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Öğe Assessment of diagnostic value of preoperative elastography in thyroid nodules having indeterminate cytology results(Scientific and Technological Research Council Turkey, 2021) Uçan, Bekir; Şahin, Mustafa; Önal, Binnur; Kizilgul, Muhammed; Duger, Hakan; Sencar, Muhammed Erkam; Çakal, ErmanBackground/aim: The management of nodules with indeterminate cytology [atypia of undetermined significance (AUS), follicular lesion of undetermined significance (FLUS), follicular neoplasm (FN), suspicious for a follicular neoplasm (SFN), and suspicious for malignancy (SM)] results is controversial. To assess the role of the elastography technique in the diagnosis of malignancy in the subtypes of indeterminate thyroid nodules. Materials and methods: We included 132 patients with indeterminate cytology who underwent thyroid surgery. Sensitivity, specificity, area under the curve, and optimal cut-off points were calculated with receiver operating characteristic (ROC) analysis for elastography score (ES) and strain index (SI). Results: Malignancy was observed in 27/95 (28.4%) of the AUS-FLUS cytology and 12/24 (50%) of FN, SFN cytology. All of the 13 patients (100 %) with SM are found to be malignant on histology. In the FLUS group, nodules with ES greater or equal to 3, the presence of malignancy was higher 17/41 (41.5%) when compared with nodules with ES smaller than 39/46 (19.6 %) (p = 0.023). In the SFN group, 2 of 2 nodules with an ES score of 4 and 1 of 1 nodule with an ES score of 5 were malignant. In the FLUS group, 4 of 10 nodules with an ES score of 4 and 2 of 2 nodules with an ES score of 5 were malignant. Conclusion: Thyroid elastography may reduce unnecessary surgery for both patients with AUS/FLUS and selected SFN cytology. Elastography appears to be helpful in follicular variants and other types of papillary thyroid cancer, however, not in follicular thyroid cancer.Öğe Can Numeric Maturation Value Be Used as a Prognostic Indicator and Diagnostic Tool in Cutaneous Melanomas? A Morphometric Study(Sci Printers & Publ Inc, 2019) Gamsızkan, Mehmet; Büyücek, Şeyma; Coşkun, Sinem Kantarcıoğlu; Sungur, Mehmet Ali; Özlü, Emin; Bahçıvan, Atike; Önal, BinnurOBJECTIVE: Some melanocytic lesions can be difficult to diagnose because of ambiguous histological and immunohistochemical features. Morphometric features of melanocytes in the upper and lower parts of a challenging lesion may help to facilitate an accurate diagnosis. STUDY DESIGN: We studied 32 cases of invasive cutaneous melanoma, 35 cases of mild or moderate dysplastic nevus, and 31 cases of benign melanocytic nevus. All cases were immunostained with Sox10. The nuclear areas of 30 melanocytes were measured on each papillary (upper al1) dermis and reticular dermis/subcutaneous tissue (lower ILI) in all cases by using the Image J analysis program. Then, a maturation index (U/L) was calculated for each case. Also, cutaneous melanomas were categorized into 2 groups that displayed pseudo-maturation or the lack of it. RESULTS: Mean maturation index was 1.04 +/- 0.29 in melanomas, 1.23 +/- 0.28 in dysplastic nevi, and 1.52 +/- 0.33 in benign melanocytic nevi, respectively. There were statistically significant differences between melanoma and dysplastic nevus (p = 0.012) and between melanoma and benign melanocytic nevus (p < 0.001) for the maturation index. Although pseudo-maturation was associated with low mitotic activity and thin Breslow thickness, there was no significant difference between survival distributions of 2 melanoma groups. CONCLUSION: Calculation of the maturation index can be used as a supporting tool for the differential diagnosis of challenging cases. However, it may possess limitation for evaluation of nevoid melanoma, melanoma in situ, or clonal nevus.Öğe Can numeric maturation value be used as prognostic indicator and diagnostic tool in cutaneous melanomas (a morphometric study)?