Turkish Journal of Pathology - 2000; 16(1-2)

TRUE HERMAPHRODITE

A 25-year-old male patient with a diagnosis of acute abdomen was accepted to Lefkosa Dr. Burhan Nalbanto�lu Hospital. During the operation hypoplastic uterus and right tuboovarian abscess was found. On the microscopic examination the ovarian portion was indicative of ovulation and the testicular portion was abnormal with incomplete development, loss of germ cells and tubular sclerosis. The case was diagnosed as a true hermaphrodite and discussed with the literature.

EXAMINATION OF THE CHROMOSOMAL ABERRATIONS AND GENITAL ORGAN HISTOPATHOLOGY IN MICE AFFECTED BY DIETHYLSTILBESTROL

[�smihan |G�ZE|1][Fahrettin |G�ZE|2][Ahmet |�OLAK|3] — 1999-12-01

In the present study, histopathology of the genital organs and the chromosomes in the bone marrow of the mice that were subjected to the doses of 6�g/day/ mouse of DES for 1, 2 and 3 months periods were examined. A significant increase in the number of chromosomes and structural anomalies have been observed statistically in mice subjected to DES directly (p<0,05). The findings showed histologically, adenosquamous metaplasia in addition to inflammation, endometrial hyperplasia ranged from mild to severe and adhesions in the endometrial cavity in all the groups; severe hyperplasia of goblet cells was found in the group which was exposed to DES for 3 months. In addition, in the groups directly affected by the drug, for 1 and 2 month period the increase in the number of the micronuclei and the anaphasebridge attracted attention.

EVALUATION OF VILLOUS TROPHOBLAST PROLIFERATION IN TERM PLACENTAS OF PREECLAMPTIC PATIENTS

Despite the numerous published studies on preeclampsia, studies evaluating proliferative indices of villous trophoblasts in this disease of the placenta are scarce. Our aim in this study is to evaluate the proliferative indices of villous trophoblasts in term placentas of preeclamptic patients and to compare obtained data with term placentas of normal pregnancies. Fifty placentas, fourty from preeclamptic and ten from normal pregnancies were included in this study. Sections from paraffin embedded tissue samples were stained immunohistochemically with proliferating cell nuclear antigen (PCNA) and Ki-67. In each section by using a projection microscope, at x400 magnification, PCNA and Ki-67 positive and negative trophoblasts were counted. PCNA index was 27.45�11.90% in normal and 46.97�18.47% in preeclamptic placentas. Ki-67 indices were 8.13�3.02% and 39.10�16.51% in normal and preeclamptic placentas respectively. In statistical analysis, difference between both PCNA and Ki-67 indices in two groups were significant (p<0.05). Our results support the opinion that trophoblasts undergo regeneration hyperplasia as a result of injuries arising on villous surface in preeclampsia.

DETECTION OF HPV IN THE TRANSITIONAL CELL CARCINOMA OF THE URINARY BLADDER USING IN SITU HYBRIDIZATION

1999-12-01

Recently published data have suggested a link between active human papillomavirus (HPV) infection and the development of bladder cancer. The aim of our study was to detect HPV DNA in of transitional cell carcinomas of the urinary bladder. We analysed a series of 30 formalin-fixed, paraffin-embedded transitional cell carcinomas of the urinary bladder for the presence of HPV DNA by using in situ hybridization technique. HPV DNA was detected in %3,3 (1/30) of the cases.Our results suggest that HPVDNA may play a minor role in the transitional cell carcinoma development in the urinary bladder.

DIFFUSE FATTY INFILTRATION OF THE THYROID IN AMYLOID GOITER

Systemic amyloidosis often involves the thyroid and in some cases, amyloid deposition is associated with fatty infiltration of the gland. This article describes six cases of chronic renal failure patients who had systemic amyloidosis involving the thyroid. We examined the relationship between the pattern and density of both amyloid deposition and fatty infiltration. The amount of fat and the amiloid showed correlation.

HEPATIC IRON AND FIBROSIS SCORE AS PREDICTORS OF RESPONSE TO INTERFERON IN CHRONIC HEPATITIS C.

