Browsing by Author "Kösem, M."

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Acute Renal Failure Due To Light Chain Cast Nephropathy
(2011) Bulut, G.; Kösem, M.
Myeloma cast nephropathy, also known Bence Jones cast nephropathy or myeloma kidney is the most common form of renal disease associated with multiple myeloma. Clinically, it may present as progressive renal insufficieny or acute renal failure. We describe a case of multiple myeloma who presented with acute renal failure due to light chain cast nephropathy and had a primary diagnosis made by renal biopsy. A renal biopsy was performed for acute renal failure in a 44 year old female patient. The renal biopsy showed numerous dilated tubules filled with pink eosinophilic fractured casts surrounded at places by multinucleated giant cells and accompanied by moderate interstitial infiltrate consisting of lymphomononuclear cells. There was tubular atrophy with interstitial fibrosis. The renal biopsy is occasionally the first test indicative of myeloma in a patient with acute renal failure of seemingly unknown origin. Thus the microscopic appearance of the tubules in this biopsy is easy to appreciate and is diagnostic of light chain cast nephropathy.
The Association of Short Segment Barrett's Esophagus With Intestinal Metaplasia in Stomach
(2003) Tuncer, I.; Ugraş, S.; Uygan, I.; Türkdoǧan, K.; Kösem, M.
Background/aims: The aims of this study were to investigate the presence of short segment Barrett's esophagus in people found to have tongue-like columnar mucosal protrusions in the distal esophagus and to determine the relationship between short segment Barrert's esophagus and Helicobacter pylori, gastritis and intestinal metaplasia observed in other parts of the stomach. Methods: The study included 50 patients (32 male, 18 female). Two biopsy specimens were taken from the antrum, at least 2 cm away from the pylorus, from the incisura angularis, corpus and cardia and four biopsy specimens were taken from tongue-like columnar protrusions (<3 cm long) above the gastroesophageal junction. Tissue samples were stained with hematoxyline-eosine, HID-Alcian blue pH 2.5 and modified Giemsa. Results: Of the 50 subjects who were found to have tongue-like columnar protrusions above the gastroesophageal junction, short segment Barrett's esophagus was detected in nine (18%). Whereas all short segment Barretti's esophagus cases were associated with chronic gastritis, Helicobacter pylori was found to be positive in five (55.5%) of them and there was intestinal metaplasia in other parts of the stomach (antrum in two patients, incisura angularis in three, antrum and cardia in one) in six (66.6%) cases. In 41 patients without short segment Barrett's esophagus 33 (80%) had chronic gastritis, 27 (66%) had Helicobacter pylori infection and eight had intestinal metaplasia in different locations (there in antrum, four in incisura angularis, one in the antrum and cardia) of the stomach. Conclusions: An association between short segment Barrett's esophagus and intestinal metaplasia was found in different parts of the stomach. The link between intestinal metaplasia in the stomach and these metaplastic changes in the tubular esophagus requires evalation in larger and more comprehensive studies.
Atypical Fibroxanthoma of the Eyelid
(TIP ARASTIRMALARI DERNEGI, 2008) Kiliç, A.; Kösem, M.; Çinal, A.; Yaşar, T.; Demirok, A.
Atypical fibroxanthoma (AFX) is probably a neoplasm of fibrohistiocytic lineage. The tumor arise in the skin and has strikingly atypical properties. We report a case of AFX that was excised from the left lower eyelid of a twelve-year-old girl. The nodular mass was reported as AFX. Though this tumor has the capability to recur aggresively, no recurrence was noted in the present case. Malignant fibrous histiocytoma, atypical fibrous histiocytoma, squamous cell carcinoma, sarcoma, dermatofibroma protuberans, and reticulohistiocytoma should be included in differential diagnosis.
