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  • Küçük Resim
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    Clinicopathological evaluation of 15 Ectopic adrenal tissues
    (Academy of Medical Sciences of I.R. Iran, 2021) Şensu, Sibel; Keser, Sevinç Hallaç; Gürbüz, Yeşim Saliha; Barışık, Nagehan Özdemir; Gül, Aylin Ege
    Background: Ectopic adrenal tissue is a rare condition associated with embryological development defects seen in many different areas in the abdomen and pelvis. Here, we aimed to discuss the clinicopathological features of ectopic adrenal tissues diagnosed in our clinic, in light of the literature. Methods: We included cases of ectopic adrenal tissues incidentally detected in the specimens from patients undergoing operation for various diagnoses during 2012- March 2020. The cases were examined according to gender, age, location and accompanying pathological diagnoses. During this period, 15 cases of ectopic adrenal tissues (6 paratubal, 3 paraovarian, 2 paratesticular, 1 spermatic cord, 1 paraaortic, 1 liver capsule, 1 omentum) were detected accompanied by two endometrial carcinomas, two serous cystadenomas, one seminoma, one mixed germ cell tumor, one bilateral ovarian serous carcinoma and hepatic high-grade colon adenocarcinoma metastasis. Results: In this report, the fifth ectopic adrenal tissue accompanying a malignant testicular tumor, the fifth and sixth ectopic adrenal tissues occurring with ovarian serous cystadenoma, the first case observed with serous cystadenocarcinoma and the first case detected with hepatic adenocarcinoma metastasis are presented. Our cases are mostly women and adult men. Conclusion: Ectopic adrenal tissues can lead to hormonal problems and also to adrenal cortex and medulla neoplasms. Microscopically, they may be confused with clear cell gynecological and germ cell tumors. If the ectopic focus is misdiagnosed as an implant, a benign entity may be incorrectly reported as malignant. Also, it is important to prevent mis-staging in malignancies. For precise diagnosis, an immunopanel such as inhibin, melan A, and calretinin can be performed.
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    Microsatellite instability in ovarian invasive and borderline epithelial tumors and comparison with prognostic parameters
    (Galenos, 2020) Türkel, Filiz İlhan; Gül, Aylin Ege; Şensu, Sibel; Keser, Sevinç Hallaç; Barışık, Nagehan Özdemir
    Aim: Ovarian cancers, 20% of which are hereditary, are considered the most lethal gynecological malignancies. Defects on DNA mismatch repair (MMR) genes are responsible for hereditary ovarian tumors related with Lynch syndrome. In this study, we aimed to determine microsatellite instability status in invasive and borderline epithelial ovarian tumors diagnosed via immunohistochemistry in our clinic and compare the results with several prognostic parameters and survival. Methods: In this retrospective study, 159 epithelial ovarian tumors were evaluated for age, tumor type, histological grade and Federation of Gynecology and Obstetrics (FIGO) stage as well as survival. MMR protein expression was immunohistochemically examined and absence of nuclear staining in tumor cells was considered MMR protein expression loss. All prognostic parameters were compared and analysed statistically. Results: MMR protein expression loss showed no statistically significant relationship with FIGO stage, age, histological grade, and survival. The only correlation was detected between tumor type and MMR protein loss (p<0.001). Conclusion: Although there are studies comparing microsatellite instability status of the tumors with several prognostic parameters, there is still no consensus on the issue. In this study on ovarian tumors, MMR protein expression loss was related with histological subtypes, but not with other prognostic parameters or survival. We believe that it is worth further investigating in larger studies with higher number of cases.
  • Küçük Resim
    Öğe
    Mitotic activity in gastrointestinal stromal tumors: Can we use phosphohistone h3 immunohistochemistry instead of hematoxylin and eosin for mitotic count?
    (KARE PUBL, 2022) Erhan, Selma Şengiz; Şensu, Sibel; Keser, Sevinç Hallaç; Kangal, Elis; Gül, Aylin Ege; Gundogan, Gokcen Alinak; Sakin, Abdullah
    Objectives: In gastrointestinal stromal tumors (GIST), malignancy potential is determined by the prognostic disease risk stratification based on mitosis, tumor size, and location. Phosphohistone H3 (PHH3) is an immunohistochemical marker showing mitotic activity in cells. In this study, we aimed to evaluate mitosis in GIST with PHH3, compare the results with hematoxylin and eosin (HE) stained slides, and examine its relationship with other prognostic data. Methods: Clinicopathological findings and survival were determined in GIST cases diagnosed between 2006 and 2017. The prognostic risk score was calculated according HE- and PHH3-based mitosis. The cases were classified as Group I: HE + and PHH3 + and Group II: HE + and PHH3-. They were also grouped as those diagnosed before and after 2012 and the staining results of HE and PHH3 were re-analyzed. Results: Ninety-eight cases were included in the study. Mitosis was detected with both HE and PHH3 in 63.3% of the cases (62/98 cases) (Group I) while in 36.7% of cases, it was detected with HE but not with PHH3 (Group II). In only two cases, the risk score changed with PHH3 (very low -> intermedier grade). The ratio of HE + and PHH3 + cases in 2012 and after was significantly higher than HE + and PHH3 - cases. A statistically significant relation was found between HE- and PHH3-based risk scores (p<0.05). There was a significant difference between HE-based risk score groups in terms of survival (p<0.05), while no difference was observed between the PHH3-based risk score groups (p>0.05). Conclusion: In GIST cases, PHH3 can be used to determine mitosis in more recent blocks, taking into account the technical conditions of the laboratory, but it does not seem to be superior to mitosis detected by HE. Research should continue on new survival determinants for GIST.