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Öğe Epithelial inclusions in the gallbladder: cytoisospora belli organisms or degenerative intracytoplasmic pas-positive hyaline globules(Nature Publishing Group, 2020) Pehlivanoğlu, Burçin; Erbarut Seven, İpek; Memiş, Bahar; Saka, Burcu; Bağcı, Pelin; Balcı, Serdar; Cheng, Jeanette; Baştürk, Olca; Reid, Michelle; Adsay, N. VolkanBackground: Lai et al. reported 18 cases of Cystoisospora belli in the gallbladders (GBs), detected incidentally in 0.5% ofimmunocompetent patients (PMID: 27158759). However, a recent molecular study failed to confirm this observation at molecular level(PMID: 30020094). Although Lai et al. indicated that Cystoisospora in the GB is quiescent in immunocompetent patients, this diagnosisnevertheless has major implications, resulting in extensive patient workup for undetected immunosuppression.Öğe Epithelial inclusions in the gallbladder: cytoisospora belli organisms or degenerative intracytoplasmic pas-positive hyaline globules(Nature Publishing Group, 2020) Pehlivanoğlu, Burçin; Erbarut Seven, İpek; Memiş, Bahar; Saka, Burcu; Bağcı, Pelin; Balcı, Serdar; Cheng, Jeanette; Baştürk, Olca; Reid, Michelle; Adsay, N. VolkanBackground: Lai et al. reported 18 cases of Cystoisospora belli in the gallbladders (GBs), detected incidentally in 0.5% ofimmunocompetent patients (PMID: 27158759). However, a recent molecular study failed to confirm this observation at molecular level(PMID: 30020094). Although Lai et al. indicated that Cystoisospora in the GB is quiescent in immunocompetent patients, this diagnosisnevertheless has major implications, resulting in extensive patient workup for undetected immunosuppression.Öğe Field risk ("field-effect"/"field-defect") in the gallbladder and biliary tree: An under-recognized phenomenon with major implications for management and carcinogenesis(Nature Publishing Group, 2019) Reid, Michelle; Losada, Hector; Muraki, Takashi; Pehlivanoğlu, Burçin; Memiş, Bahar; Koshiol, Jill; Bağcı, Pelin; Seven, İpek Erbarut; Balcı, Serdar; Saka, Burcu; Dursun, Nevra; Jang, Keetaek; Ohike, Nobuyuki; Tajiri, Takuma; Goodman, Michael; Carlos Roa, Juan; Araya, Juan; Bellolio, Enrique; Sarmiento, Juan; Xue, Yue; Baştürk, Olca; Adsay, Volkan[Abstract Not Available]Öğe Field risk ("field-effect"/"field-defect") in the gallbladder and biliary tree: An under-recognized phenomenon with major implications for management and carcinogenesis(Nature Publishing Group, 2019) Reid, Michelle; Losada, Hector; Muraki, Takashi; Pehlivanoğlu, Burçin; Memiş, Bahar; Koshiol, Jill; Bağcı, Pelin; Seven, İpek Erbarut; Balcı, Serdar; Saka, Burcu; Dursun, Nevra; Jang, Keetaek; Ohike, Nobuyuki; Tajiri, Takuma; Goodman, Michael; Carlos Roa, Juan; Araya, Juan; Bellolio, Enrique; Sarmiento, Juan; Xue, Yue; Baştürk, Olca; Adsay, Volkan[Abstract Not Available]Öğe Follicular cholecystitis: Reappraisal of incidence, definition, and clinicopathologic associations in an analysis of 2550 cholecystectomies(SAGE Publications Inc, 2020) Saka, Burcu; Memiş, Bahar; Erbarut Seven, İpek; Pehlivanoğlu, Burçin; Balcı, Serdar; Bağcı, Pelin; Reid, Michelle; Dursun, Nevra; Tapia Escalano, Oscar; Carlos Roa, Juan; Carlos Araya, Juan; Kong, So Yeon; Baştürk, Olca; Koshiol, Jill; Adsay, N. VolkanContext.Follicular cholecystitis (FC) is a poorly characterized entity.Objective.To determine its frequency/clinicopathologic associations.Design.A total of 2550 cholecystectomy specimens were examined. Two hundred three of these were consecutive routine cholecystectomies submitted entirely for microscopic examination to determine the relative frequency of incidental pathologies in gallbladders (GBs). The remainder