Bazex Syndrome: Acrokeratosis Paraneoplastica in Association With Simultaneous Multiple Genitourinary Tumors
(Elsevier Inc., 2000) Atilla, M.K.; Yilmaz, Y.; Bekerecioglu, M.; Akpolat, N.; Kösem, M.; Aydin, S.
We report a patient with Bazex (Bazex-Dupre-Christol) syndrome in association with multifocal basal cell carcinoma, epidermoid carcinoma of the lung, adenocarcinoma of the prostate, and possibly undifferentiated carcinoma of the bladder. To our knowledge, this is the first report of a patient with Bazex syndrome that consisted of four tumors, including two genitourinary tumors. (C) 2000 Elsevier Science Inc.
Calcaneal Brown Tumor With Primary Hyperparathyroidism Caused by Parathyroid Carcinoma: an Atypical Localization
(2004) Dogan, A.; Algün, E.; Kisli, E.; Harman, M.; Kösem, M.; Tosun, N.
Brown tumors are one of the characteristics of primary hyperparathyroidism, although, in some cases, they are noted with secondary hyperparathyroidism as well. The authors present a case of a 50-year-old woman with primary hyperparathyroidism caused by parathyroid carcinoma with an unusual location of a brown tumor in the calcaneus. She first presented with pain and swelling over the heel and ankle, and the diagnosis was suspected by radiographs. Biopsy of the calcaneal lesion confirmed a brown tumor. After the parathyroid lesion was removed surgically, her symptoms were relived. The calcaneal lesion was treated with immobilization of the foot.
Carcinoid Tumor of the Stomach a Rare Form of Gastrointestinal Carcinoid Tumor: a Report on Three Cases
(2001) Kotan, C.; Kösem, M.; Özgören, E.; Ilhan, M.; Sönmez, R.; Akpolat, N.
Between 1994 and 1999 three patients with gastric carcinoid tumors were diagnosed at Yüzüncü Yil University Medical Faculty, Department of Surgery. Their ages were 65, 80, and 50 years, and all were male. The major complaints were epigastric pain, dysphagia, loss of appetite and weight, postprandial vomiting and in one patient, hematemesis and melena. None of the patients had carcinoid syndrome. The tumor was located in the upper portion of the stomach in one case and distal portion of the stomach in two cases. All three patients were initially diagnosed as adenocarcinoma of the stomach due to the endoscopic appearance of the tumor and histologic evaluation of the endoscopic biopsy. Because of the diagnosis of gastric carcinoma, two of them underwent subtotal gastrectomy and the other had a total gastrectomy. Histological examination of the resected materials showed well differantiated carcinoid tumors. Two cases had lymph node metastasis. Tumor cells in the stomach were immunoreactive for chromogranin A and neuron specific enolase and Grimelius positive for argyrophil cell detection. This paper presents a literature review and describes these three cases.
Castleman's Disease Arising in the Cervical Region: a Case Report
(2003) Yuca, K.; Kösem, M.; Çankaya, H.; Kutluhan, A.; Kiris, M.
Castleman's disease (CD) (angiofollicular lymph node hyperplasia) is a rare lymphoproliferative disease of unknown etiology. On rare occasions it is the cause of a solitary neck mass. Definitive diagnosis and treatment is possible with complete surgical resection. This report describes a case of this disorder of the hyalinovascular type as a solitary neck mass in a 35-year-old woman. The patient was treated by surgical excision.
The Comparative Effects of Pentoxifylline and Ursodeoxycholic Acid on Il-1β, Il-6, Il-8 and Tnf-Α Levels in Nonalcoholic Fatty Liver
(2003) Tuncer, I.; Uygan, I.; Dülger, H.; Türkdoǧan, K.; Şekeroǧlu, R.; Kösem, M.
