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Öğe Adenomyosis: prevalence, risk factors, symptoms and clinical finding's(I R O G Canada, Inc, 2007) Yeniel, O.; Cirpan, T.; Ulukus, M.; Ozbal, A.; Gundem, G.; Onener, S.; Zekioglu, O.; Yilmaz, H.Objective: This prospective study investigated the prevalence of adenomyosis in histopathological examinations of patients who had undergone hysterectomy due to various indications in our clinic. Epidemiological characteristics, predisposing risk factors, symptoms and clinical findings of adenomyosis were evaluated. Method: A total of 298 subjects who had undergone abdominal, vaginal or laparoscopic hysterectomy with/without salpingo-oophorectomy between October 2003 and April 2004 in our clinic were included. Uterine specimens obtained through hysterectomy were weighed and histopathologically examined in the Pathology Department of Ege University. The study group (n = 103), cases with adenomyosis, was compared with the control group (n = 195), cases without adenomyosis, with respect to the epidemiological, clinical and histopathological characteristics. Results: The prevalence of adenomyosis in 298 subjects was 36.2% (103). Duration of the reproductive period in patients with adenomyosis was found to be significantly longer than for those in the control group (p < 0.05). Prevalence of pelvic pain, dysmenorrhea and dyspareunia was also significantly higher in the study group (p < 0.05). Moreover, the number of cases requiring blood transfusion before the operation was significantly higher in the study group (p < 0.05) as were the rates of smoking, previous uterine surgery and nulliparity (p < 0.05). The most common gynecological condition accompanying adenomyosis was found to be uterine myoma in both groups, but the difference was not significant. Conclusion: Adenomyosis is not a rare histopathological finding. Due to diagnostic and therapeutic methods which are being developed as an alternative to hysterectomy, the clinical effects of adenomyosis and its association with other gynecological conditions, adenomyosis appears to be an issue which will be more intensively investigated in the future.Öğe Can polyglactin mesh be used for prevention of seroma after mastectomy: an experimental study(Springer Wien, 2014) Yeniay, L.; Unalp, O. V.; Uguz, A.; Unver, M.; Karaca, A. C.; Sezer, T. O.; Yoldas, T.; Demir, H. B.; Zekioglu, O.; Kapkac, M.; Yilmaz, R.Background Seroma formation is still a common problem in breast surgery. Seroma formation is associated with morbidity and financial loss. Fibrin glue was used in several studies for solution, but the results were controversial. On the other hand surgical meshes are promising to prevent the seroma formation. Methods A total of 48 female Sprague-Dawley rats were randomly assigned to four groups. Each underwent radical mastectomy, axillary lymph node dissection, and disruption of the dermal lymphatic vessels. Group 1 is the control group (n = 12). In group 2 (n = 12), 1 x 1 cm polyglactin 910 mesh (Vicryl, Ethicon Johnson&Johson USA) is placed over the chest wall under the skin flaps prior to closure. The animals in group 3 received 0.5 mL fibrin glue (Baxter Healthcare Ltd. United Kingdom) topically throughout the wound before the closure (n = 12). The animals in group 4 (n = 12) received 0.5 mL fibrin glue topically throughout the wound, and 1 x 1 cm polyglactin 910 mesh is placed under the skin flaps prior to the closure. Full thickness tissue samples from both the chest wall and the skin were harvested. The harvested tissue samples were evaluated by a single pathologist in a blind fashion. Results The mean seroma volume of the control group was 1.536 mL whereas the mean seroma volume of the groups 2, 3, and 4 were 1.189, 0.438, and 0.556 respectively. Mean seroma volume was significantly lower, adhesion index and foreign body reaction were higher in group 4. Conclusion Although various studies show controversial results to prevent the seroma formation. This experimental study is an evidence that fibrin glue and polyglican mesh reduce seroma with increasing inflammatory reaction.