Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has been accepted as a reliable tool in diagnosing and staging intra-abdominal tumors. In this study, we aimed to investigate the performance of EUS-FNA in the evaluation of liver masses and its impact on patient management and procedure-related complications retrospectively. Data of patients who underwent EUS-FNA biopsies due to liver masses between November 2017 and July 2018 were retrieved retrospectively. Biopsies were performed using 22-G needles. The demographics, EUS-FNA results, sensitivity and specificity of the procedure, negative predictive value, positive predictive value, and specimen sufficiency rates were assessed. A total of 25 patients (10 females) were included in the study. The mean age was 62.73±15.2 years. The mean size of the masses was 34.50±16.04 mm. The technical success rate was 88%. During the EUS-FNA procedure, each patient had only one pass with 94.45% of aspirate sufficiency rate and 86.3% of biopsy sufficiency rate. The diagnostic accuracy rate was 86.3%. There were no complications. For the evaluation of liver masses, EUS-FNA using a 22-G needle with even one pass had high aspiration and biopsy success rates accompanied with high diagnostic accuracy rates.

Background and Aim: PD-1 (programmed death-1) is an immune checkpoint receptor that modulates T-cell activity in peripheral tissues via interaction with its ligands, PD-L1 (programmed death-ligand 1) and PD-L2 (programmed death-ligand 2). Tumor cells upregulate PD-L1 or PD-L2 to dampen this T lymphocyte attack. Our goal was to demostrate the PD-1 and PD-L2 expresion rate of various hematologic malignancies, and to evaluate whether PD-1 and PD-L2 expresion have impact on prognosis. Materials and Methods: For this purpose, pre-treatment bone marrow biopsy specimens of 83 patients [42 multiple myeloma (MM), 21 acute leukemias, and 20 chronic lymphocytic leukemia (CLL)] have been stained with monoclonal antibody immunstains of PD-1 and PD-L2. Results: As a result, the overall expression rate of PD-1 was 26.2%, 4.8%, and 60% in patients with MM, acute leukemias, and CLL, respectively. Whereas, PD-L2 expression rate was 61.9%, 14.3%, and 10% in patients with MM, acute leukemias, and CLL, respectively. Conclusion: Finally, we conclude that the role of PD-1 pathway can be demonstrated by immunohistochemistry (IHC). Since we have evaluated whether there is a correlation between (IHC) results and survival of patients with MM, acute leukemias, and CLL, we couldn’t demonstrate a meaningful evidence that these markers have an impact on prognosis. Key Words: PD-1, PD-L2, multiple myeloma, acute leukemias, chronic lymphocytic leukemia.

Amaç: Bu çalışma, acil şartlarında değerlendirilen femur boyun kırığı hastalarında femur başı histopatolojik inceleme gerekliliğini ve erken dönemde yapılan ameliyatların klinik sonuçlarını araştırmayı amaçladı. Gereç ve Yöntemler: Etik kurul onayı sonrası 01.01.2019–31.12.2023 arasında tek merkezde 1450 femur boyun kırığı olgusu retrospektif incelendi. Radyografide patolojik şüphe saptanan olgular BT/MR ile değerlendirildi ve yaklaşık 20 uzman hekimin katılımıyla şüpheli bulunan 293 hastadan, bilinen kanser öyküsü olan 52’si ve patolojik örnek gönderilmeyen 9’u dışlandı; 65 yaş üstü, düşük enerjili travmalı 232 hasta analize alındı. Cerrahi, patoloji sonucu beklenmeden uygun artroplasti ile gerçekleştirildi; femur baş-boyun örnekleri rutin histopatolojiye gönderildi ve gerektiğinde immünohistokimya ile moleküler testler uygulandı. Bulgular: Ortalama yaşı 82,11 (64–99) olan 232 hastanın 11’inde (%4,7) patolojik kırık saptandı; bu olguların tamamında geriye dönük sorgulamada kırık öncesi kalça ağrısı, kilo kaybı ve halsizlik vardı. On hastaya hemiartroplasti uygulandı; bir olguda metastaz progresyonuna bağlı 6. ayda implant yetmezliği gelişerek tümör rezeksiyon protezi ile revizyon yapıldı, dış merkezde total kalça protezi uygulanan bir olguda ise asetabular gevşeme ve litik alanlar nedeniyle sementli asetabular ring ile revizyon sonrası prostat kanseri metastazı tanısı kondu. İzlemde 49 hasta (%21,1) eksitus oldu ve patolojik kırık saptanan 11 hastadan 1’i bu gruptaydı. Sonuç: Kırık öncesi kasık/kalça ağrısı, hızlı kilo kaybı, halsizlik ve ailevi/kişisel kanser öyküsü gibi klinik ipuçları ile radyolojik şüpheli bulguların birlikte olduğu hastalarda seçici histopatolojik inceleme hastalık yönetimi açısından değer taşırken, histopatolojik inceleme düşük tanısal getiriyle gereksiz maliyet artışına yol açabilir.

