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Öğe Blood cell indices in High-Grade Squamous Intraepithelial Lesions(2022) Gamsızkan, Zerrin; Coşkun, Sinem Kantarcıoğlu; Erdemir, Gökhan; Yavuzcan, AliLow patient motivation and relatively long procedures can sometimes limit the gains of the PAP test. At this point, the clinician may need additional stimulating tests to persuade patients to perform screening tests. The aim of this study was to determine the predictive value of hematological parameters for the high-grade squamous intraepithelial lesion (HG-SIL). Ninety-one patients possessing HG-SIL with complete blood counts and 111 healthy patients with normal cervical cytology were reviewed retrospectively. The age, WBC, and RBC count were significantly different in patients with HG-SIL than in controls. A cutoff value was found 42.5 for age (42% sensitivity and 58 % specificity, AUC: 0.604), 8.65 for WBC (44% sensitivity and 68% specificity, AUC: 0.570), and 4.47 for RBC (65% sensitivity and 58% specificity, AUC: 0.628) in ROC curve analysis. The results of the study show that the age of the patients, RBC, and WBC counts are important in precancerous intraepithelial lesions. Clinicians should warn female patients in the risk group to have regular gynecological examinations and screenings.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 Gastrointestinal Stromal Tumors and Review of the Literature: A Single Institution Experience(Duzce Univ, Fac Medicine, 2022) Coşkun, Sinem KantarcıoğluObjective: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasias of the gastrointestinal system (GIS). The malignancy potential of GISTs may vary ranging from indolent tumors to progressive malignant tumors. This study aims to define clinicopathological and immunohistochemical features of GISTs diagnosed in our institute with a review of the literature. Methods: A total of 28 GIST cases were included in the study. The Hematoxylin&Eosin stained slides of surgical resection materials and cell blocks and immunohistochemistry performed slides were reviewed by a pathologist. The immunohistochemical expression with CD117, DOG-1, CD34, SMA, and S100 was scored between 0 and 3 points according to staining intensity. Descriptive statistics were used in the study. The demographic data, prognostic histopathological, and immunohistochemical findings are evaluated with the literature indications. Results: Eleven of the cases were male and seventeen were female. The age range was 18-88. The most common site of GISTs was the stomach, followed by the small intestine, colorectal region, and, esophagus. Twenty of the tumors were resected surgically, four were endoscopic biopsy material and four were fine-needle aspiration biopsies. The tumor size in measurable materials ranged from 0,2 to 22 cm. The mitotic count in 50 HPF ranges from 0 to 10. Seven of the GISTs were high grade and the remaining 21 were low grade. The majority of the cases were composed of spindle cells, 3 were epithelioid and 3 were the mixed type with spindle and epitheloid cells. Conclusions: A variety of criteria has been proposed to estimate the malignancy potential of GISTs and predict prognosis but definite prognostic criteria remain uncertain. Further studies with larger series of GISTs consisting of different types of biopsy materials may help define criteria to predict prognosis precisely.Öğe The Evaluation of Core Needle Breast Biopsy Analyzes Performed with 14 and 18 Gauge Needles: A Single Center Experience for Eight Years(2021) Altınsoy, Hasan Baki; Güçlü, Derya; Coşkun, Sinem Kantarcıoğlu; Boğan, MustafaAim: Percutaneous imaging-guided core needle breast biopsy has become widely used as analternative to incisional biopsy in the diagnosis of breast lesions. In this study, it was aimed toevaluate and report our core needle breast biopsy experiences performed with 14- and 18-gauge needles.Material and Methods: Patients who underwent core needle breast biopsy between March2012 and December 2019 in our radiology department and whose biopsy specimens wereevaluated in the pathology department, of all age groups and both sexes, were included in thisstudy. A total of 628 (615 female and 13 male) patients with breast masses were examined.Results: The mean age of the patients was 52.20±13.94 (median= 51, range, 13-96) years,90.4% (n=568) of the lesions were masses and the majority of lesions (53.2%, n=334) were11-20 mm in size. The most of cases (47.2%, n=268) were BI-RADS 5. There was nosignificant difference between the two needles in terms of gender distribution, age, type ofsurgery, and core needle breast biopsy results. In 86.5% (n=141) of the patients, there wasdiagnostic accuracy between the surgical specimen and the core needle breast biopsy result.Conclusion: We demonstrated that the 14-gauge and 18-gauge needles have similarperformance of results. Smaller needles should be used for ultrasound-guided breast biopsies,which is less invasive, less painful, and creates less risk of hemorrhage. Moreover, no patientadmitted to the emergency department because of the core needle breast biopsy acutecomplications such as hematoma, bleeding, etc. during this time.