Öğe Clinical significance of ASCUS and ASC-H cytological abnormalities: a six-year experience at a single center(7847050 Canada Inc, 2015) Demirtas, G. S.; Akman, L.; Demirtas, O.; Hursitoglu, B. S.; Terek, M. C.; Zekioglu, O.; Yilmaz, H.; Ozsaran, A. A.Background: To evaluate colposcopic biopsy results of patients with cervical cytological findings of atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells with high-grade lesions that cannot be excluded (ASC-H). Materials and Methods: A retrospective evaluation of data from 358 patients, who had cervical cytological findings of ASC-US (n=335) and ASC-H (n=23), and had colposcopic assessments between 2005 and 2011. Results: Cervical biopsy results of patients diagnosed with ASC-US cytology (n=335) revealed cervical squamous cell carcinoma 0.9 % (n=3) at biopsy, cervical intraepithelial neoplasia 3 (ON 3) in 3.8 % (n=13), cervical intraepithelial neoplasia 2 (CIN 2) in 1.1 % (n=4), cervical intraepithelial neoplasia 1 (CIN 1) in 35.2 % (n=118), and benign lesions in 59% (n=197). Cervical biopsy results of patients diagnosed with ASC-H cytology (n=23) revealed CIN 3 at biopsy in 39.3% (n=9), CIN 2 in 21.7% (n=5), CIN 1 in 26% (n=6), carcinoma in situ in 8.7% (n=2), and squamous cell cancer in one patient (4.3%). Conclusion: The cytological diagnosis of ASC-US may lead to the diagnosis of cervical intraepithelial lesion of higher grades as well as cervical cancer and should be evaluated by colposcopic cervical biopsy.Öğe Clinical symptoms and histopathological findings in subjects with adenomyosis uteri(I R O G Canada, Inc, 2008) Cirpan, T.; Yeniel, O.; Ulukus, M.; Ozbal, A.; Gundem, G.; Ozsener, S.; Itil, I. Mete; Zekioglu, O.Objective: The purpose of this study was to compare the clinical symptoms and histopathological findings in subjects with adenomyosis uteri. Method: Infiltration depth and spread of adenomyotic foci together with clinical symptoms and findings were compared in a total of 103 subjects who had undergone hysterectomy and were diagnosed with adenomyosis uteri through histopathological examinations. Results: The spread of adenomyotic foci in myometrial tissues was observed to significantly increase as the depth of myometrial infiltration increased in subjects with adenomyosis (p < 0.05). It was observed that there was significantly higher myometrial infiltration depth in subjects with dysmenorrhea and severe anemia, and diffuse adenomyotic foci in subjects with menometrorrhagia (p < 0.05). Conclusion: Increased infiltration depth and spread of adenomyotic foci in myometrial tissues in subjects with adenomyosis uteri were studied. When clinical symptoms and findings in subjects with adenomyosis, such as dysmenorrhea, anemia and menometrorrhagia are compared with these histopathological findings, infiltration depth and spread of adenomyotic foci appear to determine the clinical severity of adenomyosis.Öğe The colposcopic, cytological and histopathological findings in a cohort of women with Sjogren's Syndrome(B M J Publishing Group, 2006) Guliyeva, A.; Oder, G.; Terek, C.; Ozsaran, A.; Kabasakal, Y.; Zekioglu, O.; Yucebilgin, S.Öğe Comparison of human papillomavirus testing and cervical cytology with colposcopic examination and biopsy in cervical cancer screening in a cohort of patients with Sjogren's syndrome(I R O G Canada, Inc, 2007) Cirpan, T.; Guliyeva, A.; Onder, G.; Terek, M. C.; Ozsaran, A.; Kabasakal, Y.; Zekioglu, O.; Yucebilgin, S.Objective: The purpose of this study was to evaluate women with Sjogren Syndrome by using cervical cytology, colposcopic examination and HPV-DNA testing and to compare these findings with those obtained from the control group. Method: A total of 100 women, who were referred to Ege University, School of Medicine, Department of Obstetrics and Gynecology for cervical cytological screening between September 2004 