Background : Granuloma Annulare (GA) is a chronic inflammatory dermatosis with diverse presentations, yet comprehensive data integrating histopathology, long-term prognosis, and systemic inflammatory markers remain limited. This study aimed to analyze these clinicopathological characteristics and identify biomarkers for chronicity and recurrence. Methods: In this retrospective cohort study, we evaluated 34 patients with histopathologically confirmed GA diagnosed between 2013 and 2023. Demographic data, clinical features, comorbidities, treatment outcomes, and laboratory parameters were analyzed. Histopathological findings were re-evaluated to assess pattern types and the presence of specific markers. Statistical correlations between clinical parameters, inflammatory markers, and histopathological features were assessed. Results: The interstitial pattern was the predominant histopathological subtype (64.7%), with universal mucin deposition (100%). A statistically significant positive correlation was observed between lesion duration and the presence of multinucleated giant cells (r = 0.456, p = 0.033), suggesting a time-dependent granuloma maturation. Clinically, generalized GA cases demonstrated significantly longer recovery times compared to localized forms. The overall recurrence rate was 23.5%. A lower BLR was significantly associated with disease recurrence (r = −0.539, p = 0.021). At least one comorbidity was present in 76.5% of the patients. Conclusions: Our findings suggest that giant cell formation serves as a histopathological marker of lesion chronicity, supporting the concept of granuloma remodeling over time. Furthermore, a suppressed BLR may serve as a novel surrogate marker associated with disease recurrence. Given the high burden of comorbidities observed in both localized and generalized forms, GA should be approached as a cutaneous manifestation of underlying systemic dysregulation, suggesting that clinicians should consider routine metabolic screening for these patients.

SUMMARY OBJECTIVE: The aim of this study was to assess the immunohistochemical expression of second-generation neuroendocrine markers such as insulin gene enhancer protein 1, insulinoma-associated protein 1, and secretagogin in pheochromocytoma and their prognostic value. METHODS: The study included 30 operated pheochromocytoma patients. The tissue preparations were re-evaluated by two pathologists, and Pheochromocytoma of the Adrenal Gland Scaled Score score and Grading System for Adrenal Pheochromocytoma and Paraganglioma score were given. Four μm-thick paraffin block sections were stained with insulinoma-associated protein 1, insulin gene enhancer protein 1, and secretagogin antibodies to obtain staining intensity score, staining percentage, and H-score. RESULTS: The mean age at diagnosis was 50.5 (±15.9) years. The most common complaint was high blood pressure. A total of four patients (13.3%) had a nonfunctioning adenoma. The lesions were mostly localized in the right adrenal gland, and the median tumor size was 45.0 (35.0–54.2) mm. The median Ki67 proliferation index was 2.0% (0.9–3.0). According to the Pheochromocytoma of the Adrenal Gland Scaled Score score, nine (30.0%) patients showed the benign clinical behavior (score <4), while according to the Grading System for Adrenal Pheochromocytoma and Paraganglioma score, only four (13.3%) patients were in the well-differentiated-type (0–2 points) group. insulinoma-associated protein 1 and insulin gene enhancer protein 1 were positive in 21 (70%) and 26 (86.7%) of the patients, respectively. However, secretagogin was positive only in six patients (20%). Among the second-generation neuroendocrine immunohistochemical markers, insulin gene enhancer protein 1 had the highest H-score. Correlation analysis showed a negative correlation between insulin gene enhancer protein 1 and tumor Hounsfield unit and a positive correlation between insulinoma-associated protein 1 and Ki67 proliferation index. CONCLUSIONS: Insulinoma-associated protein 1, insulin gene enhancer protein 1, and secretagogin, which are second-generation neuroendocrine immunohistochemical markers, can be used in the differential diagnosis of pheochromocytoma. Notably, insulinoma-associated protein 1 may also have prognostic significance.

Ülkemizde Türkçe olarak güncel kaynak kitap eksikliği şüphe götürmez bir gerçektir. Bu açığı bir nebze olsun doldurabilmek amacı ile yola çıktık. Bilginin hızla arttığı çağımızda bu tür eserlerin hızla güncellenmesinin gerekliliği kaçınılmazdır. Elinizdeki bu kaynak kitapta mesane tümörlerinin etiyolojisi, radyolojisi, tipleri, makroskopik ve mikroskopik bulguları 22 bölümde detaylı olarak ele alınmıştır.