Predictive value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Vaginitis.

OBJECTIVES: This study was conducted to evaluate the diagnostic value of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in vaginitis patients. METHODS: This cross-sectional retrospective study was performed in Afyon Dinar State Hospital between July 2016 to August 2017. A total of 64 bacterial vaginosis (BV) patients, 66 vulvovaginal candidiasis (VVC) patients and 65 age-matched control subjects were enrolled. NLR, PLR, mean platelet volume (MPV), red cell distribution width (RDW) and other conventional inflammatory marker values were recorded for all patients before and after treatment. RESULTS: In the BV group, NLR values were found to be elevated compared to VVC and healthy controls [2.9 (1.2-14.7), 2.1 (1.1-11.7) and 2.1 (0.8-7.0), respectively] (p=0.008). Although not found to be statistically significant, the median NLR levels of BV patients decreased from 2.9 (1.2-14.7) to 2.4 (1.2-7.0) after treatment. PLR levels did not show a statistically significant difference between the three groups (p=0.970). The cut-off value of the NLR for BV was 2.19, with 67.2% sensitivity and 63.8% specificity. CONCLUSIONS: The present study demonstrated that NLR levels are elevated in bacterial vaginosis and NLR levels can be used as a reflection of systemic inflammatory response in vaginosis patients.

Histopathological Evaluation of Pterygium Patients with Type 2 Diabetes Mellitus.

OBJECTIVES: The aim of this study was to histopathologically compare patients with and without diabetes mellitus who underwent pterygium excision. METHODS: In this retrospective case-control study, 60 patients with a history of pterygium excision were divided into 2 groups: those with DM and those without DM. Histopathological findings (squamous metaplasia, dysplasia, inflammation, fibrinoid changes, and vascularization) were compared. RESULTS: The mean age of the 60 patients (females, 54.5%) included in the study was 58.6±12.8 years. The mean age was 53.7±13.7 years in the patients with DM and 63.6±9.6 years in the patients without DM. There were no significant differences in the excised pterygium tissues in terms of squamous metaplasia, dysplasia, fibrinoid changes, inflammation, or vascularization. CONCLUSION: There was no histopathological difference in the pterygium tissue in patients with DM.

Primary small bowel lymphoma presenting as invagination.

One of the causes of invagination in adults is primary small bowel lymphoma. Primary small bowel lymphomas are rare, present themselves with complications due to diagnostic difficulties, and are diagnosed only after surgical intervention. In case of invagination, one of the complications of these tumors, namely primary small bowel lymphoma, should also be considered as a cause in the diagnosis. In this paper, the diagnosis and therapy of a rare case of primary polypoid-type small intestinal lymphoma demonstrating findings of obstruction due to invagination have been presented and discussed in the light of the literature.

Host immune responses and peritumoral stromal reactions in different basal cell carcinoma subtypes: histopathological comparison of basosquamous carcinoma and high-risk and low-risk basal cell carcinoma subtypes.

BACKGROUND/AIM: The literature does not include sufficient data on the associations between host immune responses and stromal reactions in different basal cell carcinoma (BCC) subtypes. The aim of the study was to compare host immune responses and stromal reactions between basosquamous carcinoma (BSC) and high-risk (HR) and low-risk (LR) BCC subtypes. MATERIALS AND METHODS: The study included 35 BSC, 40 HR-BCC, and 40 LR-BCC patients. Age, sex, lesion location, density of peritumoral/adjacent perivascular inflammation, presence of lymphoid follicle formation, and stromal reaction type were compared between groups. RESULTS: In all 3 groups, age, sex distribution, and lesion location were similar. Overall, 70% of lesions in the LR-BCC group exhibited mild peritumoral inflammation, whereas in the BSC and HR-BCC groups dense inflammation was observed in 50% and 57.5% of lesions, respectively (P < 0.001). All lesions (100%) in the LR-BCC group had fibromyxoid stroma, whereas 61.8% and 80% of lesions in the BSC and HR-BCC groups, respectively, had desmoplastic stroma (P < 0.001). CONCLUSION: The BSC and HR-BCC groups were similar in terms of host immune responses and stromal reactions. Furthermore, BSC and HR-BCC were associated with dense peritumoral inflammation, adjacent perivascular inflammation, and desmoplastic stroma.

Perivascular epithelioid cell tumor of the ileum presenting as diverticulitis.

Perivascular epithelioid cell tumors (PEComas) are a group of rare mesenchymal neoplasms. Gastrointestinal PEComas are exceptionally rare, there being only a few case reports in the literature involving the colon and small intestine. Nearly all PEComas show immunoreactivity for both melanocytic (HMB45 and/or Melan-A) and smooth muscle (actin and/or desmin) markers. A 36-year-old male was admitted to the hospital with acut- abdomen. At laparatomy, a nodular mass protruding from the ileum which clinically simulated a diverticulitis was noticed. Gross examination of the specimen revealed a 2 × 1,5 × 1 cm secondarily ulcerated, solid, nodular, gray white tumor mass in the ileal wall. Histologically, tumor cells were composed of nests of round-polygonal epithelioid cells with abundant clear to slightly eosinophilic granular cytoplasm and round vesicular nuclei. The nests were separated by thin fibrovascular septa. Minimal necrosis and low mitotic activity were noticed in the tumor. Immunohistochemically, tumor cells were positive for SMA, HMB45, and Melan-A and negative for CD10, RCC, CD45, CD117, CD34, EMA, and Desmin. Diagnosis was PEComa of the ileum. We report the case of ileal PEComa to remind the unusual presentation (diverticulitis) of these tumors, besides rarity and diagnostic difficulties.