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Öğe Acute leukemia in pregnancy with ovarian metastasis: a case report and review of the literature(Blackwell Publishing Inc, 2003) Terek, MC; Özkınay, E; Zekioglu, O; Erhan, Y; Cagirgan, S; Pehlivan, M; Mgoyi, LAcute leukemias tend to affect a younger population and are much more common in pregnant patients than chronic leukemias are. We report a case of acute lymphoblastic leukemia diagnosed during the third trimester presenting with organomegaly and thrombocytopenia. Delivery of the fetus by cesarean section was decided because of the fulminant nature of the acute leukemia within days of admission. Bone marrow biopsy revealed acute lymphocytic leukemia, French American-British L-2 subtype B cell immunotype. A left ovarian mass was identified during the cesarean section which later proved to be lymphoblastic infiltration. The patient was started on induction chemotherapy consisting of vincristine, daunorubicin, prednisolone, and L-asparaginase immediately after the diagnosis. The patient died of Acinetobacter septicemia 18 days after the first admission.Öğe Acute leukemia in pregnancy with ovarian metastasis: a case report and review of the literature(Blackwell Publishing Inc, 2003) Terek, MC; Özkınay, E; Zekioglu, O; Erhan, Y; Cagirgan, S; Pehlivan, M; Mgoyi, LAcute leukemias tend to affect a younger population and are much more common in pregnant patients than chronic leukemias are. We report a case of acute lymphoblastic leukemia diagnosed during the third trimester presenting with organomegaly and thrombocytopenia. Delivery of the fetus by cesarean section was decided because of the fulminant nature of the acute leukemia within days of admission. Bone marrow biopsy revealed acute lymphocytic leukemia, French American-British L-2 subtype B cell immunotype. A left ovarian mass was identified during the cesarean section which later proved to be lymphoblastic infiltration. The patient was started on induction chemotherapy consisting of vincristine, daunorubicin, prednisolone, and L-asparaginase immediately after the diagnosis. The patient died of Acinetobacter septicemia 18 days after the first admission.Öğe Acute myeloblastic leukemia in pregnancy: a case report and review of the literature(I R O G Canada, Inc, 2004) Yucebilgin, MS; Cagirgan, S; Donmez, A; Özkınay, E; Akercan, F; Mgoyi, L; Vural, FLeukemia is a rare event during pregnancy. The presence of leukemia during pregnancy raises several concerns about the effect of pregnancy on the prognosis of leukemia, the effect of the disease on pregnancy outcome and the teratogenic and mutagenic effect of chemotherapeutic agents on the fetus. We report a case of acute myeloblastic leukemia diagnosed during the third trimester of gestation and treated with chemotherapeutic agents before delivery. The duration of pregnancy was able to be prolonged for four weeks after clinical diagnosis of the disease and then terminated by cesarean section due to the presence of signs of fetal distress.Öğe Large cell neuroendocrine carcinoma of the uterine corpus metastatic to brain and lung: Case report and review of the literature(I R O G Canada, Inc, 2004) Erhan, Y; Dikmen, Y; Yucebilgin, MS; Zekioglu, O; Mgoyi, L; Terek, MCNeuroendocrine carcinoma of the uterine corpus is a rare aggressive tumor with a similar unfavorable outcome to that of the cervix. The large cell type is considerably rarer than the small cell neuroendocrine carcinoma of the uterine corpus. We report a case of a 52-year-old woman who presented with a large cell neuroendocrine tumor of the uterine corpus with very aggressive clinical behavior. cerebral and Pulmonary metastases six and four months after initial diagnosis and adjuvant radiotherapy, respectively. Despite successful surgical extirpation of the cerebral metastatic lesion she did not respond to chemotherapy and died four months after disease recurrence.Öğe Postmenopausal endometrial cancer screening: is there a correlation between transvaginal sonographic measurement of endometrial thickness and body mass index?(I R O G Canada, Inc, 2004) Guven, MA; Pata, O; Bakaris, S; Kafkasli, A; Mgoyi, LObjective: The aim of this study was to correlate,the body mass index with transvaginal sonographic measurement of endometrial thickness in a cohort of postmenopausal women who were admitted for endometrial cancer surveillance. Material and Methods: Transvaginal sonographic measurement of endometrial thickness was performed in 97 postmenopausal women who attended the gynecology clinic for endometrial cancer screening with no history of hormone replacement therapy and correlated with body mass index. Baseline characteristics including age, years since menopause and body mass index were recorded for each subject. The relationship between transvaginal sonographic endometrial thickness and baseline characteristics was assessed in each. Results: Body mass index was significantly correlated with years since menopause (r = 0.292, p = 0.004) and age (r = 0.243, p 0.01) but not with endometrial thickness (r = -0.07, p = 0.454). Endometrial thickness versus time since menopause correlation was found to be significant (r = 0.274, p = 0.03) in patients with a body mass index lower than 30. Conclusion: The present findings indicate that endometrial thickness does not differ with body mass index in the screening of postmenopausal women for endometrial cancer.