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    Interobserver Agreement Among Histological Patterns and Diagnosis in Lung Adenocarcinomas
    (DE GRUYTER OPEN LTD, 2014-01-01) Urer, Halide Nur; Ahiskali, Rengin; Arda, Naciye; Batur, Sebnem; Cinel, Leyla; Dekan, Gerhard; Fener, Neslihan; Firat, Pinar; Geleff, Silvana; Oz, Buge; Ozluk, Yasemin; Yildiz, Kursat; Yilmazbayhan, Emine Dilek; Zeren, Handan; Uysal, Atilla
    Objective: The aim of this study was to investigate the interobserver agreement in determination of the dominant histological pattern and the final diagnosis in lung adenocarcinomas. Material and Method: A total of 12 patients with a diagnosis of primary lung adenocarcinoma were included in the study. Twelve pathologists from eight study centers were asked first to determine the dominant histological pattern in these cases and then to decide whether the final diagnosis was in situ, minimally invasive or invasive adenocarcinoma. Results: The kappa value for the agreement in determining the dominant pattern among the pathologists was 0.36 (p< 0.001), with the values for the lepidic, acinar, papillary, solid, micropapillary patterns and mucinous character of adenocarcinoma being 0.34, 0.28, 0.30, 0.80, 0.16 and 0.38 respectively (p< 0.001, p< 0.001, p< 0.001, p< 0.001, p< 0.001, p< 0.001). None of the cases was diagnosed as in situ adenocarcinoma. On the other hand, the kappa value for the agreement in differentiating minimally invasive from invasive adenocarcinoma among reviewers was 0.17 (p< 0.001). Conclusion: The agreement among pathologists in determining the subtype of lung adenocarcinomas that depends on the identification of the dominant pattern was at intermediate level. In addition, the agreement in deciding whether the case is minimally invasive or invasive, was at low level. The criteria defining the histological patterns should be clarified and described in more detail. Educational activities and larger multicenter studies might be helpful in improving the agreement and standardization.
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    EML4-ALK-positive lung adenocarcinoma presenting an unusual metastatic pattern in a 29-year-old woman who is alive and well in her third year follow up: A case report
    (ELSEVIER SCIENCE BV, 2017-01-01) Tokat, Fatma; Zeren, Handan; Barut, Pinar; Tansan, Sualp; Ince, Umit
    Non-small cell lung cancer (NSCLC) is a frequent tumor entity with high mortality. Although several newly discovered chromosomal translocations and mutations opened new horizons for targeted therapy, literature still lacks large series of NSCLC with chromosomal abberations and their correlations with histological and clinical features. We present a case of echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) translocation positive adenocarcinoma of the lung with an unusual metastatic pattern in a 29-year-old young woman. Conclusion: Young adult non-smoker female patients with an unexplained pleural effusion and signs of metastatic disease should alert the physicians straight away for all types of malignancies including lung cancer. Any skin lesions should be evaluated carefully, biopsies should be done to exclude metastasis in urgency. On the other hand, an uncommon clinical presentation of a lung cancer requires corresponding molecular testing rapidly in order to offer the best treatment option. (C) 2017 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license.
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    The Impact of Sex Hormone-Binding Globulin Levels on Thromboembolic Events at Patients with Advanced Stage Adenocarcinoma
    (KARE PUBL, 2022-01-01) Bozkurt, Mustafa
    OBJECTIVE Several studies have shown that increased risk of venous thromboembolism (VTE) with hormonal contraceptives is mediated through the sex hormone-binding globulin (SHBG) through different pathways. Assuming SHBG as surrogate marker for hormonal stimulus as an increasing risk factor for VTE, we investigated if background SHBG has any impact on VTE in patient with advanced stage adenocarcinoma. Blood drawn from patients with VTE (n=45) and from patients without VTE (non-VTE