Choroidal Thickness and Central Macular Thickness Measurements with Cirrus HD-OCT in Healthy Individuals in the Turkish Population

AIM: This research was conducted to determine the normal values of choroidal thickness in healthy individuals and to evaluate the relationship between this thickness and age, gender, refraction, axial length and average macular thickness using OCT. MATERIAL AND METHOD: In the study, the right eyes of 400 healthy individuals (234 women, 166 men) between the ages of 4 and 70 years, who applied to the Department of Ophthalmology outpatient clinic for examination, were evaluated. RESULTS: Macular thickness, macular volume, and foveal thickness were found to be 249.12 ±21.32 µm, 9.98 ±0.5 µm3 and 280 ±13.45 µm, respectively. According to linear regression analysis, a negative correlation was detected between age and subfoveal choroidal thickness (p < 0.05). It was determined that foveal thickness, retinal volume and average retinal thickness were higher in men, and foveal thickness increased with age (p < 0.05). CONCLUSION: As a result of the research, it was determined that age is an important factor affecting choroidal thickness. It is thought that, in future, improving in vivo imaging of the choroid and measuring choroidal thickness using OCT will facilitate understanding of the pathophysiological basis of many ophthalmological diseases.

Is There any Possible Role of Neurotrophin 3 in the Pathogenesis of Antrochoanal Polyp?

OBJECTIVE: Antrochoanal polyp (ACP) is a benign soft tissue lesion arising from the inner wall of the maxillary sinus that extends into the nasal cavity and choana. Although it was first explained by Killian in 1906, the underlying pathogenesis has not been yet fully understood. Neurotrophins have been demonstrated to have a possible role in the pathogenesis of allergic rhinitis, idiopathic rhinitis and nasal polyps. To date any study has not investigated the function of neuronal inflammation and neurotrophins in the development of ACP. The objective of this study was to investigate the possible effect of neurotrophin-3 (NT-3) in ACP pathogenesis. METHOD: Twenty adult patients with ACP who underwent endoscopic sinus surgery in our department were included in the study group. The control group included 15 patients with concha bullosa of middle concha who underwent lateral excisional surgery. Nasal tissue NT-3 staining scores were evaluated using immunohistochemical methods. Blood NT-3 levels of both groups were evaluated by enzyme-linked immunosorbent assay (ELISA). RESULTS: There were no statistically significant differences between these two groups regarding tissue NT-3 staining scores (p=0.843) and blood NT-3 levels (p=0.463). In addition, no statistically significant correlation has been observed between tissue NT-3 staining scores and blood NT-3 levels in both ACP (p=0.578) and control (p=0.359) group patients. CONCLUSION: NT-3-related neuronal inflammation does not seem to have any role in ACP pathogenesis.

Hydatid Cyst of Parotid Gland: An Unusual Case Diagnosed by Fine Needle Aspiration Biopsy.

Hydatid disease is a zoonotic disease caused by the parasite Echinococcus granulosus. This infection frequently infects the liver and the lung and even in endemic regions rarely occurs in the head and neck region. This is also true for the parotid gland. The diagnosis relies on imaging techniques and the medical history. Another method that is helpful in the diagnosis is serological tests. Fine-needle aspiration biopsy is usually not recommended due to the potential risk of anaphylactic shock or spreading of daughter cysts. The preferred treatment method of hydatid cysts in the salivary gland is surgical excision. We introduce a rare case of hydatid cyst in the parotid gland diagnosed preoperatively by fine-needle aspiration biopsy and discuss the differential diagnosis.

Orbital Metastasis of Multiple Myeloma: Case Report.

A 68-year-old woman with a history of multiple myeloma presented to the clinic with pain and vision loss in her right eye. Proptosis was observed in her right eye and eye movements were restricted in all directions. Best corrected visual acuity was 3/10 in her right eye. On biomicroscopic examination, hyperemia and subconjunctival hemorrhage were present. Fundus examination of the right eye revealed optic disc edema and choroidal folds. In magnetic resonance imaging two orbital masses were detected. Based on the patient's history and ocular examination, we evaluated the masses as orbital metastasis of multiple myeloma. Palliative radiotherapy was recommended.

Intranodal palisaded myofibroblastoma - a rare case report and literature review.

