Publications by authors named "Figen Demirkazık"

25 Publications

  • Page 1 of 1

Magnetic resonance imaging findings of invasive breast cancer in different histological grades and different histopathological types.

Clin Imaging 2021 Feb 10;76:98-103. Epub 2021 Feb 10.

Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey.

Background: The aim of this study was to evaluate the magnetic resonance imaging (MRI) findings of invasive breast cancer in different histopathological types (invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC) and mixed ductal-lobular carcinoma (MDLC)) and different histological grades.

Methods: A retrospective review was made of 1256 patients who underwent breast MRI at our hospital between January 2015 and December 2018. A total of 152 lesions (27 ILC, 102 IDC, 23 MDLC and 20 grade 1, 83 grade 2 and 49 grade 3) were included in the study. All the lesions were evaluated according to size, shape, margin, dynamic curve, ADC value and T2 signal intensity ratio (SIR).

Results: Most of the lesions tended to show type 2 and type 3 dynamic curve, type 1 dynamic curve was more commonly seen in ILC and grade 1 groups. IDC showed higher T2 SIR than the other types and grade 3 showed higher T2 SIR than other grades (p< 0,05) There was no statistically significant difference between the groups according to morphological features and mean ADC values (p > 0,05).

Conclusion: T2 SIR and dynamic curve can help the radiologists predict histopathological findings while morphological features and ADC values were not helpful in distinguishing histological types and grades.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clinimag.2021.01.039DOI Listing
February 2021

Does Internal Mammary Node Irradiation for Breast Cancer Make a Significant Difference to the Diameter of the Internal Mammary Artery? Correlation with Computed Tomography.

Breast Care (Basel) 2020 Dec 22;15(6):635-641. Epub 2020 Jun 22.

Department of Radiology, Hacettepe University Medical School, Ankara, Turkey.

Objective: Lymphatic irradiation in breast cancer improves locoregional control and has been shown to decrease distant metastasis. However, irradiation also accelerates the formation of atherosclerosis and can cause stenosis, not only in the coronary arteries but also in the internal mammary artery (IMA). The aim of this study was to investigate the effects of radiation on IMAs via computed tomography (CT).

Methods: We reviewed the data of 3,612 patients with breast cancer treated with radiotherapy (RT) between January 2010 and December 2016. We included 239 patients with appropriate imaging and nodal irradiation in the study. All patients were treated with lymphatic irradiation of 46-50 Gy, and a boost dose (6-10 Gy) to the involved internal mammary nodes (IMNs) when imaging studies demonstrated pathological enlargement. Bilateral IMA diameter and the presence of calcification were assessed via thin contrast-enhanced CT and those of ipsilateral irradiated IMAs were compared with those of contralateral nonirradiated IMAs.

Results: The mean diameter of irradiated IMAs was significantly shorter than that of nonirradiated IMAs, regardless of laterality. All vascular calcifications were determined on the irradiated side. A boost dose of radiation to the IMNs and radiation technique did not significantly affect the IMA diameter or the presence of calcification.

Conclusions: The diameter of the IMA is decreased due to RT regardless of laterality, radiation technique, and administration of a boost dose. Evaluation of vessels on CT before coronary artery bypass graft or flap reconstruction can help the surgeon select the most appropriate vessel.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000508244DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768163PMC
December 2020

COVID-19 pneumonia: the great radiological mimicker.

Insights Imaging 2020 Nov 23;11(1):118. Epub 2020 Nov 23.

Department of Radiology, School of Medicine, Tıp Fakültesi Hastanesi, Hacettepe University, 06100, Sıhhiye, Ankara, Turkey.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread worldwide since December 2019. Although the reference diagnostic test is a real-time reverse transcription-polymerase chain reaction (RT-PCR), chest-computed tomography (CT) has been frequently used in diagnosis because of the low sensitivity rates of RT-PCR. CT findings of COVID-19 are well described in the literature and include predominantly peripheral, bilateral ground-glass opacities (GGOs), combination of GGOs with consolidations, and/or septal thickening creating a "crazy-paving" pattern. Longitudinal changes of typical CT findings and less reported findings (air bronchograms, CT halo sign, and reverse halo sign) may mimic a wide range of lung pathologies radiologically. Moreover, accompanying and underlying lung abnormalities may interfere with the CT findings of COVID-19 pneumonia. The diseases that COVID-19 pneumonia may mimic can be broadly classified as infectious or non-infectious diseases (pulmonary edema, hemorrhage, neoplasms, organizing pneumonia, pulmonary alveolar proteinosis, sarcoidosis, pulmonary infarction, interstitial lung diseases, and aspiration pneumonia). We summarize the imaging findings of COVID-19 and the aforementioned lung pathologies that COVID-19 pneumonia may mimic. We also discuss the features that may aid in the differential diagnosis, as the disease continues to spread and will be one of our main differential diagnoses some time more.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13244-020-00933-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7681181PMC
November 2020

