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Issin G, Demir F, Guvendir Bakkaloglu I, Cagatay DV, Aktug Simsek H, Yilmaz I, Zemheri E. High Incidence of Appendiceal Neoplasms in the Elderly: A Critical Concern for Non-Surgical Treatment. Med Princ Pract 2023; 32:358-368. [PMID: 37778333 PMCID: PMC10727520 DOI: 10.1159/000534347] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/27/2023] [Indexed: 10/03/2023] Open
Abstract
OBJECTIVE Appendiceal neoplasms (ANs) are rare tumors that are often discovered incidentally during histopathological examinations. The increasing incidence of ANs is a critical issue in the non-operative management of acute appendicitis. This study aimed to document the temporal trends over a 12-year period by analyzing the clinical presentation, imaging findings, and histopathological features of ANs. SUBJECTS AND METHODS Health records of patients who underwent appendectomy from 2011 to 2022 were examined. Demographic and clinical data, laboratory results, imaging findings, and histopathological features were documented. The characteristics of both ANs and non-neoplastic cases were evaluated. RESULTS A total of 22,304 cases were identified, of which 330 (1.5%) were diagnosed with ANs. The odds ratio for ANs increased with age, with the highest odds ratio observed in patients aged 70 or older. Receiver Operating Characteristic analysis showed that age and appendiceal diameter were significant predictors of ANs. An optimal age cut-off point of 28.5 years was determined, yielding a sensitivity of 72% and a specificity of 64%. For appendiceal diameter, the optimal cut-off was found to be 9.5 mm, exhibiting a sensitivity of 77% and a specificity of 56%. CONCLUSION Although the incidence of ANs remains relatively low, a steady increase has been observed over the past decade. The increasing rate of ANs raises concerns regarding non-surgical management options. The results of this study highlight the importance of considering ANs as a potential diagnosis in older patients and in patients with an appendix diameter greater than 9.5 mm. These findings may have implications for treatment and management.
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Affiliation(s)
- Gizem Issin
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Fatih Demir
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Irem Guvendir Bakkaloglu
- Department of Pathology, Health Science University Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Diren Vuslat Cagatay
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | | | - Ismail Yilmaz
- Department of Pathology, University of Health Sciences, Sultan II. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Ebru Zemheri
- Department of Pathology, Health Science University Umraniye Training and Research Hospital, Istanbul, Turkey
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Issın G, Demır F, Simsek HA, Cagatay DV, Tayfur M, Kandemır A, Balcı MG. Seeds or Parasites? Clinical and Histopathological Features of Seeds and Parasites in the Appendix. Turk Patoloji Derg 2023; 39:42-54. [PMID: 36647674 PMCID: PMC10518133 DOI: 10.5146/tjpath.2022.01586] [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: 11/09/2021] [Accepted: 09/05/2022] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Parasites and plant seeds may both be found in appendectomy specimens. Each plant seed has a different appearance and can thus exhibit wide variations under the microscope. Fragmented seeds may histologically mimic parasites. The differential diagnosis between seeds and parasites can be challenging in such cases. This study aimed to determine the incidence of parasites, seeds, and foreign bodies in appendectomy materials and highlight the most characteristic histopathological features associated with these structures. MATERIAL AND METHOD In this study, pathology slides of 9,480 patients, who underwent appendectomy between 2010 and 2021, were reviewed, and cases that contained parasites, seeds, or foreign bodies were identified. We reviewed the literature on seeds and parasites in appendectomy specimens. RESULTS Parasites were observed in 56 (0.6%) cases. Of these cases, 45 had Enterobius vermicularis (80%), and 11 had Taenia subspecies (20%). Plant seeds were observed in 47 cases (0.5%), and were macroscopically recognizable in 5 of them as olive, lemon, and cherry seeds. Parasites and seeds were usually observed in the lumen of appendix vermiformis, filled with abundant fecal materials. CONCLUSION Seeds are seen in approximately 0.5% of the appendectomy specimens. Though rarely seen, the fragmented seed appearance may cause diagnostic difficulties. In this context, the key morphological features of parasites and plant seeds outlined in this study may be helpful in their differential diagnosis.
