Evaluation of Fine-Needle Aspiration of Thyroid Nodules in a Series of 1,100 Patients: Correlation Between Cytology and Histopathology Original Article

In this study, our aim was to test the usefulness of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) in indeterminate lesions in which cytological and histological diagnosis discordance was high and to investigate the contribution of TBSRTC in this indeterminate diagnostic group. The medical records of the patients who presented to the Haydarpasa Numune Training and Research Hospital in Istanbul, Turkey, between October of 1999 and September of 2010, for the cytological and histological diagnosis of thyroid nodules, were reviewed retrospectively. We reclassified these patients according to the Bethesda method, which features well-defined cytological criteria for each category within a six-tiered system. For each patient, the diagnosis and reasons for discordance were discussed and a final decision was made for each discordant case. The overall distribution of the cytological diagnoses using an in-house system was as follows: 811 benign (73.7 %), 87 suspicious follicular cell/follicular neoplasia (7.9 %), 52 suspicious for malignancy (4.7 %), and 45 malignant (4.1 %). We reclassified the diagnoses using the Bethesda system and the results are as follows: 797 benign (73.7 %), 48 follicular lesion of undetermined significance (4.3 %), 68 follicular neoplasia (7.9 %), 40 suspicious for malignancy (3.6 %), and 44 malignant (4 %). Our results showed that using TBRSTC for the lesions in the indeterminate category decreased the ratios of false-positive and false-negative diagnoses.

Comparison of endothelial function of coronary artery bypass grafts in diabetic and nondiabetic patients: Which graft offers the best?

OBJECTIVE

Diabetes associated endothelial dysfunction, which determines both long and short term graft patency, is not uniform in all coronary artery bypass surgery (CABG) grafts. Herein this study, we aimed to investigate the degree of endothelial dysfunction in diabetic radial artery (RA), internal mammarian artery (IMA) and saphenous vein (SV) grafts in vitro tissue bath system.

METHODS

This is a prospective experimental study. Fifteen diabetic and 15 non-diabetic patients were included to the study. A total number of 96 graft samples were collected; 16 graft samples for each graft type from both diabetic and non-diabetic patients. Arterial grafts were harvested with pedicles and SV grafts were harvested by 'no touch' technique. Vasodilatation response of vascular rings to carbachol, which induces nitric oxide (NO) mediated vasodilatation, was designated as the measure of endothelial function.

RESULTS

The IMA grafts had the most prominent NO mediated vasodilatation in both diabetic and non-diabetic patients, concluding a better preserved endothelial function than SV and RA. The 'no- touch' SV and RA grafts had similar vasodilatation responses in non-diabetic patients. In diabetic patients, on the other hand, RA grafts exhibited the least vasodilatation response (ie. worst endothelial function), even less vasodilatation than 'no touch' SV grafts (p<0.0001).

CONCLUSION

Deteriorated function of RA grafts in diabetic patients, even worse than SV grafts made evident by this study, encourages the use of 'no touch' technique as the method of SV harvesting and more meticulous imaging of RA before its use as a graft in diabetic patients.

Effect of high-risk human papillomavirus in esophageal squamous cell carcinoma in Somalian and Turkish cases

This study aimed to investigate the role of high-risk human papillomavirus (Hr-HPV) in Somalian and Turkish patients with esophageal squamous cell carcinoma (ESCC). In the sections obtained from paraffin-embedded blocks, the results of invasive tumor, peripheral tumor dysplasia and normal mucosa were examined. Samples containing 45 and 47 ESCC, 46 and 42 dysplasia in Somalian (n = 52) and Turkish (n = 53) cases, respectively, were included in the study. We examined the presence of 14 types of Hr-HPV in ESCC collected from Somalia and Turkey by Aptima® Panther System. Hr-HPV types were not detected in Somalian cases. p16INK4a is positive in 5 (11.4%) tumors and 6 (13%) dysplasia. p53 is positive in 28 (62.2%) tumors and 35 (76.1%) dysplasia. HPV16-18/45 are positive only in one of the Turkish cases. p16INK4a is positive in 5 (10.6%) tumors and 4 (9.5%) dysplasia. p53 is positive in 31 (63.3%) tumors and 24 (57.1%) dysplasia. No reaction was detected in normal mucosa samples in both countries. This study is regional. Although the findings did not reflect the general population, the present study shows that the effect of HPV on carcinogenesis in Somalian and Turkish ESCC patients was not significant.

