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Zeren E.H.,Ukurova University | Zeren E.H.,badem Medical Group | Demirag F.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital
Surgical Pathology Clinics | Year: 2010

Malignant mesothelioma (MM) is a rare primary malignant tumor of the surface serosal cells. The diagnosis of MM is challenging with a broad differential diagnosis. For many decades, studies have focused on distinguishing MM from other types of cancer; however, benign mesothelial cell hyperplasia, especially in small biopsies, has emerged as a major problem. The features of pleural lesions are somewhat different from peritoneal diseases, and this article primarily focuses on pleural diseases. Thorough interpretation and correlation of clinical, radiologic, and pathologic findings are essential for a correct diagnosis. © 2010 Elsevier Inc. Source


Cakir E.,Ankara Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Findik G.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Hosgun D.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Demirag F.,Ankara Ataturk Chest Diseases and Chest Surgery Education and Research Hospital
Acta Chirurgica Belgica | Year: 2010

We report a case of primary mediastinal haemangiopericytoma in a 29-year-old female patient who presented with haemoptysis, cough and dyspnea. Computed tomography showed a 9 × 6 × 5 cm mass in the left posterior mediastinum. Bronchoscopic examination failed to obtain biopsy because of massive bleeding. The patient underwent left thoracotomy. Mediastinal mass and left lower lobe resection was performed despite the persistent bleeding. The lower lobe bronchus had been infiltrated by the tumour. Microscopic examination revealed a highly cellular tumour composed of round to fusiform cells, surrounded by thin walled endothelium lined vascular channels with a staghorn appearance. Immunohistochemical and molecular techniques rule out other soft tissue tumours which have a haemangiopericytomalike vascular pattern. The patient is alive and free from tumour recurrence 6 months post-operatively. Source


Demirag F.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Cakir E.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Bayiz H.,Atatiirk Chest Diseases and Chest Surgery Education and Research Hospital | Eren Yazici U.,Atatiirk Chest Diseases and Chest Surgery Education and Research Hospital
Acta Chirurgica Belgica | Year: 2013

Background: Adenosquamous carcinoma of the lung involves both adenocarcinoma and squamous cell carcinoma, each comprising at least 10% of the tumor. Atypical adenomatous hyperplasia (ADH), bronchiolar columnar cell dysplasia (BCCD), basal cell dysplasia (BCD), columnar cell dysplasia (CCD), bronchial epithelial dysplasia with transitional differentiation (BEDT) and squamous dysplasia (SD) are preinvasive lesions. The aim of this study is to define the preinvasive lesions and evaluate the role of MUC1, bcl-2, and the preinvasive and invasive components of adenosquamous carcinoma. Methods: A group of 31 patients with adenosquamous carcinoma of the lung were selected. The ratio of squamous to glandular differentiation, the associated preinvasive lesions, the features of peritumoral tissue, the stroma of the tumor, necrosis, perineural and vascular invasion were analyzed. For the immunohistochemical study, blocks containing squamous cell carcinoma, adenocarcinoma and preinvasive lesions were selected. MUC1 and bcl-2 analyses were performed by the immunoperoxidase method using the avidin-biotin complex. Results: Associated preinvasive lesions amd SD, BCCD, BEDT, AAH and CCD were observed in 24, 6, 3, 1 and 6 cases, respectively. Expression for MUC1 was positive in the squamous component of 30 cases, the adenocarcinoma component of 27 cases and in 34 preinvasive lesions. A strong correlation was found between MUC-1 expression in the squamous component and tumor localization (p = 0, 01). The positive expression of Bcl-2 in the adenocarcinomatous component was correlated with the presence of preinvasive lesions (p = 0, 01). Conclusions: Squamous dysplasia was the most frequent preinvasive lesion of adenosquamous carcinomas. MUC1 and bcl-2 expression levels were strongly associated with preinvasive lesions in adenosquamous carcinomas. Source


Cakir E.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Demirag F.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Aydin M.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital
APMIS | Year: 2010

The aim of this study was to determine the most significant cytologic features to differentiate small cell carcinoma (SCC) from poorly differentiated non-small cell carcinoma (NSCC) in bronchial lavage specimens. Bronchial lavage specimens from 35 SCC cases and 63 poorly differentiated NSCC cases were examined and the cytologic parameters reviewed retrospectively. Thirty-five cytologic features considered useful in differential diagnosis were assessed. Statistical analysis indicated that salt and pepper chromatin, small cell size and nuclear molding have more than 90% sensitivity and 70% specificity for SCC cases. Logistic regression analysis demonstrated that the most effective criteria to differentiate SCC from poorly differentiated NSCC are small cell size, salt and pepper chromatin, prominent nucleolus and papilla formation. When these selected variables were used, sensitivity for predicting SCC was 94.3% and specificity 96.8%, and sensitivity for predicting NSCC was 96.8% and specificity 94.3%. There are several cytologic features, which are highly sensitive and specific for distinguishing SCC from NSCC. Nuclear features such as chromatin pattern, and size of the nucleoli and nuclei are more valuable than cytoplasmic features to distinguish between the two. © 2010 APMIS. Source


Duyar S.S.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Yilmaz A.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Demirag F.,Ataturk Chest Diseases and Chest Surgery Research and Education Hospital | Erdogan Y.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | And 2 more authors.
Turkish Journal of Medical Sciences | Year: 2015

Background/aim: Alpha-methylacyl-CoA racemase (AMACR), an intracellular enzyme involved in lipid metabolism, has emerged as an immunohistochemical marker for many types of cancer. Recent studies about the role of lipid metabolism in pathogenesis of mesothelioma have brought up some positive results. This study was conducted to investigate AMACR expression in the diagnosis of malignant pleural mesothelioma (MPM) and the correlation of this marker with clinical characteristics and survival. Materials and methods: The clinicopathologic characteristics and resection materials of 71 patients were reviewed retrospectively. AMACR expression was evaluated immunohistochemically. The correlations among AMACR expression, clinicopathologic factors, and survival were investigated. Results: AMACR expression was detected in 42.3% of the study group. The specificity and sensitivity of AMACR immunostaining in detecting mesothelioma were 41.1% and 42.3%, respectively. AMACR-positive and negative groups were similar for age, sex, smoking history, tumor diameter, lymph node involvement, differentiation, T–N factor, and stage. Overall survival was not significantly different between the groups, either. Conclusion: The sensitivity of immunostaining was not high enough to use AMACR as a diagnostic tool in MPM. AMACR expression did not have a prognostic value in MPM, either. © TÜBİTAK. Source

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