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Öğe Adult langerhans cell histiocytosis: Differential diagnosis(Turkiye Klinikleri, 2007) Çil T.; Gökalp D.; Tuzcu A.; Işikdoğan A.; Bahçeci M.Langerhans cell histiocytosis is a group of idiopathic disorders characterized by the abnormal proliferation of specialized bone marrow-derived Langerhans cells. There are one to two cases per million population. Most reports are based only on anecdotal experience in adult patients. Surgical excision, radiotherapy and chemotherapy, either alone or in combination are the main treatment options. In this report, we present a rare case of Langerhans cell histiocytosis in a 32 years-old-woman who developed symptomatic diabetes insipidus and multiple bone and cranial metastases during the disease course. This paper discusses controversial treatment modalities. Copyright © 2007 by Türkiye Klinikleri.Öğe Autoimmune hemolytic anemia presented in course of Hodgkin's diseases: Report of two cases(2006) Altintaş A.; Ayyildiz O.; Işikdoğan A.; Atay E.; Müftüoğlu E.Autoimmune hemolytic anemia is a rare disorder that the incidence is approximately 1/100000 in adults. 50-70 % of cases are idiopathic. Recently, the percentages of secondary causes have risen due to detailed investigation and long term follow up. Hematologic and nonhematologic malignancies plays an important role in the etiology and pathogenesis of autoimmune hemolytic anemia that has many other causes. Lenfoproliferative malignencies, especially chronic lenfoid leukemia is the most striking disease. The association of Hodgkin's disease and autoimmune hemolytic anemia is being observed as rare case reports. We discussed two cases of Hodgkin's disease associated autoimmune hemolytic anemia in recent 3 years period. One was presented after therapy and the other was presented prior to therapy.Öğe Cancer and thrombotic thrombocytopenic purpura: Presentation of two cases(Turkiye Klinikleri, 2008) Altintaş A.; Çil T.; Atay A.E.; Kaplan M.A.; Işikdoğan A.; Ayyildiz O.Thrombotic thrombocytopenic purpura (TTP) is a rare and fatal disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurologic disorder, renal function deterioration and fever. TTP may be idiopathic or secondary to autoimmune diseases, drugs, cancer and infections. Clinical findings of TTP are also present in cancer patients with disseminated intravascular coagulation and sepsis. TTP must be considered in the differential diagnosis in the case of concurrent microangiopathic hemolytic anemia and thrombocytopenia with or without leukoerythroblastic blood smear in cancer patients. Here we presented two patients who were followed up in our clinic with TTP secondary to metastatic breast cancer. Copyright © 2008 by Türkiye Klinikleri.Öğe The clinical and pathological features of patients with gastric cancer in Turkey: A Turkish Oncology Group Study(2006) Yalçin B.; Zengin N.; Aydin F.; Ilhan M.; Işikdoğan A.; Demir G.; Aykan F.Although the incidence of gastric cancer has declined dramatically in western countries; it is, after the breast cancer in women and lung cancer in men, the second most common cancer in Turkey with a high mortality. Surgery is the mainstay in the management of gastric cancer, and unresectable disease has poor prognosis. The aim of this study was to evaluate the clinicopathological and epidemiological features of patients with gastric cancer in Turkey. A questionnaire was used to collect information on clinicopathological and socioeconomic features of all patients with newly diagnosed gastric cancer in contributing 16 different centers in Turkey in the year 2004. The findings were analyzed by the geographic regions in patients live. Nine-hundred seventy-one patients with newly diagnosed gastric cancer in 2004 were included in the study. Mean age of the patients was 57±12.9 (mean±SD) years. Male-female ratio was 2/1. The rate of cancer resectability was lower in Eastern Turkey (ET) than Western Turkey (WT) (31.6% vs. 63.4%, p=0.0001). Also, socioeconomic status of the patients was lowest in ET (53.6% vs. 32.3%, p=0.0001). H. pylori gastritis and intestinal metaplasia were more common in ET when compared to WT (75.0% vs. 40.5%; p=0.003, and 68.4% vs. 18.1%; p=0.0001, respectively). Lower resectability rate of disease in ET should be appreciated. Further epidemiological study of gastric cancer is warranted in Turkey.