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Öğe Benign fibroblastic polyp of the colon: A case report(Turkish Soc Gastroenterology, 2009) Doganavsargil, Basak; Serin, Gurdeniz; Akyildiz, Murat; Ertan, Yesim; Tuncyurek, MugeThere are a fair number of polyps in the gastrointestinal tract, which cannot be classified under a certain category. We report herein a 50-year-old man with a 6-mm sigmoidal polyp; he had been operated previously for rectal carcinoma. The polyp was characterized by benign-appearing spindle cells in the lamina propria leading to a wide separation and disorganization of the colonic crypts, accompanied by focal erosion and restricted areas suspicious for inflammatory fibroid polyp. The histologic features were found consistent with the disease spectrum of "benign fibroblastic polyp of the colon" defined by Eslanzi-Varzaneh et al. The case is presented with a review of the literature and differential diagnostic considerations.Öğe Benign fibroblastic polyp of the colon: A case report(Turkish Soc Gastroenterology, 2009) Doganavsargil, Basak; Serin, Gurdeniz; Akyildiz, Murat; Ertan, Yesim; Tuncyurek, MugeThere are a fair number of polyps in the gastrointestinal tract, which cannot be classified under a certain category. We report herein a 50-year-old man with a 6-mm sigmoidal polyp; he had been operated previously for rectal carcinoma. The polyp was characterized by benign-appearing spindle cells in the lamina propria leading to a wide separation and disorganization of the colonic crypts, accompanied by focal erosion and restricted areas suspicious for inflammatory fibroid polyp. The histologic features were found consistent with the disease spectrum of "benign fibroblastic polyp of the colon" defined by Eslanzi-Varzaneh et al. The case is presented with a review of the literature and differential diagnostic considerations.Öğe Blood and tissue levels of persistent organic pollutants and genetic susceptibility in patients with breast cancer(Elsevier, 2024) Onat, Ilgen; Kocagoz, Rasih; Oz, Merve Demirbugen; Yeniay, Levent; Tiftikcioglu, Yigit Ozer; Zekioglu, Osman; Serin, GurdenizWe investigated possible associations between the internal concentrations of POPs and correlations between blood and tumor tissue concentrations in patients who underwent surgery for breast cancer and breast reduction as controls. Genetic variations in CYP1A1, GSTP1, GSTM1, and GSTT1 and hOGG1 were evaluated to determine whether they represent risk factors for breast cancer. Certain POPs have been found to be associated with breast cancer development. GST-P1 polymorphism represented a significant risk for breast cancer with unadjusted OR. However, the GSTT1 null polymorphism represented a significant risk for breast cancer when OR adjusted for age and smoking status. CYP1A1 polymorphism was a significant risk factor for breast cancer, regardless of whether the OR was adjusted. These results suggest that exposure to certain POPs, GSTT1 and CYP1A1 polymorphisms, age, and smoking status are risk factors for breast cancer. In addition, the blood concentrations of some POPs represent surrogates for breast tissue concentrations.Öğe Breast Hemangioma Evaluation with Magnetic Resonance Imaging: A Rare Case Report(Galenos Yayincilik, 2022) Aslan, Ozge; Oktay, Aysenur; Serin, Gurdeniz; Yeniay, Levent; Aghamirzayev, OrkhanVascular tumors are rare in the breasts, and the most common forms include hemangiomas and angiosarcomas. Hemangiomas are rare benign vascular tumors. Most of them are asymptomatic and nonpalpable clinically, and the vast majority of such lesions are detected incidentally by mammography. Breast hemangiomas are difficult to diagnose using conventional imaging modalities since their imaging findings are variable. The following is a case presentation of an asymptomatic forty-five-year old female patient who was diagnosed with a rare hemangioma. Physical examination, ultrasonography (US) and mammographic examination were normal. Dynamic contrast enhanced magnetic resonance imaging (MRI) showed a non-mass pathological enhancement. After a short-term follow up, a comparative MRI was obtained and biopsy was planned, due to the heterogeneous non-mass enhancement on MRI. Needle core biopsy with US guidance was performed, resulting in benign findings. However, because of the discordance between imaging and histopathology, an MRI-guided wire localization followed by open surgical biopsy was performed. Histopathologic evaluation reported capillary hemangioma. The imaging findings, including US, mammography and MRI, of hemangioma are reviewed and described in this case report.