The Importance of Estrogen Receptors in Aetiopathogenesis of Carpal Tunnel Syndrome in Postmenopausal Women

Introduction: Carpal Tunnel Syndrome (CTS) is a common peripheral neuropathy in postmenopausal women which is caused by compression of the median nerve in the carpal tunnel. Although mostly idiopathic, the aetiopathogenesis of CTS was not quite clear. Aim: To verify the possible role of the estrogen surges and the presence of Estrogen Receptor (ER) in tenosynovial tissue on postmenopausal period, in the pathogenesis of idiopathic CTS. Materials and Methods: The present study was a retrospective study conducted on, 16 patients with CTS in premenopausal group (group 1) and 18 patients with CTS in postmenopausal group (group 2). In the study, tenosynovial tissue samples of patients who had surgery due to CTS were used. Biopsy samples of 34 patients who were operated in the neurosurgery department of KSBU Medical Faculty Evliya Celebi Training and Research Hospital between January 2011 and January 2012 were included in the study. An examination was made by Haematoxylin and Eosin (H&E) in the tenosynovial tissue. ER was performed by immunohistochemistry on tissue samples. The non inflammatory fibrosis, vascular proliferation, oedema were observed. A nuclear staining for ER was observed in synovial lining cells and fibroblasts in the tenosynovial tissue. Results: The number of positive cells for ER in the tenosyvial tissue in postmenopausal patients with CTS was found higher according to premenopausal patients with CTS (p<0.01). A high association was found among patient age, severe EMG findings and ER positivity. Conclusion: There roles of hormonal surges in postmenopausal period and increased ER positivity in the tenosynovial tissue in the aetiopathogenesis of CTS.

Retrospective analysis of the appendiceal neoplasms: sampling technique may influence neoplasm detection

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.

Retrospective analysis of the appendiceal neoplasms: sampling technique may influence neoplasm detection

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.

Comparison of histopathological findings of the colon adenomas and adenocarcinomas with cyclin D1 and Ki-67 expression

Background

Cancer is one of the biggest health problems in the world. Colon adenocarcinoma is the third most common cancer and is the fourth most common cause of cancer deaths. The majority of colon adenocarcinomas originate from a previous adenoma. Cyclin D1 expression and Ki-67 proliferation index increase as the risk of malignancy transformation increases in adenomas.

Aims

This study aims to share the results of the Cyclin D1 and Ki-67 studies we performed in colon adenoma and colon adenocarcinoma cases in our hospital with the literature and contribute to the diagnosis and treatment of patients.

Materials and Methods

Surgical materials of 40 colon adenocarcinomas and 40 colon adenomas were histopathologically re-evaluated. Cyclin D1 and Ki-67 immunohistochemical staining were applied to these materials. Cyclin D1 and Ki-67 staining rates were compared in colon adenocarcinomas and adenomas.

Results

Cyclin D1 and Ki-67 staining rates were increased in colon adenocarcinoma cases compared to colon adenoma. There was a significant difference between the colon adenocarcinoma and colon adenoma case groups in terms of Cyclin D1 and Ki-67 staining scores.

Conclusion

In conclusion, immunohistochemical markers such as Cyclin D1 and Ki-67 will be helpful in differential diagnosis when there is difficulty in evaluating routine Hematoxylin-Eosin stained preparations between adenocarcinomas and adenomas.

Pathological changes in appendectomy specimens including the role of parasites: A retrospective study of 2400 cases of acute appendicitis

Background

Parasitic infestation of the appendix is uncommon. Parasitic infections can cause inflammation in the appendix and can imitate acute appendicitis clinically. Enterobius vermicularis and Taenia species are among the most common parasitic agents causing acute appendicitis.

Objective

We have studied the ratio of parasites causing acute appendicitis in appendectomy specimens and whether there is any relationship between the type of the parasite, histopathological type of acute appendicitis, age of the patient, and gender of the patient in the appendectomy cases.

Materials and Methods

We retrospectively analyzed the data of 2400 patients who underwent appendectomy with the prediagnosis of acute appendicitis between 1^st January 2004 and 31^st March 2018 at Erzincan University. The age of the patient, gender of the patient, histopathologic type of acute appendicitis, and the type of parasite were retrospectively analyzed. Positive appendectomy specimens for histopathological features of acute appendicitis were classified into four groups: catarrhal appendicitis, suppurative appendicitis, gangrenous appendicitis, and perforated appendicitis.

Results

In all, 1451 were males and 949 were females. The mean age was 25.51 years. No acute inflammation was found in 36 appendectomy specimens. The distribution of 2364 cases involving acute appendicitis was as follows: catarrhal appendicitis: 438, suppurative appendicitis: 300, gangrenous appendicitis: 1082, and perforated appendicitis: 544. Parasites were identified in 32 cases. The ratio of appendices to parasites was 1.3%. The number of appendectomy cases with Enterobius vermicularis was 22, and the number with Taenia species was 10.

