Veysel Ayyildiz

Association of breast cancer subtypes and body mass index.

AIMS AND BACKGROUND Breast cancer is a heterogeneous disease with various pathological and molecular subtypes. This study aims to determine the association between BMI and the distribution of breast cancer subtypes defined by estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER2/neu) expression in pre- and postmenopausal breast cancers. METHODS AND STUDY DESIGN A total of 1847 female breast cancer patients were involved. After the exclusion of 457 patients due to missing subtype information (n = 400) or benign histology (n = 57), 1390 were included in the analyses. The histological type of the tumor, ER and PR expression, HER2/neu with immunohistochemistry and HER2/neu gene evaluation with interphase fluorescence in situ hybridization (if necessary), age, body weight, height and menopausal status at diagnosis were investigated retrospectively. The patients were stratified as having a normal body weight if BMI was ≤24.9 kg/m², as being overweight if BMI was between 25.0 and 29.9 kg/m², and as being obese if BMI was ≥30.0 kg/m². RESULTS Median BMI was 28.7 kg/m² (17.6-55.6) in the postmenopausal and 25.6 kg/m² (16.4-51.1) in the premenopausal group (P <0.001). BMI at diagnosis did not differ significantly between the molecular subtypes (P = 0.12). Distribution of BMI strata was similar between the molecular subtypes both in pre- and postmenopausal breast cancer (P = 0.24 and P = 0.99, respectively). Premenopausal women with a BMI of ≥25.0 kg/m² showed a tendency towards ER- tumors when compared to premenopausal women with a BMI of <25.0 kg/m² (P = 0.009). CONCLUSIONS The risk of specific breast cancer subtypes may not be associated with BMI in pre- and postmenopausal breast cancer. However, obesity might be related to an increased risk of premenopausal hormone receptor-negative breast cancer. Further studies are needed for clarification of the probable mechanisms in the pathogenesis of premenopausal hormone receptor-negative breast cancer.

Prognosis of breast cancer in patients with peritoneal metastasis

Number of Patients (n) 21 Age at Breast Cancer Diagnosis Mean (range) 48 (31–64) Median (range) 50 (31–64) Age at Peritoneal Metastasis Mean (range) 56 (38–71) Menopausal Status Post-menopausal 12 (57.1%) Pre-menopausal 6 (28.6%) Peri-menopausal 3 (14.3%) Patient Survival Number of dead patients 7 (33.3%) Number of living patients 13 (61.9%) Molecular Subtype Luminal A 8 (38.1%) Luminal B 5 (23.8%) Triple negative 2 (9.5%) Her-2 overexpressing 0 (0%) Unknown 6 (28.6%) Hormone Receptor Status ER status Positive 14 (66.7%) Negative 3 (14.3%) Unknown 4 (19.0%) PR status Positive 11 (52.4%) Negative 6 (28.6%) Unknown 4 (19.0%) Her2 status Positive 5 (23.8%) Negative 10 (47.6%) Histological Subtype IDC 7 (33.3) ILC 5 (23.8) Mixed 3 (14.3) Unknown 6 (28.6) To the Editor

Pyelolymphatic backflow demonstrated by an abdominal CT: A case report.

Summary Background Pyelolymphatic backflow phenomenon, which is a subtype of pyelorenal backflow, is a rare condition that occurs during the acute phase of urinary obstruction. Pyelorenal backflow has already been described in humans with retrograde pyelography. Our report presents a rare case of pyelolyphatic backflow demonstrated by a computed tomography. Case Report A 67-year-old man with a history of bladder carcinoma was admitted to the emergency department due to right-sided flank pain and hematuria. Hematuria resolved after insertion of a 3-way urinary catheter, but flank pain persisted. As a result, an abdominopelvic CT was performed. CT revealed numerous tiny, serpiginous tubular structures connected with each other and filled with urine. They began intrarenally and extended caudally surrounding the ureter in the retroperitoneum. Subsequently, the patient underwent an ultrasound-guided nephrostomy to decompress the collecting system of the right kidney. Antegrade pyelography revealed minimal hydroneprosis. However, no leakage from the ureter to the retroperitoneum was observed, proving that the changes demonstrated by a CT were due to pyelolymphatic reflux caused by increased pressure in the collecting tubules filling the lymphatics with opaque urine. Conclusions This report presents a very rare case of pyelolymphatic reflux demonstrated by a CT. We present this case report as a reminder that although rare, pyelolymphatic reflux can occur as a result of obstruction without manifestations of hydronephrosis and it can be confused with leakage from the ureter.