and March 2005 and 33 of whom had Sjogren syndrome were included in this study. The patients were informed and subjected to cervical cytology, colposcopic examination and HPV-DNA testing. Colposcopic biopsy and endocervical canal curettage were carried out in cases of suspicious colposcopic examination and cytological findings. The findings obtained from 33 women with Sjogren syndrome and 67 subjects in the control group were compared. Results: Normal cervical cytology was detected in five women (5.7%), while suspicious cervical cytology was reported in 62 women (92.5%) in the control group. The prevalence of normal cytology in patients with Sjogren syndrome was 93.9% (n = 31), where 6.1 % (n = 2) of the women had suspicious cervical cytology findings. HPV-DNA findings were negative in 66 women (98.5%) in the control group, where the test result of one women (1.5%) was positive. HPV-DNA findings of patients with Sjogren syndrome were positive in one women (3%) and negative in 32 (97%). Colposcopic findings were normal in 63 women (94%) in the control group, where abnormal colposcopic findings were observed in four women (6%). Normal colposcopic findings were observed in 32 women (97%) with Sjogren syndrome, while pathological findings were recorded in one woman (3%). Suspicious cervical cytology, positive findings at colposcopic examination and biopsy and positive HPV-DNA tests were observed together in only one 40-year-old woman who was diagnosed with Sjogren syndrome for a period of four years. Prevalence of dyspareunia and vaginal dryness (atrophic vaginitis) symptoms were observed in Sjogren syndrome and control groups as 36.3% and 22.3%, respectively. Conclusion: No significant differences were observed between Sjogren syndrome and the control group who were evaluated by using cervical cytology, colposcopic examination and HPV-DNA tests. A higher prevalence of dyspareunia and vaginal dryness were observed in patients with Sjogren syndrome, yet this difference was not considered as significant with respect to either colposcopic or histopathological findings.Öğe Comparison of the success of histopathological diagnosis with dilatation-curettage and Pipelle endometrial sampling(Informa Healthcare, 2012) Kazandi, M.; Okmen, F.; Ergenoglu, A. M.; Yeniel, A. O.; Zeybek, B.; Zekioglu, O.; Ozdemir, N.The aim of this study is to compare collection of sufficient material and diagnostic accuracy of Pipelle biopsy with curettage and hysterectomy. A total of 82 cases with indications for endometrial biopsy for any reason and in which endometrial biopsy was performed with dilatation and curettage (D&C) and Pipelle aspiration biopsy, and 66 cases in which an indication for hysterectomy was established for any reason were included in the study. Histopathological findings were examined in the following six groups: normal; endometrial polyps; hyperplasia without atypia; hyperplasia with atypia; atrophy; and insufficient material. Descriptive statistical methods and McNemar's test were used. When the histopathological compatibility between Pipelle and D&C was considered (n = 82), a diagnosis that was different from that obtained by D&C was obtained in 22 of the 63 cases (34%), in whom normal endometrial histology was found with a Pipelle biopsy specimen. It was observed that only 1 of 13 cases of endometrial polyps was diagnosed with Pipelle biopsy. Insufficient material was obtained in six cases (7%) with Pipelle biopsies and three cases (4%) with D&C. While Pipelle biopsies and D&C have a nearly equal level of success in widespread endometrial lesions, Pipelle biopsies provide limited diagnostic accuracy in cases with focal pathologies.Öğe Do Clinical and Immunohistochemical Findings of Pure Mucinous Breast Carcinoma Differ from Mixed Mucinous Breast Carcinoma ?