Impression Cytologic Evaluation of the Conjunctiva in Patients Treated with Topical 1% Voriconazole

Objectives: The aim of the present study was to evaluate any conjunctival metaplastic changes by impression cytology in patients who underwent topical 1% voriconazole treatment for severe fungal keratitis. Materials and Methods: The study was conducted at Ege University Faculty of Medicine, Departments of Ophthalmology and Medical Pathology. Patients who were treated with 1% topical voriconazole for fungal keratitis for at least 3 months were included. The used topical voriconazole treatment was initiated as one drop every hour and was tapered according to clinical improvement in all patients. Treatment was continued 4 times a day for at least 3 months. Impression cytology samples were collected at least 3 months after cessation of topical voriconazole from the affected eyes and from the fellow eyes as a control group. Collected specimens were transferred to the pathology department for evaluation and grading (Nelson's grading system). Results: The mean age of the patients was 57.68±17.32 years (range, 22-87 years). The impression cytology grade of the inferior bulbar conjunctiva was 1.73±0.77 (range, 0-3) in the study group and 1.19±0.98 (range, 0-3) in the control group (p=0.03). The impression cytology grade of the temporal bulbar conjunctiva was 1.69±0.73 (range, 0-3) in the study group and 1.15±0.88 (range, 0-3) in the control group (p=0.02). The impression cytology grades of the nasal and superior bulbar conjunctiva did not differ statistically (p values 0.13 and 0.17, respectively). Conclusion: Topical voriconazole is an effective broad-spectrum antifungal drug, but it induces conjunctival squamous metaplasia. Clinicians should be aware of this possible side effect of topical voriconazole and should carefully evaluate the conjunctiva of treated patients at each visit to detect possible metaplastic changes.

Comparison of PD-L1, EGFR, ALK, and ROS1 Status Between Surgical Samples and Cytological Samples in Non-Small Cell Lung Carcinoma.

BACKGROUND: The expression levels of Programmed death ligand-1 (PD-L1), epidermal growth factor receptor (EGFR), anaplastic lymphoma tyrosine kinase gene (ALK), and proto-oncogene tyrosineprotein kinase 1 ROS (ROS1) are important for targeted treatment selection in advanced lung cancer. Most patients with lung cancer are diagnosed at an advanced stage and have no chance of surgery. For this reason, the accuracy and reliability of cytology samples for detecting those markers is important in patients whose histological sampling cannot be performed. AIMS: To test the compatibility of histological and cytological sample analysis results of EGFR, ALK, ROS1 and PDL-1 in patients with NSCLC and to determine the adequacy of cytological analysis for PD-L1 expression. STUDY DESIGN: Retrospective cross-sectional study. METHODS: The results of 231 patients whose PD-L1 was studied in 2018 were analyzed retrospectively. We excluded 11 inappropriate samples. A total of 220 samples were distributed as follows; 66 (30.0%) cytology specimens, 64 (29.1%) small histology biopsies, and 90 (40.9%) surgical biopsies. EGFR, ALK, ROS1 and PD-L1 analysis were performed in 139, 134, 116, and 220 patients, respectively. Samples containing >400 cells were considered suitable for molecular cytological study. RESULTS: A total of 154 (70.0%) histological (surgical biopsy) and 66 (30.0%) cytology samples were analyzed. There was no statistically significant difference between histological and cytological samples in terms of cellular adequacy for all molecular markers [EGFR: 93.7% and 90.9% (P = .556), ALK: 97.8% and 95.3% (P = .436) , ROS1: 89.9% vs. 91.9% (P = .729), PD-L1: 95.5% vs. 92.4% (P = .364)]. There was no statistically significant difference in the expression positivity rates of all biomarkers between histological and cytological samples [EGFR: 9.0% vs. 2.5% (P = .018), ALK: 7.9% vs. 9.8% (P = .719), ROS1 : 1.4% vs. 2.9% (P = .591), PD-L1: 54.4% vs. 41.0% (P = .078)]. CONCLUSION: The cellular adequacy of cytology specimens for molecular testing in patients with NSCLC is satisfactory. This study shows that EGFR, ALK, ROS-1 and PDL-1 expression rates in cytological samples are not statistically different from histological samples.

Hamartoma mesenquimal rabdomiomatoso en una ubicación inesperada / Rhabdomyomatous mesenchymal hamartoma developed at an unexpected location

El hamartoma mesenquimal rabdomiomatoso es una lesión cutánea rara descripta por primera vez en 1986 como "hamartoma de músculo estriado". En general, se presenta en la región de la cabeza y el cuello de los recién nacidos. En este artículo, describimos el caso de una niña de 38 días con un apéndice cutáneo congénito en la región perianal. En el examen físico, no se observaron anomalías congénitas ni otras lesiones cutáneas. En el examen histopatológico, se observó un hamartoma con fibras de músculo esquelético desorganizadas. El diagnóstico diferencial incluyó apéndice cutáneo, trago accesorio y fibroma péndulo. El hamartoma mesenquimal rabdomiomatoso se diferencia de las lesiones mencionadas debido al componente de músculo estriado. Dado que no conlleva el riesgo de recurrencia ni de transformación a neoplasia maligna, no es muy relevante diferenciarlo de estas lesiones. Sin embargo, es importante establecer el diagnóstico correcto porque aproximadamente un tercio de los casos se asocian con anomalías congénitas. Asimismo, es necesario un diagnóstico histopatológico en los niños con ubicación perianal debido a las manifestaciones clínicas similares al rabdomiosarcoma.

