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CONTEXT.: PIT1 and SF1-multilineage pituitary neuroendocrine tumors (PitNETs) have been defined since the classification of adenohypophysial tumors based on the PIT1, SF1, and TPIT transcription factors. OBJECTIVE.: To describe the clinicopathologic features of PIT1 and SF1-multilineage PitNETs and to contribute to the pituitary pathology practice by questioning the expression of NKX2.2 in PitNETs. DESIGN.: We reviewed 345 PitNETs and described the clinicopathologic features of 8 PIT1 and SF1-multilineage tumors. NKX2.2 positivity and staining pattern were compared to those of 45 PitNETs from the control group. RESULTS.: PIT1 and SF1-multilineage PitNET patients had a mean age of 41.13 (range, 14-58 years) and a mean diameter of 14.0 mm (range, 8-20 mm). The most common clinical presentation was acromegaly (6 of 8), and postoperative remission was achieved in all patients. On histomorphologic examination, a pseudopapillary pattern was seen in 5 of the tumors, either focally or diffusely. In addition to PIT1 and SF1, there was a diffuse staining with growth hormone and a predominantly perinuclear staining with cytokeratin 18. With NKX2.2, all multilineage tumors were positive, of which 5 were diffuse and 3 were focal. In the control group, 8 tumors (8 of 45) were positive, of which only 1 was diffuse and 7 were focal. CONCLUSIONS.: In conclusion, NKX2.2 is a transcription factor that can be used as an additional tool in pituitary pathology, and PIT1 and SF1-multilineage PitNETs are specific tumors that usually present with acromegaly, show signs of a nonaggressive clinical course, have a pseudopapillary histomorphology, and express NKX2.2.
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Objectives: 18F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) is a useful staging method in pancreatic cancer. The prognosis of pancreatic adenocarcinoma is affected by the tumor stage and resectable state. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of primary tumors are related to prognostic parameters in pancreatic cancer. This study compared 18F-FDG PET/CT findings with prognostic factors and overall survival of patients with pancreatic cancer. Methods: Patients with pancreatic adenocarcinoma, referred to our department between 2015 and 2022 for staging, were retrospectively evaluated. Head-to mid-thigh PET/CT images were obtained 1 h after 18F-FDG injection. Demographic data, survival, and clinical and pathological findings of 39 patients, who underwent surgery after PET/CT imaging, were collected. All primary tumor MTV, SUVmax, background SUVmax, and TLG data have were measured. Results: The images of 39 patients (24 women and 15 men) with a mean age of 66.62±9.60 years were evaluated. The mean SUVmax, MTV 40%, and TLG of the primary tumors in the pancreatic tissue were 6.28±2.33, 19.33±9.77, and 66.56±45.99, respectively. The average survival after disease diagnosis was 18.97±11.47 (2-55) months. MTV and TLG were significantly higher in patients who died during our study. SUVmax has a significant effect on mortality. Conclusion: 18F-FDG PET/CT metabolic parameters of SUVmax, MTV, and TLG could help predicting the prognosis of pancreatic cancer preoperatively and follow-up in patients with resectable tumors. Additionally, in our study group tumor grade and perineural invasion significantly affected overall survival.
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Objectives: Vitamin D deficiency is a very common global health problem. Evidence from recent studies focuses on the extraskeletal effects of vitamin D (Vit D) deficiency. Chronic lymphocytic thyroiditis (or Hashimoto's thyroiditis) is an autoimmune disease of the thyroid. Although there are many studies reporting that autoimmune thyroid diseases may be associated with Vitamin D deficiency, this is still a controversial issue that has not yet been proven. In this study, we aimed to appraise whether there is a relationship between lymphocytic thyroiditis diagnosed by histopathological evaluation and Vitamin D deficiency. Methods: Data of 256 patients whom were operated by a single surgeon in a single center between 2012 and 2017 and whose preoperative vitamin D tests and thyroid pathologies have been collected, were retrospectively evaluated. Due to the pathological examination, two groups were formed considering the presence of lymphocytic thyroiditis (Group 1), and the absence of lymphocytic thyroiditis (Group 2). Vitamin D deficiency was defined as the level <20 ng/mL (50 nmol/L) and Vitamin D insufficiency was defined as the level 21-29 ng/mL (525-725 nmol/L). Results: There were 108 (92F/16M) patients in Group 1, and 148 (116F/32M) patients in Group 2, and the mean age was lower in Group 1 (p=0.053). The mean vitamin D levels (16.6±15.2 vs. 14±10, p=0.409) and vitamin D deficiency rates (67.6% vs. 72.3%, p=0.416) were found similar between the Groups 1 and 2. No positive significant correlation was found between lymphocytic thyroiditis and vitamin D level or vitamin D deficiency rates. There was a positive correlation between lymphocytic thyroiditis and age, preoperative thyroid-stimulating hormone level, preoperative anti-thyroglobulin ,and anti-thyroid peroxidase levels, but no significant relationship was found with Vitamin D level. Conclusion: According to our results, lymphocytic thyroiditis was not associated with either Vitamin D deficiency or Vitamin D level.
