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  • Küçük Resim
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    A retrospective evaluation of the epithelial changes/lesions and neoplasms of the Gallbladder in Turkey and a review of the existing sampling methods: A multicentre study
    (Federation of Turkish Pathology Societies, 2018) Esendağlı, Güldal; Akarca, Fahire Göknur; Balcı, Serdar; Argon, Asuman; Şengiz Erhan, Selma; Turhan, Nesrin; İnce Zengin, Neslihan; Hallaç Keser, Sevinç; Çelik, Betül; Bulut, Tangül; Abdullazade, Samir; Erden, Esra; Savaş, Berna; Bostan, Temmuz; Sağol, Özgül; Aysal Ağalar, Anıl; Kepil, Nuray; Karslıoğlu, Yıldırım; Günal, Armağan; Markoç, Fatma; Saka, Burcu; Özgün, Gonca; Özdamar, Şükrü Oğuz; Bahadır, Burak; Kaymaz, Esin; Işık, Emre; Ayhan, Semin; Tuncel, Deniz; Özgüven Yılmaz, Banu; Çelik, Sevinç; Karabacak, Tuba; Erbarut Seven, İpek; Ataizi Çelikel, Çiğdem; Gücin, Zuhal; Ekinci, Özgür; Akyol, Gülen
    Objective: As there is continuing disagreement among the observers on the differential diagnosis between the epithelial changes/lesions and neoplasms of the gallbladder, this multicentre study was planned in order to assess the rate of the epithelial gallbladder lesions in Turkey and to propose microscopy and macroscopy protocols. Material and Method: With the participation of 22 institutions around Turkey that were included in the Hepato-Pancreato-Biliary Study Group, 89,324 cholecystectomy specimens sampled from 2003 to 2016 were retrospectively evaluated. The numbers of adenocarcinomas, dysplasias, intracholecystic neoplasms/adenomas, intestinal metaplasias and reactive atypia were identified with the review of pathology reports and the regional and countrywide incidence rates were presented in percentages. Results: Epithelial changes/lesions were reported in 6% of cholecystectomy materials. Of these epithelial lesions, 7% were reported as adenocarcinoma, 0.9% as high-grade dysplasia, 4% as low-grade dysplasia, 7.8% as reactive/regenerative atypia, 1.7% as neoplastic polyp, and 15.6% as intestinal metaplasia. The remaining lesions (63%) primarily included non-neoplastic polypoids/hyperplastic lesions and antral/pyloric metaplasia. There were also differences between pathology laboratories. Conclusion: The major causes of the difference in reporting these epithelial changes/lesions and neoplasms include the differences related to the institute’s oncological surgery frequency, sampling protocols, geographical dissimilarities, and differences in the diagnoses/interpretations of the pathologists. It seems that the diagnosis may change if new sections are taken from the specimen when any epithelial abnormality is seen during microscopic examination of the cholecystectomy materials.
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    Stereotactic body radioablation therapy as an immediate and early term antiarrhythmic palliative therapeutic choice in patients with refractory ventricular tachycardia
    (Springer, 2023) Aras, Dursun; Çetin, Elif Hande Özcan; Öztürk, Hüseyin Furkan; Özdemir, Elif; Kara, Meryem; Ekizler, Firdevs Ayşenur; Özeke, Özcan; Özcan, Fırat; Korkmaz, Ahmet; Kervan, Ümit; Turhan, Nesrin; Coşkun, Nazım; Topaloğlu, Serkan
    Background: Stereotactic body radioablation therapy (SBRT) has recently been introduced with the ability to provide ablative energy noninvasively to arrhythmogenic substrate while reducing damage to normal cardiac tissue nearby and minimizing patients’ procedural risk. There is still debate regarding whether SBRT has a predominant effect in the early or late period after the procedure. We sought to assess the time course of SBRT’s efficacy as well as the value of using a blanking period following a SBRT session. Methods: Eight patients (mean age 58 ± 14 years) underwent eight SBRT sessions for refractory ventricular tachycardia (VT). SBRT was given using a linear accelerator device with a total dose of 25 Gy to the targeted area. Results: During a median follow-up of 8 months, all patients demonstrated VT recurrences; however, implantable cardioverter-defibrillator (ICD) and anti-tachycardia pacing therapies were significantly reduced with SBRT (8.46 to 0.83/per month, p = 0.047; 18.50 to 3.29/per month, p = 0.036, respectively). While analyzing the temporal SBRT outcomes, the 2 weeks to 3 months period demonstrated the most favorable outcomes. After 6 months, one patient was ICD therapy-free and the remaining patients demonstrated VT episodes. Conclusions: Our findings showed that the SBRT was associated with a marked reduction in the burden of VT and ICD interventions especially during first 3 months. Although SBRT does not seem to succeed complete termination of VT in long-term period, our findings support the strategy that SBRT can be utilized for immediate antiarrhythmic palliation in critically ill patients with otherwise untreatable refractory VT and electrical storm.
  • Küçük Resim
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    The contribution of additional sampling in cholecystectomy materials: A multicenter prospective study
    (Federation of Turkish Pathology Societies, 2020) Abdullazade, Samir; Akarca, Fahire Göknur; Esendağlı, Güldal; Turhan, Nesrin; Erden, Esra; Savaş, Berna; Markoç, Fatma; Tuncel, Deniz; Özgüven Yılmaz, Banu; Saka, Burcu; Hallaç Keser, Sevinç; Şengiz Erhan, Selma; Gücin, Zühal; Sağol, Özgül; Ağalar, Anıl Aysal; Çelik, Sevinç; Özer, Hatice; Erbarut Seven, İpek; Ataizi Çelikel, Çiğdem; Ekinci, Özgür; Eğilmez, Hatice Reyhan; Balcı, Serdar; Akyol, Gülen
    Objective: Cholecystectomy materials arc frequently encountered in routine practice. The aim of this study was to determine the true frequency of gallbladder lesions, the diagnostic consistency, and standardization of reports after macroscopic sampling and microscopic evaluation based on previously defined criteria.Material and Method: 14 institutions participated in the study within the Hepato-Pancreato-Biliary Pathology Study Group. Routinely examined cholecystectomies within the last year were included in the study in these institutions. Additional sampling was performed according to the indications and criteria. The number of blocks and samples taken in the first macroscopic examination and the number of blocks and samples taken in the additional sampling were determined and the rate of diagnostic contribution of the additional examination was determined.Results: A total of 5,244 cholecystectomy materials from 14 institutions were included in the study. Additional sampling was found to be necessary in 576 cases (10.98%) from all institutions. In the first macroscopic sampling, the mean of the numbers of samples was approximately 4 and the number of blocks was 2. The mean of the numbers of additional samples and blocks was approximately 8 and 4, respectively. The diagnosis was changed in 144 of the 576 new sampled cases while the remaining 432 stayed unaltered.Conclusion: In this study, it was observed that new sampling after the first microscopic examination of cholecystectomy materials contributed to the diagnosis. It was also shown that the necessity of having standard criteria for macroscopic and microscopic examination plays an important role in making the correct diagnosis.