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Öğe Assessment of demographic, clinical and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis(Turkish Assoc Trauma Emergency Surgery, 2021) Akbulut, Sami; Bahce, Zeynep Sener; Oztas, Tulin; Gumus, Serdar; Sogutcu, Nilgun; Sakarya, Hamdi; Gok, Ali Fuat KaanBACKGROUND: To compare the clinical, biochemical, and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis (AAp). METHODS: The demographic, biochemical and histopathological data of 8206 patients who underwent appendectomy for AAp between January 2006 and March 2014 were retrospectively analyzed in this study. Patients were compared regarding the following characteristics: disruption by season (autumn vs. winter vs. spring vs. summer), working days (weekdays vs. weekends), histopathological findings (AAp vs. normal appendix [NAp]) and histopathological subgroup (non-perforated AAp vs. perforated AAp vs. NAp). RESULTS: Of the 8206 patients aged between 16 and 89 years, 4763 (58.0%) were male. Appendectomy distribution by season was as follows: autumn (n=1959; 23.9%), winter (n=2062; 25.1%), spring (n=2061; 25.1%) and summer (n=2124, 25.9%). NAp rates were higher in summer than those in other seasons. White blood cell (WBC) and neutrophil levels were significantly higher in autumn and winter compared with those in other seasons. In total, 6120 (74.6%) appendectomies occurred on weekdays and 2086 (25.4%) on weekends. WBC and neutrophil levels were significantly higher on weekends than those on weekdays. Appendectomy distribution by histopathological groups as follows: AAp (n=7414; 90.3%) and NAp (n=792; 9.7%). Appendectomy distribution by histopathological subgroups was as follows: non-perforated AAp (n=6966; 84.9%), perforated AAp (n=448; 5.5%), and NAp (n=792; 9.7%). WBC, neutrophil, and TBil levels in the non-perforated and perforated AAp groups were significantly higher than in the NAp group. While most of the patients with perforated AAp (62.1%) and non-perforated AAp (59.6%) were males, most of the patients with NAp (58.1%) were females. CONCLUSION: This study suggests that a relationship exists between demographic features, histopathological findings of appendectomy specimens, seasons, days of the week, and working days in patients undergoing appendectomy.Öğe Assessment of the relationship between clinical and histopathological features in cases of thyroidectomy(Edizioni Luigi Pozzi, 2018) Yagmur, Yusuf; Akbulut, Sami; Sakarya, Hamdi; Sogutcu, Nilgun; Gumus, SerdarAim: The aim of this study is to evaluate the relationship between clinical parameters and ultimate histopathologic features of patients underwent thyroid surgery. METHOD: Demographic and clinicopathologic parameters of patients who underwent thyroid surgery for benign or malignant disease in our clinic between June 2006 and March 2014 were retrospectively reviewed. Pearson's Chi-Square, Independent Sample T test, ROC Curve and Youden J Index were used to investigate whether there was any relationship between the clinical parameters and permanent histopathologic features of patients. RESULTS: A total of 3059 patients (Benign: 2727; Malign: 332) aged between 15 and 90 years were reviewed. The patients age was higher in malign group (mean +/- SD: 468 +/- 4.2) than benign group (mean +/- SD: 43.7 +/- 12.9 yr) and this difference was statistically significant (p <0.001). The nodule diameter (mean +/- SD: 30.8 +/- 13.5 mm) was greater in malign group than the benign group (mean +/- SD: 28.3 +/- 13.4 mm) and this difference was statistically significant (p = 0.002). The sensitivity and specificity rates of the most appropriate cut-off point (> 26 mm) for the nodule size were 60% and 49.05%, respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAB were calculated as 4.17 %, 100 %, 100 %, 89.96% and 90 %, respectively. CONCLUSION: This study showed that higher age and greater nodule diameter (> 26 mm) are associated with malignancy.Öğe Coexistence of Ovarian Granulose Cell Tumor, Congenital Adrenal Hyperplasia, and Triple Translocation: Is a Consequence or Coincidence?(Springer, 2021) Akbulut, Sami; Ceylan, Senay Durmaz; Tuncali, Timur; Sogutcu, NilgunPurpose Congenital adrenal hyperplasia (CAH) is rare autosomal recessive disease. CAH due to 21-hydroxylase deficiency accounts for 95% of cases. We aimed to share the first case of coexistence of simple virilizing-type congenital adrenal hyperplasia [I172N mutation in the CYP21A], triple translocation [t(9;11;12)], and ovarian granulose cell tumor. Methods A 59-year-old female patient was presented to our clinic, complaining with abdominal pain and distension. Physical examination revealed palpable abdominal mass, virilism, ambiguous genitalia, clitoramegaly, and hyperpigmentation. Contrast-enhanced abdominal computed tomography showed a giant mass originating from the right tubo-ovarian structure. Results The patient was operated