Nurdan Tunali

The expression of cytoskeletal proteins (α-SMA, vimentin, desmin) in kidney tissue: A comparison of fetal, normal kidneys, and glomerulonephritis

Background: The aim of the study is a comparison of the expression of cytoskeletal proteins, alpha smooth muscle actin (α-SMA), vimentin, and desmin in fetal, normal kidney and proliferative (diffuse proliferative and membranoproliferative glomerulonephritis) and nonproliferative (membranous glomerulonephritis) glomerulonephritis.Methods: We have studied the expression of cytoskeletal proteins (α-SMA, vimentin, desmin) in the paraffin embedded tissue sections from the kidneys of 10 normal kidney (adults and infants), 13 fetal kidney, 12 membranous glomerulonephritis (MGN), 8 membranoproliferative glomerulonephritis (MPGN), 8 diffuse proliferative glomerulonephritis (DPGN). Interstitial and glomerular positive stainings were evaluated.Results: Vimentin expression was similar in normal infant and adult kidneys with positive staining in glomeruli and negative staining in interstitium. In fetal kidneys, glomerular mesangial and epithelial cells and blastematous areas showed positive reactivity with vimentin. α-SMA staining was different among the groups. In fetal kidney, α-SMA expression was found in glomerular mesangial cells and blastematous areas. α-SMAstaining was positive in peritubular area and glomerular mesangial cells in infant kidney. In adult kidneys, glomerular staining with α-SMA disappeared but peritubular positivity continued. Interstitial staining with α-SMA was positive in fibrotic areas of proliferative (MPGN, DPGN) and non-proliferative (MGN) glomerulonephritis, but positive glomerular staining with α-SMA was found only proliferative glomerulonephritis. Desmin expression was negative in all groups.Conclusions: Desmin is not expressed in early stages of kidney growth, infant and adult kidneys, and proliferative and nonproliferative glomerulonephritis. Interstitial staining of vimentin in the diseased kidney tissues revealed increased fibrosis. α-SMA revealed important differences in different stages of nephrogenesis. Glomerular mesangial staining with α-SMA in developing (fetal and infant kidneys) and proliferative glomerulonephritis suggest that it may be a marker of proliferation. In addition, it shows myofibroblastic differentiation in interstitium in diseased kidneys.

Combined occurence of primary cerebral lymphoma and meningioma

A unique combination of primary cerebral lymphoma and meningioma was encountered in a 38-year-old woman who recently presented clinically with headache and papilledema. The both tumors were identified by CT scan and diagnosed histopathologically after the surgery. The association of a highly malignant primary cerebral lymphoma and a slowly growing meningioma is extremely rare. The possibility of an unknown underlying pathologic mechanism predisposing to multiple tumors should be considered.

Hairy polyp of the tongue: a case report

Hairy polyps or dermoids of the oro- and nasopharynx are benign lesions containing elements of both ectodermal and mesodermal origin. Because of its rarity, we report a case of hairy polyp arising from the tongue in a 40-day-old infant. The lesion was covered by squamous epithelium and a central core of fibroadipose tissue, minor salivary glands, and cartilage. We discuss the clinicopathological features, terminology, etiology, and differential diagnosis of this condition.

Comparative genomic hybridization in ganglioneuroblastomas

The ganglioneuroblastoma are rare lesions with widespread neuronal differentiation that have been classified as intermediate stages between neuroblastoma and ganglioneuroma. To identify overall chromosome aberrations in ganglioneuroblastoma, we performed comparative genomic hybridization. All of the five tumor samples were found to exhibit multiple gains involving different chromosomal regions. Chromosomal gains displayed by chromosomes and chromosome loci were 2p25 approximately pter (60%), 5p15.1 approximately p15.3 (60%), 7 (60%), 13q22 approximately q31 (60%), and 22 (60%), which were detected as minimal common regions in all five tumor samples. Chromosome 22 gain, which had not been reported in neuronal tumors before, and novel site 13q22 approximately q31 may be considered to play an important role in progression and differentiation of ganglioneuroblastoma.

Testicular adrenal rest hyperplasia due to 21-hydroxylase deficiency: A case report

Bilateral testicular tumors are a rare complication of congenital adrenal hyperplasia. It can be extremely difficult to distinguish histologically between Leydig cell tumors and adrenocortical rest hyperplasia, which may lead in some cases to unnecessary orchidectomy. A 7-yr-old boy was admitted because of precocious puberty and enlargement of testicles. Hormonal studies established the diagnosis of congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Testicular biopsy revealed interlacing strands, cords, and rests of cells resembling interstitial (Leydig) cells but with no Reinke crystalloids. Here we report a case of testicular adrenal rest hyperplasia in congenital adrenal hyperplasia and discuss the pathological and clinical features and origin of this rare lesion by using immunohistochemical evaluation.