(Springer, 2018) Gamsızkan, Mehmet; Büyücek, Şeyma; Coşkun, Sinem Kantarcıoğlu; Sungur, Mehmet Ali; Özlü, Emin; Bahçıvan, Atike; Önal, Binnur…Öğe Clinicopathological features of melanomas in our university and comparison of meta-analysis in a specific region(Springer, 2018) Büyücek, Şeyma; Gamsızkan, Mehmet; Coşkun, S. Kantarcıoğlu; Yalçın, A.; Karagün, E.; Gamsızkan, Zerrin; Önal, Binnur…Öğe Combination of Biochemical and Cytological Findings for Better Diagnosis in Pleural Effusions(Springer, 2022) Elmas, Hatice; Biancosino, Christian; Önal, Binnur; Schmitt, Fernando; Büyücek, Şeyma; Nordholt, Gerhard; Sauter, GuidoSerous pleural effusions result from increased permeability and changed hydrostatic or colloid osmotic pressure. Laboratory biochemical findings provide conclusions about the effusion compositions. Together with the anamnesis and clinical assessment, they enable the evaluation of the effusion nature. The present study retrospectively analyzed combined biochemical and morphological findings in 2307 effusions of patients from two clinical centers: LungenClinic Grosshansdorf in Germany and Duzce University in Turkey. The effusion cytology results of 1771 and 536 patients from the respective centers were combined with clinical/radiological/biochemical findings and counter compared with the final diagnoses. Cytology verified 738 malignant tumors (643 and 95, respectively). Most effusions were benign (n = 1569; 77%) and 367 of them were paramalignant (293 and 74, respectively) and 594 were inflammatory (465 and 129, respectively). There was a distinctly lower number of malignant tumors in transudates than exudates (87 vs. 725; p < 0.0001). Squamous cell carcinoma was more frequent in paramalignant pleura effusions (122 cases out of the 367 effusions) than pleural carcinomatosis (32 cases out of the 780 malignant tumors; p < 0.0001). The cell formula was a suitable marker for malignant mesothelioma, predominantly mesothelial, or neutrophilic characterized by elevated LDH (>500 U/L) in the early stage of empyema or its late manifestation. İn conclusion, most effusions are benign. Cytologists, assisted by clinical and biochemical data and microscopic findings, can make significant differential diagnostic contributions beyond the sole detection of malignancy. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.Öğe Cytomorphological findings in diagnosis of Warthin tumor(2020) Köybaşıoğlu, Fatma Fulya; Önal, Binnur; Han, Ünsal; Adabağ, Ayşegül; Şahpaz, AhmetBackground/aim: To define the cytomorphologic findings leading to difficulties in diagnosis of Warthin tumors (WTs).Materials and methods: Forty-eight histopathologically diagnosed WT patients who had fine needle aspiration cytology preoperativelywere reevaluated for defining the presence or absence of lymphocytes, oncocytic cell layer, oncocytic cell papillae, granular debrisbackground, mucoid background, macrophages, polymorphonuclear cells, mast cells, squamous-like cells, atypical vacuolatedcytoplasmic cells, and giant cells.Results: Forty-seven tumors were in the parotid gland and one in the submandibular gland. There were 37 (77%) male and 11 (23%)female patients. Cytopathologically in 36 patients the diagnosis was benign neoplasm (WT); in 6, other benign entities; and in 6,suspicious for malignancy. The main characteristic cytomorphologic features of WTs were as follows: 92% lymphoid cells, 83% oncocyticcell layers, and 67% granular debris background. These percentages were 67%, 17%, and 17% in the benign cytology group and 67%,50%, and 17% in the suspicious for malignancy group, respectively.Conclusion: Absence or lack of main features of WTs with or without presence of squamous-like cells, vacuolated cytoplasmic cells,and inflammatory reaction may cause diagnostic dilemma. The presence of the mast cells accompanied by epithelial tissue was strikingfor WT diagnosis.Öğe Prevalence of High-Risk Human Papillomavirus Types and Their Association with Cervical Squamous Cell Carcinoma, and High-and Low-Grade Squamous Intraepithelial Lesions in Turkish Women(Tehran University of Medical Sciences, 2023) Erkinüresin, Taşkın; Kartal, Esra; Üstünyurt, Emin; Demirci, Hakan; Kilitçi, Asuman; Önal, BinnurBackground: This study aimed to investigate human papillomavirus (HPV) type prevalence in our region and the relationship between uterine cervical HPV types and squamous cell carcinoma (SCC)/intraepithelial lesions. Methods: HPV test results were obtained from patient file archives of the Gynecology and Obstetrics Clinic. Pathology report results were obtained from the digital records of the Pathology Laboratory