Objective: To investigate the comparative effects of the pentoxifylline (PTX) and ursodeoxycholic acid (UDCA) on IL-1β, IL-6, IL-8 and TNF-α in non-alcoholic fatty liver (NAFL) cases. Method: Twenty-eight cases diagnosed to have NAFL were included in our study. The cases were divided into 3 groups. 20 mg/kg/day PTX was given to the subjects in group A (6 male, 4 female), 15 mg/kg/day UDCA was given to the subjects in group B (5 males, 5 females) for 6 months. The cases in group C (5 male, 3 female) were followed as control group. The biochemical values and cytokine levels of the cases were evaluated before and at the end of the sixth month of the treatment. Results: When compared with the serum cytokine levels before and after the treatment, IL-8 and TNF-α levels were found to be significantly decreased both in group A and group B (p< 0.05), whereas there was no statistically significant change in IL-1β and IL-6 levels (p > 0.05). Conclusion: While PTX and UDCA significantly decreased the serum IL-8 and TNF-α levels in NAFL, their effects on IL-1β and IL-6 were not significant.
Differential Diagnosis of Papillary Thyroid Carcinoma: Immunocytochemical Study of 112 Cases
(2005) Kösem, M.; Polat, S.; Öztürk, M.; Kotan, Ç.; Özbek, H.; Algün, E.
Papillary carcinoma is diagnosed mainly by its classical papillary structures and nuclear changes. However similar structural and cytological features may also be seen in other lesions of thyroid. Immunohistochemical staining methods help in these circumstances that cytological features do not suffice for differential diagnosis. In this study we stained 112 parafin-embedded blocks with thyroidal lesions (60 papillary carcinoma and 52 other benign or malignant thyroidal lesions) with HBME-1, CK-19, S-100 and EMA. Papillary carcinomas were stained 8.3% weakly, 90% moderately and strongly with HBME-1; 11.7% weakly, 88.3% moderately and strongly with CK-19; 50% weakly, 50% moderately and strongly with EMA; 26.6% weakly, 48.4% moderately and strongly with S-100. Other thyroid lesions were stained 36.5% weakly, 5.8% moderately with CK-19; 26.6% weakly, 15.4% moderately with EMA; 7.7% weakly, 1.9% moderately with S-100. None of the thyroid lesions, but papillary carcinoma, were stained with HBME-1. Papillary carcinoma cases had significantly higher staining with all four markers. However, HBME-1 and CK-19 were considered more valuable in differential diagnosis for papillary carcinomas, since they showed moderate and strong staining. Also high sensitivity and specificity of HBME-1 makes it a good marker for the diagnosis of papillary thyroid cancer.
Hibernoma: a Case Report and Discussion of a Rare Tumor
(2001) Kösem, M.; Karakök, M.
Influence of the Refinement of Surgical Technique and Surgeon's Experience on the Rate of Complications After Total Thyroidectomy for Benign Thyroid Disease
(ARSMB-KVBMG, 2003) Kotan, C.; Kösem, M.; Algün, E.; Ayakta, H.; Sönmez, R.; Söylemez, O.
Background: In recent years, many surgeons dealing with endocrine surgery have increasingly performed total thyroidectomy for benign thyroid disease. However, total excision of the thyroid in the treatment of benign lesions has been surrounded by even more controversy than its role in cancer treatment. The complication rate appears to be higher when the operation is done by inexperienced surgeons who have no special skills in endocrine surgery using proper techniques. The aim of this study is to determine whether surgeons experience and the refinement of surgical techniques are associated with postoperative recurrent laryngeal nerve (RLN) palsy or hypocalcemia after total thyroidectomy for benign thyroid disease. Methods: A total of 68 consecutive patients who underwent total thyroidectomy for benign thyroid disease were reviewed. Twenty-six of these were from between January 1998 and June 1999 (first period) and 42 from between June 1999 and September 2000 (second period). Patients were divided into two subgroups according to different periods and different surgical techniques to identify the RLNs and the parathyroid glands. RLNs function was evaluated pre- and post-operatively by an otolaryngologist, and serum calcium levels were measured at the postoperative follow-up. Results: During the first period of the study, transient hypocalcaemia was determined in 8 (31%) patients. Hypocalcaemia was clinically symptomatic in 5 (19%) patients. Transient RLN palsy developed in 4 (15%) patients. Unilateral permanent RLN palsy due to operative injury was observed in 1 (4%) patient. During the second period, we noted transient hypocalcemia in 11 (26%) patients and symptomatic hypocalcemia in 6 (4%) patients. Serum calcium levels returned to normal within 4 weeks after operation in all patients. Neither transient nor permanent RLN palsy was observed during this period. Conclusions: Complications of total thyroidectomy can be minimized with increasing experience and the refinement of surgical technique.