Öğe Preoperative and postoperative correlation of histopathological findings in cases of endometrial hyperplasia(I R O G Canada, Inc, 2003) Gundem, G; Sendag, F; Kazandi, M; Akercan, F; Mgoyi, L; Terek, MC; Zekioglu, OObjectives: To determine the preoperative and postoperative correlation of histopathological findings in cases of endometrial hyperplasia. Material and Methods: One hundred and three patients with endometrial hyperplasia detected by surgical curettage performed due to various gynecologic pathologies were treated by hysterectomy. We compared retrospectively the histopathological diagnoses found on curettage with those found on hysterectomy specimens. The classification scheme endorsed by the International Society of Gynecological Pathologists was used to classify the endometrial hyperplasia. The histologic findings found on the endometrial tissue of curettage specimens were correlated with those from hysterectomy specimens. Histopathologic evaluation was performed by a single skilled gynecologic pathologist. Results: A total number of 103 women -76 (73.8%) premenopausal and 27 (26.2%) postmenopausal - were determined to have endometrial hyperplasia on histopathological evaluation of endometrial tissues obtained by endometrial curettage performed for evaluation of various bleeding abnormalities. These included 94 patients with simple hyperplasia without atypia (91.3%), two patients with simple hyperplasia with atypia (1.9%), five patients with complex hyperplasia without atypia (4.9%), and two patients with complex hyperplasia with atypia (1.9%). Histopathological evaluation of endometrial tissue obtained from hysterectomy specimens (of patients diagnosed with hyperplasia on curettage) revealed a total number of 65 cases (63.1%) with endometrial hyperplasia, and 38 cases (36.9%) with various histopathological findings. The correlation between preoperative and postoperative endometrial histologic findings was found to be statistically insignificant (r = 0.105, p = 0.29). Among 94 patients who were found to have simple hyperplasia without atypia on curettage specimens, 55.3%, were found to have simple hyperplasia without atypia, 1.1% simple hyperplasia with atypia, 5.3% complex hyperplasia without atypia, 9.6% secretory endometrium, 4.3% proliferative endometrium, 21.3% disorganized proliferative endometrium, 1.1% corpus luteum persistency, 1.1% basal endometrium, and 1.1% endometrium cancer on final hysterectomy specimens. Conclusion: Postoperative diagnosis of endometrial pathology might be different from that of preoperative especially in cases with simple endometrial hyperplasia without atypia.Öğe Preoperative and postoperative correlation of histopathological findings in cases of endometrial hyperplasia(I R O G Canada, Inc, 2003) Gundem, G; Sendag, F; Kazandi, M; Akercan, F; Mgoyi, L; Terek, MC; Zekioglu, OObjectives: To determine the preoperative and postoperative correlation of histopathological findings in cases of endometrial hyperplasia. Material and Methods: One hundred and three patients with endometrial hyperplasia detected by surgical curettage performed due to various gynecologic pathologies were treated by hysterectomy. We compared retrospectively the histopathological diagnoses found on curettage with those found on hysterectomy specimens. The classification scheme endorsed by the International Society of Gynecological Pathologists was used to classify the endometrial hyperplasia. The histologic findings found on the endometrial tissue of curettage specimens were correlated with those from hysterectomy specimens. Histopathologic evaluation was performed by a single skilled gynecologic pathologist. Results: A total number of 103 women -76 (73.8%) premenopausal and 27 (26.2%) postmenopausal - were determined to have endometrial hyperplasia on histopathological evaluation of endometrial tissues obtained by endometrial curettage performed for evaluation of various bleeding abnormalities. These included 94 patients with simple hyperplasia without atypia (91.3%), two patients with simple hyperplasia with atypia (1.9%), five patients with complex hyperplasia without atypia (4.9%), and two patients with complex hyperplasia with atypia (1.9%). Histopathological evaluation of endometrial tissue obtained from hysterectomy specimens (of patients diagnosed with hyperplasia on curettage) revealed a total number of 65 cases (63.1%) with endometrial hyperplasia, and 