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Erhan SŞ, Keser SH, Kamalı GH, Sensu S, Dinçer S, Sağlam F. Is it possible that we can increase the lymph node number in cases with rectum tumor receiving neoadjuvant therapy? INDIAN J PATHOL MICR 2023; 66:780-785. [PMID: 38084532 DOI: 10.4103/ijpm.ijpm_1230_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Background Though the recommended sampled lymph node number in colorectal carcinomas is at least 12, due to shrinkage after preoperative neoadjuvant chemoradiotherapy (NCRT), it can be difficult to attain that number. Aim Our aim is to increase the lymph node number by applying alcohol fixation on the formalin-fixed resection materials of the patients that received or not received neoadjuvant therapy and to evaluate the changes in staging due to obtained lymph nodes. Settings and Design Non-randomized controlled trial. Materials and Methods Lymph node dissection was performed in the resection materials with rectum tumor which were formalin- and afterwards, alcohol-fixed. The number of lymph nodes obtained by both of the methods and status of metastasis were evaluated statistically. Results Of the total 76 rectal tumors, 57 had and 19 had not received NCRT. The number of lymph node was adequate in 89.5% cases with no NCRT and in 63.2% cases with NCRT. While no change was observed after the alcohol fixation in the cases fulfilling adequacy criterion among those with no NCRT (p = 1.000), the adequacy rate increased from 63.2% to 87.7% in those with NCRT (p < 0.001). Although statistically insignificant, there was a change in pN stage in eight cases. In three of them, the stage varied from pN0 to pN1c, and in five cases, from pN1a to pN1b. Conclusion Using solutions as alcohol during fixation might facilitate the identification of metastatic lymph nodes, might change the stage of the disease and therefore, might affect the patient-based therapy.
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Affiliation(s)
- Selma Şengiz Erhan
- Department of Pathology, Istanbul Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey
| | - Sevinç Hallaç Keser
- Department of Pathology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Gülçin Harman Kamalı
- Department of Pathology, Istanbul Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey
| | - Sibel Sensu
- Department of Pathology, Medical Faculty, University of Istinye, Istanbul, Turkey
| | - Selvi Dinçer
- Department of Radiation Oncology, Istanbul Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey
| | - Fazıl Sağlam
- Department of Surgery, Istanbul Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey
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Şensu S, Ege Gül A, Hallaç Keser S, Gürbüz YS, Altıntaş M, Barışık CC, Özdemir Barışık N, Erdoğan N. Clinical and Pathological Features of Adrenal Myelolipoma and Myelolipomatous Metaplasia Cases in Our Hospital Over 13 Years. cjms 2023. [DOI: 10.4274/cjms.2022.2022-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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İlhan Türkel F, Ege Gül A, Sensu S, Hallaç Keser S, Özdemir Barışık N. Microsatellite Instability in Ovarian Invasive and Borderline Epithelial Tumors and Comparison with Prognostic Parameters. Haseki 2020. [DOI: 10.4274/haseki.galenos.2020.6125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Abdullazade S, Akarca FG, Esendağlı G, Turhan N, Erden E, Savaş B, Markoç F, Tunçel D, Özgüven Yılmaz B, Saka B, Hallaç Keser S, Şengiz Erhan S, Gücin Z, Sağol Ö, Aysal Ağalar A, Çelik S, Özer H, Erbarut Seven İ, Ataizi Çelikel Ç, Ekinci Ö, Eğilmez HR, Balcı S, Akyol G. The Contribution of Additional Sampling in Cholecystectomy Materials: A Multicenter Prospective Study. Turk Patoloji Derg 2020; 36:188-194. [PMID: 32364613 PMCID: PMC10510599 DOI: 10.5146/tjpath.2020.01483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 02/26/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Cholecystectomy materials are frequently encountered in routine practice. The aim of this study was to determine the true frequency of gallbladder lesions, the diagnostic consistency, and standardization of reports after macroscopic sampling and microscopic evaluation based on previously defined criteria. MATERIAL AND METHOD 14 institutions participated in the study within the Hepato-Pancreato-Biliary Pathology Study Group. Routinely examined cholecystectomies within the last year were included in the study in these institutions. Additional sampling was performed according to the indications and criteria. The number of blocks and samples taken in the first macroscopic examination and the number of blocks and samples taken in the additional sampling were determined and the rate of diagnostic contribution of the additional examination was determined. RESULTS A total of 5,244 cholecystectomy materials from 14 institutions were included in the study. Additional sampling was found to be necessary in 576 cases (10.98%) from all institutions. In the first macroscopic sampling, the mean of the numbers of samples was approximately 4 and the number of blocks was 2. The mean of the numbers of additional samples and blocks was approximately 8 and 4, respectively. The diagnosis was changed in 144 of the 576 new sampled cases while the remaining 432 stayed unaltered. CONCLUSION In this study, it was observed that new sampling after the first microscopic examination of cholecystectomy materials contributed to the diagnosis. It was also shown that the necessity of having standard criteria for macroscopic and microscopic examination plays an important role in making the correct diagnosis.