Öğe Paraneoplastic Severe Sensorimotor Axonal Polyneuropathy in Pancreatic Neuroendocrine Carcinoma: A Case Report and Review of the Literature(Duzce Univ, Fac Medicine, 2022) Akbaş, Türkay; Coşkun, Sinem Kantarcıoğlu; Torun, Serkan; Öztürk, Ayhan; Esbah, Onur; Önbaş, ÖmerObjective: Paraneoplastic neurological syndromes (PNSs) are a diverse group of neurological disorders affecting any part of the nervous system before or during cancer. Case: A 78-year-old man first experienced pain and burning in the upper extremity three years previously, to which muscle weakness was added a short time later. The same symptoms developed in the lower extremities one year previously. He was admitted to the intensive care unit due to pneumonia and was conscious but quadriplegic with a modified Rankin score of 5. Abdominal computed tomography showed mass lesions in the liver and pancreas. Biopsies revealed pancreatic small cell neuroendocrine carcinoma. Electrophysiological studies revealed severe sensorimotor axonal polyneuropathy. Paraneoplastic sensorimotor axonal polyneuropathy was diagnosed since other causes of polyneuropathy had been excluded. Palliative care was considered due to the patient's poor functional state. Conclusions: Early diagnosis of cancer is of paramount importance in patients with PNSs if appropriate treatment is to be provided.Öğe Psödosarkomatöz Bir Antite Olarak Sellüler Schwannoma: Ayırıcı Tanıda Potansiyel Bir Tuzak*(2020) Coşkun, Sinem Kantarcıoğlu; Sayar, Ayşe; Avcı, Özlem Haskan; Yalçınkaya, Ülviye; Sungur, Mehmet AliKlasik schwannomalar periferik sinir kılıfından köken alan iyi sınırlı benign tümörlerdir. Tüm schwannomaların yaklaşık %5 kadarını sellüler schwannomlar (SS) oluşturur. Fasiküler patern, yüksek sellülarite ve mitotik aktivite varlığı bazı vakalarda yanlış değerlendirme sonucumalign olarak tanı alabilir. Bursa Uludağ Üniversitesi ve Düzce Üniversitesi Tıp Fakültesi Patoloji Laboratuarı arşivlerindeki 16 SS olgusuyeniden değerlendirildi. En sık görülen yerleşim yeri paravertebral/paraspinöz bölge olup bunu mediasten, ekstremiteler, gövde, adrenal bezve dil takip ediyordu. İmmünohistokimyasal boyama uygulanan 15 vakanın tamamında S100 ile kuvvetli pozitivite görüldü. Ki 67 ile boyanma düşük-orta seviyelerde olup sellüler alanlarda %25’e varan ki 67 proliferasyon indeksi mevcuttu. SS tanısı bazen zorlayıcı olabilir vehistopatolojik özelliklerinin bilinmesi olası yanlış tanı ve gereksiz tedavileri önlemek açısından önemlidir. Bu çalışmada iki merkezin arşivlerindeki SS olgularının klinikopatolojik özelliklerinin incelenmesi ve literatür ile karşılaştırılması amaçlanmıştır.Öğe A Rare Case of Rectal Cancer With Endometrial Metastasis: A Case Report(2020) Ipor, Sinem; Esbah, Onur; Coşkun, Sinem KantarcıoğluBackground:Colorectal cancer (CRC) is ranked third in the world in incidence and cancer-related mortality. In this case report, we aimed to present a case of rectum cancer with endometrial metastasis which is rare in the literatüre.Case report:On October, 2014; a 62-year-old woman was admitted to outer clinic with a complaint of rectal bleeding. In the colonoscopy, an ulcerovegetan mass was detected and biopsied. Biopsy pathology was reported as adenocarcinoma and the patient underwent a low anterior resection due to diagnosis of rectal cancer. The adjuvant therapy of the patient was completed and the patient was transferred to our clinic for follow-up. After adjuvant therapy, PET/CT examination was performed due to the fact that the sizes of nodules showed 20% increase according to RECIST criteria by thoracic tomography performed three months intervals. In PET / CT, hipermetabolic foci were detected in nodular lesions in the lung and within the uterine corpus. The patient's lung tru-cut biopsy and biopsy of the endometrial cavity was reported adenocarcinoma.Conclusion:Approximately 20% of patients with CRC have distant metastasis at the time of diagnosis. In general, CRCs metastasize to regional lymph nodes, liver, lung, and less frequently to the bone, brain, and peritoneal cavity. The uterus, which is mostly composed of smooth muscle tissue, is rarely described as the metastatic region of extragenital cancers. Endometrium metastases of CRCs are cases in a limited number in the literature. We emphasize this case because of its rarity and beacuse of importance of differatial diagnosis of primary and metastatic tumors of the uterus.