The relationship between types of inflammatory cells located at the micro-environment of papillary thyroid microcarcinoma prognostic factors.

PURPOSE: To determine the relationship between inflammatory cell types in the microenvironment of papillary thyroid microcarcinoma (PTMC) and prognostic factors. METHODS: The previous diagnoses and subtypes-variants of 163 patients with papillary thyroid microcarcinoma were re-evaluated according to the 2017 WHO classification. The peritumoral lymphocyte, plasma cell, neutrophil, eosinophil, and mast cell density were classified as none (0.24 mm2), mild (0-10/0.24 mm2), moderate (10-50/0.24 mm2), and severe (˃50/0.24 mm2) under 40x magnification and the relationship with prognostic factors was investigated. RESULTS: There was a statistically significant relationship between tumor capsule invasion (p=0.024) and surgical margin (p=0.049) with mast cell infiltration. A statistically significant relationship was observed between tumor capsule invasion (p=0.0001) and the postoperative disease-free period (p=0.0001) with neutrophil cell infiltration. The postoperative disease-free period of those with neutrophil infiltration was statistically significantly shorter than that of those with no infiltration. The tumor diameter of those with no plasma cells was statistically significantly smaller than that of patients with plasma cells (p=0.003). CONCLUSIONS: Closer follow-up of patients with neutrophils, mast cells, and plasma cells, which have been found to be associated with poor prognostic factors in terms of recurrence, lymph node involvement, and distant metastasis, may increase survival.

Prognostic value of tumour budding in stomach cancers.

OBJECTIVE: The present study aimed to investigate the importance and prognostic value of tumour budding (TB) in Gastric Carcinoma (GC). METHODS: Pathologic grading of tumours was performed according to the criteria specified by the American Joint Committee on Cancer (AJCC). Histopathologic types, histopathologic grading and all histopathologic characteristics were determined using the Lauren and World Health Organization (WHO) classifications. Forty-three surgically treated GC cases were examined in terms of TB according to the International Tumor Budding Consensus Conference (ITBCC) and budding grading [budding degree (Bd)] was performed. They were recorded as Bd1 (1-4 buddings), Bd2 (5-9 buddings) or Bd3 (10 buddings or more). Bd score, clinicopathologic parameters and prognostic factors were analysed. RESULTS: There were 13 (30.2%) Bd1, 11 (25.6%) Bd2 and 19 (44.2%) Bd3 cases. A statistically significant relationship was found between Bd scores and pT, N, and histologic grade (P < .01, P < .05). In the Bd1 group, stage pT2 was statistically significantly more frequent than pT3 (P = .001). In the poorly differentiated group, Bd3 was statistically significantly higher than Bd1, but Bd1 was statistically significantly higher than Bd2 in the well-differentiated group (P = .001). In the N0 group, Bd1 was significantly higher than Bd2 and Bd3, whereas Bd2 was higher than Bd1 and Bd3 in the N2 group. Bd3 was higher than Bd1 and Bd2 in the N3 group (P = .001). CONCLUSION: In the present study, Bd was statistically significantly related to characteristics such as pathologic stage, lymph node involvement, and grade. The data obtained here suggest that Bd can be applied to GC and it might contribute to the standardisation of diagnosis and prognostic factors.

Diagnostic Value of Inflammatory Factors in Patients with Gallbladder Cancer, Dysplasia, and Cholecystitis.