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Affiliation(s)
- Gizem Issın
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Fatih Demır
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | | | - Diren Vuslat Cagatay
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Mahir Tayfur
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Ali Kandemır
- Department of Biology, Erzincan Binali Yildirim University, Faculty of Science and Art, Erzincan, Turkey
| | - Mecdi Gürhan Balcı
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
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Issin G, Demir F, Simsek HA, Cagatay DV, Tayfur M, Balci MG. Retrospective analysis of the appendiceal neoplasms: sampling technique may influence neoplasm detection. Postgrad Med J 2021; 99:postgradmedj-2021-141244. [PMID: 34911697 DOI: 10.1136/postgradmedj-2021-141244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/23/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND AIMS Appendiceal neoplasms are uncommon entities that are usually determined incidentally during the histopathological examination. Different techniques used for the macroscopic sampling of appendectomy material may affect the determinating neoplasms. MATERIALS AND METHODS H&E-stained slides of 1280 cases who underwent appendectomy between 2013 and 2018 were reviewed retrospectively for histopathological features. RESULTS Neoplasms were determined in 28 cases (3.09%); 1 lesion was observed in the proximal part of the appendix, 1 covering the entire length from proximal to distal and 26 in the distal part. In the 26 cases that observed in the distal part, the lesion was seen on both sides of the longitudinal section of the distal appendix in 20 cases, while it was seen on only one distal longitudinal section in the remaining 6 cases. CONCLUSION The vast majority of appendiceal neoplasms are seen in the distal part of the appendix, and, in some cases, neoplasms might be seen on only one side of the distal section. Sampling only one-half of the distal part of the appendix, where tumours are most often observed, could result in some neoplasms being missed. Therefore, sampling the whole distal part would be more beneficial to determine small diameter tumours that do not create macroscopic findings.
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Affiliation(s)
- Gizem Issin
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Fatih Demir
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | | | - Diren Vuslat Cagatay
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Mahir Tayfur
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Mecdi Gurhan Balci
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
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Issin G, Demir F, Simsek HA, Cagatay DV, Tayfur M, Balci MG. Retrospective analysis of the appendiceal neoplasms: sampling technique may influence neoplasm detection. Postgrad Med J 2021:7126370. [PMID: 37068778 DOI: 10.1136/postmj/postgradmedj-2021-141244] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/23/2021] [Indexed: 04/19/2023]
Abstract
BACKGROUND AND AIMS Appendiceal neoplasms are uncommon entities that are usually determined incidentally during the histopathological examination. Different techniques used for the macroscopic sampling of appendectomy material may affect the determinating neoplasms. MATERIALS AND METHODS H&E-stained slides of 1280 cases who underwent appendectomy between 2013 and 2018 were reviewed retrospectively for histopathological features. RESULTS Neoplasms were determined in 28 cases (3.09%); 1 lesion was observed in the proximal part of the appendix, 1 covering the entire length from proximal to distal and 26 in the distal part. In the 26 cases that observed in the distal part, the lesion was seen on both sides of the longitudinal section of the distal appendix in 20 cases, while it was seen on only one distal longitudinal section in the remaining 6 cases. CONCLUSION The vast majority of appendiceal neoplasms are seen in the distal part of the appendix, and, in some cases, neoplasms might be seen on only one side of the distal section. Sampling only one-half of the distal part of the appendix, where tumours are most often observed, could result in some neoplasms being missed. Therefore, sampling the whole distal part would be more beneficial to determine small diameter tumours that do not create macroscopic findings.