Intranodal palisaded myofibroblastoma (IPM) is a benign mesenchymal neoplasm originating from smooth muscle cells and myofibroblasts. The inguinal region is the most common site of this rare tumor. As there are only about 89 such cases reported in the literature, the precise etiology and pathogenesis have yet to be explained adequately. It is characterized by spindle cells, amianthoid fibers, and by the proliferation of hemosiderin-containing histiocytes in the lymph node. A nodular lesion was excised from the inguinal region of a 47-year-old female patient with the clinical diagnosis of lymphoma and/or metastase. Macroscopic examination of a section of the lesion demonstrated a solid appearance. Microscopic examination revealed spindle-cell proliferation, amianthoid fibers, hemosiderin pigment, and extravasated erythrocytes. Nuclei of the spindle cells displayed a palisaded appearance. Compressed lymphoid tissue was observed around the lesion. Neoplastic cells were identified by the presence of vimentin, SMA, Cyclin D1, and beta-catenin. The Ki67 index was less than 1%. Histological examination confirmed the diagnosis of IPM. Although IPM is benign, it is frequently confused with metastatic lesions and lymphomas.

A Rare Cause of Proptosis in Childhood: Langerhans Cell Histiocytosis.

A three-year-old male patient was admitted to the clinic with proptosis in his right eye. He had a history of fever with an unknown etiology. In examination, right proptosis was observed and an immobile mass was palpated at the lateral wall of the right orbita. Eye movement was unrestricted in all directions and anterior and posterior segment examination was normal in both eyes. On computed tomography, diffuse bone destruction and expansion was observed in the right orbital lateral wall and other cranial bones. Langerhans cell histiocytosis was diagnosed by bone biopsy. Malignancy is an important cause of proptosis in childhood. Pediatric patients who are admitted to clinic with proptosis should be carefully examined and Langerhans cell histiocytosis should also be considered as an etiology.

Sinonasal inflammatory myofibroblastic pseudotumor (plasma cell granuloma).

Inflammatory myofibroblastic pseudotumor (plasma cell granuloma) is a soft tissue lesion consisting of myofibroblasts, mature lymphocytes, histiocytes, plasma cells, eosinophils, and extracellular collagen. Various sites in the body may harbor these lesions. Lungs, omentum, intestines, mesentery, and urinary system are the most susceptible areas. It is usually seen in children and young adults. The lesion is rarely detected in the head and neck region. The orbit and the upper respiratory system are the most common localizations in the head and neck region. Sinonasal tract is a rare site of involvement. The differential diagnosis includes squamous cell carcinoma (spindle cell variant), inflammatory fibrosarcoma, leiomyosarcoma, schwannoma, and nonspecific inflammation. Our patient who had a sinonasal mass showed a benign tumor consisting of spindle tumor cells and inflammatory cells histopathologically. This case was presented due to its rare existence to this site.

Two rare entities in the same palate lesion: hyalinizing-type clear cell carcinoma and necrotizing sialometaplasia.

Hyalinizing clear cell carcinoma is a low-grade malignant epithelial neoplasm of the salivary glands. The tumor has epithelial cells and lacks myoepithelial cells. Necrotizing sialometaplasia is a benign, self-limiting lesion of the salivary glands. The clinical and histologic features mimic those of mucoepidermoid carcinoma or squamous cell carcinoma. The importance of these entities are the rarity of both of them and their potential to be misdiagnosed as other lesions. Pathologists and clinicians should be aware of these entities to prevent misdiagnosis. This is the first clinical report of 2 rare and consecutive different entities of the same location on the hard palate to our knowledge.

Contribution of DOG1 expression to the diagnosis of gastrointestinal stromal tumors.

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract, and the majority contain KIT or PDGFRA-activating mutations. However, up to 10% of GISTs are c-kit-negative. Antibodies with increased sensitivity and specificity for the detection of c-kit-negative GIST cases may be of value, especially because some of these cases may also benefit from tyrosine kinase inhibitor therapy. Hematoxylin and Eosin sections of 33 GISTs were re-examined in order to define histopathological criteria used in risk assessment of these tumors. Immunohistochemistry with a panel of antibodies [c-kit, DOG1 (discovered on GIST 1), CD34, smooth muscle actin (SMA), Desmin, S100 and Ki67] was performed on 5µm-thick paraffin sections of all tumors. Statistical analysis of immunohistochemical studies showed that DOG1 and CD117 were the most sensitive and specific antibodies in the diagnosis of GISTs. Other antibodies were unhelpful in confirming a diagnosis of GIST, but were particularly useful in the differential diagnosis. Reactivity for DOG1 may aid in the diagnosis of GISTs, which fail to express c-kit antigen, and lead to appropriate treatment with imatinib mesylate, an inhibitor of the KIT tyrosine kinase.

Follicular dendritic cell sarcoma of the tonsil.