Lung and kidney perfusion deficits diagnosed by dual-energy computed tomography in patients with COVID-19-related systemic microangiopathy.

Eur Radiol 2021 Feb 29;31(2):1090-1099. Epub 2020 Aug 29.

Faculty of Medicine, Department of Radiology, Hacettepe University, Sihhiye, Ankara, Turkey.

Objectives: There is increasing evidence that thrombotic events occur in patients with coronavirus disease (COVID-19). We evaluated lung and kidney perfusion abnormalities in patients with COVID-19 by dual-energy computed tomography (DECT) and investigated the role of perfusion abnormalities on disease severity as a sign of microvascular obstruction.

Methods: Thirty-one patients with COVID-19 who underwent pulmonary DECT angiography and were suspected of having pulmonary thromboembolism were included. Pulmonary and kidney images were reviewed. Patient characteristics and laboratory findings were compared between those with and without lung perfusion deficits (PDs).

Results: DECT images showed PDs in eight patients (25.8%), which were not overlapping with areas of ground-glass opacity or consolidation. Among these patients, two had pulmonary thromboembolism confirmed by CT angiography. Patients with PDs had a longer hospital stay (p = 0.14), higher intensive care unit admission rates (p = 0.02), and more severe disease (p = 0.01). In the PD group, serum ferritin, aspartate aminotransferase, fibrinogen, D-dimer, C-reactive protein, and troponin levels were significantly higher, whereas albumin level was lower (p < 0.05). D-dimer levels ≥ 0.485 μg/L predicted PD with 100% specificity and 87% sensitivity. Renal iodine maps showed heterogeneous enhancement consistent with perfusion abnormalities in 13 patients (50%) with lower sodium levels (p = 0.03).

Conclusions: We found that a large proportion of patients with mild-to-moderate COVID-19 had PDs in their lungs and kidneys, which may be suggestive of the presence of systemic microangiopathy with micro-thrombosis. These findings help in understanding the physiology of hypoxemia and may have implications in the management of patients with COVID-19, such as early indications of thromboprophylaxis or anticoagulants and optimizing oxygenation strategies.

Key Points: • Pulmonary perfusion abnormalities in COVID-19 patients, associated with disease severity, can be detected by pulmonary DECT. • A cutoff value of 0.485 μg/L for D-dimer plasma levels predicted lung perfusion deficits with 100% specificity and 87% sensitivity (AUROC, 0.957). • Perfusion abnormalities in the kidney are suggestive of a subclinical systemic microvascular obstruction in these patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00330-020-07155-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455509PMC
February 2021

Imaging findings and classification of the common and uncommon male breast diseases.

Insights Imaging 2020 Feb 18;11(1):27. Epub 2020 Feb 18.

Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey.

Male breast hosts various pathological conditions just like "female breast." However, histo-anatomical diversities with female breast lead to many differences regarding the frequency and presentation of diseases, the radiologic appearance of lesions, the diagnostic algorithm, and malignity features.Radiological modalities may play an important role in evaluating male breast lesions. Although some imaging findings are non-specific, having knowledge of certain imaging characteristics and radiologic patterns is the key to reduce the number of differential diagnoses or to reach an accurate diagnosis.Male breast imaging is mostly based on physical examination and is required for the complaints of palpable mass, breast enlargement, tenderness, nipple discharge, and nipple-skin changes. The majority of the male breast lumps are benign and the most common reason is gynecomastia. Although it is difficult to exclude malignancy in some cases, gynecomastia often has distinguishable imaging features. Pseudogynecomastia is another differential diagnosis that may be confused with gynecomastia. The distinction is important for the treatment plan.Apart from gynecomastia, other male breast lesions form a highly heterogeneous group and can be classified based on "Tissue origin," "Histopathological type and behavior," and "Radiologic features" for both simplification and comprehensive understanding.This article mainly focuses on emphasizing the results of basic histo-anatomical differences of male and female breasts, classifying male breast lesions, covering the spectrum of male breast diseases, and assisting radiologists in recognizing the imaging findings, in interpreting them through a holistic approach, in making a differential diagnosis, and in being a part of proper patient management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13244-019-0834-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7028902PMC
February 2020