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Affiliation(s)
- Gizem Issin
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Fatih Demir
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | | | - Diren Vuslat Cagatay
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Mahir Tayfur
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Mecdi Gurhan Balci
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
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Abuaf OK, Yildiz H, Baloglu H, Bilgili ME, Simsek HA, Dogan B. Re: Histologic Evidence of New Collagen Formulation Using Platelet Rich Plasma in Skin Rejuvenation: A Prospective Controlled Clinical Study: Authors' Reply. Ann Dermatol 2017; 30:111. [PMID: 29386849 PMCID: PMC5762464 DOI: 10.5021/ad.2018.30.1.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Hamza Yildiz
- Department of Dermatology, Eskisehir Military Hospital, Eskisehir, Turkey
| | - Hüseyin Baloglu
- Department of Pathology, Anadolu Medical Center, Kocaeli, Turkey
| | - Memet Ersan Bilgili
- Department of Dermatology, Yunus Emre Government Hospital, Eskisehir, Turkey
| | | | - Bilal Dogan
- Department of Dermatology, GATA Haydarpasa Teaching Hospital, Istanbul, Turkey
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Abuaf OK, Yildiz H, Baloglu H, Bilgili ME, Simsek HA, Dogan B. Histologic Evidence of New Collagen Formulation Using Platelet Rich Plasma in Skin Rejuvenation: A Prospective Controlled Clinical Study. Ann Dermatol 2016; 28:718-724. [PMID: 27904271 PMCID: PMC5125953 DOI: 10.5021/ad.2016.28.6.718] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/24/2016] [Accepted: 04/04/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Platelet-rich plasma (PRP) is an autologous concentration of human platelets contained in a small volume of plasma and has recently been shown to accelerate rejuvenate aging skin by various growth factors and cell adhesion molecules. OBJECTIVE This study was conducted to evaluate the efficacy and safety of intradermal injection of PRP in the human facial rejuvenation. METHODS This study was a prospective, single-center, single-dose, open-label, non-randomized controlled clinical study. PRP injected to the upper site of this right infra-auricular area and all face. Saline was injected to the left infra-auricular area. Histopathological examinations were performed before PRP treatment, 28 days after the PRP, and saline (control) treatments. RESULTS Twenty women ranging in age from 40 to 49 years (mean age, 43.65±2.43 years) were enrolled in the study. The mean optical densities (MODs) of collagen in the pre-treatment, control, and PRP-treated area were measured. They were 539±93.2, 787±134.15, 1,019±178, respectively. In the MOD of PRP, 89.05 percent improvement was found when MOD of PRP was compared with MOD of pre-treatment. The mean MOD of collagen fibers was clearly highest on the PRP side (p<0.001). The PRP-to-saline improvement ratio (89.05% to 46.01%) was 1.93:1. No serious side effects were detected. CONCLUSION PRP increases dermal collagen levels not only by growth factors, but also by skin needling (the mesotherapy technique 'point by point'). PRP application could be considered as an effective (even a single application) and safety procedure for facial skin rejuvenation.
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Affiliation(s)
| | - Hamza Yildiz
- Department of Dermatology, Eskisehir Military Hospital, Eskisehir, Turkey
| | - Hüseyin Baloglu
- Department of Pathology, Anadolu Medical Center, Kocaeli, Turkey
| | - Memet Ersan Bilgili
- Department of Dermatology, Yunus Emre Government Hospital, Eskisehir, Turkey
| | | | - Bilal Dogan
- Department of Dermatology, GATA Haydarpasa Teaching Hospital, Istanbul, Turkey
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Abstract
Intraosseous cavernous hemangioma is an uncommon benign vascular tumor. A 21-year-old man presented with a small painless swelling of the left foot's long toe. X-ray examination showed an outgrowing bony lesion that has cortical continuity in the tip of the long toe's distal phalanx lateral aspect. Preoperative examination yielded no final diagnosis. En bloc resection was performed. The histological diagnosis was intraosseous cavernous hemangioma. To the best of our knowledge, this case is a first report of primary intraosseous cavernous hemangioma of the toe.
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Affiliation(s)
- Yakup Cil
- Department of Plastic Surgery, Eskisehir Military Hospital, 26020, Eskisehir, Turkey,
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Affiliation(s)
- Yakup Cil
- Department of Plastic Surgery, Eskisehir Military Hospital 26020 Eskisehir, Turkey. E-mail:
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