Öğe Comparison of HER2 status determination methods in HER2 (2+) patients: Manual fluorescent in situ hybridization (FISH) vs. dual silver enhanced in situ hybridization (SISH)(Elsevier Science Inc, 2017) Pehlivanoglu, Burcin; Serin, Gurdeniz; Yeniay, Levent; Zekioglu, Osman; Gokmen, Erhan; Ozdemir, NecmettinHER2 amplification has been demonstrated in 15-25% of invasive breast carcinomas and can be assessed using immunohistochemical and in situ hybridization methods. Here, we compared the accuracy of dual SISH to manual FISH in HER2 (2 +) breast carcinoma and evaluated the feasibility of dual SISH method in routine practice. Sixty HER2 (2 +) consecutive tumor samples diagnosed between January 2009 and February 2013 were selected. Demographic, histological and immunohistochemical features and FISH results were recruited from patient records and compared to dual SISH results. Nine (15%) of the 60 tumor samples were excluded from statistical analysis due to lack of interpretable SISH signals. HER2 staining percentages by immunohistochemistry differed between 20 and 80%. HER2 amplification was shown in 7 (13.7%) and 8 (15.7%) patients by FISH and SISH, respectively. Very good agreement was observed between FISH and SISH methods (kappa value: 0.92). Significant correlation was found between HER2 staining percentage and FISH positivity, in contrast to SISH positivity (p = 0.012 vs. p = 0.069). Our results are consistent with previously reported literature, indicating SISH can be used to determine HER2 status. However, preanalytical and analytical problems may cause inadequate or uncountable signals, making interpretation impossible for the pathologist and highlighting the importance of standardization and quality control programs.Öğe Diagnostic Dilemma in a Patient with Central Precocious Puberty: Ovarian Steroid Cell Tumor(Karger, 2021) Balki, Hanife Gul; Ata, Aysun; Karayazili, Ayse Merve; Serin, Gurdeniz; Koc, Gonca; Ozdemir, Necmettin; Celik, Ahmet[No Abstract Available]Öğe The Importance of Minor Salivary Gland Biopsy in Sjogren Syndrome Diagnosis and the Clinicopathological Correlation(De Gruyter Open Ltd, 2016) Serin, Gurdeniz; Karabulut, Gonca; Kabasakal, Yasemin; Kandiloglu, Gulsen; Akalin, TanerObjective: Minor salivary gland biopsy is one of the objective tests used in the diagnosis of Sjogren syndrome. The aim of our study was to compare the clinical and laboratory data of primary and secondary Sjogren syndrome cases with a lymphocyte score 3 and 4 in the minor salivary gland biopsy. Material and Method: Data from a total of 2346 consecutive minor salivary gland biopsies were retrospectively evaluated in this study. Clinical and autoantibody characteristics of 367 cases with lymphocyte score 3 or 4 and diagnosed with primary or secondary Sjogren syndrome were compared. Results: There was no difference between lymphocyte score 3 and 4 primary Sjogren syndrome patients in terms of dry mouth, dry eye symptoms and Schirmer test results but Anti-Ro and Antinuclear Antibody positivity was statistically significantly higher in cases with lymphocyte score 4 (p= 0.025, p= 0.001). Anti-Ro test results were also found to be statistically significantly higher in secondary Sjogren syndrome patients with lymphocyte score 4 (p= 0.048). Conclusion: In this study, the high proportion of cases with negative autoantibody but positive lymphocyte score is significant in terms of showing the contribution of minor salivary gland biopsy to Sjogren syndrome diagnosis. Lymphocyte score 3 and 4 cases were found to have similar clinical findings but a difference regarding antibody positivity in primary Sjogren syndrome. We believe that cases with lymphocyte score 4 may be Sjogren syndrome cases whose clinical manifestations are relatively established and higher autoantibody levels are therefore found.Öğe Is the presence of deep infiltrative endometriosis underestimated in the surgical management of endometriosis?