in the light of the clinico-radiological features mentioned above. A giant mass weighing 3500 g was detected on the right tubo-ovarian structure during laparotomy, and mass was excised with right tubo-ovarian structure. Immunohistochemical examination revealed ovarian granulosa cell tumor. The high serum concentration of 17-OH progesterone was measured at baseline and after 250-mu g bolus of synthetic ACTH. In genetic analysis, we screened for six-point mutations, large deletions, and non-common mutations using restriction fragment length polymorphism (RFLP) methods, PCR, and sequencing of CYP21 gene respectively. The patient was detected to be homozygous for the I172N mutation. In addition, 50% of the metaphases examined had triple translocation [t(9;11;12)]. Conclusion The coexistence of congenital adrenal hyperplasia, triple chromosomal translocations, and ovarian granulosa cell tumor has not been described previously. This coexistence may be a sign of a new syndrome.Öğe Coexistence of tuberculosis and extranodal marginal zone lymphoma of the thyroid gland: Case report and literature review(Elsevier Sci Ltd, 2022) Akbulut, Sami; Demyati, Khaled; Yavuz, Ridvan; Sogutcu, Nilgun; Samdanci, Emine Turkmen; Yagmur, YusufIntroduction: Primary thyroid tuberculosis (TB) is rare even in countries where TB disease is endemic, with the prevalence ranging from 0.1 to 1.15%. Primary thyroid lymphoma is uncommon, and the majority of lymphomas arising in the thyroid gland are non-Hodgkin's lymphomas of B-cell origin, of which about 25% is extranodal marginal zone B cell lymphoma (MALToma). Case presentation: An 86 -year-old Turkish female patient with thyroid nodules and cervical lymphadenopathies presented with large multinodular goiter and compressive symptoms. Total thyroidectomy and central lymph node dissection were performed. The revised histological and immunohistochemical revealed the coexistence of thyroid TB and MALToma. The patient received an anti-TB treatment for six months before a revised histopathological examination. About seven months after anti-TB treatment, the patient died due to an unknown cause. Clinical discussion: Although six cases of thyroid TB and papillary thyroid cancer have been documented in the medical literature, no cases of TB and MALToma coexistence have been published so far, to our knowledge. Another essential feature of this study is that the initial pathological examination was reported as thyroid TB. A subsequent re-examination revealed that the patient had both TB and MALT lymphoma. Conclusion: We discuss this rare association and the dilemma encountered in the diagnosis and management of this patient with a review of the literature.Öğe Relationship between clinical and histopathological features of patients undergoing cholecystectomy(Termedia Publishing House Ltd, 2020) Akbulut, Sami; Yagmur, Yusuf; Sakarya, Hamdi; Bahce, Zeynep Sener; Gumus, Serdar; Sogutcu, NilgunIntroduction: Cholelithiasis is most common disease of the gallbladder and cholecystectomy is the one of the most performed surgical procedure worldwide. Aim: To assess the relationship between the demographic, biochemical, and histopathological variables of patients who underwent cholecystectomy. Material and methods: Demographic, biochemical, and histopathological data of 5077 patients undergoing cholecystectomy were compared in terms of two different aspects: open cholecystectomy (OC group; n = 2090) versus laparoscopic cholecystectomy (LC group; n = 2987), and an elective group (n = 4814) versus an emergency group (n = 263). Results: A total of 5077 patients aged between 13 and 97 years were included in the study. Aspartate aminotransferase (AST) levels, alanine aminotransferase (ALT) levels, mean platelet volume, and prevalence of acute/chronic cholecystitis were significantly higher in the LC group than in the OC group. On the other hand, age, direct bilirubin level, thrombocyte count, and prevalence of gallbladder cancer/gangrenous cholecystitis were significantly higher in the OC group than in the LC group. Levels of AST, ALT, white blood cells, neutrophils, and some prevalence of acute/chronic active cholecystitis were higher in the emergency group than in the elective group. On the other hand, the lymphocyte count and prevalence of chronic cholecystitis/hyperplastic polyps were higher in the elective group than in the emergency group. Histopathological analysis identified 32 patients with malignant gallbladder cancer as follows: adenocarcinoma (n = 21), mucinous adenocarcinoma (n = 3), papillary adenocarcinoma (n = 3), adenosquamous carcinoma (n = 1), clear cell adenocarcinoma (n = 2), squamous carcinoma (n = 1), and hepatocellular carcinoma metastasis (n = 1). Conclusions: Even when the appearance of gallbladder specimens is normal, histopathological assessment allows for early diagnosis of many unusual findings such as gallbladder cancer.