Rhabdomyomatous mesenchymal hamartoma is a rare dermal lesion which was first described in 1986 as "striated muscle hamartoma". It usually develops in the head and neck region of newborns. We report a 38-day-old girl with a congenital skin tag in the perianal region. Physical examination did not reveal any congenital abnormalities or other dermal lesions. Histopathological examination showed a hamartoma with disorganized skeletal muscle fibers. The differential diagnosis includes skin tag, accessory tragus and soft fibroma. Rhabdomyomatous mesenchymal hamartoma differs from the listed lesions with its striated muscle component. Since it does not carry the risk of recurrence and malignant transformation, it is not very important to distinguish it from these lesions. However, a correct diagnosis is important because approximately one third of the cases are associated with congenital anomalies. Also, histopathological diagnosis should be made in children with perianal localization due to similar clinical manifestation of rhabdomyosarcoma.

Rhabdomyomatous mesenchymal hamartoma developed at an unexpected location. / Hamartoma mesenquimal rabdomiomatoso en una ubicación inesperada.

Rhabdomyomatous mesenchymal hamartoma is a rare dermal lesion which was first described in 1986 as "striated muscle hamartoma". It usually develops in the head and neck region of newborns. We report a 38-day-old girl with a congenital skin tag in the perianal region. Physical examination did not reveal any congenital abnormalities or other dermal lesions. Histopathological examination showed a hamartoma with disorganized skeletal muscle fibers. The differential diagnosis includes skin tag, accessory tragus and soft fibroma. Rhabdomyomatous mesenchymal hamartoma differs from the listed lesions with its striated muscle component. Since it does not carry the risk of recurrence and malignant transformation, it is not very important to distinguish it from these lesions. However, a correct diagnosis is important because approximately one third of the cases are associated with congenital anomalies. Also, histopathological diagnosis should be made in children with perianal localization due to similar clinical manifestation of rhabdomyosarcoma.

El hamartoma mesenquimal rabdomiomatoso es una lesión cutánea rara descripta por primera vez en 1986 como "hamartoma de músculo estriado". En general, se presenta en la región de la cabeza y el cuello de los recién nacidos. En este artículo, describimos el caso de una niña de 38 días con un apéndice cutáneo congénito en la región perianal. En el examen físico, no se observaron anomalías congénitas ni otras lesiones cutáneas. En el examen histopatológico, se observó un hamartoma con fibras de músculo esquelético desorganizadas. El diagnóstico diferencial incluyó apéndice cutáneo, trago accesorio y fibroma péndulo. El hamartoma mesenquimal rabdomiomatoso se diferencia de las lesiones mencionadas debido al componente de músculo estriado. Dado que no conlleva el riesgo de recurrencia ni de transformación a neoplasia maligna, no es muy relevante diferenciarlo de estas lesiones. Sin embargo, es importante establecer el diagnóstico correcto porque aproximadamente un tercio de los casos se asocian con anomalías congénitas. Asimismo, es necesario un diagnóstico histopatológico en los niños con ubicación perianal debido a las manifestaciones clínicas similares al rabdomiosarcoma.

Loss of Nuclear ARID-1A Expressions Is Associated with Hormone Receptor Status in Breast Cancers.

OBJECTIVE: Breast cancer is the most common cancer among women worldwide. Adenine thymine-rich interactive domain 1A (ARIDIA) is a tumor suppressor gene involved in chromatin remodeling and it encodes the ARIDIA protein. Recent studies have shown the loss of ARIDIA protein expression in different carcinomas may have a prognostic significance. In the present study, we aimed to evaluate the interactions between ARIDIA loss and molecular subtypes of breast carcinomas. MATERIALS AND METHODS: ARIDIA expressions were studied in 292 formalin- fixed, paraffin- embedded breast carcinoma specimens and its association with different pathological and clinical parameters was evaluated. RESULTS: Loss of ARIDIA expression was detected in 123 cases. There was no statistically significant association between ARID-1A expression and molecular subtype of breast carcinomas (p=0.110) or HER2 amplification (p=0.909). Contrarily, there was a significant association between ARIDIA expression and presence of estrogen (p=0.047) or progesterone receptors (p=0.023). Besides a statistically significant relationship was found between loss of ARID1A, and the presence of both in situ component (p=0.016) and lymph node metastasis (p=0.001). CONCLUSION: In this study, we have demonstrated that loss of ARID1A expression positively correlates with hormone receptor status as well as tumor aggressiveness.

Does ozone administration have a protective or therapeutic effect against radiotherapy-induced testicular injury?