(Via Medica, 2023) Ari, Sabahattin Anil; Akdemir, Ali; Serin, Gurdeniz; Ulukus, Murat; Sendag, FatihObjectives:The aim of the study was to determine the presence of deep infiltrative endometriosis (DIE) in the surgical management of endometriosis.Material and methods: Operation notes and histopathological reports of women with endometriosis were retrospectively analyzed in the Ege University Hospital between 2008 and 2018. A total of 191 women with suspicious of endometriosis but without clinical signs of DIE were enrolled in the study. Laparoscopic diagnosis of DIE was compared with histopatho-logical reports. There was no histopathology before surgery. Endometriosis was suspected only based on symptoms.Results: A total of 213 lesions that were thought to be DIE were removed from 191 women with endometriosis. Among these 213 lesions, 179 specimens were reported as endometriosis and 34 lesions as fibro-adipose tissue. Forty-nine right uterosacral ligaments were excised, and endometriosis was detected in 44 out of 49 specimens. Histopathological examination of 45 left uterosacral ligaments revealed endometriosis in 35 specimens. Finally, 25 endometriotic nodules were removed from the recto-vaginal space, and 22 of these were verified as endometriosis by a pathologist. The positive predictive value of laparoscopic visualization for DIE in the group suspected of endometriosis but without any clinical findings of DIE was 84%.Conclusions: Women with the suspicious of endometriosis, qualified to surgery, because of infertility or pain, should be prudently investigated to confirm or to exclude coexistence of DIE even if no preoperative sign of DIE was observed to provide complete resection. Otherwise, DIE continues to grow, causes pain postoperatively, and complicates subse-quent surgery.Öğe MICROSATELLITH INSTABILITY IN ENDOMETRIAL CANCER: DETECTION WITH IMMUNOHISTOCHEMICAL MARKERS AND ITS RELATIONSHIP WITH CLINICAL OUTCOME(Bmj Publishing Group, 2023) Kamalli, Goncha; Sirma, Tugce; Akman, Levent; Serin, Gurdeniz; Terek, Mustafa Cosan[Abstarct Not Available]Öğe Primary Ovarian Fibrosarcoma-An Unusual Tumor in an Adolescent: Case Report and Review of the Pediatric Literature(Elsevier Science Inc, 2017) Kurtmen, Bade T.; Dokumcu, Zafer; Divarci, Emre; Serin, Gurdeniz; Ergun, Orkan; Ozok, Geylani; Celik, AhmetBackground: Primary ovarian fibrosarcomas are rare and usually observed in perimenopausal and postmenopausal women. To our knowledge, to date, there are only 3 reports of ovarian fibrosarcoma in childhood and adolescence in the English-language literature. In this report, we aimed to present to our knowledge, the first pediatric case with advanced stage primary ovarian fibrosarcoma and to compare with previous cases. Case: A 14-year-old teenage girl was admitted because of a giant abdominal mass. Imaging techniques revealed a giant heterogeneous and vascular ovarian mass. Salpingo-oophorectomy along with staging procedures were performed. Pathologic examination confirmed grade III ovarian fibrosarcoma with severe nuclear atypia and high mitotic count. Because of pulmonary metastasis, she received 4 courses of adjuvant combination chemotherapy (Ewing protocol). The patient withstood the treatment well and is disease-free at 2 years of follow-up. Conclusion: Fibrosarcoma of the ovary is an uncommon neoplasm with poor prognosis. To our knowledge, the presented patient is the first pediatric case with advanced staged primary ovarian fibrosarcoma to be treated with surgery and adjuvant chemotherapy.Öğe Prognostic impact of mitosis and necrosis in non-mucinous lung adenocarcinomas and correlation with IASLC grading system(F Hernandez, 2024) Serin, Gurdeniz; Savas, Pinar; Isgor, Irem Sahver; Ozdil, Ali; Mizrak, Ali; Veral, Ali; Nart, DenizBackground. In 2020, the International Lung Cancer Study Group (IASLC) Pathology Committee established a grading system for non-mucinous primary lung adenocarcinomas. This grading system is based on whether areas of high-grade patterns are present in more than 20% of the tumor. Parameters, such as necrosis, mitotic activity, lymphovascular invasion (LVI) and spread through air spaces (STAS), are excluded from evaluating the grading system. Methods. A total of 217 patients' lung resection materials for primary lung adenocarcinoma were rereviewed using the IASLC grading system. Necrosis, mitotic activity, LVI status and STAS were also evaluated in the resection materials, aiming to demonstrate the relationship between these histopathological features and clinical outcome data. Results. At all stages, overall survival (OS) and recurrence -free survival (RFS) were related to grade ( p =0.011 and 0.024, respectively). Additionally, patients with necrosis were associated with worse OS and RFS ( p =0.002 and 0.048, respectively). When grade 2 and 3 tumors were analyzed individually, a significant relationship was found between necrosis and OS in grade 3 tumors ( p =0.002). Patients with a high mitotic count (>= 10/10 high -power fields) had significantly worse OS ( p =0.046). The prevalence of LVI and STAS increased with grade; however, their prognostic significance has not been demonstrated. Conclusions. The new grading system provides a highly efficient prognostic classification for survival. Necrosis and high mitotic count are important prognostic parameters for survival. Additionally, necrosis is a stageindependent prognostic factor for OS in grade 3 tumors, although no effect on prognosis can be demonstrated in grade 2 tumors.