Osman Zekioglu

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.

Effect of chemotherapy on primordial follicular reserve of rat: an animal model of premature ovarian failure and infertility.

Aim:  To determine the effect of paclitaxel and cisplatin in the reduction of primordial follicular reserve in rat.

Neuroendocrine differentiated breast carcinoma: imaging features correlated with clinical and histopathological findings.

Abstract. The aim of this study was to describe the imaging features of neuroendocrine differentiated breast carcinoma (NEDBC) and to correlate the radiological findings with the clinical and histopathological findings. A retrospective review of the mammograms of 1845 histopathologically proven breast cancer cases revealed five NEDBC. The clinical, imaging, and histopathological findings were analyzed. On mammography, a high-density mass was seen in all patients. The shape of the mass was round in 4 and irregular in 1 patient. The margins were spiculated in 2, indistinct in 1, microlobulated in 1, and partially obscured in 1 patient. On sonography, 4 patients had homogeneously hypoechoic masses with normal sound transmission. In 1 patient the mass was heterogeneously hypoechoic with mild posterior acoustic enhancement. The margins were microlobulated in 2, irregular in 2, and well-circumscribed in 1 patient. Neuroendocrine differentiated breast carcinoma should be included in the differential diagnosis of mammographically dense, round masses with predominantly spiculated or lobulated margins. Sonographically, they mostly present as irregular or microlobulated, homogeneously hypoechoic masses with normal sound transmission.

Primary pelvic hydatid cyst

Abstract We report a case of hydatid cyst of the pelvis in a 36-year-old woman presented with right adnexal cystic mass with similar cystic lesions in the liver. Laparatomy revealed a right paraovarian cystic mass densely adhered to the uterus, to the pelvic side wall, and to the right fallopian tube. Histopathological examination of the cyst wall showed the cuticular layer of the cyst. Cystic liver lesion was later proved to be hepatic hemangioma by magnetic resonance imaging.

In-situ gel formulations of econazole nitrate: preparation and in-vitro and in-vivo evaluation

Objectives  This study describes the in‐situ gelling of econazole nitrate containing thermosensitive polymers composed of poloxamer 407 and 188 as a novel treatment platform for vaginal candidiasis.

Histological Chorioamnionitis: Effects on Premature Delivery and Neonatal Prognosis

BACKGROUND Chorioamnionitis is closely related to premature birth and has negative effects on neonatal morbidity and mortality. METHODS In this prospective study, 43 mothers who delivered earlier than 35 gestational weeks and their 57 infants were evaluated clinically and with laboratory findings. Placentas and umbilical cords were investigated histopathologically for chorioamnionitis and funisitis. RESULTS The overall frequency of clinical and histological chorioamnionitis (HCA) was 8.3% and 23.2%, respectively. The frequency of HCA was 47.3% and 83.3% in mothers delivered <32 weeks and <30 weeks, respectively. Maternal demographic and clinical findings and also leukocyte and C-reactive protein values were not indicative of HCA. Infants of mothers with HCA had significantly lower Apgar scores together with higher SNAP-PE-II and CRIB scores. These infants had increased mechanical ventilator and surfactant requirements, higher incidences of patent ductus arteriosus, early sepsis, and bronchopulmonary dysplasia, and higher mortality rates. The effect of HCA on neonatal morbidity and mortality was more prominent than the effect of low birthweight and lower gestational age. CONCLUSION Chorioamnionitis not only causes premature deliveries, but is also associated with neonatal complications and increased mortality. Clinical findings and infectious markers in mother or infant do not predict the diagnosis of histological chorioamnionitis. Therefore, placental histopathology may have a role in predicting neonatal outcome in premature deliveries, especially those below 30 weeks.

Breast carcinomas with choriocarcinomatous features: case reports and review of the literature.

Breast cancer with choriocarcinomatous features is rare. This report describes four cases of breast cancer with choriocarcinomatous features. The tumor cells were positive for human placental lactogen (hPL) and human chorionic gonadotropin (hCG) by immunohistochemistry. The cases reported in the literature had a poor prognosis and the patients died within a few months after the diagnosis. In this series, two cases were lost to follow‐up, but the other two have had disease‐free survival for 2 and 4 years, respectively.