had representative sampling. Underlying conditions were nonobstructive pathologies (1270 nonspecific cholecystitis), obstructive (62 distal biliary tract tumors, 35 primary sclerosing cholangitis, and 31 autoimmune pancreatitis), and neoplastic (n = 949). FC was defined as 3 distinct lymphoid follicles (LFs)/centimeter.Results.In the GBs totally submitted for microscopic examination, the true frequency of FC was found to be 2.5% (5/203), and in the representatively sampled group, it was 1.9%, with similar frequencies in nonobstructive, obstructive, and neoplastic cases (2.3%, 3.1%, and 1.3%, respectively, P = .77). When the 39 FC in nonneoplastic GBs contrasted with ordinary chronic cholecystitis, they were associated with older age (68 vs 49 years, P < .0001), similar gallstone frequency (68 vs 81%), female/male ratio (2.7 vs 2.6), and wall thickness (4 mm for both). None had lymphoma/parasites/Salmonella infection. Of 17 cases who had undergone gastric biopsy, 5 had chronic gastritis (2 with Helicobacter pylori). Microscopically, the LFs were the main inflammatory process often with minimal intervening inflammation. IgG4-positive plasma cell density was low (<10/high-power field) in 21/24(87.5%) cases.Conclusions.Follicular cholecystitis is seen in 2% of cholecystectomies, typically in significantly older patients, suggesting a deranged immune response. A third of the patients reveal biopsy-proven gastritis. FC does not seem to be associated with autoimmunity, lymphoma, or obstructive pathologies.Öğe Gallbladder polyps: Correlation of size and clinicopathologic characteristics based on updated definitions(Public Library of Science, 2020) Taşkın, Orhun C.; Baştürk, Olca; Reid, Michelle D.; Dursun, Nevra; Bağcı, Pelin; Saka, Burcu; Balcı, Serdar; Memiş, Bahar; Bellolio, Enrique; Araya, Juan Carlos; Roa, Juan Carlos; Tapia, Oscar; Losada, Hector; Sarmiento, Juan; Jang, Kee-Taek; Jang, Jin-Young; Pehlivanoğlu, Burçin; Erkan, Mert; Adsay, VolkanBackground Different perspectives exist regarding the clinicopathologic characteristics, biology and management of gallbladder polyps. Size is often used as the surrogate evidence of polyp behavior and size of >= 1cm is widely used as cholecystectomy indication. Most studies on this issue are based on the pathologic correlation of polyps clinically selected for resection, whereas, the data regarding the nature of polypoid lesions from pathology perspective -regardless of the cholecystectomy indication- is highly limited. Methods In this study, 4231 gallbladders -606 of which had gallbladder carcinoma- were reviewed carefully pathologically by the authors for polyps (defined as >= 2 mm). Separately, the cases that were diagnosed as "gallbladder polyps" in the surgical pathology databases were retrieved. Results 643 polyps identified accordingly were re-evaluated histopathologically. Mean age of all patients was 55 years (range: 20-94); mean polyp size was 9 mm. Among these 643 polyps, 223 (34.6%) were neoplastic: I. Non-neoplastic polyps (n = 420; 65.4%) were smaller (mean: 4.1 mm), occurred in younger patients (mean: 52 years). This group consisted of fibromyoglandular polyps (n = 196) per the updated classification, cholesterol polyps (n = 166), polypoid pyloric gland metaplasia (n = 41) and inflammatory polyps (n = 17). II. Neoplastic polyps were larger (mean: 21 mm), detected in older patients (mean: 61 years) and consisted of intra-cholecystic neoplasms (WHO's "adenomas" and "intracholecystic papillary neoplasms", >= 1 cm; n = 120), their "incipient" version (<1 cm) (n = 44), polypoid invasive carcinomas (n = 26) and non-neoplastic polyps with incidental dysplastic changes (n = 33). In terms of