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Affiliation(s)
- Samir Abdullazade
- Department of Pathology, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
| | - Fahire Göknur Akarca
- Department of Medical Pathology, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Güldal Esendağlı
- Department of Medical Pathology, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Nesrin Turhan
- Department of Pathology, Turkey Yüksek İhtisas Education and Research Hospital, Ankara, Turkey
| | - Esra Erden
- Department of Medical Pathology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Berna Savaş
- Department of Medical Pathology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Fatma Markoç
- Department of Pathology, Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Ankara, Turkey
| | - Deniz Tunçel
- Şişli Etfal Education and Research Hospital, İstanbul, Turkey
| | | | - Burcu Saka
- Department of Medical Pathology, Medipol University, Faculty of Medicine, İstanbul, Turkey
| | - Sevinç Hallaç Keser
- Department of Pathology, Lütfi Kırdar Education and Research Hospital, İstanbul, Turkey
| | | | - Zühal Gücin
- Department of Medical Pathology, Bezmialem Vakıf University, Faculty of Medicine, İstanbul, Turkey
| | - Özgül Sağol
- Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | | | - Sevinç Çelik
- Bozok University, Faculty of Medicine, Yozgat, Turkey
| | - Hatice Özer
- Cumhuriyet University, Faculty of Medicine, Sivas, Turkey
| | | | | | - Özgür Ekinci
- Department of Medical Pathology, Gazi University, Faculty of Medicine, Ankara, Turkey
| | | | | | - Gülen Akyol
- Department of Medical Pathology, Gazi University, Faculty of Medicine, Ankara, Turkey
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Şengiz Erhan S, Hallaç Keser S, Özer M. Clinicopathologic Characteristics of Gallbladder Adenomyomas and the Contribution of Macroscopic Sampling in Adenomyoma Diagnosis. Turk Patoloji Derg 2020; 36:11-16. [PMID: 31633192 PMCID: PMC10512676 DOI: 10.5146/tjpath.2019.01471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/27/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Adenomyoma, a reactive and hamartomatous lesion of the gallbladder, is included in the differential diagnosis of several benign and malignant lesions. Macroscopic sampling is very important in the determination of these lesions. The agreed macroscopy protocol in recent years has been prepared by the Hepatopancreatobiliary Pathology Working Group. We aimed to evaluate the clinicopathologic properties of adenomyoma cases in the gallbladder and the contribution of new macroscopy techniques to the diagnosis of adenomyoma in the pre-protocol and post-protocol parts of a one-year period. MATERIAL AND METHOD Two institutes were included in the study. Adenomyoma cases diagnosed in the pre-protocol and post-protocol periods of one year duration were included in the study. Slides and demographic properties of the cases were reexamined. RESULTS While adenomyoma was present in 22 of 1879 gallbladder before the protocol, it was observed in 32 of 1781 gallbladders in the post-protocol period. 17 of the cases were male and 37 were female. The mean age of the cases was 51.8. 52% of the lesions were located in the fundus. A gallstone was observed in 37 cases, and cholesterolosis in 14 cases. In the comparison of the two periods, the number of cases was lower in the post-protocol period but a 0.6% increase in the diagnosis of adenomyoma was found. CONCLUSION Adenomyoma is one of the lesions of the gallbladder that should be recognized but can be easily overlooked macroscopically. When we conducted the sampling according to the last protocol, the increase in the diagnosis of adenomyoma showed that adequate and accurate sampling was very useful for the detection of adenomyoma in the gallbladder.