Male Breast Cancer (Case Report)
(2003) Alici, S.; Kösem, M.; Çalka, Ö.; Kotan, Ç.; Mercan, R.
In this report, a 65 year-old man diagnosed as breast cancer with lung metastasis is presented. The patient was misdiagnosed as infection many times for the previous 4 years. Although breast cancer is rare in males, the importance of biopsy and histopathologic examination in nonhealed infiltrative skin lesions of male breast, is emphasized.
Multiple Bowel Perforations in Systemic Lupus Erythematosus
(2005) Aydin, M.; Baser, M.; Kösem, M.; Aslaner, A.
Systemic lupus erythematosus (SLE) is a connective tissue disorder that has rarely been seen with acute surgical manifestations. Intestinal perforation is one of the most devastating complications of SLE which necessitates prompt surgical intervention. We report a case having multiple intestinal perforations on exploration and has undergone primary repair. SLE should be taken into account as a diagnosis of choice in patients with bowel perforation.
Non-Reactive Tuberculosis Mimicking Histopathological Features of Kikuchi's Disease: a Case Report
(2002) Kösem, M.; Karakök, M.; Özbay, B.; Özen, S.
The Presence of Erythropoietin Receptor in Parathyroid Cells
(Editrice Kurtis s.r.l., 2007) Öztürk, M.; Üstek, D.; Akbaş, F.; Kösem, M.; Abaci, N.; Alagöl, F.; Kotan, Ç.
Context: Effects of erythropoietin on parathyroid cell function has not been studied before. Objective: We aimed to demonstrate whether erythropoietin receptor present in parathyroid cells. Design: The specimens of normal parathyroid gland, parathyroid adenoma and hyperplasia were retrieved from our pathology archieves. The sections were stained immunohistochemically. Quantitative gene expression study was performed for erythropoietin and erythropoietin receptor. Results: Erythropoietin receptors were detected by immunohistochemical staining and by its gene expression. Its density was higher in normal parathyroid, followed by parathyroid adenoma and hyperplasia. Conclusion: Erythropoietin receptor is present in normal parathyroid, parathyroid adenoma, and hyperplasia. © 2007, Editrice Kurtis.
Reticular Erythematous Mucinosis: Case Report
(2012) Güneş Bilgili, S.; Karadaǧ, A.S.; Çalka, Ö.; Önder, S.; Kösem, M.
The cutaneous mucinoses are a heterogeneous group of diseases in which mucin accumulates in the skin or within the hair follicle. The reticular erythematous mucinosis syndrome is a dermal, local, diffuse, and primary type of cutaneous mucinosis mainly effecting middle-aged women. The skin lesions usually appear on the chest and upper back. Rarely arms, face and abdominal region can be involved. It presents with reticular, macular lesions or erythematous papules and plaques have usually peau d'orange appearance. A 46-year-old woman had an 3-month history of itchy erythematous indurated plaques on her abdomen. Reticular erythematous mucinosis syndrome was diagnosed on the basis of the clinical picture and histological findings. Our case has been reported because of the rarity of disease and atypical clinical appearance and localization. Copyright © 2012 by Türkiye Klinikleri.
The Role of Fine-Needle Aspiration Biopsy in the Evaluation of Head and Neck Masses
(2002) Kutluhan, A.; Kisli, E.; Yakut, F.; Yurttaş, V.; Kösem, M.