OBJECTIVE: We investigate the protective and therapeutic effects of ozone therapy (OT) in radiotherapy (RT)-induced testicular damage. METHODS: Thirty healthy adult male Wistar rats divided into five groups consisting of six animals each as follows: (1) Control (C), (2) RT, (3) OT, (4) OT + RT, and (5) RT + OT group. Histopathological findings, Johnsen scores, thiobarbituric acid-reactive substances (TBARS), glutathione (GSH), superoxide dismutase (SOD), catalase, and glutathione peroxidase (GPx) levels were evaluated. RESULTS: RT caused a significant decrease in testicular weight and Johnsen score compared to the control group. In addition, TBARS level was significantly higher, whereas GSH, SOD, catalase, and GPx levels were significantly lower in the RT group when compared to the control group. Pre and postRT OT significantly increased GSH, SOD, catalase, and GPx levels and decreased TBARS level. Furthermore, testicular weight and Johnsen score were increased with OT. CONCLUSIONS: The present study showed that OT is protective and therapeutic in radiation-induced testicular damage. OT may be beneficial to the patients who underwent RT.

Prognostic significance of tumor budding in muscle invasive urothelial carcinomas of the bladder.

OBJECTIVE: The aim of this study was to evaluate the prognostic significance of tumor budding in muscle invasive urothelial carcinoma of bladder (MIBC). MATERIAL AND METHODS: A total of 60 patients who underwent radical cystectomy and cystoprostatectomy for MIBC were included in the study. The correlations between tumor budding, and tumor necrosis, lymphovascular invasion (LVI), perineural invasion (PNI) and histopathological data with distant metastasis were evaluated. The correlation between progression free (PFS) and overall survival (OS) rates and the presence, and grade of tumor budding was investigated. RESULTS: A statistically significant correlation was not seen between tumor budding, necrosis, LVI, and PNI. There was a strong correlation between distant organ metastasis, and presence of tumor necrosis. There was no statistically significant correlation between PFS, OS and tumor budding. A statistically significant relationship was observed between OS and tumor stage, lymph node metastasis, and distant organ metastasis. CONCLUSION: In our study, statistically significant effect of tumor budding on survival rates in MIBCs was not observed. Also, no significant correlation was observed between tumor budding and tumor necrosis, LVI, and PNI.

Evaluation of human epididymal secretory protein 4 expression according to the molecular subtypes (luminal A, luminal B, human epidermal growth factor receptor 2-positive, triple-negative) of breast cancer.

BACKGROUND/AIMS: Human epididymal secretory protein 4 (HE4) is originally described as an epididymis-specific protein but more recently suggested to be a putative serum tumor marker for some tumors, including breast carcinomas. In this study, we aimed to investigate the interactions between HE4 expression and molecular subtypes of breast carcinomas. METHODS: HE4 expressions were studied in 242 formalin-fixed, paraffin-embedded breast carcinoma specimens and their association with different pathological and clinical parameters was evaluated. RESULTS: Immunohistochemical (IHC) staining for HE4 was negative in 3 (1.2%) cases, weakly positive (1+) in 7 (2.9%) cases, moderately positive (2+) in 58 (24.0%) cases, and strongly positive (3+) in 174 (71.9%) cases. A correlation between IHC HE4 staining grade and molecular groups was detected (P = 0.005). Furthermore, it was found that HE4 expression was strongly associated with histological tumor grade, c-erbB2 expression, and positive fluorescence in situ hybridization test results that detect human epidermal growth factor receptor 2 (HER2)/neu amplification (P = 0.022, P = 0.014, and P = 0.011). CONCLUSION: This study showed that HE4 expression is associated with HER2/neu amplification in breast cancers. These results may be commented as HE4 expression rises in patients with HER2/neu amplification. As is known, HER2/neu amplification is a poor diagnostic factor in breast cancer and HE4 expression is possibly associated with poor prognosis.

Expression of Stromal Caveolin- 1 May Be a Predictor for Aggressive Behaviour of Breast Cancer.

Caveolin-1 (Cav-1) is well known as a principal scaffolding protein of caveolae which are specialized plasma membrane structures. The role of Cav-1 in tumorigenesis of breast cancers is relatively less studied. The aim of the present study is to describe the biological roles of Cav-1 in breast cancers considering its contrasting dual functions as an oncogene and as a tumor suppressor. This study included 71 females with breast cancer who had been histopathologically diagnosed in Private Gunes Pathology Laboratory between the years 2007, and 2012. The mean age is 52.48 ± 12.8 years. Patients were followed up for a mean period of 47.97 ± 20.48 months. We didn't determine Cav-1 positive tumor cells. In 36 cases (50.7%), there were stromal expressions of Cav-1. In the statistical analysis, there was a statistically significant correlation between Cav-1 expression and ER (p = 0.033), metastasis (p = 0.005), lymphatic invasion (p = 0.000), nodal metastasis (p = 0,003), perinodal invasion (p = 0.003), metastasis (p = 0.005) and survival (p = 0.009). We found that Cav-1 expression is associated with tumor size, histological grade, lymph node involvement. Accordingly, we have suggested that Cav-1 may be a predictive biomarker for breast cancer.