Can Radiologist and Pathologist Reach The Truth Together in The Diagnosis of Benign Fibroepithelial Lesions?

Eur J Breast Health 2019 Jul 1;15(3):176-182. Epub 2019 Jul 1.

Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.

Objective: Benign fibroepithelial lesions (BFL) lesions of the breast are various and predominantly benign, although a few can be locally aggressive. Definitive diagnosis of some BFL can be challenging from core needle biopsy (CNB). Radiological findings can help guide the management of the lesions. The aim of this study was to investigate the accuracy rate of CNB results and evaluate the radiological findings of the most common BFL according to the final excision pathology results. The secondary aim was to assess the contribution of the imaging findings to CNB results.

Materials And Methods: A retrospective review was made of 266 patients diagnosed with suspicious BFL, conventional fibroadenoma, complex fibroadenoma, cellular fibroadenoma and benign phyllodes tumor (PT). The study included 132 patients who underwent surgical excision. The radiological and histopathological findings were evaluated.

Results: While 66 patients were diagnosed with more descriptive results on CNB, the other 66 patients were diagnosed with suspicious BFL. Agreement between CNB and excisional pathology was good, when CNB provided a definite diagnosis. While conventional and complex fibroadenoma were observed to have hypo or normal vascularity, cellular fibroadenoma and PT showed hypervascularity. Oval shaped and homogeneous internal echo pattern were significantly associated with conventional fibroadenoma. A heterogeneous internal echo pattern was seen in complex fibroadenomas and PT.

Conclusion: CNB often reaches the correct diagnosis alone when it gives a definite diagnosis. The radiological findings which help in the differentiation of BFL are hypervascularity, oval shape and internal heterogeneity. More accurate results can be obtained when histopathological and radiological findings are evaluated together.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/ejbh.2019.4656DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619778PMC
July 2019

Imaging Findings and Clinicopathological Correlation of Breast Cancer in Women under 40 Years Old.

Eur J Breast Health 2019 Jul 1;15(3):147-152. Epub 2019 Jul 1.

Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey.

Objective: The aim of this study was to evaluate the clinical, imaging and histopathological features of breast cancer in patients aged under 40 years of age. The relationship between radiological characteristics and histopathological features was also investigated.

Materials And Methods: The study included 131 patients aged under 40 years, diagnosed pathologically with breast cancer. A retrospective evaluation was made of the imaging and clinicopathological findings and the relationship between pathological and imaging findings was investigated.

Results: Most of the cancers were detected from clinical symptoms, especially a palpable mass (76.3%). The most common histological type of tumor was invasive ductal carcinoma and 64.8% of the tumors were high grade tumors. The predominant features were irregular borders (92.4%), microlobulated-angulated contours (43.5%), hypo-homogeneous internal echogenicity (80.9%) on ultrasonography, and the presence of a mass (41.2%) and suspicious microcalcifications (40.2%) on mammography. Magnetic resonance imaging commonly showed mass enhancement (66.7%) with type 2 or 3 dynamic curve (92.6%). High-grade tumors were associated with posterior acoustic enhancement (p: 0.03) while low-grade tumors presented with spiculated margins more than high grade tumors (p: 0.04).

Conclusion: Breast cancer in women aged under 40 years usually presents with a self-detected palpable mass and can show different imaging findings according to the histological grade. Ultrasonography is the main modality for the diagnosis of breast cancer in young women, but mammography and magnetic resonance imaging can help in both diagnosis and evaluation of the extent of disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/ejbh.2019.4606DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619779PMC
July 2019

Comparison of MRI and US in Tumor Size Evaluation of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy.