Conclusion

Although they are a rare cause of acute appendicitis, parasitic infestations must always be considered. Accurate identification of acute appendicitis and appropriate therapy will improve the quality of life as much as the prevention of acute appendicitis sourced from parasites.

Loss of E-cadherin expression in recurrent non-invasive urothelial carcinoma of the bladder

BACKGROUND

Bladder cancer is the most common malignancy in the urothelial tract. Invasive cancer has a poor prognosis compared to non-invasive cancer, and identifying the cancer type is useful in determining the most appropriate treatment. In this study, the expression ratios of E-cadherin in non-invasive urothelial carcinoma of the bladder were investigated. The goal of the study was to predict possible invasion in the recurrence of these cases.

MATERIAL AND METHODS

Seventy-two recurrent non-invasive cases of urothelial carcinoma of the bladder were retrospectively analyzed. An immunohistochemical study of E-cadherin was performed of the baseline tissue sections. An evaluation was carried out of the intensity of membranous staining of E-cadherin and the percentage of cells that stained positive.

RESULTS

Invasive cancer was identified in the recurrence material of 14 of the 72 urothelial carcinomas of the bladder that were originally non-invasive based on the baseline samples. The rate of invasion in the recurrence material was significantly higher in cases in which the loss of E-cadherin expression was observed.

CONCLUSION

If E-cadherin expression is negative or weak, close clinical follow-up of patients is necessary, even if the initial diagnosis is non-invasive urothelial carcinoma of the bladder. This is because the rate of invasion in these cases is higher in recurrent cases.

Aggressive papillary adenocarcinoma on atypical localization: A unique case report

INTRODUCTION

Aggressive digital papillary adenocarcinoma (ADPA) is a rare sweat gland tumor that is found on the fingers, toes, and the digits. To date, <100 cases have been reported in the literature. Apart from 1 case reported in the thigh, all of them were on digital or nondigital acral skin.

CASE PRESENTATION

A 67-year-old Caucasian woman was admitted to the hospital due to a mass on the scalp. This lesion was present for almost a year. It was a semimobile cyctic mass that elevated the scalp. There was no change in the skin color. Its dimensions were 1.5 × 1 × 0.6 cm. The laboratory, clinic, and radiologic findings (head x-ray) of the patient were normal. It was evaluated as a benign lesion such as lipoma or epidermal cyst by a surgeon due to a small semimobile mass and no erosion of the skull. It was excised by a local surgery excision. The result of the pathologic examination was aggressive papillary adenocarcinoma. This diagnosis is synonymous with ADPA.

CONCLUSION

In our case, localization was scalp. This localization is the first for this tumor in the literature. In addition, another atypical localization of this tumor (ADPA) is thigh in the literature. This case was presented due to both the rare and atypical localizations. That is why, in our opinion, revision of "digital" term in ADPA is necessary due to seem in atypical localizations like thigh and scalp.

Can thıamıne pyrophosphate prevent desflurane ınduced hepatotoxıcıty ın rats?

PURPOSE

To investigate the effects of thiamine pyrophosphate (TPP) against desflurane induced hepatotoxicity.

METHODS

Thirty experimental animals were divided into groups as healthy (HG), desflurane control (DCG) , TPP and desflurane group (TDG). 20 mg/kg TPP was injected to intraperitoneally TDG. After one hour of TPP administration, desflurane was applied for two hours. After 24 hours, liver tissues of the animals killed with decapitation were removed. The oxidant/antioxidant levels and ALT, AST and LDH activities were measured. The histopathological examinations were performed in the liver tissues for all rats.

RESULTS

Notwithstanding the levels of oxidants and liver enzymes were significantly increased (p<0.0001), antioxidant levels were significantly decreased in DCG (p<0.0001). On contrary to the antioxidant parameters were increased (p<0.05) the oxidant parameters and liver enzymes were decreased in TDG (p<0.0001). Whereas multiple prominent, congestion, hemorrhage and dilatation were observed in sinusoids and lymphocyte-rich inflammation results in the centrilobular and portal areas of liver tissue in DCG, these findings were observed less frequently in TDG. CONCLUSİON : Thiamine pyrophosphate prevented liver oxidative damage induced with desflurane and may be useful in prophylaxis of desflurane induced hepatotoxicity.

Giant Cutaneous Leiomyosarcoma Originating From the Abdominal Wall: A Case Report

Patient: Male, 44

Final Diagnosis: Cutaneous Leiomyosarcoma

Symptoms: Abdominal mass

Medication: —

Clinical Procedure: Surgery

Specialty: Surgery