A Pediatric Case of Granulomatous Appendicitis Operated Due to Recurrent Abdominal Pain.

Granulomatous appendicitis (GA) is granulomatous inflammation of the appendix wall. It is generally idiopathic; however, it may also be associated with many diseases such as Crohn's disease, parasitic infections, tuberculosis, or foreign bodies. An 11-year-old male patient, with a 3-month history of abdominal pain and bilious vomiting, had right lower quadrant abdominal tenderness. His white blood cell count was 8.6 x103/µL. An abdomen ultrasound was considered to show plastron appendicitis and an appendectomy was performed. Microscopically, thickening of the appendix wall with edema, fibrosis and lymphoid infiltration was observed. The patient was evaluated as idiopathic GA since no disease was detected that caused GA. When the appendix has a firm consistency and is difficult to separate from the surrounding tissues, GA should be considered before malignancy, particularly in the pediatric age group. An appendectomy should be performed before deciding on radical surgery.

Correlation of [18F]FDG PET activity with expressions of Ki-67 in non-small-cell lung cancer.

BACKGROUND: Lung carcinoma is the most commonly diagnosed cancer throughout the world and is the leading cause of cancer-related deaths. Non-small cell lung cancer (NSCLC) accounts for up to 80% of newly diagnosed lung cancer cases. This study aimed to investigate the relationship between Ki-67 proliferation index (PI) and the maximum standardized uptake value (SUVmax) obtained from [18F]FDG PET/CT in NSCLCs and whether prognosis was predicted with SUVmax values. MATERIAL AND METHODS: This retrospective study included biopsy and resection materials of 41 patients, who were examined in the pathology laboratory of Konya Training and Research Hospital between January 2010 and December 2019, and diagnosed with NSCLC, and whose [18F]FDG PET/CT images were present. RESULTS: There was no significant difference between histopathological subtypes in terms of age (p = 0.077), Ki-67 PI (p = 0.454), and SUVmax (p = 0.143). No correlation was observed between Ki-67 PI and SUVmax values obtained from [18F]FDG PET/CT (p = 0.338, r = 0.153). There was no significant correlation between Ki-67 PI and tumor diameter (p = 0.531). The SUVmax value was found to be lower (12.78 ± 6.14) in tumors measuring ≤ 2.5 in diameter and higher (18.46 ± 7.81) in tumors measuring > 2.5 cm (p = 0.027). Metastases not proven histopathologically but detected in [18F]FDG PET/CT were found to have no significant correlation with Ki-67 and SUVmax values (p = 0.881, p = 0.837). CONCLUSIONS: This study showed that there was no significant relationship between Ki-67 PI and SUVmax value obtained from [18F]FDG PET/CT in NSCLC tumors.

Evaluation of P57, P53 and Ki67 Expression in Meningiomas.

OBJECTIVE: We conducted this study with the aim of predicting the biological behavior of meningiomas, and determining the benefits of associating histological subtype and grade with the expression of proliferative markers and tumor suppressor proteins. METHODS: The study included 29 patients with primary intracranial and intraspinal meningioma diagnosed in the pathology laboratory of Konya City Hospital between January 2014 and December 2020. Clinicopathological characteristics of the patients including parameters such as age and gender were obtained from the hospital records. Histopathological findings were obtained by re-evaluating the preparations stained with Hematoxylin-Eosin, which were extracted from the archive, and by evaluating new sections obtained from paraffin blocks of patients stained with Ki67, p53, and p57 immunohistochemical stains. RESULTS: A moderate correlation was found between tumor size and Ki67 proliferation index (PI) (p=0.003, r=0.530). There was no significant difference between grade I and grade II tumors in terms of p53 (p=0.184) and p57 (p=0.487) expressions. There were higher levels of Ki67 PI in grade II tumors. The histological subtypes of the tumor had no significant difference with Ki67 PI (p=0.018), p53 (p=0.662), and p57 (p=0.368) expressions. CONCLUSION: In order to obtain more definitive results, there is a need for studies, which are conducted with a greater number of patients and in multiple centers, and in which a long prospective follow-up is planned. The combination of histological, surgical, and imaging markers could make a more sensitive tool for predicting recurrence, and this could also be tested in future studies.

Ectopic Cushing's syndrome due to adrenocorticotropic hormone secreting atypical thymic carcinoid tumor.

Cushing's syndromes (CS) due to thymic carcinoids are rarely seen. In this text, a case with CS due to ectopic adrenocorticotropic hormone (ACTH) secreting atypical thymic carcinoid tumor is presented. A 50-year-old Turkish male patient was admitted to our emergency department with typical CS features. Basal hormone profile, low- and high-dose dexamethasone suppression tests, and inferior petrosal sinus sampling results were consistent with ectopic ACTH secretion. Thorax computerized tomography showed an upper mediastinal mass, and trans-thoracic biopsy showed atypical thymic carcinoid with positive ACTH staining. Since the vascular invasion was detected, tumor was accepted inoperable; somatostatine receptor analogs, chemotherapy, and radiotherapy were planned. Ectopic CS can be derived from atypical thymic carcinoid. In this case, ACTH staining was used to confirm ACTH secretion from thymic tissue, and positive staining was detected. ACTH staining routinely was not performed for extra hypophyseal tissue tumors. In suspicious and difficult cases, ACTH staining can be helpful to confirm the presence of ACTH in tumor tissues.

An exceedingly rare localization of a brown tumor in a hemodialysis patient.

Brown tumor, which is seen in the context of hyperparathyroidism, is defined as a uremic bone disease characterized by increased osteoclastic activity and fibroblastic proliferation in the involved bone. In chronic renal failure, there is an excessive parathyroid hormone secretion due to hypocalcemia, hyperphosphatemia, and vitamin D deficiency. Brown tumor of the femur, facial bones, mandible, sternum, ribs, and pelvis are rare, whereas, it rarely involves sacrum. Here, we presented a brown tumor of the sacrum that developed secondary to parathyroid hyperplasia in a patient receiving hemodialysis.