and the patient file archives of the Gynecology and Obstetrics Clinic in 2018. Results: The most frequently detected was HPV16 (29.2%), followed by HPV51 (13.1%), HPV56 (11%), HPV31 (9.2%), HPV52 (8.4%), and HPV68 (8.2%). HPV16 was positive in 50% of patients diagnosed with SCC, 54.9% of patients with HSIL, 27% of patients with LSIL, and 25% of cases diagnosed as benign (P<0.001). HPV18 was positive in 25% of patients diagnosed with SCC, 11% of patients with HSIL, 4.7% of patients with LSIL, and 5.2% of cases diagnosed as benign (P=0.019). Conclusion: The most frequent hrHPV genotype was HPV16, followed by HPV51, HPV 56, and HPV 31. There is an increase in the frequency of HPV51 and HPV56. HPV51, not included in HPV vaccines and is the second most frequent, should be included in these vaccines. In addition, although the frequency of HPV18 has decreased, HSIL and SCC generation is still high together with HPV16. © 2023 Erkinüresin et al.Öğe Receptor Tyrosine Kinase Pathway and Infiltrating Urothelial Carcinoma(Begell House Inc, 2023) Büyücek, Şeyma; Coşkun, Sinem Kantarcıoğlu; Önal, Binnur; Gamsızkan, Mehmet; Cangür, Şengül; Esbah, OnurReceptor tyrosine kinase pathway is frequently searched for cancer causing mutations in tumors. Emerg-ing targeted therapies are gleam of hope for them. Infiltrating urothelial carcinoma can have many morphological aspects according to their differentiation/variants. To evaluate KRAS, BRAF, and PIK3CA mutations and HER2, EGFR, and p16 expression, we divided urothelial carcinomas into two groups: differentiated/variants (n = 12) and conventional (n = 12). We compared results with clinical, demographic, histopathologic features and survival rates. No statistically sig-nificant results could be obtained in the comparison of histopathologic properties/survival rates with mutation analysis and EGFR, HER2, and p16 status. Differentiated/variants urothelial carcinoma showed higher EGFR expression (P < 0.001). Glandular differentiation was the most frequent type, followed by squamous and sarcomatoid differentiation. We observed the most common mutation at KRAS with a propensity for urothelial carcinoma with glandular differentiation. More than one mutation/high protein expression was seen in some tumors. Targeted therapies for KRAS mutation can be effective at urothelial carcinoma with glandular differentiation. Heterologous expression of relevant proteins and genes can be a cause for targeted treatment obstacle. The determination of the molecular characters of tumors is a guide in creating targeted treatment algorithms and in choosing the patient.Öğe TERT promoter mutation and HER2 gene amplification in malignant peripheral nerve sheath tumours: is there a molecular signature playing role in malignant transformation?(Springer, 2018) Coşkun, S. Kantarcıoğlu; Gamsızkan, Mehmet; Yılmaz, İsmail; Yalçınkaya, Ulviye; Sungur, Mehmet Ali; Büyücek, Şeyma; Önal, Binnur…Öğe Waterpipe (narghile, hookah) tobacco smoking-induced acute eosinophilic pneumonia(Turkish Respiratory Soc, 2018) Annakkaya, Ali Nihat; Balbay, Ege Güleç; Öztürk, Özlem; Önal, Binnur; Aytekin, Fuat; Balbay, Öner AbidinAcute eosinophilic pneumonia (AEP) is characterized by a febrile illness, diffuse pulmonary infiltrates, hypoxemic respiratory failure, and pulmonary eosinophilia. A temporal relationship has been described in a number of patients between the development of AEP and the recent onset of cigarette smoking. A 22-year-old male patient with no known chronic disease was admitted to the emergency service for 3 days with the complaints of cough, fever, dyspnea, and pleuritic chest pain. He was formerly a nonsmoker but was a waterpipe (narghile, hookah) tobacco smoker as a new habit once a night for the last 2 months. The erythrocyte sedimentation rate and C-reactive protein are elevated. Arterial blood gases revealed moderate hypoxemia. Computed tomography scans included bilateral, random, and patchy ground-glass opacities and also small bilateral pleural effusions. Echocardiograhic examination was normal. We had accepted the patient as an acute eosinophilic pneumonia due to rapid response to corticosteroid treatment, no microorganism in bronchoalveolar lavage (BAL) culture, and predominant eosinophilia was observed (70%-80%) in BAL.
