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    An Unusual Presentation of Lung Cancer Metastasis: Perianal Abscess
    (Derman Medical Publ, 2014) Kilic, Murat Ozgur; Sen, Meral; Turkan, Ahmet; Yildirim, Umran; Koktener, Asli
    Lung cancer is one of the most commonly diagnosed cancers in both men and women. Although the most frequent sites of distant metastasis of lung cancers are the pleura, liver, adrenal glands, skeletal system and brain, perianal region has been rarely reported as a metastasis site. A male patient was admitted to our emergency room with a long standing perianal abscess. During abscess drainage, a mass was noticed at the base of the abscess pouch, and thus a biopsy was taken. Pathologically, it was reported as a metastasis of squamous cell carcinoma, therefore some radiological investigations and endoscopic procedures were performed to determine the primary focus of cancer. A pulmonary mass was revealed in PET/CT, and was considered as primary tumor. Both primary and metastatic perianal tumors can be rarely presented as an abscess formation. In this situation, a biopsy should be performed from the lesion to avoid misdiagnosis.
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    Isolated Intrapulmonary Castleman's Disease: A Case Report, Review of the Literature
    (Medical Tribune Inc, 2014) Nadir, Aydin; Colak, Necmettin; Koktener, Asli; Yildirim, Umran
    Castleman's disease (CD), also known as angiofollicular lymph node hyperplasia, is an uncommon, lymphoproliferative disorder of unknown etiology, mostly involving the mediastinum. Parenchymal lung involvement of the disease is extremely rare. Intrapulmonary CD has been reported in seven cases in the English literature. We describe an asymptomatic 28-year-old woman with lesion in the chest X-ray. Computed tomography (CT) of the chest confirmed a 5.5 x 5 cm well-defined, lobulated mass in the hilum of the right upper lobe. She underwent surgical resection for diagnosis and treatment. Pathologic examination showed hyaline vascular type (Castleman's disease) lymph node hyperplasia. CD rarely arises from the intrapulmonary lymph nodes. In these patients, preoperative diagnosis is difficult and invasive attempts may be required.
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    Role of ?-glutamyl transferase levels in prediction of high cardiovascular risk among patients with non-alcoholic fatty liver disease
    (Wolters Kluwer Medknow Publications, 2016) Kasapoglu, Benan; Turkay, Cansel; Yalcin, Kadir Serkan; Carlioglu, Ayse; Koktener, Asli
    Background & objectives: Non-alcoholic fatty liver disease (NAFLD) is an important cause of elevated liver functions. There is evidence showing an association between NAFLD and subclinical atherosclerosis independent of traditional risk factors. We undertook this retrospective study to determine the association of Framingham cardiovascular risk scoring system with liver function tests and inflammatory markers and to find the role of liver function tests in determination of CVD risk among non-obese and nondiabetic subjects with non-alcoholic fatty liver disease. Methods: A total of 2058 patients were included in the study. Framingham cardiovascular risk scoring was done of all patients according to the age, gender, systolic blood pressure, serum total cholesterol and HDL cholesterol levels, smoking and antihypertensive medication history. Liver function test, lipid profile, insulin, uric acid, ferritin levels, etc. were determined. Results: According to the ultrasonography findings, patients were grouped as without any fatty infiltration of the liver (control group) (n= 982), mild (n= 473), moderate (n= 363) and severe fatty liver disease (n= 240) groups. In severe fatty liver disease group, the mean Framingham cardiovascular risk score was significantly higher than that of other groups. There was a positive correlation between GGT, uric acid and ferritin levels with Framingham cardiovascular score. In multivariate analysis, high GGT levels were positively associated with high-risk disease presence (OR: 3.02, 95% CI: 2.62-3.42) compared to low GGT levels independent of the age and sex. Interpretation & conclusions: Cardiovascular disease risk increases with the presence and stage of fatty liver disease. Our findings showed a positive correlation between elevated GGT levels and Framingham cardiovascular risk scoring system among non-diabetic, non-obese adults which could be important in clinical practice. Though in normal limits, elevated GGT levels among patients with fatty liver disease should be regarded as a sign of increased cardiovascular disease risk. Larger studies are warranted to elucidate the role of GGT in prediction of cardiovascular risk.