Objective: PD-1 (programmed death-1) is an immune checkpoint receptor that modulates T-cell activity in peripheral tissues via interaction with its ligands, PD-L1 (programmed death-ligand 1) and PD-L2 (programmed death-ligand 2). Tumor cells upregulate PD-L1 or PD-L2 to dampen T lymphocyte attack. The checkpoint inhibition by tumor cells via the PD-1 pathway suppress the antitumor immune response. The role of PD-1 pathway has been extensively investigated in non-hematologic malignancies, however, the exact role of this pathway is not established in hematologic disorders. So, we aimed to demostrate the PD-1 and PD-L2 expresion rate of various lymphoma subtypes, and to evaluate whether PD-1 and PD-L2 expresion have impact on prognosis. Method: For this purpose, pre-treatment lymph node biopsy specimens of 92 patients [25 Hodgkin lymphoma (HL) and 67 non-Hodgkin lymphoma (NHL)] have been stained with monoclonal antibody immunstains of PD-1 and PD-L2. Results: The overall expression rate of PD-1 was 76% and 82.1% in patients with HL and NHL, respectively. PD-L2 expression rate was weak in both HL and NHL cases. Since we have evaluated whether there is a correlation between immunohistochemistry (IHC) results and survival of patients with HL and NHL, we couldn’t demonstrate a meaningful evidence that these markers have an impact on prognosis. Conclusions: We conclude that the role of PD-1 pathway can be demonstrated by IHC. If IHC markers might be standardized in the future, especially a cutoff that defines a clinically significant positive and predictive value, may help identifying patients more likely to benefit from anti-PD-1 therapies.

Adenoid cystic carcinoma is a rare malignant neoplasm of the salivary gland. Salivary gland neoplasms constitute 3% of cancers of all sites, of which, 10–15% are malignant. Though adenoid cystic carcinoma is the most common malignant tumor of the submandibular, sublingual and minor salivary glands, it accounts for only 15% of parotid cancers. They are generally slow-growing and spread relentlessly to adjacent structures. Hematogenous spread is more common than lymphatic spread, the common sites of metastasis being the lung, bone, liver, and brain. We present a case of multiple liver metastases occurring 3 years after surgery for adenoid cystic carcinoma of the parotid gland. The primary therapy, metastasis, and outcome of adenoid cystic carcinoma are discussed.

Background: The aim of this study is to evaluate the HER2 (c-erbB-2) gene status in patients with invasive breast cancer who have received an equivocal (2+) score during immunohistochemical (IHC) testing. The study employs the Silver DNA in Situ Hybridization (SISH) technique for this estimation and further investigates its association with various clinicopathological variables. Materials and methods: This study is a retrospective analysis consisting of 133 formalin-fixed paraffin-embedded tissue blocks from female patients diagnosed with invasive breast carcinoma and having an equivocal (2+) HER2 IHC score. HER2 DNA amplification in all cases was studied using the SISH technique. ER, PR, and Ki-67 stainings were evaluated by the IHC method. Results: From a total of 442 invasive breast carcinoma cases, 224 (50.70%) were found to be HER2 negative, 85 (19.20%) were HER2 3(+), and 133 (30.10%) had an equivocal 2+ HER2 score as determined by IHC. Among these 133 cases, HER-2 gene amplification was confirmed in 29.30% (39/133) by SISH. A statistically significant association was found between SISH status and Ki-67 index (P=0.04). Additionally, for cases with negative SISH results, a positive correlation was observed between the estrogen receptor (ER) and progesterone receptor (PR) statuses (P <0.01). Conclusion: The study underscores the importance of employing genetic tests like SISH to confirm the HER-2 gene status in cases with an equivocal 2+ IHC score. The SISH technique is emphasized as easy, time-efficient, cost-effective, and a reliable method for such confirmatory tests.