Eur J Breast Health 2019 Apr 1;15(2):119-124. Epub 2019 Apr 1.

Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.

Objective: Magnetic resonance imaging (MRI) and ultrasonography (US) are commonly used in the pre-surgery determination of tumor size and the follow-up of breast cancer patients treated with neoadjuvant chemotherapy (NAC). The aim of this study was to compare the efficiency of preoperative MRI and US in tumor size evaluation of patients with breast cancer after NAC to guide clinicians on the appropriate treatment plan.

Materials And Methods: The study included a total of 75 patients who had undergone radiological follow-up, surgical treatment and pathological examination in our hospital between 2013 and 2016. Of these, 28 patients were followed-up with MRI and 47 with US. The dimension evaluations in pathology examination and on both MRI and US were based on the longest dimension of the tumor.

Results: There was no statistically significant difference between the tumor size measured pathologically and the size measured preoperatively on MRI (p=0.379). The tumor size measured on US before surgery was significantly smaller than the size measured in pathology (p=0.004). MRI did not overestimate by more than 10 mm in any patient, whereas US overestimated in 4 patients (8.6%). The correlation coefficient of MRI was higher than that of US (0.927 and 0.687, respectively).

Conclusion: MRI is superior to US in preoperative tumor size evaluation of patients receiving NAC.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/ejbh.2019.4547DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456278PMC
April 2019

Comparison of wire-guided localization and radio-guided occult lesionlocalization in preoperative localization of nonpalpable breast lesions.

Turk J Med Sci 2016 Dec 20;46(6):1829-1837. Epub 2016 Dec 20.

Department of Nuclear Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Background/aim: Breast lesions that are not palpable on physical examination but considered suspicious for malignancy on mammography or ultrasonography should be marked before surgery. Wire-guided localization (WGL) is the most frequently used method for preoperative marking of nonpalpable breast lesions (NPBLs). An alternative is marking by a radioactive agent (radio-guided occult lesion localization; ROLL). The present study aimed to compare WGL and ROLL for preoperative marking.

Materials And Methods: The study included 25 patients marked by ROLL and 11 patients marked by WGL. The groups were compared in terms of patient and lesion characteristics, method-related characteristics, hospital stay duration, complications, cosmetic outcomes, and rate of correct marking.

Results: Suspicious lesions were marked with a success rate of 95.6% by ROLL and 100% by WGL. Complications and pain sensation rates were found significantly lower in the ROLL group compared to WGL. Although ROLL was considered more advantageous in terms of hospital stay duration, positive surgical margins, cosmetic outcomes, and excision duration, the differences between the groups were not statistically significant.

Conclusion: ROLL, which is a simple, comfortable, and reliable method, could be used as an alternative to the WGL in preoperative marking of NPBLs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3906/sag-1507-162DOI Listing
December 2016

Efficiency of ultrasound and ultrasound-guided fine needle aspiration cytology in preoperative assessment of axillary lymph node metastases in breast cancer.

J Breast Cancer 2012 Jun 28;15(2):211-7. Epub 2012 Jun 28.

Department of Radiology, Hacettepe University, Ankara, Turkey.

Purpose: We performed this study to detect preoperative axillary metastases with ultrasound (US)-guided fine needle aspiration biopsy (FNAB), to eliminate the need for time-consuming and costly sentinel lymph node (SLN) scintigraphy and biopsy steps in the treatment of breast cancer patients, and in that of with suspicious US findings, and to evaluate the accuracy of preoperative US-guided FNAB for patients with suspicious lymph node metastases on US.

Methods: Patients with a suspicious breast lump or histopathologically proven breast cancer underwent breast-axillary US. Increase in lymph node size, cortical thickening, non-hilar cortical flow, and hilar changes were evaluated with gray scale-color Doppler US. FNAB was performed if US results were suspicious for malignancy.