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 Renal Hücreli Karsinomlarda Patolojik Prognostik Parametrelerin Değerlendirilmesi: Tek Merkez Deneyimi(2022) Coşkun, Sinem KantarcıoğluAmaç: Böbrek kanserleri dünyada en sık görülen kanserler arasındadır. Sosyoekonomik gelişme durumlarına göre farklılıklar göstermekle birlikte pek çok ülkede insidans ve mortalite oranları artmaktadır. Bu çalışmada renal hücreli karsinomların (RHK) patolojik prognostik parametrelerini literatür bilgileri eşliğinde değerlendirmek amaçlanmıştır. Gereç ve Yöntemler: RHK tanısı alan toplam 105 olgu çalışmaya dahil edildi. Hastalara ait yaş, cinsiyet, ameliyat tipi (parsiyel/total rezeksiyon), patolojik tanı, tümör lokalizasyonu, makroskopik tümör görünümü, tümör sınırları (düzenli/düzensiz), tümör derecesi, tümör büyüme paterni, tümör çapı, renal kapsül invazyonu, perirenal yağ dokusu invazyonu, renal ven invazyonu, tümörde nekroz ve kistik dejenerasyon varlığı, patolojik tümör evresi, üreter cerrahi sınır, adrenal bez tutulumu ve metastatik tümör durumu verileri hasta dosyalarından ve patoloji raporlarından retrospektif olarak elde edildi. Prognostik parametreler gözden geçirildi. Bulgular: Olguların 71’i erkek, 34’ü kadındı. Yaş aralığı 26 ile 87 arasındaydı. En sık görülen alt tip berrak hücreli olup (n=80), onu papiller tip 1 (n=12), kromofob (n=8) ve papiller tip 2 (n=5) RHK’lar takip ediyordu. Tümör çapı 1,7 cm ile 17 cm arasındaydı. Olguların %71,1’inin nükleer derecesi 2 olarak izlendi. 27 olguda renal kapsül invazyonu mevcut olup, perirenal yağ doku invazyonu 19 olguda görüldü. Sonuç: RHK’lar farklı histolojik alt tiplere sahip, ayırt edici genetik ve moleküler değişiklikler içeren, farklı klinik davranışları nedeniyle terapilere farklı yanıtlar veren hastalıkların bir spektrumudur. Bireyselleştirilmiş surveyans protokolleri oluşturmada, hasta danışmasında ve gelecekteki potansiyel adjuvan tedaviyi belirlemede prognostik parametreler önemli role sahiptir.Öğe STAT3, VEGF, and PSMA Expression Patterns in Malignant Peripheral Nerve Sheath Tumors, Malignant Melanomas, and Glioblastomas: Does Staining Percentage and Intensity Have an Effect on Survival?(Begell House Inc, 2022) Coşkun, Sinem Kantarcıoğlu; Gamsızkan, Mehmet; Yalcinkaya, Ulviye; Sungur, Mehmet AliMalignant peripheral nerve sheath tumors (MPNSTs), glioblastomas (GBMs), and malignant melanomas (MMs) are neural crest-originating aggressive tumors with a poor prognosis. Signal transducer and transcription activator 3 (STAT3) plays a role in many biological processes, including cell life and proliferation, the acute phase response, chronic inflammation, autoimmunity, metabolism, and cancer progression, It is also known to be a prooncogenic transcription factor. Vascular endothelial growth factor (VEGF) is one of the most potent proangiogenic stimuli ever identified. It mediates tumor neovascularization, and is associated with angiogenesis and lymphangiogenesis. The prostate-specific membrane antigen (PSMA) folate hydrolase I, despite its name, has been found in tissues other than the prostate. It is overexpressed in prostate cancer cells and several other cancers, and has the potential to be a target for radioligand therapy. We investigated the value of STAT3, VEGF and PSMA immunohistochemical expression patterns and their effects on survival in MPNSTs, GBMs, and MMs. Their expression patterns were evaluated in 25 MPNSTs, 27 GBMs, and 25 MM cases. All GBM cases stained positively for STAT3 and VEGF. In the other groups, the staining patterns were heterogeneous. None of the cases showed positive staining with PSMA. There was no statistically significant difference in survival between cases with differing VEGF and STAT3 staining patterns in the MPSNT and MM groups, but there was an increase in mortality as the VEGF score increased in the GBM group. The suppression of VEGF and STAT3 may be a promising avenue for treatment of MPNSTs, GBMs, and MMs, although further research is needed.
