Person: BAĞCI ÇULÇİ, PELİN
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BAĞCI ÇULÇİ
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PELİN
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Publication Open Access Solitary fibrous tumor of the pancreas: Analysis of 9 cases with literature review(2023-11-01) ŞAHİN ÖZKAN, HÜLYA; BAĞCI ÇULÇİ, PELİN; Yavas A., Tan J., Sahin Ozkan H., Yilmaz F., Reid M. D., Bagci P., Shi J., Shia J., Adsay V., Klimstra D. S., et al.Solitary fibrous tumor (SFT) has been increasingly reported in various anatomic sites. However, it is still extremely rare in the pancreas. Herein, we present the first series of primary pancreatic SFTs. Nine cases of primary pancreatic SFTs were analyzed. The mean age was 60 years (36 to 76 y) with no sex predilection. Six tumors were in the head, 3 were in the tail. On imaging studies, tumors were described as a hypervascular mass, 2 revealed cystic areas, and 3 were favored to be neuroendocrine tumors. On biopsy, 2 cases were diagnosed as atypical spindle cell tumor; one was misdiagnosed as suspicious for sarcoma, and another case as metastatic renal cell carcinoma. Two were diagnosed as low-grade sarcoma and low-grade stromal tumor on frozen sections. Grossly, tumors were well-demarcated with a median size of 4 cm (0.9 to 15 cm). Microscopically, they were composed of ovoid to spindle tumor cells with no significant mitotic activity and were arranged in alternating hypercellular and hypocellular areas. Staghorn-like vessels and entrapped pancreatic parenchyma were also detected within all tumors. Tumor cells revealed diffuse/strong nuclear STAT6 expression in 7 of 8, CD34 in 7 of 9, and bcl-2 in 4 of 4 tested cases. One tested tumor harbored NAB2-STAT6 fusion. Eight patients with available follow-up data were free of disease at a mean follow-up of 76 months (3 to 189 mo). SFT should be considered in the differential diagnoses of mesenchymal neoplasms of the pancreas. Immunohistochemical nuclear STAT6 expression is a characteristic feature of SFT. Primary pancreatic SFTs seem to have favorable biological behavior in our series.Publication Metadata only The Importance of Lymph Node Drainage Areas of Ampullary Carcinomas(2022-03-01) BOZKURTLAR, EMİNE; BAĞCI ÇULÇİ, PELİN; Akar K., BOZKURTLAR E., BAĞCI ÇULÇİ P., Balci S.Publication Open Access Pancreatic neuroendocrine tumor mimicking intraductal papillary mucinous neoplasm: Case report(2021-01-01) AKMERCAN, AHMET; BAĞCI ÇULÇİ, PELİN; ATICI, ALİ EMRE; YEGEN, ŞEVKET CUMHUR; UPRAK, TEVFİK KIVILCIM; AKMERCAN A., UPRAK T. K., BAĞCI ÇULÇİ P., ATICI A. E., YEGEN Ş. C.ABSTRACTPancreatic neuroendocrine tumors (PanNETs) are rare pancreatic tumors. They usually exhibit parenchymal growing, however some cases can exhibit intraductal growing. PanNET with intraductal growth may cause intraductal papillary mucinous neoplasm (IPMN)- like clinic scenario by presenting as cystic formations secondary to duct obstruction. In our case, a 69-year- old man with a history of abdominal pain and nausea underwent a computed tomography scan that showed dilated pancreatic duct and cystic lesion which was 8 cm originating from the pancreas. Imaging and laboratory findings were considered to be consistent with an IPMN so the patient underwent distal pancreatectomy and splenectomy. However, the pathological examination of the surgical specimen showed a millimeter-sized PanNET located in pancreatic tail mimicking the IPMN by obstructing the pancreatic duct.Keywords: Gastroenteropancreatic neuroendocrine tumor; pancreatic intraductal neoplasmsPublication Metadata only Centrally-necrotic/hyalinizing demarcated (CND) carcinomas of the pancreas: A clinico-pathologically distinct group with divergent metaplastic patterns and high-grade characteristics(2022-03-01) BAĞCI ÇULÇİ, PELİN; BOZKURTLAR, EMİNE; Cengiz D., Saka B., BAĞCI ÇULÇİ P., Altinmakas E., Bozkurt E., Armutlu A., PEHLİVANOĞLU B., BOZKURTLAR E., Reid M., Mericoz M. A., et al.Publication Open Access Relationship of PPARG overexpression with prognostic