Results: Thirty-eight axillary lymph nodes (ALN) underwent FNAB. ALN dissection, SLN scintigraphy, and biopsy steps were bypassed in 23 axillas with positive ALN FNAB (60.5%). The sensitivity of ALN FNAB was 88.46%; specificity and positive predictive value were 100%; and negative predictive value was 66.6% (inadequate cytology included; 76.7%, 100%, 100%, 53.3%, respectively). Asymmetrical cortical thickening, non-hilar cortical flow, and increase in hypoechogenity were only detected in metastatic nodes. Cortical thickening, and lymph node and breast mass size was higher in the metastatic group.

Conclusion: By performing FNAB on suspicious lymph nodes, the routine, high-cost SLN scintigraphy and intraoperative gamma probe steps may be skipped, and axilla dissection can be performed directly. This leads to the elimination of the need for SLN investigation in more than half of the patients. The assessment of ALN metastases with preoperative US-guided FNAB is a cost-effective method with high specificity, that eliminates the need for costly and time-consuming SLN scintigraphy and biopsy steps, and helps in preoperative staging.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4048/jbc.2012.15.2.211DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395745PMC
June 2012

Floating aortic thrombus in a patient with non-Hodgkin's Lymphoma.

Diagn Interv Radiol 2010 Mar 5;16(1):63-5. Epub 2009 Oct 5.

Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.

Aortic thrombus is a rare condition unless there is an underlying wall pathology such as atherosclerosis, aneurysm, dissection, or thrombus within the left heart chambers. It causes visceral or peripheral embolisms, and is fatal, if not treated. These characteristics make early diagnosis and therapy essential. We report here the computed tomography findings of a floating thrombus that hanged on to the normal aortic wall with a thin peduncle and caused peripheral embolism in a 58-year-old lymphoma patient who had no evident source of emboli.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4261/1305-3825.DIR.1226-07.1DOI Listing
March 2010

CT findings in immunocompromised patients with pulmonary infections.

Diagn Interv Radiol 2008 Jun;14(2):75-82

Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.

Purpose: To evaluate computed tomography (CT) findings of pulmonary infections in immunocompromised patients with hematologic malignancies, and to detect the accuracy of first-choice diagnoses.

Materials And Methods: CT chest scans of 57 immunocompromised patients who had pulmonary infections were evaluated retrospectively, and a first and second interpretation of etiology (first- and second-choice diagnosis) was proposed. The etiology of pulmonary infection was verified by microbiological tests such as blood, sputum, bronchoalveolar lavage (BAL) cultures, sputum, and BAL smears, or diagnosed on the basis of response to treatment and clinical follow-up.

Results: Nineteen patients had a bacterial infection, 20 patients had a fungal infection, 8 patients had a cytomegalovirus (CMV) infection, 8 patients had Pneumocystis jiroveci pneumonia (PCP) and 2 patients had a Mycobacterium tuberculosis infection. There were consolidations in 13 patients (68.4%) and areas of ground-glass attenuation and ground-glass nodules in 6 patients (31.6%) with bacterial infection. Six of 8 eight patients (75%) with CMV infection had centrilobular nodules associated with bronchial wall thickening and ground-glass areas and nodules. There were parenchymal nodules in 18 of 20 patients (90%) who had a fungal infection. All 8 patients who had PCP had bilateral areas of ground-glass densities on CT scans. The first-choice diagnosis was accurate in most of the fungal infections (95.0%) and PCP (87.5%), but was less accurate for bacterial and viral infections (73.7% and 75.0%, respectively). Neither of the 2 tuberculous infections was identified on the basis of CT findings.

Conclusion: In the evaluation of febrile immunocompromised patients, pulmonary fungal infection and PCP may be identified with high accuracy on the basis of CT findings.
View Article and Find Full Text PDF

Download full-text PDF

Source
June 2008

Wilms' tumor associated with vertebral anomalies.

J Pediatr Hematol Oncol 2008 May;30(5):394-5

Department of Pediatric Oncology, Institute of Oncology, Hacettepe University, Ankara, Turkey.

The association of Wilms tumor (WT) and vertebral disorders, such as hemivertebrae or fusion anomalies, have been described in literature. Here, we report a rare association of butterfly T3, T8 vertebrae and a T2, T7 hemivertebrae in a patient with WT, determined during initial examinations of tumoral extension. In patients with WT, investigation of vertebral malformations should be a part of diagnostic work-up.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MPH.0b013e318168e78eDOI Listing
May 2008

Isolated breast involvement at recurrence in a child with T-cell lymphomas.