size cut-off correlations, overall, only 27% of polyps were >= 1 cm, 90% of which were neoplastic. All (except for one) >= 2 cm were neoplastic. However, 14% of polyps <1 cm were also neoplastic. Positive predictive value of >= 1 cm cut-off -which is widely used for cholecystectomy indication-, was 94.3% and negative predictive value was 85%. Conclusions Approximately a third of polypoid lesions in the cholecystectomies (regardless of the indication) prove to be neoplastic. The vast majority of (90%) of polyps >= 1 cm and virtually all of those >= 2 cm are neoplastic confirming the current impression that polyps >= 1 cm ought to be removed. However, this study also illustrates that 30% of the neoplastic polyps are <1 cm and therefore small polyps should also be closely watched, especially in older patients.Öğe Histopathologic infiltration pattern predicts metastasis and progression better than pT-stage and grade in well-differentiated pancreatic neuroendocrine tumors: A proposal for an infiltration-based morphologic grading system(Springer Nature, 2021) Taşkın, Orhun; Reid, Michelle; Bağcı Çulçi, Pelin; Balcı, Serdar; Armutlu, Ayşe; Demirtaş, Deniz; Pehlivanoğlu, Burçin; Saka, Burcu; Memiş, Bahar; Bozkurtlar, Emine; Leblebici, Can Berk; Corobea, Adelina Birceanu; Xue, Yue; Erkan, Mert; Kapran, Yersu; Sökmensüer, Cenk; Scarpa, Aldo; Luchini, Claudio; Baştürk, Olca; Adsay, Nazmi Volkan[Abstract Not Available]Öğe Histopathologic infiltration pattern predicts metastasis and progression better than pT-stage and grade in well-differentiated pancreatic neuroendocrine tumors: A proposal for an infiltration-based morphologic grading system(Springer Nature, 2021) Taşkın, Orhun; Reid, Michelle; Bağcı Çulçi, Pelin; Balcı, Serdar; Armutlu, Ayşe; Demirtaş, Deniz; Pehlivanoğlu, Burçin; Saka, Burcu; Memiş, Bahar; Bozkurtlar, Emine; Leblebici, Can Berk; Corobea, Adelina Birceanu; Xue, Yue; Erkan, Mert; Kapran, Yersu; Sökmensüer, Cenk; Scarpa, Aldo; Luchini, Claudio; Baştürk, Olca; Adsay, Nazmi Volkan[Abstract Not Available]Öğe Poorly cohesive cell (diffuse-infiltrative/signet ring cell) carcinomas of the gallbladder: Clinicopathological analysis of 24 cases identified in 628 gallbladder carcinomas(W B Saunders Co-Elsevier Inc, 2017) Tuncel, Deniz; Carlos Roa, Juan; Carlos Araya, Juan; Bellolio, Enrique; Villaseca, Miguel; Tapia, Oscar; Jang, Kee-Taek; Quigley, Brian; Saka, Burcu; Baştürk, Olca; Sarmiento, Juan; Losada, Hector F.; Patel, Samip; Reid, Michelle D.; Memiş, Bahar; Adsay, VolkanSignet ring cell carcinoma is an extremely rare type of gallbladder carcinoma: In the gastrointestinal system, carcinomas with single-cell or cord-like infiltration, previously called "diffuse-infiltrative" type or "signet ring cell," are now designated as "poorly cohesive cell" (PCC) type (regardless of with/without signet ring cells) in the World Health Organization 2010 classification. Six hundred twenty-eight primary invasive gallbladder carcinomas were reviewed for the PCC pattern. Twenty-four cases in which classical PCC pattern constituted greater than 50% of the tumor were included in the study. The mean age was 63 (range, 44-84) years. A strong female predominance was present (female/male ratio, 6.3 versus 3.9 for all gallbladder carcinomas). Most cases (79%) had advanced carcinoma (pT3+) in comparison with 51% of usual carcinomas (P < .01). All cases (100%) showed at least focal signet ring morphology (intracytoplasmic mucin), and this was predominant in 50%. Twelve cases (50%) demonstrated a focal invasive glandular component of the usual type. Overlying focal high-grade dysplasia was identified in 11 (46%). Due to block loss, immunohistochemistry could be