(Acta Medical Belgica, 2009) Erhan, Y.; Ciris, M.; Zekioglu, O.; Erhan, Y.; Kapkac, M.; Makay, Oe.; Ozdemir, N.Mucinous carcinoma of the breast is a relatively rare histologic type with two subtypes : pure and mixed. It has a favourable prognosis with a low risk of axillary metastases. The prognosis for pure mucinous carcinoma (PMC) was much better than for the mixed mucinous carcinoma (MMC). The aim of the study is to determine suitable candidates for breast or axillary conservation in mucinous carcinoma subtypes. The slides of 26 pure and 23 mixed mucinous carcinomas of the breast were evaluated. The clinical, pathological and immunohistochemical features between PMCs and MMCs were compared. MMC displayed greater metastatic potential (p < 0.05), p53 positivity (p < 0.05) and c-erbB-2 positivity (p < 0.001) than PMCs. PMCs smaller than 2 cm had less metastatic capacity and extranodal invasion compared to MMCs smaller than 2 cm (p < 0.001 and p < 0.01, respectively). MMCs smaller than 2 cm displayed weaker ER positivity but greater c-erbB-2 positivity than PMCs smaller than 2 cm (p < 0.01). In conclusion, MMC had worse prognostic factors than PMC with both types of mucinous carcinoma showing similar ER and PR positive status. Even if PMCs and especially smaller PMCs display more favourable prognostic features, including less axillary lymph node involvement, it is appropriate to use sentinel lymph node biopsy to make better axillary assessment.Öğe Epithelioid trophoblastic tumour metastasising to lungs bilaterally: A case report and review of the literature(Springer, 2017) Erbil, S.; Serin, G.; Turhan, K.; Veral, A.; Zekioglu, O.Öğe Expression of cyclin D1 and its relation with ER, PgR, C-erbB2, Ki-67, and p53 in breast cancer.(Amer Soc Clinical Oncology, 2010) Haydaroglu, A.; Demirci, S.; Demir, D.; Aydin, B.; Bolukbasi, Y.; Zekioglu, O.; Yeniay, L.; Ozdemir, N.; Gokmen, E.; Ylmaz, R.Öğe Fine needle aspiration cytology of inflammatory myofibroblastic tumour (inflammatory pseudotumour) of the breast: a case report and review of the literature(Blackwell Publishing, 2007) Akbulut, M.; Gunhan-Bilgen, I.; Zekioglu, O.; Duygulu, G.; Oktay, A.; Ozdemir, N.Öğe High-Grade Ductal Carcinoma in Situ of the Breast with Regressive Changes: Radiological and Clinicopathological Findings(Galenos Publishing House, 2023) Gursoy, M.; Oktay, A.; Aslan, O.; Zekioglu, O.Objective: Tumour regression is defined as continuity of changes leading to the elimination of a neoplastic population and is reflected as periductal fibrosis and intraductal tumour attenuation. The aim of this study was to describe the radiological and clinicopathological characteristics of high-grade breast ductal carcinoma in situ (DCIS) with regressive changes (RC). Materials and Methods: Thirty-two cases of high-grade DCIS with RC on biopsy specimens followed by excision were included. The mammographic, ultrasonographic (US), and magnetic resonance imaging (MRI) findings of cases were retrospectively reviewed according to the breast imaging reporting and data system (BI-RADS) lexicon. Clinical and histopathological findings [comedonecrosis, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) status and Ki-67 proliferation index] were recorded. The rate of upgrade to invasive cancer after surgical excision and lymph node involvement were evaluated. Results: The most common mammographic finding was microcalcifications alone (68.8%). The most frequently seen findings on US were microcalcifications only (21.9%), followed by microcalcifications and hypoechoic area (18.7%). On MRI, most lesions presented as clumped non-mass enhancement with segmental distribution. ER/PR negativity (53.1%, 65.6%), HER2 positivity (56.3%) and high Ki-67 (62.5%), which are known to be associated with more aggressive behavior, were found to be proportionally higher. The rate of upgrade to invasive cancer was 21.8%. Conclusion: DCIS with RC lesions present most often as microcalcifications alone on both mammography and US. MRI features are not distinguishable from those of other DCIS lesions. DCIS with RC lesions show biomarker status reflecting more aggressive behavior and high upgrade rate to invasive cancer. © Copyright 2023 by the Turkish Federation of Breast Diseases Societies / European Journal of Breast Health published by Galenos Publishing House.