Breast J 2007 Jan-Feb;13(1):97-8

Department of Pediatric Oncology, Institute of Oncology, Hacettepe University, Ankara, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/j.1524-4741.2006.00374.xDOI Listing
March 2007

Organizing pneumonia after radiation therapy for breast cancer.

Diagn Interv Radiol 2006 Sep;12(3):121-4

Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.

We report a case of organizing pneumonia (OP) that developed after radiation therapy (RT) for breast cancer. A 54-year-old woman presented with malaise and fever within a month after the completion of RT for breast cancer. Chest radiographs and computed tomography (CT) demonstrated consolidation in the left upper lobe consistent with radiation pneumonia. The patient was given 60 mg/day IV cortisone for 15 days after which her complaints and consolidation in the left upper lobe disappeared. The daily dose of her corticosteroid was tapered down to 20 mg/day. Two weeks later, the patient again had fever and malaise. Chest X-ray and CT revealed bilateral pulmonary opacities located outside the irradiated fields, predominantly in the middle and lower lung zones. The patient's laboratory tests were normal except for her erythrocyte sedimentation rate, which was elevated. Bronchial lavage revealed moderate elevation of the total cell number with lymphocyte predominance. Open lung biopsy was performed and histopathological examination demonstrated findings consistent with OP. High dose (60 mg/day) prednisolone treatment resulted in rapid clinical and radiological improvement. When the prednisolone dose was gradually tapered down to 20 mg/day during follow-up, new pulmonary opacities developed in both lungs, as well as the recurrence of the patient's symptoms. Increased dose of prednisolone resulted in the rapid improvement of the clinical symptoms and radiological abnormalities. OP rarely presents after RT for breast and lung cancer. One should always consider OP in the clinical setting of a patient who has a history of RT completed 3-6 months prior to fever, multiple areas of consolidation, and ground glass opacities outside the RT field.
View Article and Find Full Text PDF

Download full-text PDF

Source
September 2006

Transformation of a ruptured giant pulmonary artery aneurysm into an air cavity after transcatheter embolization in a Behçet's patient.

Cardiovasc Intervent Radiol 2006 Jan-Feb;29(1):151-4

Department of Radiology, Hacettepe University School of Medicine, Sihhiye, Ankara 06100, Turkey.

Pulmonary artery aneurysms due to Behçet's disease are mainly seen in young males and very rarely in females. To our knowledge there are only 10 cases reported in the related literature. Emergent transcatheter embolization was performed in a female patient with a known history of Behçet's disease in whom massive hemoptysis developed because of rupture of a giant pulmonary artery aneurysm. At 6-month follow-up, transformation of the aneurysm sac into an air cavity was detected. To our knowledge, such a transformation has never been reported in the literature before. Embolization of the pulmonary artery aneurysm and the mechanism of cavity transformation are reviewed and discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00270-005-0225-7DOI Listing
May 2006

Tracheobronchopathia osteochondroplastica in a 9-year-old girl.

Pediatr Pulmonol 2006 Jan;41(1):95-7

Department of Pediatrics, Hacettepe University, Ankara, Turkey.

Tracheobroncopathia osteochondroplastica (TO) is a rare disease of adult males characterized by osteocartilagious submucosal nodules protruding into the airway lumen, causing variable degrees of airway obstruction. Here we describe a case of TO in a 9-year-old girl patient presenting with chronic cough, along with a brief review of this rare benign condition.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ppul.20311DOI Listing
January 2006

IIVP salvage regimen induces high response rates in patients with relapsed lymphoma before autologous stem cell transplantation.

Am J Clin Oncol 2005 Jun;28(3):264-9

Hacettepe University, Institute of Oncology, Ankara, Turkey.