Cardiac mucormycosis in a child with severe aplastic anemia: a case report.

Mucormycosis is an uncommon, severe, life-threatening fungal infection in the immunocompromised host. Mucormycosis with aplastic anemia is seen rarely. Only a few cases of cardiac mucormycosis with aplastic anemia have been reported in the literature. The authors present a case with severe aplastic anemia that did not respond to classic and immunosuppressive treatment for disease and developing invasive cardiac mucormycosis despite empiric treatment for febrile neutropenia.

Perinatal autopsy evaluation of 2150 autopsies in the Çukurova region of Turkey.

Abstract Objective: We aimed to document the reasons of perinatal deaths in a large autopsy series performed in our institute, which is a reference center in the Çukurova region of Turkey. Material and Method: The study included 2150 autopsies performed between January 2000 and December 2012at our institute. Diagnoses were categorized according to the detected pathologies; congenital malformations were detailed based on systems. Results: A pathology was detected in 1619 of 2150 (73.3%) autopsies. Congenital malformations were the most common diagnosis with 68.2%. Neural tube defects and central nervous system malformations were the most frequent system malformation in 28.8% of cases, followed by the urogenital system (11.4%) and musculoskeletal system (8.3%), respectively. Malformation syndromes including multisystem anomalies were defined in 109 cases (9.3%). Conclusion: Congenital malformations are the most common reason for perinatal deaths, with autopsy having an additive role to prenatal and genetic evaluations and providing foresight for planning a subsequent pregnancy. Öz Amaç: Türkiye’nin Çukurova bölgesi için referans merkez konumunda olan ve oldukça geniş otopsi serisi içeren kurumumuzda yapılan fetal otopsi olgularını, değerlendirerek perinal ölüm nedenlerini tespit etmeyi amaçladık. Gereç ve Yöntem: Ocak 2000 ve Aralık 2012 yılları arasında kurumumuza gelen 2150 adet otopsi raporu yeniden değerlendirildi. Olgular tanılarına göre gruplandırıldı. Ayrıca konjenital malformasyonlar yer aldıkları sistemlere göre alt gruplara ayrıldı. Bulgular: Toplam 2150 olgunun 1619’unda (%73,3) patolojik bulgu saptandı. En sık patoloji %68,2 oranında konjenital malformasyonlar idi. Nöral tüp defektleri ve santral sinir sistemi anomalileri en sık malformasyon idi (%28,8). Bunu sırasıyla ürogenital sistem (%11,4) ve kas-iskelet sistemi (%8,3) takip etmekteydi. Bunun yanısıra, 109 olguda (%9,3) çoklu sistem tutulumu gösteren malformasyon sendromları tanımlandı. Sonuç: Fetal otopsi prosedürü, son yıllarda sayısal düşüş göstermekle birlikte, özellikle gebelik beklentisi olan kişiler için, prenatal tarama yöntemlerine tanısal katkısı olmakta ve malformasyonun yineleme olasılığı hakkında öngörü sağlamaktadır.

Gastric cyst of the oral cavity

A case of a heterotopic gastric cyst of the oral cavity is described and a review of the literature, with emphasis on the possible etiological theories of this rare lesion, is presented. This developmental lesion is found more commonly in males. It most likely arises from misplaced embryonal tissue. Surgical treatment is the preferred choice of treatment, and CO2 laser is a safe alternative surgical approach for the removal of this lesion.

Adenomatous hyperplasia of the rete testis: Report of two cases

We present two adenomatous hyperplasia of the rete testis (AHRT) cases. One of them was a 67-year old patient with prostatic adenocarcinoma and the other was a 38-year old patient with undescended testis. AHRT is a rarely seen lesion and usually detected as incidental microscopic finding. It may be confused with malignancy and related to testicular atrophy and hormonal imbalance.The treatment of choice is complete excision.

Primary rhabdomyosarcoma of the heart presenting with increased intracranial pressure.

An 18-month-old boy presented with signs of increased intracranial pressure. Computed tomographic scans of the brain and lungs showed multiple masses in the brain and lungs. Echocardiography revealed homogeneous, irregular pericardial thickening, minimal pericardial effusion, and irregular echogenic areas in the left ventricular inferoposterior and apical regions. Postmortem examination of tumor tissue showed that the masses were primary rhabdomyosarcoma of the left ventricle with multiple metastases. Primary rhabdomyosarcoma of the heart is uncommon, especially in patients under 2 years of age.