Purpose: The purpose of this study is to evaluate the role of diagnostic fine-needle aspiration biopsy (FNAB) of head and neck masses and to calculate the sensitivity and specificity of this method. Materials and Methods: The records of 219 patients who had undergone an FNAB of head or neck masses were reviewed. FNAB results were correlated with the histopathologic findings observed after surgery in 96 of 219 patients. Sensitivity, specificity and positive predictive value of FNAB for the detection of malignancy were calculated. Results: Four false-negative, 4 false-positive and 22 unsatisfactory results were obtained using FNAB, according to histopathologic findings. The overall sensitivity, specificity, accuracy and positive predictive value for malignancy were 87.5, 93.8, 91 and 87.5%, respectively. Conclusions: FNAB is a useful diagnostic tool for head and neck masses. However, FNAB results by themselves could be insufficient in the management of head and neck masses; therefore, they should be combined with clinical and radiologic findings. Copyright © 2005 S. Karger AG.
Subcutaneous Dermatofibrosarcoma Protuberans in Parotid Region: Case Report
(2013) Garça, M.F.; Kösem, M.; Turan, M.; Bozan, N.; Çankaya, H.
Dermatofibrosarcoma protuberans (DFSP) is a low-grade soft tissue sarcoma (fibrosarcoma) originated from dermal and subdermal layer of the skin. But subcutaneous localization is quite rare. It is one of the rare tumors and accounts for 0.1% of all malignancies. The tumor infiltrates into the deeps in the villous and finger shape. For this reason, it is quite difficult to get surgical margins in the tumor excision and the recurrence is a problem encountered frequently. An excision or Mohs technique of micrographic surgery is suggested by leaving a surgical space up to 5 cm from the tumor margines. In this case report, a case with DFSP atypically subcutaneous localized on superficial parotis gland was presented. It should be kept in mind that probability of the microscopic spread is high in these patients and they should be followed by reminding that the disease can recur in the following long years.
Treatment of Mucoepidermoid Carcinoma of the Parotid Gland and Successful Repair of Iatrogenic Facial Nerve Paralysis
(2008) Kutluhan, A.; Yurttaş, V.; Yuca, K.; Kösem, M.; Yakut, F.
A 15-year-old female patient developed facial nerve paralysis following surgical excision of a right parotid mass at another center. The histopathologic diagnosis of the lesion was mucoepidermoid carcinoma. On admission to our clinic, she underwent extended total parotidectomy and functional neck dissection. For facial nerve reanimation, cervical plexus nerve grafting was performed for frontal and buccal branches, and ansa hypoglossi anastomosis for the marginal mandibular branch. Postoperative radiotherapy was administered. Facial nerve functions returned to normal in the postoperative sixth month (House-Brackmann grade II). No locoregional recurrence or distant metastasis occurred in the follow-up period.
Two Cases With Benign Cephalic Histiocytosis
(2012) Güneş Bilgili, S.; Karadaǧ, A.S.; Akdeniz, N.; Çalka, Ö.; Özaydin Yavuz, G.; Kösem, M.
Benign cephalic histiocytosis is a rare form of non-Langerhans cell histiocytosis in infants and children characterized by a self-healing eruption of papules and macules on the head and neck. Its etiology is unknown. Due to its rarity we report these two cases of benign cephalic histiocytosis. The first case was a 1.5 year-old boy with small, asymptomatic, yellow-brown papules distributed over his trunk and upper extremities and yellow-brown plaques localised bilaterally to his cheeks. The second case was a 16 months old boy with purple-erythematous papules and nodules on his left cheek, left earlobe and right preauricular region ranging from 2 mm to 5 mm in diameter. There were no symptoms or signs of systemic involvement in both of the cases. It is uncommon and can therefore be easily mistaken for other more common skin diseases seen in children. Copyright © 2012 by Türkiye Klinikleri.