Patients with relapsed lymphoma can be cured with high-dose chemotherapy and autologous hematopoietic stem cell transplantation (HSCT). New therapeutic approaches with better cytoreductive capacity are needed for relapsed patients to keep their chance for cure with transplantation. We report 30 patients with relapsed lymphoma, median age 43 years, treated with IIVP salvage regimen consisting of ifosfamide, mesna, idarubicin, and etoposide for 2 or 3 cycles. Seventeen patients had non-Hodgkin lymphoma (NHL) and 13 patients had Hodgkin disease (HD). Fourteen (47%) patients were at their first relapse. Overall response rate was 86.6% (n = 26) with 19 patients (63.3%) achieving complete response. Overall response rate was 92% in patients with HD and 82% in NHL. The most frequent side effects observed were grade III-IV neutropenia (87%) and thrombocytopenia (73%). IIVP regimen is a highly effective salvage therapy for patients with relapsed HD or NHL who are candidates for autologous HSCT. Close follow up is necessary because of the high incidence of grade III-IV hematologic toxicity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/01.coc.0000145984.39639.0dDOI Listing
June 2005

Breast abscess mimicking malignant mass due to retained penrose drain: diagnosis by mammography and MRI.

Clin Imaging 2004 Jul-Aug;28(4):278-9

Department of Radiology, Hacettepe University School of Medicine, Sihhiye, 06100 Ankara, Turkey.

We report a breast mass associated with a foreign body mimicking malignancy on mammography. Although retained penrose drains have been reported in other parts of the body, our case is the first report of a retained penrose drain in breast diagnosed by mammography. Mammography can be used if there is suspicion of a retained penrose drain during the course of breast abscess treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S0899-7071(03)00103-7DOI Listing
November 2004

Analysis of menstrual, reproductive, and life-style factors for breast cancer risk in Turkish women: a case-control study.

Med Oncol 2004 ;21(1):31-40

Department of Medical Oncology, Hacettepe University Institute of Oncology, Ankara, Turkey.

The aim of this study was to investigate the association between menstrual, reproductive, and life-style factors and breast cancer in Turkish women. In a hospital-based case-control study in Ankara, 622 patients with histologically confirmed breast cancer were compared with 622 age-matched controls, admitted to the same hospital for acute and non-neoplastic diseases. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) related to risk factors. Overall, menopausal status and age at menopause were found to be significantly associated with breast cancer. Having a full-term pregnancy and early age at first birth were associated with decreased breast cancer risk (OR = 0.45, 95% CI = 0.30-0.66; OR = 0.34, 95% CI = 0.22-0.53, respectively). Postmenopausal women with lactation longer than 48 mo had reduced risk of breast cancer (OR = 0.36, 95% CI = 0.14-0.93). In conclusion, decreased parity, late age at first birth, early menopause, and shorter duration of lactation were the most important determinants of breast cancer risk in Turkish women.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1385/MO:21:1:31DOI Listing
July 2004

Mammographic features of nonpalpable spiculated lesions.

Clin Imaging 2003 Sep-Oct;27(5):293-7

Department of Radiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.

Objective: To evaluate the mammographic features of nonpalpable spiculated lesions in order to find differentiating findings between malignant and benign pathologies.

Materials And Methods: Standard mammograms of 27 patients with 28 nonpalpable spiculated lesions were evaluated retrospectively. Two dimensions of dense centre of the spiculated lesions were measured and the mean dimensions were compared in analysing the malignant and benign features. Fine radiolucent lines between dense spicules were noted.

Results: Thirteen spiculated lesions (46.4%) were malignant and 15 were benign. Eleven malignant lesions (84.6%) have dense centre larger than 5 mm, whereas only four benign lesions (26.7%) had a dense core larger than 5 mm. There were fine radiolucent lines parallel to dense spicules in 5 malignant lesions (38.5%) and in 13 benign lesions (86.7%). Only one invasive carcinoma and one radial scar with florid ductal epithelial hyperplasia and papillomatosis had punctate calcifications. The sensitivity and specificity of the dense core larger than 5 mm for malignancy were 84.6% and 73.3%, respectively. The sensitivity of radiolucent lines for benign lesions was 86.7% and the specificity was 61.5%.

Conclusion: When the dense centre of a nonpalpable spiculated lesion is larger than 5 mm, the probability of malignant pathology increases. The fine radiolucent lines between dense spicules may indicate benign etiology. However, there is no reliable mammographic feature differentiating benign spiculated lesions from carcinomas. Therefore, all of them should be diagnosed pathologically unless they are postsurgical.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/s0899-7071(02)00566-1DOI Listing
January 2004

Evaluation of breast microcalcifications according to Breast Imaging Reporting and Data System criteria and Le Gal's classification.

