idiopathic Scrotal Calcinosis

Idiopathic scrotal calcinosis is a rare, benign condition with the presence of multiple slow-growing yellowish-white calcified asymptomatic nodules that appear within the scrotal skin. The disease affects patients in childhood or early adulthood. The etiology of idiopathic scrotal calcinosis is still controversial. It can extensively affect the scrotal skin, but primary closure is usually achievable with good esthetic outcomes.

Yedi olguda mesanenin nöroendokrin tümörlerinin değerlendirilmesi

Bu calismada 2006-2014 yillari arasinda Antalya bolgesinde iki merkezde tani alan 690 mesane karsinomu icinden 7 tane noroendokrin tumorun klinikopatolojik ozellikleri sunularak tartisilmistir. Her olgunun yas, cinsiyet, basvuru semptomlari, tumorun yerlesimi, klinik evresi, tedavi, takip ve sonuclari kaydedilmistir. Calismamiz mesanenin noroendokrin karsinomlarinin akcigerde gorulenler gibi saldirgan ve cok kotu prognozlu oldugunu gostermistir.

Primary Leiomyosarcoma of the Kidney: Four Cases

Renal sarcomas are rare tumors. They constitute only %1-2 of malignant renal tumors in adulthood. Though leiomyosarcoma is the most common histologic type of renal sarcoma (%50-60) (1). Renal leiomyosarcomas are aggressive tumors arising from the renal capsule, renal vein, pelvic musculature or the renal parenchyma. Diagnosis is usually post-operative and requires a thorough sampling of the tumor to rule out an epithelial component (2). We report new four cases of primary renal leiomyosarcomas.

Hyperpigmentation of tongue associated with hepatitis C treatment.

che A. Tongue hyperpigmentation during PEG-interferon-alfa/ ribavirin therapy in a non-Caucasian patient with chronic hepa- titis C:a case report and review of the literature. Int J Dermatol 2013;52:643-4. [CrossRef]