38 cases (36.9%) with various histopathological findings. The correlation between preoperative and postoperative endometrial histologic findings was found to be statistically insignificant (r = 0.105, p = 0.29). Among 94 patients who were found to have simple hyperplasia without atypia on curettage specimens, 55.3%, were found to have simple hyperplasia without atypia, 1.1% simple hyperplasia with atypia, 5.3% complex hyperplasia without atypia, 9.6% secretory endometrium, 4.3% proliferative endometrium, 21.3% disorganized proliferative endometrium, 1.1% corpus luteum persistency, 1.1% basal endometrium, and 1.1% endometrium cancer on final hysterectomy specimens. Conclusion: Postoperative diagnosis of endometrial pathology might be different from that of preoperative especially in cases with simple endometrial hyperplasia without atypia.Öğe Subcutaneous metastasis of endometrial adenocarcinoma: Case report of an incidental diagnosis during abdominal sonography(I R O G Canada, Inc, 2004) Dikmen, Y; Terek, MC; Mgoyi, L; Zekioglu, O; Akercan, F; Yucebilgin, MSA rare case of subcutaneous metastasis from endometrial adenocarcinoma detected incidentally on the anterior abdominal wall during routine abdominal sonography is reported. A 62-year-old woman with clinical FIGO Stage IA, grade 2 endometrial mixed type (endometrioid and mucinous) adenocarcinoma was found with a subcutaneous mass located in the abdomen 18 months after initial surgery.Öğe The triage of squamous cell abnormalities of cervical cytology by human papilloma virus screening(I R O G Canada, Inc, 2003) Ozsaran, AA; Dikmen, Y; Akercan, F; Zekioglu, O; Terek, MC; Mgoyi, L; Altuglu, IObjective: The aim of the study was to determine the presence of human papilloma virus (HPV) infection in cervical swabs by the use of the Digene((R)) Hybrid Capture assay in a cohort of patients with squamous cell abnormalities found in cervical cytologic screening. Materials and methods: Thirty-four (0.3%) of 1,100 patients who came for their routine cervical cytologic screening and diagnosed as having squamous cell abnormalities were enrolled in the study. Colposcopy-directed biopsy was obtained from all study patients'. HPV DNA was sought in cervical swab specimens placed in Digene((R)) transport medium by the use of the Digene((R)) Hybrid Capture assay. The findings of cervical cytology, colposcopy-directed biopsy and HPV screening were compared. Results: In a total of 34 women who were diagnosed as having squamous cell abnormalities in their routine cervical cytologic screening, 15 women had atypical squamous cell lesions of undetermined significancy (ASCUS), 16 women had low-grade cervical intraepithelial lesions (LGSIL), and three women had high-grade cervical intraepithelial lesions (HGSIL). Five (15%) of these women tested positive for HPV screening in cervical swabs where four women had infection with high-risk and one woman had infection with low-risk subtypes. None of the patients with koilocytotic changes of the squamous cells in the class of LGSIL histopathologically tested positive for HPV screening. In addition, one patient diagnosed as having invasive cervical carcinoma histopathologically tested negative for HPV screening. Atypical vascularization was seen colposcopically in this 37-year-old woman who had ASCUS cytologically, Conclusion: HPV screening seems to have value in the triage of patients with ASCUS with no clear advantage to colposcopy-directed biopsy. The routine performance of HPV screening for the triage of patients with squamous cell abnormalities has no advantage over colposcopy-directed biopsy.Öğe The triage of squamous cell abnormalities of cervical cytology by human papilloma virus screening(I R O G Canada, Inc, 2003) Ozsaran, AA; Dikmen, Y; Akercan, F; Zekioglu, O; Terek, MC; Mgoyi, L; Altuglu, IObjective: The aim of the study was to determine the presence of human papilloma virus (HPV) infection in cervical swabs by the use of the Digene((R)) Hybrid Capture assay in a cohort of patients with squamous cell abnormalities found in cervical cytologic screening. Materials and methods: Thirty-four (0.3%) of 1,100 patients who came for their routine cervical cytologic screening and diagnosed as having squamous cell abnormalities were enrolled in the study. Colposcopy-directed biopsy was obtained from all study patients'. HPV DNA was sought in cervical swab specimens placed in Digene((R)) transport medium by the use of the Digene((R)) Hybrid Capture assay. The findings of cervical cytology, colposcopy-directed biopsy and HPV screening were compared. Results: In a total of 34 women who were diagnosed as having squamous cell abnormalities in their routine cervical cytologic screening, 15 women had atypical squamous cell lesions of undetermined significancy (ASCUS), 16 women had low-grade cervical intraepithelial lesions (LGSIL), and three women had high-grade cervical intraepithelial