Öğe Immunohistochemical. evaluation of PTEN protein in patients with endometrial intraepithelial neoplasia compared to endometrial adenocarcinoma and proliferative phase endometrium(I R O G Canada, Inc, 2006) Cirpan, T.; Terek, M. C.; Mgoyi, L.; Zekioglu, O.; Iscan, O.; Ozsaran, A.Objective: The aim of this study was to reclassify endometrial hyperplasia cases and examine PTEN protein immunoreactivity compared to cases with endometrial adenocarcinoma and proliferative endometrium. Design: Endometrial samples from 37 women with endometrial hyperplasia with atypia were reclassified as endometrial intraepithelial neoplasia (EIN). Eighteen were complex and 19 were simple endometrial hyperplasia. Twenty-our cases of EIN, ten endometrial adenocarcinoma cases and ten proliferative phase endometrium sections were immunostained for PTEN expression. PTEN expression was documented according to the degree of immunoreactivity as complete loss, partial loss and present. Results: Twenty-four of 37 (64%) women with endometrial hyperplasia were reclassified as EIN. Complete loss of PTEN immunoreactivity was found in only one of the 24 EIN patients (4.2%), partial loss in eight of 24 (33.3%) and present in 15 of 24 (62.5%). There were no difference in PTEN immunoreactivity between EIN, endometrial adenocarcinoma and endometrial proliferation (p = 0.342). PTEN immunoreactivity was partially lost in seven and present in three of the patients with endometrial adenocarcinoma. None of the patients expressed complete loss of PTEN immunoreactivity in this group. Conclusion: EIN classification may provide a better and more objective assessment of endometrial hyperplasia cases. PTEN expression showed no differences among the cases of EIN, endometrial carcinoma and proliferative phase endometrium.Öğe Invasive carcinoma and ductal carcinoma coexisting with Paget disease of the nipple(Springer, 2013) Buberal, G. Emiroglu; Acar, K.; Yeniay, L.; Kapkac, M.; Yilmaz, R.; Zekioglu, O.; Ozdemir, N.Öğe Is the Memorial Sloan-Kettering Cancer Center breast cancer nomogram feasible on Turkish breast cancer patients? Analysis of 740 patients(Amer Soc Clinical Oncology, 2011) Yeniay, L.; Carti, E. B.; Karaca, C. A.; Yararbas, U.; Zekioglu, O.; Kapkac, M.Öğe Lymphovascular space invasion and positive peritoneal cytology are independent prognostic factors for lymph node metastasis and recurrence in endometrial cancer(I R O G Canada, Inc, 2018) Yildirim, N.; Bilgi, A.; Gokulu, S. G.; Akman, L.; Zekioglu, O.; Serin, G.; Ozdemir, N.; Alanyali, S.; Ozsaran, Z.; Ozsaran, A. A.; Terek, M. C.Aim: The aim is to identify the risk factors for recurrence and lymphatic metastasis of endometrial cancer. Materials and Methods: Patients who were operated primarily for endometrial cancer between 2010-2016 were included. Parameters such as stage, grade, histology, depth of invasion, cytology status, lymphovascular space invasion (LVSI), and tumor size were recorded. Univariate and multivariate logistic regression models were used to identify pathological predictors of lymphatic dissemination and recurrence. Results: A total of 278 patients were evaluated. Mean age was 60. 80% were Stage I, 10% were Stage III, and 4% were Stage IV, and 36.7% of patients had LVSI. Lymphadenectomy was performed in 56% of patients and lymphatic metastasis was observed in 7.1% of patients. In 13 patients, recurrence occurred; seven were loco-regional and six were distant. Three patients who had recurrence (3/13) were in early stage. With multivariate analysis, LVSI [OR = 8.826;1.874-41.576 (95%CI),p = 0.006] and positive cytology [OR = 9.503;1.811-49.876 (95%CI),p = 0.008] were independent factors for recurrence in endometrial cancer. Additionally, for lymphatic metastasis. LVSI [OR = 6.195;1.258-30.506 (95%CI), p = 0.025] and positive cytology [OR = 14.258; 2.330-87.247 (95%CI), p = 0.004] were found as significant risk factors. Conclusion: LVSI and positive cytology are significant risk factors for lymphatic metastasis and recurrence in endometrial cancer. Patients who had these risk factors should be followed-up more cautiously in terms of recurrence.