Araştırma Çıktıları
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Item What does the Data of 354,725 Patients from Turkey Tell Us About Cervical Smear Epithelial Cell Abnormalities? - The Epithelial Cell Abnormality Rate is Increasing - Quality Control Studies and Corrective Activity are Musts(DE GRUYTER OPEN LTD, 2017-01-01) Turkmen, Ilknur Cetinaslan; Usubutun, Alp; Cakir, Asli; Aydin, Ozlem; Bolat, Filiz Aka; Akbulut, Metin; Altinay, Serdar; Arici, Sema; Aslan, Figen; Astarci, Muzeyyen; Bagir, Emine Kilic; Bas, Yilmaz; Bassullu, Nuray; Celik, Betul; Cetiner, Handan; Cobanoglu, Bengu; Aydin, Abdullah; Demir, Hale; Dogan, Hayriye Tatli; Eken, Kamile Gulcin; Erhan, Selma Sengiz; Erdogan, Gulgun; Erdogan, Kivilcim Eren; Eren, Funda; Ersoz, Safak; Firat, Pinar; Gurses, Iclal; Haberal, Nihan; Kahraman, Dudu Solakoglu; Kamali, Gulcin Harman; Karabulut, Yasemin Yuyucu; Kefeli, Mehmet; Koyuncuoglu, Meral; Koseoglu, R. Dogan; Muezzinoglu, Bahar; Onal, Binnur; Onder, Sevgen; Ozcan, Zuhal; Kimiloglu, Elife; Ozer, Hatice; Sonmez, F. Cavide; Sahin, Sevinc; Sahin, Nurhan; Yalta, TulinObjective: There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories. Material and Method: In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire. Results: The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08\% in the total 354,725 smears and ranging between 0.3\% to 16.64\% among centers. The Atypical squamous cells/Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers. Conclusion: There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.Item Burkitt lymphoma with a granulomatous reaction: an M1/Th1-polarised microenvironment is associated with controlled growth and spontaneous regression(WILEY, 2022-01-01) Granai, Massimo; Lazzi, Stefano; Mancini, Virginia; Akarca, Ayse; Santi, Raffaella; Vergoni, Federica; Sorrentino, Ester; Guazzo, Raffaella; Mundo, Lucia; Cevenini, Gabriele; Tripodo, Claudio; Di Stefano, Gioia; Puccini, Benedetta; Ponzoni, Maurilio; Sabattini, Elena; Agostinelli, Claudio; Bassullu, Nuray; Tecimer, Tulay; Demiroz, Ahu Senem; Mnango, Leah; Dirnhofer, Stephan; Quintanilla-Martinez, Leticia; Marafioti, Teresa; Fend, Falko; Leoncini, LorenzoAims Burkitt lymphoma (BL) is an aggressive B-cell lymphoma that, in some instances, may show a granulomatous reaction associated with a favourable prognosis and occasional spontaneous regression. In the present study, we aimed to define the tumour microenvironment (TME) in four such cases, two of which regressed spontaneously. Methods and results All cases showed aggregates of tumour cells with the typical morphology, molecular cytogenetics and immunophenotype of BL surrounded by a florid epithelioid granulomatous reaction. All four cases were Epstein-Barr virus (EBV)-positive with type I latency. Investigation of the TME showed similar features in all four cases. The analysis revealed a proinflammatory response triggered by Th1 lymphocytes and M1 polarised macrophages encircling the neoplastic cells with a peculiar topographic distribution. Conclusions Our data provide an in-vivo picture of the role that specific immune cell subsets might play during the early phase of BL, which may be capable of maintaining the tumour in a self-limited state or inducing its regression. These novel results may provide insights into new potential therapeutic avenues in EBV-positive BL patients in the era of cellular immunotherapy.Item Does it take three to tango? An unsuspected multimorbidity of CD8(+) T cell lymphoproliferative disorder, malaria, and EBV infection(BMC, 2018-01-01) Ekemen, Suheyla; Uzay, Ant; Bassullu, Nuray; Dikicioglu-Cetin, Emel; Matsuda, Kyoko; Ince, Umit; Coban, CevayirBackground: Malaria is known to cause acute and deadly complications. However, malaria can cause unforeseen pathologies due to its chronicity. It increases the risk of endemic Burkitt Lymphoma development by inducing DNA damage in germinal centre (GC) B cells, and leading higher frequency of Epstein-Barr virus (EBV)-infected cells in GCs. EBV is well known for its tropism for B cells. However, less is known about EBV's interaction with T cells and its association with T cell lymphoma. Case presentation: A 43-year-old Sudanese male admitted to hospital in Istanbul, Turkey, a non-endemic country, with hyperpigmented painful skin rashes on his whole body. A complete blood count and a peripheral blood smear during admission revealed large granular lymphocytes (LGLs) with abnormally higher CD8 T cell numbers. Additional skin biopsy and pathology results were compatible with CD8(+) T cell lymphoproliferative disorder with skin involvement. Patient was treated and discharged. However, a pathologist noticed unusual structures in skin tissue samples. Careful evaluation of skin biopsy samples by polarized microscopy revealed birefringent crystalloid structures resembling malarial haemozoin mainly loaded in macrophages and giant histiocytes. After purification of DNA from the skin biopsy samples, nested PCR was performed for the detection of Plasmodium parasites and Plasmodium falciparum DNA was amplified. Because, the co-presence of EBV infection with malaria is a well-known aetiology of lymphoma, EBV-early RNA (EBER) transcripts were investigated in paraffin-embedded tissue samples and found to be positive in macrophage-like histiocytes. Conclusions: This is a unique case of malaria and EBV infection in a T-LGL lymphoma patient who presented in a non-endemic country. This case emphasizes the clinical importance of EBV monitoring in T-LGL patients with skin involvement. Notably, Plasmodium infection should be examined in patients from malaria endemic regions by pathological and molecular investigations.