Comparison of the success of histopathological diagnosis with dilatation-curettage and Pipelle endometrial sampling

The aim of this study is to compare collection of sufficient material and diagnostic accuracy of Pipelle biopsy with curettage and hysterectomy. A total of 82 cases with indications for endometrial biopsy for any reason and in which endometrial biopsy was performed with dilatation and curettage (D&C) and Pipelle aspiration biopsy, and 66 cases in which an indication for hysterectomy was established for any reason were included in the study. Histopathological findings were examined in the following six groups: normal; endometrial polyps; hyperplasia without atypia; hyperplasia with atypia; atrophy; and insufficient material. Descriptive statistical methods and McNemars test were used. When the histopathological compatibility between Pipelle and D&C was considered (n = 82), a diagnosis that was different from that obtained by D&C was obtained in 22 of the 63 cases (34%), in whom normal endometrial histology was found with a Pipelle biopsy specimen. It was observed that only 1 of 13 cases of endometrial polyps was diagnosed with Pipelle biopsy. Insufficient material was obtained in six cases (7%) with Pipelle biopsies and three cases (4%) with D&C. While Pipelle biopsies and D&C have a nearly equal level of success in widespread endometrial lesions, Pipelle biopsies provide limited diagnostic accuracy in cases with focal pathologies.

p53 and Ki‐67 Expression as Prognostic Factors in Cystosarcoma Phyllodes

We have reviewed the histopathological, clinical outcome and immunohistochemical status in 21 women with cystosarcoma phyllodes (CSP) tumors of the breast. We assessed 12 tumors as histopathologically benign and 9 tumors as malignant. The median patient ages in benign and malignant CSP tumors were 39.6 and 45.4 years of age, respectively. The stromal cellularity, stromal cellular atypism, high mitotic activity, atypic mitoses, stromal overgrowth, infiltrative tumor contour, and heterologous stromal elements were significant features of the malignant CSP tumors. Benign CSP tumors were predominantly of fibroadenomatous architecture with cellular stroma (mild or moderate) and some distortion and elongation of glandular elements. Five malignant CSP tumors were stained positively with p53, and 6 malignant CSP tumors were stained immunohistochemically with Ki‐67. All benign CSP tumors were negatively stained for p53 and Ki‐67. The patients with benign CSP tumors were treated with local excision (n = 11) and with subcutaneous mastectomy (n = 1). Malignant CSP tumors were treated with wide local excision (n = 1), partial mastectomy (n = 1), simple mastectomy (n = 2), and modified radical mastectomy (n = 5). Two patients with a high mitotic rate and high values of p53 and Ki‐67 received additional radiotherapy and chemotherapy. One case had liver metastasis. This tumor had high mitotic figures, stromal overgrowth, severe stromal cellularity, and 20% Ki‐67 and mild p53 positivity. We suggest that p53 and Ki‐67 can play an important role in predicting prognosis and yielding additional therapy besides conventional prognostic factors in the treatment of the CSP patients.

Potential Predictive Factors for Response to Weekly Paclitaxel Treatment in Patients with Metastatic Breast Cancer

Abstract The authors compare results obtained from weekly paclitaxel treatment in advanced breast cancer patients with biological and clinical prognostic factors. Expression of c-erbB-2, Ki-67, p53 and hormone receptors (HR) was examined by immunohistochemistry in samples of breast tissue from 30 patients. Univariate analysis showed that Ki-67 positivity and low performance status (PS) were associated with poor outcome (P <0.05). We observed that expression of p53 and c-erbB-2 did not have any negative effect on response to chemotherapy and survival. HR-negative patients had better response and slightly statistically significant overall survival (OS) rates compared to HR-positive patients (P >0.05). In a multivariate analysis low PS was the only significant predictor of shorter survival (P <0.05). In conclusion, while the expression of p53 and c-erbB-2 did not have any effect on treatment results, negative Ki-67 expression and negative HR status were associated with better OS in this patient population. PS was the only significant predictor for OS.