Öğe Cranial involvement in a follicular lymphoma patient with systemic complete remission after Yttrium-90-ibritumomab-tiuxetan treatment: Scientific letter(Turkiye Klinikleri, 2008) Çil T.; Altintaş A.; Paşa S.; Kilinç I.; Işikdoğan A.Non-Hodgkin's lymphoma is a heterogeneous group of lymphoproliferative disorders with varying patterns of behavior and treatment responses. Advances in understanding of tumor biology have made it possible to exploit novel treatment strategies such as monoclonal antibodies and their conjugation with radioimmunotherapy was recommended in patients with first relapse of low-grade lymphomas such as follicular lymphoma after rituximab containing chemotherapy. Treatment with radioimmunotherapy such as yttrium-90-ibritumomab-tiuxetan utilizes a monoclonal anti-CD20 antibody to deliver beta-emitting yttium-90 to the malignant B-cells. Clinical trials have demonstrated its efficacy, which is largely independent of the intrinsic activity of the anti-CD20 antibody. Relapses of nodal lymphomas usually occur in extra lymphoid areas. Central nervous system (CNS) involvement develops in less than 1% of patients with lymphomas. Herein, we are presenting a rare case of CNS involvement of follicular lymphoma in a patient who has achieved systemic complete remission after yttrium-90-ibritumomab treatment. Copyright © 2008 by Türkiye Klinikleri.Öğe Cutaneous and scalp metastases of pancreatic carcinoma: Case report(2011) Küçüköner M.; Kaplan M.A.; Inal A.; Sula B.; Firat U.; Uçmak F.; Işikdoğan A.Pancreatic carcinomas are very rapidly progressing tumors. Approximately 50% patients with newly diagnosed pancreatic cancer have many kinds of metastases. The most frequent sites of metastasis of the pancreatic carcinomas are the lymph nodes, lungs, liver, adrenal glands, kidneys and bones. Cutaneous metastases from pancreatic adenocarcinomas are very rare, far less common sites of pancreatic metastases are the scalp and skull metastases. The most common site of cutaneous metastasis is the umbilicus, there are scant reports of pancreatic cutaneous metasta sis at nonumbilical areas. In the literature, togetherness of cutaneous, scalp and skull metastases have not usually been reported and in our interesting case, we present these rare metastases together. Copyright © 2011 by Türkiye Klinikleri.Öğe Gastric ring cell carcinoma metastasis to the breast: Two case reports(2009) Çil T.; Altintaş A.; Paşa S.; Işikdoğan A.Metastatic tumors of breast are rare and account only for approximately 2% of all malignant breast cancers. Breast metastasis of stomach's signet ring cell carcinoma (SRCC) is also a very rare condition. Herein, we report two rare cases of gastric SRCC metastasis to the breast. First case is a 63-year-old female patient who was admitted to our clinic with swelling in the left breast and arm with enlarged left axillary lymphadenopathy. She was diagnosed with gastric SRCC a year ago. Second case is a 65-year-old woman diagnosed with gastric SRCC who had undergone total gastrectomy two years ago, and had one-year history of operation for kruckenberg's tumor. This patient was admitted to our clinic with two months history of pain and swelling in the left breast. She was also diagnosed as a gastric SRCC metastasis.Öğe Hairy cell leukemia variant and differantial diagnosis: Case report(2006) Altintaş A.; Işikdoğan A.; Ayyildiz O.Hairy-cell leukemia-variant is an uncommon chronic B cell lymphoproliferative disorder, characterized by splenomegaly and leukocytosis. A variant form of Hairy-cell leukemia has been considered with features intermediate between Hairy-cell leukemia and B-prolymphocytic leukemia. Although there are some cases diagnosed during routine diagnostic tests, most of them admit with abdominal discomfort secondary to massive splenomegaly. A 72-years old female patients with abdominal distention, early satiety, and night sweating for 2 years admitted and a diagnosis variant form of hairy cell leukemia was established. In this report, we discussed clinic and laboratory features of Variant-Hairy cell leukemia.Öğe Patients with Hodgkin's disease: Clinical and pathological evaluation(2006) Altintaş A.; Çil T.; Kaplan M.A.; Atay A.E.; Işikdoğan A.; Büyükbayram H.; Ayyildiz O.Hodgkins' disease accounts 25% of all lymphoid malignancies and 1% of all cancers. In this study, 150 patients with Hodgkins' disease were reviewed retrospectively and compared according to age, gender, histopathologic subtype and stage of disease. 102 (68%) of patients were male and 48 (32%) were female with a median age of 41 (16-73) years. The frequencies of histopathological subtypes, mixed cellularity, nodular sclerosis, lymphocyte-rich and lymphocyte-depletion, were 63 (42%), 37 (24.6%), 25 (16.6%) and 21 (14%), respectively. Histological subtype was not determined in 4 (2.7%) patients. Distribution of patients according to stages were; 18 (12%) patients were in stage I, 35 (23.3%) patients were in stage II, 52 (34.7%) patients were in stage III and 43 (28.7%) patients were in stage IV. Sufficient staging procedure was not performed in two patients. SPSS 11.0 program was used for statistical analyzes. Patients were divided into two groups; older and younger than 40 years age and no statistical significancy was detected between groups. Also there was no significant relation between histopathological subtype and age. In conclusion; Hodgkin disease predominantly seen in males (M/F: 2.1). Mixed celularity HD was the most frequent subtype and 63.7% of our patients were in advanced stage (stage III ve IV).