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Affiliation(s)
- Selma Şengiz Erhan
- Department of Pathology, University of Health Sciences, Okmeydani Education and Research Hospital, Istanbul, Turkey
| | - Sevinç Hallaç Keser
- Department of Pathology, University of Health Sciences, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey
| | - Mehmet Özer
- Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
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Esendağlı G, Akarca FG, Balcı S, Argon A, Erhan SŞ, Turhan N, Zengin Nİ, Keser SH, Çelik B, Bulut T, Abdullazade S, Erden E, Savaş B, Bostan T, Sağol Ö, Ağalar AA, Kepil N, Karslıoğlu Y, Günal A, Markoç F, Saka B, Özgün G, Özdamar ŞO, Bahadır B, Kaymaz E, Işık E, Ayhan S, Tunçel D, Yılmaz BÖ, Çelik S, Karabacak T, Seven İE, Çelikel ÇA, Gücin Z, Ekinci Ö, Akyol G. A Retrospective Evaluation of the Epithelial Changes/Lesions and Neoplasms of the Gallbladder in Turkey and a Review of the Existing Sampling Methods: A Multicentre Study. Turk Patoloji Derg 2018; 34:41-48. [PMID: 28984336 DOI: 10.5146/tjpath.2017.01404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE As there is continuing disagreement among the observers on the differential diagnosis between the epithelial changes/lesions and neoplasms of the gallbladder, this multicentre study was planned in order to assess the rate of the epithelial gallbladder lesions in Turkey and to propose microscopy and macroscopy protocols. MATERIAL AND METHOD With the participation of 22 institutions around Turkey that were included in the Hepato-Pancreato-Biliary Study Group, 89,324 cholecystectomy specimens sampled from 2003 to 2016 were retrospectively evaluated. The numbers of adenocarcinomas, dysplasias, intracholecystic neoplasms/adenomas, intestinal metaplasias and reactive atypia were identified with the review of pathology reports and the regional and countrywide incidence rates were presented in percentages. RESULTS Epithelial changes/lesions were reported in 6% of cholecystectomy materials. Of these epithelial lesions, 7% were reported as adenocarcinoma, 0.9% as high-grade dysplasia, 4% as low-grade dysplasia, 7.8% as reactive/regenerative atypia, 1.7% as neoplastic polyp, and 15.6% as intestinal metaplasia. The remaining lesions (63%) primarily included non-neoplastic polypoids/hyperplastic lesions and antral/pyloric metaplasia. There were also differences between pathology laboratories. CONCLUSION The major causes of the difference in reporting these epithelial changes/lesions and neoplasms include the differences related to the institute's oncological surgery frequency, sampling protocols, geographical dissimilarities, and differences in the diagnoses/interpretations of the pathologists. It seems that the diagnosis may change if new sections are taken from the specimen when any epithelial abnormality is seen during microscopic examination of the cholecystectomy materials.
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Affiliation(s)
- Güldal Esendağlı
- Department of Medical Pathology, Gazi University School of Medicine, Ankara, Turkey
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Keser SH, Selek A, Ece D, Barişik CC, Şensu S, Geçmen GG, Erhan SŞ, Kökten ŞÇ, Barişik NÖ, Gül AE. Review of Hydatid Cyst with Focus on Cases with Unusual Locations. Turk Patoloji Derg 2017; 33:30-36. [PMID: 28044304 DOI: 10.5146/tjpath.2016.01369] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study has been conducted so as to contribute to health statistics of hydatid cyst by the data obtained from our clinic, and to discuss hydatid cysts in unusual locations. MATERIAL AND METHOD Cases diagnosed as hydatid cyst at Dr. Lutfi Kirdar Kartal Research and Education Hospital Pathology Clinic between 2007 and 2015 have been evaluated based on criteria such as age, sex and location. RESULTS A total of 364 cases, 209 females and 155 males, have been included in the study. The subjects in the cases are aged between 4 and 81 (mean: 38.84). Regarding the sites, 254 (69.8℅) of the cases are located in liver, and 53 (14.6℅) in the lung. Fifty-seven cases (15.6℅) have been detected in unusual sites other than the lung or liver. The rate of isolated organ involvement, other than the lung and liver, has been found to be 10.3℅. CONCLUSION Since hydatid cyst can be found in all the body sites, it should be taken into account in the differential diagnosis of all cystic lesions.
