Post-radiotherapy cribriform-morular thyroid carcinoma

BACKGROUND

According to the new 2022 World Health Organization classification of endocrine tumors, thyroid malignancy, formerly known as the cribriform-morular variant of papillary thyroid carcinoma, is now categorized as differentiated thyroid malignancy; it is, at present, called cribriform-morular thyroid carcinoma and classified as a tumor of unknown histogenesis.

CASE REPORT

In this case report, we report on a 15-year-old patient who underwent external radiotherapy to the neck for Hodgkin's disease and developed cribriform-morular thyroid carcinoma 5 years after radiotherapy.

CONCLUSIONS

We believe that cribriform-morular thyroid carcinoma with diffuse nuclear beta-catenin expression has exciting and unresolved uncertainties that may affect disease prognosis and follow-up for cytopathologists and endocrinologists.

Pre-operative neutrophil/lymphocyte and platelet/lymphocyte ratios are effective in predicting complicated acute cholecystitis

BACKGROUND

Acute cholecystitis is a severe disease that requires urgent operation in some cases. To select suitable patients for a conservative approach, there is a need for an affordable and reliable marker for determining complication risk. Evaluation of systemic inflammatory markers in combination with other parameters such as white blood cell and the C-reactive protein might help to decide the appropriate treatment option. This study aims to evaluate the diagnostic value of the neutrophil-lymphocyte ratio (NLR) and thrombocyte-lymphocyte ratio (PLR) in determining the risk of complicated acute cholecystitis and to compare with intraoperative and pathological findings.

METHODS

A total of 229 patients operated on for acute cholecystitis were included in this study. Intraoperative and pathologically complicated acute cholecystitis in 78 cases and controls group was 151 cases. The two groups were compared in terms of inflammation markers. Then, we used the receiver operating characteristic curve analysis to determine the optimal value for NLR and PLR concerning the severity of cholecystitis. Then, the differences in clinical symptoms were investigated according to the cutoff value for NLR and PLR.

RESULTS

The NLR and PLR levels were found to be significantly higher in the complicated group (4.18±4.53 vs. 15.23±20.99, 145.34±87.58, and 251.92±245.93, respectively, p<0.01). The best cutoff value for NLR and PLR was 5.5 and 146.90, respectively. Sensitivity for NLR was 80% and specificity was 80.1%. Sensitivity for PLR was 66.7% and specificity was 66.2%.

CONCLUSION

Systemic inflammation markers can be used to predict the risk of complicated acute cholecystitis. They are inex-pensive tools that can be used to make surgical decisions, especially in resource scarce environments.

Expression of M30 and M65 in celiac disease. Analytical cross-sectional study

BACKGROUND

The role of villous atrophy in apoptosis, a distinctive feature of celiac disease, is a matter of controversy. The aim of this study was to determine the apoptosis rate through immunohistochemical staining for M30 and M65 in celiac disease cases.

DESIGN AND SETTING

Analytical cross-sectional study in a tertiary-level center.

METHODS

Duodenal biopsies from 28 treatment-naive patients with celiac disease, 16 patients with potential celiac disease, 10 patients with a gluten-free diet and 8 controls were subjected to immunohistochemical staining for the end-apoptotic marker M30 and the total cell death marker M65. H-scores were compared. Several laboratory parameters were recorded concomitantly, and at the one-year follow-up for celiac disease and potential celiac disease patients.

RESULTS

There was a significant difference in H-score for M30 expression between the celiac disease, potential celiac disease and gluten-free diet groups (P = 0.009). There was no significant difference in H-score for M65 expression. There was a positive correlation between the H-score for M30 expression and the anti-tissue transglutaminase immunoglobulin A (anti-tTgIgA) and anti-tissue transglutaminase immunoglobulin G (anti-tTgIgG) levels (R = 0.285, P = 0.036; and R = 0.307, P = 0.024, respectively); and between the H-score for M65 expression and the anti-tTgIgA and anti-tTgIgG levels (R = 0.265, P = 0.053; and R=0.314, P = 0.021, respectively). There was no difference between celiac disease and potential celiac disease patients regarding the laboratory parameters selected.

CONCLUSION

The rates of apoptosis and nutritional deficiencies in patients with potential celiac disease were similar to those in patients with celiac disease.

Comparing the type and severity of inflammatory bowel disease in relation to IgG4 immunohistochemical staining

BACKGROUD AND STUDY AIM

The role of immunoglobulin (Ig) G4 in the etiopathogenesis of inflammatory bowel disease (IBD) and its association with endoscopic and pathological activity are not yet completely understood. The purpose of this study was to determine the possible relationship between IgG4 status and IBD.

PATIENTS AND METHODS

Endoscopic colon biopsies of 55 patients with ulcerative colitis (UC) and of 17 patients with Crohn's disease (CD) were examined. Numbers of IgG4-positive plasma cells stained immunohistochemically were counted in a minimum of 5 high power fields (HPFs) for each specimen. The presence of > 10 cells/HPF IgG4-positive PCs was considered positive.

RESULTS

he prevalence of IgG4-positive plasma cells in the lamina propria of the colonic mucosa was significantly higher in patients with UC than in those with CD (p :0.01). Additionally, the prevalence of IgG4-positive plasma cells increased in line with endoscopic and pathological activity in UC patients. Conversely, we determined no significant correlation between IgG4 positivity and pathological activity in the CD group. IgG4-positive UC patients also exhibited findings of more severe disease compared to IgG4-negative UC patients.

CONCLUSION

Immunohistochemical IgG4 staining may predict disease severity in UC and may be a useful marker for distinguishing between UC and CD.

Cytological Diagnosis of Small Cell Carcinoma of Urinary Bladder in a Patient with CLL

Small cell carcinoma of the urinary bladder (SCCUB) is an extremely rare bladder malignancy characterized by an aggressive clinical behavior. So, it is important to diagnose this high grade disease by urinary cytology. We report a case of SCCUB in an old man with chronic lymphocytic leukemia (CLL) in remission, while bladder tumor was diagnosed by cytology. With this article, we aimed to review and to update the literature concerning this tumor.