Öğe PURE vs. mixed clear cell ovarian carcinomas: Is there any impact on survival?(Elsevier, 2024) Guzel, Duygu; Terek, Cosan; Besler, Aysegul; Serin, Gurdeniz; Onal, Zueleyha; Akman, Levent; Goker, ErdemObjective: Our primary aim in this study is to define the clinical characteristics of patients with clear-cell ovarian carcinoma and evaluate the prognostic factors affecting survival. Study design: Records of 85 patients, operated between 2000 and 2018, for an adnexal mass and whose final pathology reported clear cell ovarian carcinoma were reviewed. The study considered demographic data, clinical characteristics of the patients, as well as pure and mixed-type clear cell histology. The patients' follow-up time, disease-free and overall survival recorded. The primary outcomes were disease-free survival (DFS) and overall survival (OS). Results: The median age of the patients at diagnosis was 52. In 64.7 % of the cases, clear cell histology was pure, while the others (35.3 %) were mixed. Patients with ovarian endometriosis constituted 27.1 % of the whole population. The median OS for the entire population was 92 months (95 %CI:72-124). On univariate and multivariate analyses, advanced age was found to have a significant independent impact on OS and DFS (p < 0.05) and, was associated with a worse prognosis. Also, the multivariate analyses showed that the presence of endometriosis has a significant independent impact on OS (p < 0.05). When examining the relationship between the histological origin (mixed vs. pure) and 5-year survival, the mixed type showed longer OS and DFS rates (76.8 % vs. 69.8 %, 61.5 % vs. 53.8 %), the difference was not statistically significant (p > 0.05). Conclusion: This retrospective study showed that although mixed type histological origin was associated with higher OS and DFS rates compared to pure type in patients with CCOC, the difference was not statistically significant. Advanced age and the presence of endometriosis was found to have a significant independent effect on OS and DFS and was associated with a worse prognosis. Overall, this study provides useful insights into the clinical characteristics of patients with CCOC and identifies important prognostic factors affecting survival.Öğe A rare carcinoma metastasizing to the lung: Sertoli-leydig cell tumor(Turkish Assoc Tuberculosis & Thorax, 2021) Gayaf, Mine; Dogan, Betul Ikbal; Anar, Ceyda; Serin, Gurdeniz; Ozdemir, NecmettinThe lung is the most common site of metastasis for many malignancies. Especially the gastrointestinal system, gynecological malignancies and osteosarcomas frequently metastasize to the lung. It accounts for less than 0.5% of all ovarian neoplasms. The frequency of recurrence and metastasis is less than 5%. In most cases, they are stage I tumors, limited to the ovary and carry a good prognosis. Here, while investigating the nodules in the lung that were detected incidentally at the age of 64, the rare Sertoli-leydig cell tumor of the lung is discussed clinically, radiologically and pathologically in the presence of a 64-year-old patient who was found to have undergone ovarian surgery 9 years ago. Since imaging methods and tumor markers did not yield significant results in terms of primary malignancy, wedge resection was performed from the left lung nodules. The histology of the lung nodule was the same as the poorly differentiated foci of the ovarian tumor. The immunohistochemical profiles of the two tumors were also similar. As a result of the evaluation of the patient's old materials belonging to the ovary and the samples taken from the lung together; The diagnosis was reached by obtaining similar results with the primary tumor in the immunohistochemical examination performed for the metastatic focus. Sex cord stromal tumors of the ovary, which rarely cause lung metastasis and have a tendency to recur and metastasis in a very long time after the first diagnosis, should also be kept in mind in the elderly woman and the patient with a gynecological history.