lesions (HGSIL). Five (15%) of these women tested positive for HPV screening in cervical swabs where four women had infection with high-risk and one woman had infection with low-risk subtypes. None of the patients with koilocytotic changes of the squamous cells in the class of LGSIL histopathologically tested positive for HPV screening. In addition, one patient diagnosed as having invasive cervical carcinoma histopathologically tested negative for HPV screening. Atypical vascularization was seen colposcopically in this 37-year-old woman who had ASCUS cytologically, Conclusion: HPV screening seems to have value in the triage of patients with ASCUS with no clear advantage to colposcopy-directed biopsy. The routine performance of HPV screening for the triage of patients with squamous cell abnormalities has no advantage over colposcopy-directed biopsy.Öğe Value of cervical phosphorylated insulinlike growth factor binding protein-1 in the prediction of preterm labor(Sci Printers & Publ Inc, 2004) Akercan, F; Kazandi, M; Sendag, F; Cirpan, T; Mgoyi, L; Terek, MC; Sagol, SOBJECTIVE: To determine the value of cervical phosphorylated insulin-like growth factor binding protein-1 (IGFBP-1) in the prediction of preterm labor. STUDY DESIGN: In this prospective study, 77 pregnant women, gestational age 24-36 weeks, were enrolled in the study. Twenty women with completely healthy pregnancies formed the control group. Fifty-seven women with signs and symptoms of preterm labor formed the study group. Phosphorylated IGFBP-1 in cervical secretions was assessed in all patients by using a qualitative, immunochromatographic, I-step dipstick test. Cervical length was measured by transvaginal sonography. RESULTS: The IGFBP-1 test was negative in all patients in the control group (n = 20), and all of them delivered after 37 weeks, while the test was positive in 15 of 45 (33.3%) patients in the study group. The correlation between cervical length and gestational age at the time of delivery in patients with a positive phosphorylated IGFBP-1 test (n = 15) was significant (r = .553, P = .03). The sensitivity., specificity, positive predictive value and negative predictive value for the phosphorylated IGFBP-1 test were 78%, 87%, 73% and 90%, respectively. CONCLUSION: Use of a I-step dipstick test for detecting phosphorylated IGFBP-1 in cervical secretions is of value in the prediction of preterm labor. The high negative predictive value of the test may be useful in avoiding unnecessary medical interventions.Öğe The value of the insulin-like growth factor binding protein-1 in the cervical-vaginal secretion detected by immunochromatographic dipstick test in the prediction of delivery in women with clinically unconfirmed preterm premature rupture of membranes(Elsevier Ireland Ltd, 2005) Akercan, F; Cirpan, T; Kazandi, M; Terek, MC; Mgoyi, L; Özkınay, EObjective: The aim of this study was to determine the value of detecting insulin-like growth factor binding protein-1 (IGFBP-1) in the cervical-vaginal secretion in the prediction of delivery in women with clinically uncorfirmed preterm premature rupture of membranes (PPROM). Material and methods: A total of 87 women, gestational age between 20 and 36 weeks were enrolled into this prospective study. Based on the clinical diagnosis, patients were grouped as clinically evident PPROM (n = 25), clinically suspected PPROM (n = 42) and women with intact fetal membranes (n = 20). Detection of IGFBP-1 in the cervical-vaginal secretions was done using a one-step immunochromatographic dipstick test in all women. The outcome measures were gestational age at delivery, neonatal birth weight and duration of the interval between the test and delivery between women with positive and negative test results. Results: The test was positive in all 25 women (100 % sensitivity) with clinically evident PPROM and all delivered prematurely, and negative in 19 out of the 20 (95 % specificity) women with intact fetal membranes. Among 36 women with clinically suspected PPROM, 13 (36 %) tested positive and 23 (63 %) tested negative for IGFBP-1. In this group, the mean gestational age and birth weight at the time of delivery were significantly lower in patients with positive test (31.38 +/- 2.6 weeks versus 38.61 +/- 0.99 weeks and 1761 +/- 527 g versus 3500 +/- 355 g, P < 0.05 for both). Eleven (85 %) of the 13 women with positive test, delivered within 2 weeks after the performance of the test whereas all the women with negative test results delivered after 2 weeks (P = 0.001). The test had 100, 92, 84 and 100 % sensitivity, specificity, positive predictive value and negative predictive value, respectively, for the outcome measure of test-delivery interval. Conclusion: The screening test for IGFBP-1in the cervical-vaginal secretions is a useful adjunct in the prediction of delivery in women with clinically unconfirmed PPROM. (c) 2004 Elsevier Ireland Ltd. All rights reserved.
