Efficacy of diffusion-weighted magnetic resonance imaging in follow-up patients treated with open partial cystectomy of liver hydatid cysts.

BACKGROUND AND OBJECTIVE: The aim of this study was to evaluate the efficacy of DWI in differentiation of patients with residual cavity and type 1 hydatid cyst (HC) in the liver. METHODS: 32 patients were included. 12 of these patients had type 1 HC and the remainders (n = 20) had postoperative residual cavities. In all patients, axial T2-weighted and DWI images were obtained. An apparent diffusion coefficient (ADC) map of the images was automatically generated and the ADC values were measured on this map for all patients. Mann-Whitney U test was used for comparison of continuous variables between two groups. RESULTS: The mean diameters of type 1 hydatid cyst and residual cavity groups were 83.42 mm, 49.30 mm, respectively (P = 0.001). There were no significant differences in gender and age between the groups (both P > 0.05). The mean ADC values of type 1 hydatid cyst and residual cavity groups were 2.58 ± 0.13 × 10(-3) s/mm(2), 2.58 ± 0.16 × 10(-3) s/mm(2), respectively (P = 0.953). CONCLUSION: DWI might not be suitable to differentiate the postoperative residual cavity from the type 1 hydatid cyst in the liver due to similarity of ADC values between postoperative residual cavity and type 1 hydatid cyst.

Clinical and pathological features of lipoleiomyoma of the uterine corpus: a review of 76 cases.

BACKGROUND: Uterine lipoleiomyoma is a rare and specific type of leiomyoma with a considerable amount of adipocytes. AIMS: The aim of the study was to investigate the clinical, pathological and immunohistochemical features of lipoleiomyoma of the uterine corpus, and review its histogenesis and differential diagnosis from other neoplastic and non-neoplastic lesions in order to obtain a detailed profile of this somewhat uncommon lesion. STUDY DESIGN: Descriptive study. METHODS: This study is a retrospective analysis of 70 consecutive women with 76 lipoleiomyomas, who underwent surgery mainly for uterine leiomyoma and gynecological carcinomas between January 2000 and April 2013. Clinical and pathological information was obtained from medical records. Immunohistochemistry was applied in selected cases. Parametric methods were used to compare clinical and pathologic features. RESULTS: The patients ranged in age from 34 to 77 years (mean 55.49 years). Lipoleiomyomas ranged from 0.5 to 55 cm in diameter (mean 5.50 cm). Typical macroscopic and microscopic features were noted. Sixty-nine (90.7%) tumors were in the uterine corpus and five (6.5%) were in the cervix. One broad ligament tumor and one retroperitoneal tumor were also studied. No tumors displayed cytologic atypia, mitosis, necrosis, calcification, or other degenerative changes. Immunohistochemically, the adipose tissue element was positive for vimentin, desmin, S100 protein, estrogen (ER), progesterone (PR), and Ki-67. Among patients with lipoleiomyomas, 53 cases (75.7%) had different types of lesions associated with hyperestrogenic status, such as adenomyosis, endometriosis, endometrial hyperplasia, and polyps, complex atypical endometrial hyperplasia, and gynecologic carcinomas. The follow-up period ranged from one to eight years (mean 4.6 years). There were no recurrences or tumor-related fatalities. CONCLUSION: In the present study, the lipoleiomyomas were seen more frequently in patients with adenomyosis, endometriosis, endometrial hyperplasia, polyps, and various gynecologic carcinomas. Lipoleiomyoma of the uterus seems to have a benign clinical course.

Gastric histopathological findings and ghrelin expression in morbid obesity.

OBJECTIVE: The role of Ghrelin, also known as the appetite hormone, is not fully explained in the development of morbid obesity. Plasma Ghrelin level is low in obese and high in slim subjects. Ghrelin-expressing cells were investigated histopathologically in the stomach of morbid obese patients in this study. Tissue Ghrelin expression was also compared with various parameters such as the distribution of endocrine cells, age, gender, body mass index, preoperative plasma Ghrelin level and presence of accompanying diseases. MATERIAL AND METHOD: The study included 33 morbidly obese patients, and 8 non-obese control patients. Plasma Ghrelin levels were measured preoperatively. Sleeve gastrectomy resection materials of 33 cases were evaluated with histopathological and immunohistochemical (Ghrelin and Chromogranin-A) techniques. The results were statistically evaluated by nonparametric tests. RESULTS: Histopathological findings observed in sleeve gastrectomy resection materials were interstitial lymphocytic infiltration (63.6%), hyperplasia of lymphoid follicles in the lamina propria (60.7%) and microvesiculation / dilatation of parietal cells (57.6%). The number of Ghrelin immunopositive cells in the gastric mucosa in females was significantly higher compared to males (p=0,007). Additionally, the number of Ghrelin immunopositive cells was significantly higher at the fundus-proximal corpus compared to the distal corpus of the stomach (p=0.0001). No significant correlation was found between Ghrelin-chromogranin immunopositive endocrine cell distribution and preoperative plasma Ghrelin levels and endocrine cell hyperplasia. CONCLUSION: Our study confirms that Ghrelin producing cells are most dense in the proximal stomach. Increased number of Ghrelin expressing cells in the gastric mucosa in females compared to males suggests that gender may also be a factor in determining the method for treatment of morbid obesity.

The role of diffusion-weighted magnetic resonance imaging in the classification of hepatic hydatid cysts.

The aim of the study was to classify different types of hepatic hydatid cysts (HHCs) by measuring the mean apparent diffusion coefficient (ADC) using diffusion-weighted magnetic resonance imaging (DWI). This prospective study comprised 44 patients. The 44 HHCs were classified using Gharbi ultrasonographic classification (GUC) and then T2WIs and DWIs were obtained. The ADC values were measured of the hydatid cyst (HC) subtypes. The distribution of the ADC values in the cyst groups was compared using the Kruskal-Wallis test for multi groups and the Mann-Whitney U test for paired groups. To evaluate the efficacy of ADC values in cyst diagnosis, receiver operating characteristic (ROC) analysis was performed. According to the GUC, there were 15 type 1, 11 type 2, 7 type 3, 5 type 4 and 6 type 5 HHCs. According to the ADC values in the paired comparisons, while types 1, 2 and 5 HCs were statistically differentiated from all other groups except the type 3 group, the type 4 group was differentiated from all other groups and the type 3 group was only differentiated from the type 4 group. When two groups were formed from the HHC subtypes with types 1, 2, and 3 in one group and types 4 and 5 in the other, a statistically significant difference was determined in the mean ADC values of these new groups. In conclusion the measurement of ADC values can be considered a promising parameter as an alternative to ultrasonography in the determination of subtypes of HHCs.