Long-term results and prognostic factors after surgical treatment for gallbladder cancer

Objectives

Gallbladder cancer is relatively rare and traditionally regarded as having poor prognosis. There is controversy about the effects of clinicopathological features and different surgical techniques on prognosis. The aim of this study was to investigate the effects of clinicopathological characteristics of the patients with surgically treated gallbladder cancer on long-term survival.

Material and Methods

We retrospectively analyzed the database of gallbladder cancer patients treated at our clinic between January 2003 and March 2021.

Results

Of 101 evaluated cases, 37 were inoperable. Twelve patients were determined unresectable based on surgical findings. Resection with curative intent was performed in 52 patients. The one-, three-, five-, and 10-year survival rates were 68.9%, 51.9%, 43.6%, and 43.6%, respectively. Median survival was 36.6 months. On univariate analysis, poor prognostic factors were determined as advanced age; high carbohydrate antigen 19-9 and carcinoembryonic antigen levels; non-incidental diagnosis; intraoperative incidental diagnosis; jaundice; adjacent organ/structure resection; grade 3 tumors; lymphovascular invasion; and high T, N1 or N2, M1, and high AJCC stages. Sex, IVb/V segmentectomy instead of wedge resection, perineural invasion, tumor location, number of resected lymph nodes, and extended lymphadenectomy did not significantly affect overall survival. On multivariate analysis, only high AJCC stages, grade 3 tumors, high carcinoembryonic antigen levels, and advanced age were independent predictors of poor prognosis.

Conclusion

Treatment planning and clinical decision-making for gallbladder cancer requires individualized prognostic assessment along with standard anatomical staging and other confirmed prognostic factors.

Pattern of primary tumors and tumor-like lesions of bone in children: retrospective survey of biopsy results

BACKGROUND

Although primary bone tumors are relatively uncommon, they constitute the most important tumors in patients less than 20 years. We aimed to determine the frequencies of primary bone tumors and tumor-like lesions of bone and the anatomical sites of their occurrence.

METHODS

A retrospective review of histopathology reports of all bone specimens received in a private pathology laboratory in Istanbul between 2009 and 2015.

RESULTS

A total of 57 patients (aged 5 to 18 years) with a mean of 13.12 years were studied. Thirty five patients (61.4%) were males and 22 (38.6%) were females. Fifty five (94.4%) of the tumors were benign. Osteochondroma was the commonest tumor accounting for 31 cases (54.3%) followed by osteoid osteoma, 9 cases (15.7%). Chondrosarcoma observed in two patients and Ewing sarcoma in one patient as malignant tumors. Of the 57 bone tumors 13 (22.8%) occurred in the upper extremities, while 44 (77.2%) were in the lower extremities. Proximal humerus was the most commonly involved site in upper extremity tumors, with osteochondromas representing the most frequent type of tumor (4 patients; 7%). In the lower extremities again osteochondromas were the most common type of tumor (8 cases, 14%), with the femur being the most common site of involvement (18 patients, 31.5%). Of the patients with tumor-like lesions; four patients had fibrous dysplasia, 4 patients had non-ossified fibromas, 4 patients had simple bone cysts and 3 had aneurismal bone cyst.

CONCLUSION

This study showed that primary bone tumors were mainly benign, settled predominantly in the lower extremities mostly in the femur with a male preponderance. Osteochondroma was the most common benign bone tumor. We didn't observed osteosarcoma, which is the most frequent malignant bone tumor.