The aim of this study was to assess the following variables as potential predictive factors of complete response to interferon- in chronic hepatitis C patients: age, sex, serum aminotransferase level, necroinflammatory score, fibrosis score, steatosis and hepatic iron distribution. The influence of all these variables about complete response was studied in 40 patients. Each patient was treated for 6 months with interferon-, and then followed up for at least 1 year. According to the improvement status of serum aminotransferase levels during this period, the patients were classified into complete responders, non responders and partial responders. Pretreatment biopsies from all patients were analyzed with no prior knowledge of the efficacy of the treatment. A complete response was predicted only by a low hepatic iron score and by a low fibrosis score. These data indicate that liver biopsy provides useful information for selection of patients with hepatitis C for inreferon- therapy.

ESTROGEN AND PROGESTERONE RECEPTORS IN GYNECOMASTIA (40 CASES):

Gynecomastia is defined as a potentially reversible enlargement of the male breast. It is characterized by an unencapsulated proliferation of ducts and connective tissue. The overall prevalence of gynecomastia is about 32%. It does not appear to constitute a risk factor for the development of breast carcinoma. The mean percentage of estrogen and progesterone eceptor positive cells were significantly higher in gynecomastia than in carcinoma. The aim of this study is to investigate the positivity of estrogen and progesterone receptors in gynecomastia. The material of our study are 40 cases of gynecomastia diagnosed at our department. In 40 cases of gynecomastia, immunohistochemistry was performed using estrogen and progesterone antibody by streptavidin-biotin peroxidase method. Estrogen receptor expression was observed in 16 of 40 cases (40%). Progesterone receptor expression was observed in 14 of 40 cases (35%). Estrogen and progesterone receptor expression probably constitute steps in the pathogenesis of gynecomastia.

FOCAL PREGNANCY-LIKE CHANGES IN HUMAN BREAST TISSUE (PSEUDO-LACTATIONAL CHANGES) (11 CASES)

1999-12-01

Pregnancy-like changes make up about 3.1-3.7 percent of all breast tissue examined. There is no association between the pregnancy-like changes and other breast pathology. This morphologic curiosity of the breast worth knowing about, not because of its clinical significance but because it can simulate other conditions of greater importance. Pregnancy-like changes are seen in one or several lobules in the absence of pregnancy or hormonal manipulation. The cause is unknown. In this study, 11 cases of pregnancy-like changes diagnosed in our department are presented and clinicopathologic characteristics are discussed. The patient’s ages ranged from 25 to 56 years (median 43.1). In our cases, focal pregnancy-like changes were present in 11 women who were not receiving drug theraphy.

UTILITY OF Ki-67 AND p53 IN DISTINGUISHING BETWEEN MALIGNANT MELANOMA, SPITZ NEVUS AND ATYPICAL SPITZ TUMOR

In this study, immunohistochemically Ki-67 (MIB-1) and p53 (D0-7) were applied to 22 nodular malignant melanomas (NMM), 25 Spitz nevi (SN) and eight atypical Spitz tumors (AST). In terms of p53, a significant difference was found between NMM and SN (p=0,0001), but the difference between NMM and AST was insignificant. Ki-67 index values were significant between NMM and AST (p=0,013), and also between NMM and SN (p=0,0001). The p53 values have significant difference between AST and SN (p=0,0002), but not the Ki-67 values. Immunohistochemical detection of Ki-67 and p53 are additional means to conventional histopathologic findings to differentiate between malignant melanoma, SN and AST. Specially considering AST cases, Ki-67 is more valuable than p53. We think, it is reasonable to label the cases as atypical Spitz tumor which have different aspects from Spitz nevus but also have no sufficent findings to be diagnosed as conventional malignant melanoma. It is reasonable to suggest reexcision and clinical follow-up for these cases.

AGGRESSIVE ANGIOMYXOMA: CASE REPORT

Aggressive angiomyxoma is a rare, locally infiltrative but not metastasizing tumor of pelvic soft parts and is seen mostly in child-bearing aged women. Our case was 35-year-old female who was operated for a tumor clinically misdiagnosed as Bartholin cyst. Histopathological examination of the surgical specimen revealed, haphazardly scattered spindle-shaped mesenchymal cells and vessels of medium size having dilated lumens within a loose hyposellular myxoid stroma. In order to assess the diagnosis and make the differential diagnosis between angiomyofibroblastoma, fibroephitelial polyp, myxoid epitheliod leiomyoma, myxoid malignant fibrous hystictyoma; vimentin, sitokeratin, FVII-RAg, smooth muscle spesific actin (SMA), desmin, -1 antichymotrypsin (Dako-AS, Denmark) immune markers were studied using avidin-biotin-peroxidase complex (ABC). Immunohistochemically, the stromal cells were reactive consistently for vimentin but not for other markers. Immunreactivity for SMA found in vessel walls and spindle cells with myoid apperance arround the vessels were also focally positive. No recurrence was observed by gynecological follow-up in the fourteen months period.