Follicular dendritic cell sarcoma (FDCS) is an uncommon tumour within the spectrum of histiocytic and dendritic cell neoplasms that can occur at nodal and extra-nodal sites. Besides being rare, these tumours are difficult to diagnose. A 72-year-old man with a painless mass in the right tonsil was admitted to the Mersin University Hospital. Tonsillectomy was performed. Microscopically, the tumour consisted of spindle-shaped cells with large oval to polygonal nuclei. Lymphocytes were scattered among the tumour cells. Immunohistochemically, the cells were positive for CD23 and vimentin. The tumour was diagnosed as FDCS with histological and immunohistochemical findings. Recognition of extranodal FDCS requires knowledge of this entity and to consider it during the diagnosis. Confirmatory immunohistochemical staining is essential for diagnosis. Correct characterisation of this neoplasm is important because of its potential for recurrence and metastasis.

Seasonal variation of vitamin and sterol content of chironomidae larvae.

In the present study, seasonal variation of vitamin and sterol content of Chironomidae larvae were determined by using HPLC. As the result of vitamin analysis, we found alpha-tocopherol, retinol, K1, K2, D2 and D3. When the seasonal variation of vitamin groups were compared, a significant increase was observed in vitamin K1, K2, D2 and alpha-tocopherol in all seasons. A significant increase was observed in vitamin D3 in spring. And also vitamin A level high in autumn and winter, alpha-tocopherol level was significantly high among vitamins. When vitamin groups were compared statistically, differences were detected between seasons (p < 0.001). Analyzing the content of sterol, we found ergosterol, cholesterol, stigmasterol and beta-sitosterol in all seasons. Cholesterol level was found to be significantly high in sterols. When sterol contents were compared statistically, differences were detected between seasons (p < 0.001). In conclusion, the reasons for these differences are larval development feature and the variety of food in different seasons.

Sinonasal glomangiopericytoma.

Glomangiopericytoma (sinonasal-type hemangiopericytoma) is a rare tumor arising from the periyctes surrounding capillaries and accounts for less than 0.5% of all sinonasal tumors. It falls within the category of borderline and low-malignant-potential soft tissue tumors of the nose and paranasal sinuses. It is defined by the World Health Organization as a sinonasal tumor demonstrating a perivascular myoid phenotype. It was noted that when this lesion arose in the nasal cavity, it tended to behave in a more indolent fashion than its soft tissue counterpart, suggesting that sinonasal hemangiopericytomas represented a distinct entity. We report a case of a 68-year-old female patient diagnosed with glomangiopericytoma arising in the left sinonasal cavity and discussed the condition in terms of differential diagnosis.

Pathologic Features of Behçet's Disease in the Tubuler Gut.

Behçet's disease (BD) is a vasculitic disorder of relapsing acute inflammation characterized by recurrent oral ulcers, genital ulcers, uveitis, and skin lesions. The disease also affects other organs, including joints, the nervous system, blood vessels, and gastrointestinal (GI) system may also be involved and the lower GI tract is the mostly involved part, leading to severe morbidity. The frequency of GI involvement in BD varies among different ethnic groups. Although 50-60% of Japanese patients have GI disease, these manifestations are rare in patients from Mediterranean countries. The gastrointestinal manifestations of BD usually appear 4.5-6 years after the onset of the oral ulcers. The intestinal lesions are usually resistant to medical treatment and recur after surgery. The elementary lesion is apthous ulcer. Deep, round or oval ulcers with a punched-out appearance tend to perforate easily, so that many patients require urgent operation.

Granulomatous mastitis: clinical, pathological features, and management.

This clinical study was conducted to present clinical, radiologic, and histopathologic features of Granulomatous Mastitis (GM) and evaluate the result of surgical and steroid treatment. Sixteen cases diagnosed histologically as GM were reviewed. Patient characteristics, clinical presentation, radiologic imaging, microbiologic, histopathologic assessment, treatment modalities, recurrence, morbidity, and follow-up data were analyzed. Majority of the patients were child bearing age and all of the patients had a history of breast feeding. Radiologic findings were nonspecific. Histopathology showed the characteristic distribution of granulomatous inflammation in all cases. In 12 cases, surgical excision of the lesion with negative margins was performed. Four cases required quadranectomy because of wideness of the disease. Three patients who had local reoccurrence and three resistant patients were treated by oral prednisone after surgical attempt. Complete remission was obtained and no further recurrence was observed in this patients. GM predominantly occurs in premenopausal women and the clinical symptoms might be misjudged as breast cancer. Histopathologic examination remains the gold standard for the diagnosis. Wide excision of the lesions is the recommended therapy and we suggest steroid therapy in resistant or recurrent disease following the idea that the disease has an autoimmune component.