performed in only 5 cases and revealed a profile similar to upper gastrointestinal carcinomas CK7++/CK20-+/CDX2+-/p53+. E-cadherin was decreased in the PCC component of all cases. The clinical course appeared to be more aggressive than ordinary gallbladder. carcinomas, with median survival of 3.3 months versus 11.8 months, which did not reach statistical significance (P = .06 by log-rank test). In conclusion, PCC carcinoma originating in the gallbladder should be kept in mind for the differential diagnosis of disseminated poorly differentiated carcinomas in the abdomen.Öğe Whipple-ables: clinicopathologic comparison of 1032 cancers removed by pancreatoduodenectomy based on pathologic re-review using refined site-specific criteria(Nature Publishing Group, 2020) Balcı, Serdar; Reid, Michelle; Erbarut Seven, İpek; Saka, Burcu; Pehlivanoğlu, Burçin; Memiş, Bahar; Bağcı, Pelin; Baştürk, Olca; Adsay, N. VolkanBackground: The literature is highly conflicted on the differential clinicopathologic characteristics of cancers arising from differentcompartments of the ampulla-pancreato-biliary tract and duodenum that are removed by pancreatoduodenectomy (Whipple) operation,largely due to differences in the criteria employed (or lack thereof) in the site-specific classification of these cancers until recently. Lack ofstandardized grossing approaches and careful evaluation appear to be significant contributors to the controversy.Öğe Whipple-ables: clinicopathologic comparison of 1032 cancers removed by pancreatoduodenectomy based on pathologic re-review using refined site-specific criteria(Nature Publishing Group, 2020) Balcı, Serdar; Reid, Michelle; Erbarut Seven, İpek; Saka, Burcu; Pehlivanoğlu, Burçin; Memiş, Bahar; Bağcı, Pelin; Baştürk, Olca; Adsay, N. VolkanBackground: The literature is highly conflicted on the differential clinicopathologic characteristics of cancers arising from differentcompartments of the ampulla-pancreato-biliary tract and duodenum that are removed by pancreatoduodenectomy (Whipple) operation,largely due to differences in the criteria employed (or lack thereof) in the site-specific classification of these cancers until recently. Lack ofstandardized grossing approaches and careful evaluation appear to be significant contributors to the controversy.Öğe Will the real "hepatobiliary cystadenocarcinoma" please stand up? True malignancy is exceedingly rare in cystic liver lesions; implications for pathologic evaluation and pre-operative decision making(Springer Nature, 2021) Armutlu, Ayşe; Quigley, Brian; Choi, Hegyong; Baştürk, Olca; Akkaş, Gizem; Pehlivanoğlu, Burçin; Memiş, Bahar; Jang, Keetaek; Erkan, Mert; Erkan, Burcu; Balcı, Serdar; Saka, Burcu; Bağcı Çulçi, Pelin; Farris, Alton Brad; Kooby, David; Martin, Diego; Kalb, Bobby; Maithel, Shishir; Sarmiento, Juan; Reid, Michelle; Adsay, Nazmi VolkanBackground: Concern for hepatic cysts being “hepatobiliary cystadenocarcinoma” along with the allegedly high frequency of its occurrence in the literature (up to 30% of the hepatic cysts) remains a major driver for the management of cystic lesions in this organ.Öğe Will the real "hepatobiliary cystadenocarcinoma" please stand up? True malignancy is exceedingly rare in cystic liver lesions; implications for pathologic evaluation and preoperative decision making(Springer Nature, 2021) Armutlu, Ayşe; Quigley, Brian; Choi, Hegyong; Baştürk, Olca; Akkaş, Gizem; Pehlivanoğlu, Burçin; Memiş, Bahar; Jang, Keetaek; Erkan, Mert; Erkan, Burcu; Balcı, Serdar; Saka, Burcu; Bağcı Çulçi, Pelin; Farris, Alton Brad; Kooby, David; Martin, Diego; Kalb, Bobby; Maithel, Shishir; Sarmiento, Juan; Reid, Michelle; Adsay, Nazmi Volkan[Abstract Not Available]