BACKGROUND: Involving pre-sampled patients with cholecystitis, dysplasia, and adenocarcinoma, the present study aimed to compare the neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), platelet/lymphocyte (PLR) ratios, and plateletcrit (PCT), mean platelet volume (MPV), and platelet distribution width (PDW) values and to determine their prognostic importance. METHODS: The present study involved 187 cholecystectomy specimens that were diagnosed as cholecystitis, dysplasia, and adenocarcinoma. Preoperative neutrophil, monocyte, lymphocyte, and platelet counts, NLR, MLR, and PLR ratios, and PCT, MPV, and PDW levels of the same patient groups were retrospectively recorded. RESULTS: In the present study, the cut-off values for dysplasia of NLR, PLR, and MLR were found as 1.61, 81.45, and .19, whereas those for cancer of NLR, PLR, and MLR were 2.65, 182.69, and .35, respectively. The NLR, PLR, and MLR values of the chronic cholecystitis and chronic calculous cholecystitis groups were statistically significantly lower than those of the chronic active calculous cholecystitis group (P < .01). The NLR and MLR values of the non-cancer and non-dysplasia groups were statistically lower than those of the cancer and dysplasia groups (P < .05). CONCLUSION: According to the results of the present study, using additional imaging methods, acute-phase cholecystitis can be distinguished using preoperative neutrophil and monocyte counts, and NLR, PLR, and MLR cut-off values can be used to distinguish dysplasia, which is the antecedent of gallbladder cancer. It is thought that this might provide patients with an advantage in terms of early treatment and survival.

Sirenomelia (Mermaid Syndrome): A Case Report.

Sirenomelia, which is also known as mermaid syndrome and characterized by the fusion of the lower extremities, is the most severe form of caudal regression syndrome and one of the rare and lethal congenital malformations. The anomalies that might be seen in this syndrome include pelvic-sacral dysplasia, genital anomalies, bilateral pelvic renal fusion accompanied by renal dysplasia, colon atresia, unilateral umbilical artery, and imperforated anus. The incidence of sirenomelia is 0.8-1 cases in 60,000-100,000 deliveries and the male/female ratio is 2.7-3:1. The case reported in the present study was a 13-week-old male fetus 30 g in weight with a macerated appearance. The upper extremities had a relatively normal appearance but the lower extremities were conjoined and there was a single lower extremity consisting of conjoined feet and toes. In the face, the nasal bridge was sunken, the ears had a low position, and there were cleft palate and cleft lip. Examination of the external genital organs revealed that the penile part was in the anal region. There was no anus opening. The crown-rump length was 8.5cm, the heel-toe length was approx. 1cm, and the rump-heel length was approx. 3.7cm. There were none of the two kidneys, ureter, bladder, urethra, or rectum. In the umbilical cord, there were 2 venous structures, one of which was the artery. Perivillous congestion and hyperemia, perivillous calcification, deciduitis, and focal infarct regions were observed in placental tissues. This report aims to discuss this very rare case together with the literature.

Cytopathologic diagnosis in pleural effusion and cyto-histopathologic correlation.

OBJECTIVE: Cytological examination of pleural fluids is a fast, efficient and non-invasive diagnostic method. Identification of malignant effusions bears critical importance in treatment and prognosis. The aim of this study was to investigate the distribution of cytopathologic diagnoses in pleural effusions and the cyto-histopathologic correlation rates. MATERIAL AND METHOD: A total of 298 pleural fluid cases diagnosed from 2008 to 2009 in our laboratory were retrospectively identified as the study group. Evaluation results were classified in 5 groups as inconclusive, benign, atypical, suspicious and malignant, and compared with the biopsy results. RESULTS: Of the total 298 pleural fluid cases, 114 (38.3%) were females and 184 (61.7%) were males. The age range was between 15 and 89 with a mean value of 58.4 +/- 17.8. Of the cases, 3 (1%) were diagnosed as inadequate, 246 (82.6%) benign, 8 atypical, 10 suspicious, and 31 malignant by cytology. Among the cases who were diagnosed as malignant, 24 (8.1%) were reported as metastatic carcinoma and 7 (2.3%) as malignant mesothelioma. Of the 8 cases reported as atypical, biopsy results of 2 showed malignant mesothelioma, and of the 10 cases reported as suspicious, 1 case whose biopsy result was obtained was diagnosed as epidermoid carcinoma metastasis. CONCLUSION: Cytological examination is the most valuable diagnostic method for pleural effusions which may have various etiological causes. The most common cause of pleural effusions in our region is metastatic carcinomas including those from the lung, breast and ovarian tumors, followed by malignant mesothelioma.