THE EVALUATION OF FEMALE GENITAL TRACT TUMORS IN MERS�N BETWEEN

1989-1999: In this study for evaluating morphological and epidemiological features of our area, 2272 tumor cases of female genital tract which were diagnosed in private and official laboratories between January 1989 and August 1999 were evaluated according to their localization, age, frequency and histological type. Ninety five and a half percent of cases were reported as benign and 4.5 percent of cases were reported as malignant. Benign tumors were located in corpus, ovaries, cervix, vulva and vagina, respectively. Malignant tumours were located in corpus, cervix, ovaries, vulva and vagina respectively. In this area, it is found that uterine leiomyoma is the most common benign tumor and endometrial cancer is the most common malignant tumor.

THE RELATIONSHIP AMONG THE AgNOR AND MITOTIC INDEX WITH TUMOR GRADE IN BLADDER PAPILLOM AND THE TRANSITIONAL CELL CARCINOMA

We planned this study to search AgNOR and Mitotic Index (MI) values which are known as proliferating markers in the bladder papilloma and the transitional cell carcinoma (TCC). In the course of this research we have used five (5) papillomas, ninety-nine (99) TCC and as the control group thirty (30) cystitis cases. As far as the methods concerned, we have utilized WHO, Simpson and Croker’s methods for determining grade, MI and AgNOR, respectively. As expected, we have observed that as grade increased the averaged values of MI and AgNOR also increased beginning from the values of papilloma. However, for the cases of papilloma with grade I, we have observed that averaged AgNOR and MI values were very close, often overlapping with each other. When we examined the relationship between grade with AgNOR and MI in bladder TCC, we found that MI has a stronger relationship with grade and MI gives better results compared to AgNOR. We have found that AgNOR and MI values for cytitis cases were signifivantly lower than papilloma and TCC cases as expected (p<0.001). Under the light of this research, we conclude that using only AgNOR and MI values one can not determine the grade of a case. But, if we work with a long term follow-up and large series, we can find AgNOR and MI values that are meaningfull prognostically.

THE RELATIONSHIP AMONG THE AgNOR AND MITOTIC INDEX WITH TUMOR STAGE IN BLADDER PAPILLOMA AND THE TRANSITIONAL CELL CARCINOMA

Transitional cell carcinomas of the urinary bladder vary in their biologic potential, which may be correlated with the grade and stage of the tumor. Cellular proliferation may prove to be another predicting measure of biologic potential of tumor. We have compared two different methods (AgNOR and mitotic index) to assess proliferation in 104 tumors and correlated these results with tumor stage. For each case, we applied AgNORs and mitotic index methods. Although AgNORs and mitotic index methods were related to pathological stage, clearly indicated the need for further studies before the clinical importance of these methods can be fully appreciated in bladder cancer.

A STUDY OF CANCER INCIDENCE AND DISTRIBUTION IN MERS�N

The aim of the present study is to contribute determination of the regional cancer incidence, to accelerate more detailed studies dealing with same subject and to support obtaining true data. Among 23780 biopsies 1834 cancer cases diagnosed in private and official laboratories between January 1989 and August 1999 were evaluated. The ratio of male: female is 1.16. In general the most common 5 cancers are; skin (%22.19), gastrointestinal (%17.50), respiratory system (%11.17), breast (%10.30) and urinary system (%8.50). Breast cancer for females and skin cancer for males are the most frequent cancer types. The peak for the ages is the interval between 60-69.

p53 EXPRESSION IN PROSTATIC CARCINOMAS: ITS RELATION TO THE HISTOPATHOLOGICAL PARAMETERS AND APOPTOSIS

1999-12-01

This study was designed to evaluate the immunohistochemical expression of p53 according to the stage, Gleason score, and WHO grade of the prostatic adenocarcinomas and to determine the association between the expression of p53 and apoptosis. p53 positivity was statistically related to the WHO grade but not to the Gleason score and pathological stage of the prostatic carcinomas. When the tumors were grouped according to the stage and grade there was a significant difference between p53(-) and p53(+) cases in respect to the apoptotic index in early stage and low grade tumors which could not be demonstrated in high grade and late stage. Our results revealed that although p53 mutations are usually late events in prostatic adenocarcinomas, the apoptotic role of p53 is evident only in early stage and low grade tumors.