Ön Kol-El Bileğinde Hibernom: Kahverengi Yağ Dokusunun Nadir Görülen Benign Tümörü

OZET Amac: Fetal yag doku kalintilarindan gelisen genellikle yetiskinlerde, nadir gorulen kahverengi yag dokusunun benign tumoru olan hibernomun magnetik rezonans goruntuleme bulgularini ortaya koyacagiz. Olgu Sunumu: 14 yas kiz cocuk sol on kol-el bilegi duzeyinde son 1 aydir farkina vardigi hareketsiz yumusak doku sisligi nedeniyle ortopedi poliklinigine basvurdu. Muayenesinde palpasyonla agri yoktu. Bu ekstremitede dolasim problemi ya da norolojik defisit bulunmamaktaydi. Ardindan hasta radyoloji bolumune refere edildi. Hastaya magnetik rezonans goruntuleme (MRG) yapildi. MRG’de kontrast sonrasi yag baskili T1 agirlikli goruntude lezyon lipomun aksine homojen kontrast tutulumu gostermekteydi ( Lezyonun santralinde yag dokusunu temsil eden kontrast tutmayan kucuk bir alan mevcuttu). Hasta opere edildi. Histopatolojik tani hibernomdu. Sonuc: On kol-el bileginde belirgin semptomu olmadan immobil yumusak doku kitlesi ile basvuran hastalarda hibernom akilda tutulmalidir.

Craniocervical Pseudomeningocele Following Cerebellar Meningioma Resection: Demonstration of Neck of Pseudomeningocele With Three-Dimensional Isotropic T2-Weighted SPACE Sequence at 3 Tesla (3T) Magnetic Resonance Imaging

Postoperative pseudomeningocele is an uncommon complication of craniospinal surgery. Diagnosis is reached on a postoperative computed tomography and magnetic resonance (MR) imaging. Demonstration of the location and dimension of the dural defect before surgical therapy is a very important. T1- and T2-weighted MR images revealed a significant pseudomeningocele extending from left cervicooccipital region. Magnitude and phase-contrast-MR images showed a cerebrospinal fluid (CSF) flow into pseudomeningocele, but they no revealed dural defect. Three-dimensional isotropic T2-weighted SPACE sequence revealed a signal void indicating CSF flow into pseudomeningocele and location and exact size of dural tear. Three-dimensional isotropic T2-weighted SPACE sequence is certainly the noninvasive and optimal method for demonstrating postoperative pseudomeningocele sacs. It demonstrates a pseudomeningocele regardless of an existing communication with the dural membrane.

Common celiacomesenteric trunk: a computed tomography radiological study

BACKGROUND There is an increasing trend for administration of invasive radiological interventions, laparoscopic surgery, and transplantation procedures in recent years, and determining the vascular variations prior to these procedures is crucially important. Coeliacomesenteric trunk (CMT) is among these variations. This study aimed to retrospectively evaluate this rare anomaly by computed tomography (CT). MATERIALS AND METHODS A total of 1000 CT angiography images were analysed retrospectively, and the patients with mesenteric and coeliac arteries arising from the abdominal aorta with a single root were identified. The level that CMT arose, and its branching patterns were determined individually for all patients. RESULTS Ten patients (6 males and 4 females) with a mean age of 50.2 years (17-87 years) had CMT in CT images. CONCLUSIONS The knowledge of variations in the CMT prior to vascular or laparoscopic interventions will contribute to early intervention in case of a complication, or to avoid from a potential damage.