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Affiliation(s)
- Sevinç Hallaç Keser
- Department of Pathology, Dr. Lütfi Kırdar Kartal Educational and Research Hospital, İstanbul, Turkey
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Ece D, Keser SH, Selek A, Başak K, Karadayı N. Diagnostic Accuracy of Preoperative Fnac in Salivary Gland Lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 2015. [DOI: 10.1016/j.oooo.2014.07.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kandemir NO, Barut F, Gün BD, Tekin NS, Keser SH, Ozdamar SO. Histopathological analysis of vesicular and bullous lesions in Kaposi sarcoma. Diagn Pathol 2012; 7:101. [PMID: 22894735 PMCID: PMC3488507 DOI: 10.1186/1746-1596-7-101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Accepted: 08/05/2012] [Indexed: 12/03/2022] Open
Abstract
Background In this study, the clinical and morphological features of vesiculobullous lesions observed in Kaposi sarcoma are analyzed, and the features of bullous Kaposi sarcoma cases are emphasized. Methods A total of 178 biopsy materials of 75 cases diagnosed as classic-type cutaneous Kaposi sarcoma were reviewed. Twenty-five cases showing vesiculobullous features were included in the study. Tumor, epidermis, dermis, and clinical data regarding these cases was evaluated. Results Vesicular changes were observed in 21 (12%) out of 178 lesions of the 75 cases, while bullous changes were present in only 4 (2%). In all cases where vesicular and bullous changes were detected, tumor, epidermis, and dermis changes were similar. All cases were nodular stage KS lesions, whereas hyperkeratosis and serum exudation in the epidermis, marked edema in the dermis, and enlarged lymphatic vessels and chronic inflammatory response were observed. Conclusions Our findings suggest that changes in vascular resistance occurring during tumor progression are the most important factors comprising vesiculobullous morphology. Virtual slides The virtual slide(s) for this article can be found here:
http://www.diagnosticpathology.diagnomx.eu/vs/1646397188748474
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Affiliation(s)
- Nilüfer Onak Kandemir
- Department of Pathology, Karaelmas University, Faculty of Medicine, Zonguldak, Turkey.
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Bılıcı A, Şeker M, Öven Ustaalıoğlu BB, Keser SH, Cınaral F, Gümüş M. Gallbladder metastasis secondary to gastric cancer as a first site of recurrence presented with acute cholecystitis: case report and literature review. Turk J Gastroenterol 2012; 23:764-768. [PMID: 23864451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Metastasis to the gallbladder from other malignancies is extremely rare and is related with a very poor prognosis. Malignant melanoma has been reported to be the most common origin of gallbladder metastasis. Although only eight cases of gallbladder metastasis originating from gastric cancer have been documented in the literature based on small series, of these cases, only one case with signet ring cell carcinoma histology has been reported previously. We report the case of a 58-year-old male with early-stage signet ring cell carcinoma of the stomach who presented with acute cholecystitis previously treated with curative gastrectomy. After laparoscopic cholecystectomy, the diagnosis of gallbladder metastasis with signet ring cell histology secondary to gastric cancer was made. To our knowledge, this is only the second case of signet ring cell carcinoma of the stomach metastasized to the gallbladder as a first site of recurrence. We suggest that for patients with gastric cancer who complain of the findings of acute cholecystitis or cholecystolithiasis, gallbladder metastasis from gastric cancer should be considered in the differential diagnosis.
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Affiliation(s)
- Ahmet Bılıcı
- Dr. Lütfi Kırdar Kartal Education and Research Hospital, Department of Medical Oncology, İstanbul, Turkey.
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Keser SH, Gül AE, Barişik NO, Cakir C, Sensu S, Kandemir NO, Karadayi N. The relationship of COX-2 expression with estrogen receptor, progesterone receptor and prognostic parameters in endometrial carcinomas. J Obstet Gynaecol Res 2010; 36:560-6. [PMID: 20598038 DOI: 10.1111/j.1447-0756.2010.01179.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Endometrial cancer (EC), which is the most common gynecologic cancer, develops as a result of disruption of the delicate balance between cell proliferation and cell loss, or apoptosis through activation of oncogenesis, or loss of tumor suppressor genes. Among the biochemical factors proposed to give a more detailed characterization of EC biology, estrogen receptors (ER) and progesterone receptors (PR) play a major role. Most of the studies in the literature have shown increased expression of cyclooxygenase-2 (COX-2) in EC. Recent experiments suggest that COX-2 antagonizes cell apoptosis, increases the invasiveness of malignant cells and promotes angiogenesis. The aim of this study was to investigate the expression of COX-2 in EC, to study its correlation to established menstrual status, grade, myometrial invasion, lymph node status, stage and ER and PR status. MATERIAL & METHODS The study was performed on 72 ECs. Immunohistochemically was analyzed for ER, PR, and COX-2. RESULTS COX-2 positivity was found in 91.7% of the cases. In 61 cases (84.7%) there was ER positive staining, and in 59 cases (81.9%) PR positive staining was observed. We have not found a statistically significant relation between COX-2 and prognostic factors, ER and PR. CONCLUSIONS A high expression rate still suggests a probable relation with endometrial carcinogenesis. If such a relation exists, new therapeutic options might be available in the future.
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Affiliation(s)
- Sevinç Hallaç Keser
- Dr. Lütfi Kirdar Kartal Educational and Research Hospital, Pathology Department, Istanbul, Turkey.
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