Eur J Radiol 2003 Sep;47(3):227-31

Department of Radiology, Faculty of Medicine, Hacettepe University, Sihhiye, 06100 Ankara, Turkey.

Introduction/objective: Our aim was to evaluate the positive predictive value (PPV) of the analysis of breast microcalcifications according to Breast Imaging Reporting and Data System (BI-RADS) and Le Gal's classification in identification of malignancy, and to assess the interobserver agreement using these criteria.

Methods And Material: Eighty-two patients with breast microcalcifications on their screening mammograms underwent surgical excision after a needle localization at our institution between July 1993 and June 2000. The mammograms were examined by two experienced mammographers retrospectively and independently. Each observer noted the morphology, distribution, associated findings, final assessment categories of microcalcifications according to BI-RADS criteria and the morphologic type of microcalcifications according to Le Gal's classification. The PPVs for each radiologist and the interobserver agreement were determined by using these data and histologic findings.

Results: Histopathologic results yielded malignancy in 25 (30%) cases. The evaluation of microcalcifications according to BI-RADS criteria revealed PPVs of 17% and 25% for category 4 lesions, and 68% and 44% for category 5 lesions. In the assessment of microcalcifications according to Le Gal's classification, the PPV of type 4 lesions was 45% (for both observers), whereas the PPVs of type 5 lesions were 70% and 50%. The interobserver agreement was fair in evaluation of morphology of microcalcifications (kappa:0.31), distribution of microcalcifications (kappa:0.29), final assessment categories (kappa:0.27), and moderate in evaluation of associated findings (kappa:0.48) by using BI-RADS lexicon. It was higher for the assessment of milk of calcium and round microcalcifications than other typically benign microcalcifications, and for fine linear or fine linear branching microcalifications than other probably malignant calcifications. There was a fair interobserver agreement (kappa:0.30) in the description of the morphologic type of microcalcifications according to Le Gal's classification.

Discussions And Conclusion: In our study, both BI-RADS lexicon and Le Gal's classification did not succeed expectedly in reducing the ambiguity in assessment of breast microcalcifications. Further studies and perhaps development of new methods are required to improve accuracy and standardization in mammographic interpretation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/s0720-048x(02)00181-xDOI Listing
September 2003

Bilateral multiple pulmonary tuberculous nodules mimicking metastatic disease.

Eur J Radiol 2002 Oct;44(1):33-6

Department of Radiology, Hacettepe University School of Medicine, Sihhiye, 06100 Ankara, Turkey.

We present CT findings of a young woman who has bilateral pulmonary nodules mimicking metastases. Clinical presentation with active multiple pulmonary macronodules without cavitation responsive to treatment is an atypical manifestation of pulmonary tuberculosis. We reviewed the causes of multiple pulmonary nodules, role of radiological findings in differential diagnosis and parenchymal manifestations of pulmonary tuberculosis in this report.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/s0720-048x(01)00402-8DOI Listing
October 2002

MR imaging features of breast lymphoma.

Eur J Radiol 2002 Apr;42(1):62-4

Department of Radiology, Hacettepe University, 06100 Sihhiye, Ankara, Turkey.

Mammographic, ultrasonographic and MR imaging features in a patient with non-Hodgkin's lymphoma are reported in this paper. Mammography and ultrasonography revealed ill-defined, round masses with skin thickening. Precontrast T1W images demonstrated multiple well-defined, hypointense masses, which showed rapid rim enhancement in dynamic postcontrast sequence. The enhancement rate indicated malignant pathology. MR imaging demonstrated the extent of involvement more apparently than conventional imaging. Although, not pathognomonic for lymphoma, MR imaging may be helpful in evaluation and follow-up of breast masses in patients with previous lymphoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/s0720-048x(01)00416-8DOI Listing
April 2002

Malignant thymoma invading the right atrium: a rare echocardiographic finding.

Echocardiography 2002 Jan;19(1):61-2

Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Malignant thymoma is a rare tumor. We report a case of malignant thymoma with intracaval extension and direct invasion of the right atrium presenting as superior vena cava syndrome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1046/j.1540-8175.2002.00061.xDOI Listing
January 2002