Öğe MMAC tumor supressor gene expression in ovarian endometriosis and ovarian adenocarcinoma(I R O G Canada, Inc, 2007) Cirpan, T.; Aygul, S.; Terek, M. C.; Kazandi, M.; Dikmen, Y.; Zekioglu, O.; Sagol, S.Objective: The aim of this study was to investigate the role of MMAC1 protein in the relationship between ovarian endometriosis and clear cell and endometrioid-type ovarian adenocarcinomas. Methods: A total of 63 subjects who underwent surgery for a pelvic tumoral mass, 30 of whom were diagnosed with grade 1 to 3 ovarian adenocarcinoma and 33 of whom were diagnosed with grade 1 to 4 endometriosis during histopathological examination were included in this study. The mean age for subjects with ovarian endometrioid type adenocarcinoma was 51.8 +/- 12.4, whereas the mean age for subjects with ovarian clear cell type adenocarcinoma was 59.5 +/- 13.7. Ovarian carcinomas were graded in accordance with the FIGO 1989 grading system. The mean age for subjects with endometriosis was 37 +/- 11.9. New sections were obtained from paraffin blocks in the archives of Ege University, School of Medicine, Department of Pathology onto lysinated slides and immunohistochemical staining by using mouse monoclonal antibody (MMAC1, 28H6 clone, Novocastra, UK) as MMAC antibody was applied in order to determine MMAC1 protein. Brown staining on the nucleus was considered as positive immunoreactivity. Immunoreactive staining was evaluated as percentage staining over the whole preparative. Results: Of the 63 subjects included in the immunohistochemical study, ovarian endometrioid adenocarcinoma was identified in 18 subjects, while 12 subjects were diagnosed with ovarian clear cell adenocarcinoma and 33 subjects with ovarian endometriosis. No significant relationships were observed between age and MMAC immune staining in the ovarian endometrioid adenocarcinoma (r = -0.41, p = 0.08) and ovarian endometriosis (r = 0.12, p = 0.50) groups, whereas a significant relationship was observed in the ovarian clear cell adenocarcinoma group (r = 0.631, p = 0.02). No significant relationships were observed between CA125 levels and MMAC immune staining in the ovarian endometrioide adenocarcinoma (r = 0.056, p = 0.82), ovarian endometriosis (r = 0.21, p = 0.36) and ovarian clear cell adenocarcinoma (r=0.363, p=0.24) groups. No correlations were observed between endometriosis stages and the MMAC immune staining (r = -0. 17, p = 0.92). There was no correlation between mean diameter of endometrioma and MMAC immune staining (r = -0.230, p = 198). Mean endometrioma diameter was 5.7 +/- 3.5 (1-15.5). No correlations were detected between MMAC immune staining and ovarian endometrioide adenocarcinoma or ovarian clear cell adenocarcinoma stage (r = -0.22, p = 0.37; r = 0.44, p = 0.14, respectively). No significant relationships with respect to MMAC immune staining were detected between the endometriosis and ovarian clear cell adenocarcinoma groups (p = 0.05) and between the ovarian clear cell adenocarcinoma and ovarian endometrioid adenocarcinoma groups (p = 0.27). A significant relationship with respect to MMAC immune staining was observed between ovarian endometrioide adenocarcinoma and endometriosis groups (p = 0.001). Conclusion: Immunohistochemical determination of MMAC defective protein expressions could be considered for utilization as a new, simple and useful technique in determination of endometriosis patients with increased risk of malignant transformation, patients where early surgical treatment would be necessary and patients that should be subjected to follow-up controls with a higher frequency.Öğe Molecular Resistance Mechanisms in the Treatment of Locally Advanced Cervical Cancer: HIF-1 alpha? ERCC1?