Öğe Spectrum of pathogenic and likely pathogenic gene mutations detected in BRCA-negative breast cancers and their pathologic evaluation(Springernature, 2024) Ak, Bilgesu; Solmaz, Asli Ece; Serin, Gurdeniz; Zekioglu, Osman; Utku, Ceren; Akin, Haluk[Abstarct Not Available]Öğe The Future of Surgical Diagnostics: Artificial Intelligence-Enhanced Detection of Ganglion Cells for Hirschsprung Disease(Elsevier Sci Inc, 2024) Demir, Derya; Ozyoruk, Kutsev Bengisu; Durusoy, Yasin; Cinar, Ezgi; Serin, Gurdeniz; Basak, Kayhan; Turan, Mehmet; Yakut, Basak DoganavsargilHirschsprung disease, a congenital disease characterized by the absence of ganglion cells, presents significant surgical challenges. Addressing a critical gap in intraoperative diagnostics, we introduce transformative artificial intelligence approach that significantly enhances the detection of ganglion cells in frozen sections. The data set comprises 366 frozen and 302 formalin-fixed-paraffinembedded hematoxylin and eosin-stained slides obtained from 164 patients from 3 centers. The ganglion cells were annotated on the whole-slide images (WSIs) using bounding boxes. Tissue regions within WSIs were segmented and split into patches of 2000 x 2000 pixels. A deep learning pipeline utilizing ResNet-50 model for feature extraction and gradient-weighted class activation mapping algorithm to generate heatmaps for ganglion cell localization was employed. The binary classification performance of the model was evaluated on independent test cohorts. In the multireader study, 10 pathologists assessed 50 frozen WSIs, with 25 slides containing ganglion cells, and 25 slides without. In the first phase of the study, pathologists evaluated the slides as a routine practice. After a 2-week washout period, pathologists re-evaluated the same WSIs along with the 4 patches with the highest probability of containing ganglion cells. The proposed deep learning approach achieved an accuracy of 91.3%, 92.8%, and 90.1% in detecting ganglion cells within WSIs in the test data set obtained from centers. In the reader study, on average, the pathologists' diagnostic accuracy increased from 77% to 85.8% with the model's heatmap support, whereas the diagnosis time decreased from an average of 139.7 to 70.5 seconds. Notably, when applied in real-world settings with a group of pathologists, our model's integration brought about substantial improvement in diagnosis precision and reduced the time required for diagnoses by half. This notable advance in artificial intelligence-driven diagnostics not only sets a new standard for surgical decision making in Hirschsprung disease but also creates opportunities for its wider implementation in various clinical settings, highlighting its pivotal role in enhancing the efficacy and accuracy of frozen sections analyses. (c) 2024 United States & Canadian Academy of Pathology. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.Öğe The usefulness of p16 and COX-2 expression on the prediction of progression to endometrial cancer(F Hernandez, 2024) Kalkan, Hande Ece; Akman, Levent; Serin, Gurdeniz; Terek, Mustafa Cosan; Zekioglu, Osman; Ozsaran, Ahmet AydinObjectives. Endometrial cancer (EC) is the most commonly diagnosed gynecological cancer. Endometrial hyperplasia (EH) is a more common diagnosis than EC. Endometrial hyperplasia is found in approximately 1.5% of all women presenting with abnormal bleeding. Endometrial hyperplasia progresses to EC, and especially, cancer risk increases in cases with atypical hyperplasia. p16, one of the tumor suppressor proteins involved in the cell cycle, and COX -2, one of the key enzymes of prostaglandin synthesis, are important markers for the diagnosis of both EH and EC. There is lack of consensus in the classification, diagnosis and treatment of EH. The subject of changes in the cell cycle in the progression of endometrial pathologies may help to identify and prevent these affected pathways in the treatment stage. The aim of this study is to investigate the expression of p16 and COX -2 during the development of EC from EH. Material and methods. We investigated COX -2 and P16 expressions in patients with proliferative endometrium, complex/simple endometrial hyperplasia and endometrioid adenocarcinoma. Results. p16 expression increased in EH and EC (p<0.001). COX -2 expression was increased in endometrial cancer compared to other groups, but this increase was not found to be statistically significant. Although p16 and COX -2 expression were increased in patients with advanced grade/stage, lymphovascular invasion, and >50% of myometrial invasion, this increase was not statistically significant. Conclusions. More detailed studies are needed to investigate the prognostic significance of the COX -2 molecule. COX -2 might be a potential biomarker for the prognosis of endometrial cancer and a potential therapeutic target for EC treatment. Also, it might be used to prevent the progression of precursor lesions to invasive EC.