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ABSTRACT Objectives: Liver biopsy is the gold standard for assessing liver inflammation, necrosis and fibrosis. The aim of the study is to evaluate clinical indications and histopathological results of percutaneus liver biopsy. Materials and methods: A total of 516 children who underwent blind liver biopsy were evaluated retrospectively. Results: Blind liver biopsy was performed for chronic active hepatitis B in 50% of the cases (n=260), neonatal cholestasis in 14% (n=68), autoimmune hepatitis in 7.7% (n=40), Wilson disease in 7.3% (n=38), isolated elevation of the liver enzymes in 5% (n=26), chronic active hepatitis C in 4.2% (n=22), metabolic disease in 3.4% (n=17), malignancies in 2.2% (n=11) and the others in 3.4% (n=17). Major complications were observed in 0.19% of the cases (n=1) and minor complications such as pain at the biopsy site in 13.5% of the cases (n=70), hypotension and tachycardia in 1.9% (n=10). Conclusions: Blind liver biopsy is a safe method in diagnosing liver diseases in childhood.
RESUMEN Objetivos: La biopsia de hígado es el estándar de oro para evaluar la inflamación, necrosis y fibrosis del hígado. El objetivo del estudio es evaluar las indicaciones clínicas y los resultados histopatológicos de la biopsia hepática percutánea. Materiales y métodos: Se evaluó retrospectivamente a un total de 516 niños a los que se les realizó una biopsia hepática a ciegas. Resultados: Se realizó biopsia hepática a ciegas por hepatitis B crónica activa en el 50% de los casos (n = 260), colestasis neonatal en el 14% (n = 68), hepatitis autoinmune en el 7,7% (n = 40), enfermedad de Wilson en el 7,3%. % (n = 38), elevación aislada de las enzimas hepáticas en el 5% (n = 26), hepatitis C crónica activa en el 4,2% (n = 22), enfermedad metabólica en el 3,4% (n = 17), neoplasias en el 2,2% (n = 11) y los demás en un 3,4% (n = 17). Se observaron complicaciones mayores en el 0,19% de los casos (n = 1) y complicaciones menores como dolor en el sitio de la biopsia en el 13,5% de los casos (n = 70), hipotensión y taquicardia en el 1,9% (n = 10). Conclusiones: La biopsia hepática a ciegas es un método seguro en el diagnóstico de enfermedades hepáticas en la infancia.
Subject(s)
Child , Humans , Infant, Newborn , Hepatitis C, Chronic , Liver Cirrhosis , Biopsy , Retrospective Studies , Liver/pathology , Liver Cirrhosis/pathologyABSTRACT
OBJECTIVES: Liver biopsy is the gold standard for assessing liver inflammation, necrosis and fibrosis. The aim of the study is to evaluate clinical indications and histopathological results of percutaneus liver biopsy. MATERIALS AND METHODS: A total of 516 children who underwent blind liver biopsy were evaluated retrospectively. RESULTS: Blind liver biopsy was performed for chronic active hepatitis B in 50% of the cases (n=260), neonatal cholestasis in 14% (n=68), autoimmune hepatitis in 7.7% (n=40), Wilson disease in 7.3% (n=38), isolated elevation of the liver enzymes in 5% (n=26), chronic active hepatitis C in 4.2% (n=22), metabolic disease in 3.4% (n=17), malignancies in 2.2% (n=11) and the others in 3.4% (n=17). Major complications were observed in 0.19% of the cases (n=1) and minor complications such as pain at the biopsy site in 13.5% of the cases (n=70), hypotension and tachycardia in 1.9% (n=10). CONCLUSIONS: Blind liver biopsy is a safe method in diagnosing liver diseases in childhood.
Subject(s)
Hepatitis C, Chronic , Liver Cirrhosis , Biopsy , Child , Humans , Infant, Newborn , Liver/pathology , Liver Cirrhosis/pathology , Retrospective StudiesABSTRACT
Gastroenteropancreatic neuroendocrine tumors (GEP-NET) are classified according to tumor grade. Ki-67 and mitotic count are the two determinants of this classification. Therefore, Ki-67 scoring becomes very important in classifying the patients accurately. Eye-balling, counting of cells through the microscope, automated image analysis systems, and manual counting of printed image are the four major scoring methods in use. The aim of this study is to show the agreement between monitor-image method (MIM) and printout-image method (PIM) of Ki-67 scoring. In our study, 120 GEP-NETs from 85 patients diagnosed between January 2005 and July 2017 were evaluated. Thirty-seven cases with either polypectomy or resection material were selected. Seven different scoring methods using either a monitor-image or a printout-image were applied for Ki-67 scoring. They are as follows: whole-PIM, 1/9-PIM, whole-MIM, 1/4-MIM, 1/6-MIM, 1/9-MIM, and 1/12-MIM. In the comparison of Ki-67 scoring methods, intraclass correlation coefficients ranging from 0.951 to 0.999 were found. The Bland-Altman analysis showed near-perfect agreement between whole-MIM and whole-PIM as well as 1/9-MIM and 1/9-PIM. The level of agreements among the other methods were sufficient too, but there was a relative decrease in the level of agreement as the area of counting becomes smaller. The average application time decreased from 373.7 to 41.7 s gradually as the scoring area becomes smaller. Our study shows that there is a remarkable agreement between the MIM and PIM used in Ki-67 scoring.