(Elsevier Ireland Ltd, 2022) Sert, F.; Serin, G.; Ozturk, M.; Zekioglu, O.; Alanyali, S.; Ozsaran, Z.[No Abstract Available]Öğe Prognosis-Related Novel Immunostaining Pattern for Programmed Cell Death Ligand 1 and Prognostic Value of Tumour-Infiltrating Lymphocytes in Triple-Negative Breast Cancer(Termedia Publishing House Ltd., 2023) Savaş, P.; Serin, G.; Gürsoy, P.; Zekioglu, O.; Özdemir, N.This study aims to determine the prognostic significance of programmed cell death ligand 1 (PD-L1) expression and tumour-infiltrating lymphocytes (TILs) in triplenegative breast cancer (TNBC). PD-L1 expression and TIL percentage were determined in TNBCs that did not receive neoadjuvant therapy. The relationship between PD-L1 expression and the percentage of TILs with survival was investigated. The presence of intratumoural PD-L1-positive tumour-infiltrating immune cells (TIICs) in tumours with ? 1% PD-L1 expression was identified as a new PD-L1 evaluation parameter. The presence of intratumoural PD-L1-positive TIICs as a new parameter in PD-L1-positive cases increased overall survival. The percentage of TILs increased in both overall and distant metastasis-free survival (p = 0.040 and p = 0.006, respectively). As a result, it was found that the risk of death was increased 5.18-fold (p = 0.013) in patients without intratumoural PD-L1-positive TIICs. This risk of death was calculated to be 5.40-fold higher in patients with TIL percentage ? 10% than in those with > 40% (p = 0.024), and the risk of distant metastasis was calculated to be 11.95 times higher. In our study, we discovered that the percentage of TILs made a statistically significant difference in TNBC survival. The presence of intratumoural PD-L1-positive TIICs in PD-L1-positive cases significantly increased survival. © 2023, Termedia Publishing House Ltd.. All rights reserved.Öğe Signet ring cells in fine needle aspiration cytology of breast carcinomas: review of the cytological findings in ten cases identified by histology(Wiley, 2009) Kelten, C.; Akbulut, M.; Zekioglu, O.; Kapkac, M.; Erhan, Y.; Ozdemir, N.Objective: To establish whether the presence of signet ring cells (SRCs) in histology sections of breast carcinoma cases was reflected by their presence in fine needle aspiration cytology (FNAC) smears, correlating to the histological type of breast carcinoma. Methods: We reviewed the FNAC findings of ten cases that had been diagnosed as primary breast carcinoma with SRCs on histological sections between 1998 and 2007. Slides and histological sections were obtained from the archives of Ege University Hospital. Results: FNA smears were reviewed for the following cytomorphological features: background, cellularity, architecture, nuclear pleomorphism and the presence of SRCs. The background was bloody in eight cases, necrotic in one, and clean in one. There was no mucinous material in any of the cases. Cellularity was prominent in five cases (hypercellular), moderate in three (cellular) and low in two (hypocellular). Loosely cohesive groups of tumour cells of varying size were observed in all cases. A plasmacytoid appearance to some of the tumour cells was seen in all cases and discohesive tumour cells were present in eight. Nuclear pleomorphism was high in six cases and moderate in four. SRCs were observed in seven of the ten cases. Two of these seven cases also had a tubular pattern and one had tumour giant cells. Conclusions: FNAC should be evaluated carefully regarding the presence of SRCs when cells with a plasmacytoid appearance are observed in either hyper- or hypocellular smears. The presence of single SRCs in FNACs with hypercellularity, high nuclear grade and tubular formation or tumour giant cells may be a clue in favour of ductal carcinoma. The presence of single SRCs in FNACs with hypocellularity and mild to moderate nuclear grade may be suggestive of lobular carcinoma. However, larger studies would be needed to establish the predictive value of the presence of SRCs on FNAC.
