Zuhtu Tansug

Prostatic intraepithelial neoplasia in prostate specimens: frequency, significance and relationship to the sampling of the specimen (a retrospective study of 121 cases).

AbstractObjectives: To determine the frequency of PIN (prostatic intraepithelial neoplasia) in prostate specimens and the relationship of PIN with PCA (prostatic carcinoma) and amount of sampling of the specimen. Materials and methods: All the haematoxylin-eosin stained slides of 121 cases diagnosed between 1990 and 1995 were re-examined retrospectively. The amount of sampling of prostate specimens was also re-examined. Results: PIN was observed in 47.9% of all prostate specimens. The frequency of incidental PIN was 71.4% in cystoprostatectomy specimens. PIN was present in 58.3% of the cases with PCA. We observed foci of high-grade PIN adjacent to sites of invasive carcinoma in 100.0% of prostatectomy specimens with PCA. PIN was high-grade in 100.0% of the carcinomatous prostates with PIN. It was multifocal in 53.4% of 58 cases with PIN. Incidental PCA was identified in 14.3% of cytoprostatectomies for bladder cancer. The average number of paraffin blocks of prostatic tissue was 4.1 (±2.6) in cases with PIN and 3.2 (±1.4) in cases without PIN. Conclusion: In prostate specimens, the determination of PIN is very important since it is the most likely precursor of PCA. The probability of detecting PIN and PCA in a prostate specimen is directly related to the amount of sampling.

Genetic alterations of chromosomes, p53 and p16 genes in low- and high-grade bladder cancer

A majority of patients with bladder cancer present with superficial disease and subsequently, some patients show progression to muscle invasive or metastatic disease. Bladder cancer has a complex genetic process and identification of the genetic alterations which occur during progression may lead to the understanding of the nature of the disease and provide the possibility of early treatment. The aim of the present study was to compare the structural and numerical chromosomal differences and changes in the p16 and p53 genes between low-grade (LG) and high-grade (HG) bladder cancer (BC) using cytogenetic and molecular cytogenetic methods. Between March 2009 and March 2010, cytogenetic analyses were carried out on tumor and blood samples in 34 patients with transitional cell type BC, and on blood samples of 34 healthy patients as a control group. Fluorescence in situ hybridization probes for the p16 and p53 genes were also used to screen the alterations in these genes in 32 patients with BC. The patients were divided into two groups (LG and HG) and the findings were compared. A total of 11 (32.3%) patients exhibited LGBC, 22 (64.7%) exhibited HGBC and one (3%) patient exhibited carcinoma in situ. There were no differences between the LGBC and HGBC groups according to the number of chromosomal aberrations (P=0.714); however, differences between alterations of the p16 and p53 genes were significant (P=0.002 and P=0.039). Almost all structural abnormalities were found to be located to the 1q21, 1q32, 3p21 and 5q31 regions in patients with HG tumors. In conclusion, the p16 and p53 genes were altered more prominently in patients with HG tumors compared with LG tumors. The structural abnormalities in the 1q21, 1q32, 3p21 and 5q31 regions were observed more frequently in patients with HG tumors. These regions may play significant roles in the progression of BC, but further studies are required to find candidate genes for a panel of BC.

An unusual cause of hematospermia: Primary adenocarcinoma of the seminal vesicle.

Adenocarcinoma of the seminal vesicles is one of the rare causes of hematospermia. Primary seminal vesicle adenocarcinoma is extremely rare and difficult to diagnose due to frequent invasion of adenocarcinomas of the surrounding organs, especially the prostate. In the present study, a case of a primary seminal vesicle adenocarcinoma will be discussed in the light of the current literature.

Three different techniques for administering analgesia during transrectal ultrasound-guided prostate biopsy: a comparative study

PURPOSE The efficacy of three different analgesic techniques during transrectal ultrasound (TRUS) guided prostate biopsy, including (i) periprostatic blockage (PPB), (ii) intrarectal gel instillation, and (iii) sedoanalgesia were compared. MATERIAL AND METHODS During a period of five months, 100 consecutive men were enrolled in this study. A 10-point linear visual analogue scale (VAS) was used to assess the pain scores during (VAS 1), immediately after (VAS 2) and one hour after (VAS 3) the needle biopsy procedure. The relationship between the level of pain, prostate volume, age and PSA was determined. RESULTS There were no statistically significant differences between the four groups in terms of mean age and PSA values. The pain scores were significantly lower in sedoanalgesia and PPB groups (p = 0.0001). There was no statistically significant difference between the groups in terms of complications. CONCLUSIONS In this study, it was shown that patient comfort is better and it is possible to get decreased pain scores with PPB or sedoanalgesia. However, PPB is a preferable method in TRUS-guided prostate biopsy since it is much more practical in outpatient clinics.

Primary Malignant Melanoma of the Kidney

The fourth patient with a solitary malignant melanoma of the kidney with no apparent primary lesion or metastasis is reported.

Acute urinary retention due to cystic echinococcosis: A case report

Urinary hydatidosis is very rare and represents 2% to 4% of all cases of cystic echinococcosis. We present a case of a 21-year-old man with symptoms of frequency, urinary retention and reduced force in urinary stream due to cystic echinococcosis. Anti-Echinococcus granulosus antibodies were determined by echinococcosis western blotting, and pelvic computed tomography revealed a 11 × 14 × 10-cm retrovesical homogeneous cystic mass. The patient underwent surgical intervention; the cystic mass and retrovesical cavity were removed. After a 3-year follow-up period, there was no episode of lower urinary tract symptoms. This case illustrates that cystic echinococcosis should be considered in every case of cystic mass, especially in endemic countries, such as Turkey.

Evaluation of Concordance between Gleason Scores of Tansrectal Ultrasound Guided Biopsy and Radical Prostatectomy Samples in Prostate Cancer

Objective : In this study, we investigated the concordance between Gleason scores of transrectal ultrasound guided biopsy and radical prostatectomy specimens in patients diagnosed with prostate cancer via transrectal ultrasound guided biopsy and treated with radical prostatectomy in our clinic. Material and Method : 115 patients were included in our study treated with radical prostatectomy for organ-confined prostate cancer between the dates of November 2011 and December 2014. Data of these patients are reviewed retrospectively. Results : The average age of the patients was 61.8 ± 6.8 (43-76) years. The average body mass index of these patients were (BMI) 26.7 ± 3.34 (19.3 – 35.3) kg/m². Average PSA value was 6.6 ± 10.1 (1.4 – 80) ng/ml. Gleason scores of transrectal ultrasound guided biopsy and radical prostatectomy were observed concordant in 74 (64.3%) of 115 patients, while 41 (35.6%) were not concordant. Gleason score was decreased by 1 grade for 8.6% (10 patients) of patients, it was increased by 1 for 26.0% (30 patients) of patients and for 0.8% (1 patient) it was increased by 3. Discussion : These findings indicate indicate that Gleason scores of transrectal ultrasound guided biopsy and prostatectomy specimens may be discordant.