parameters in papillary thyroid carcinoma(2022-02-01) ASYA, ORHAN; YUMUŞAKHUYLU, ALİ CEMAL; BAĞCI ÇULÇİ, PELİN; ŞAHİN, AKIN; OYSU, ÇAĞATAY; KAYA, HANDAN; ASYA O., YUMUŞAKHUYLU A. C., BAĞCI ÇULÇİ P., KAYA H., Gonen A., Gundogdu Y., Muradov T., ŞAHİN A., OYSU Ç.Objectives. PAX8/PPARG chromosomal rearrangement is frequently seen in thyroid cancer, and PPARG overexpression has been shown in the follicular variant of papillary thyroid carcinoma, but not in papillary thyroid carcinoma other than the follicular variant. The main aim of this study was to investigate the frequency of PPARG overexpression among papillary thyroid carcinoma and if there were any variants of papillary thyroid carcinoma with PPARG overexpression other than the follicular variant. Methods. Immunohistochemical analysis of PPARG overexpression was performed using a PPARG monoclonal antibody in a series of 111 paraffin-embedded blocks of thyroid tumours. Of the patients in our study, 100 were diagnosed with papillary thyroid carcinoma, 9 with follicular adenoma and 2 with follicular carcinoma. Results. PPARG staining was detected in 19 of the 111 cases. Sixteen patients with PPARG overexpression had papillary thyroid carcinoma and 3 had follicular adenoma. Conclusion. PPARG overexpression was detected mainly in follicular-variant papillary thyroid carcinoma. Vascular invasion, lymphatic invasion, thyroid capsule invasion and lymph node positivity were lower in patients with PPARG overexpression.Publication Metadata only Patterns of intraparenchymal spread of pancreatic ductal adenocarcinoma within whipple specimens, and their clinical significance: Importance of focused lymph node examination, and sampling of the anterior surfaces(2022-03-01) BAĞCI ÇULÇİ, PELİN; Saka B., Balci S., PEHLİVANOĞLU B., BAĞCI ÇULÇİ P., Memis B., Reid M., Basturk O., Adsay N. V.Publication Metadata only Ki67 of >=10% Identifies an Aggressive Group of PanNETs and Lends Support to Emerging Protocols in Oncology Literature Utilizing This Cut-off for Closer Follow-up and Chemotherapy Candidates(2022-03-01) BAĞCI ÇULÇİ, PELİN; Eren O., Bagci P., Balci S., Saka B., Sokmensuer C., Leblebici C. B., Xue Y., Reid M., Taskin O., Kapran Y., et al.Publication Open Access A single-center multidisciplinary study analyzing thyroid nodule risk stratification by comparing the thyroid imaging reporting and data system (TI-RADS) and American thyroid association (ATA) risk of malignancy for thyroid nodules(2022-01-01) ASYA, ORHAN; YUMUŞAKHUYLU, ALİ CEMAL; ENVER, NECATİ; İNCAZ, SEFA; GÜNDOĞMUŞ, CEMAL AYDIN; ERGELEN, RABİA; BAĞCI ÇULÇİ, PELİN; OYSU, ÇAĞATAY; ASYA O., YUMUŞAKHUYLU A. C. , ENVER N., Gündoğdu Y., Abuzaid G., İNCAZ S., GÜNDOĞMUŞ C. A. , ERGELEN R., Bağcı P., OYSU Ç.© 2022 Elsevier LtdObjectives: The thyroid imaging reporting and data system (TI-RADS) and 2015 American Thyroid Association (ATA) guidelines are two well-known risk stratification systems for classifying thyroid nodules based on cancer risk. This study aims to evaluate the diagnostic efficacy of these two systems in predicting malignancy in patients undergoing thyroid surgery. Methods: We studied data on 120 individuals who were scheduled to undergo surgery for benign or malignant nodular diseases of the thyroid gland between October 2017 and October 2019. The TI-RADS category and ultrasound pattern based on ATA guidelines were assigned to dominant thyroid nodule categories by two experienced radiologists blinded to patients’ previous thyroid ultrasonography and fine-needle aspiration biopsy results. A pathologist with experience in thyroid diseases blinded to patients’ sonographic and clinical data reviewed the thyroidectomy specimens. Results: A total of 120 patients, 88 women and 32 men, were included in our study. Final histopathological results were as follows: 50% (n=60) papillary thyroid carcinoma, 36.6% (n=44) benign nodular thyroid diseases, 4.1% (n=5) follicular adenoma, 2.5% (n=3) hurtle cell adenoma, 1.7% (n=2) follicular thyroid carcinoma, 1.7% (n=2) medullary thyroid carcinoma, 1.7% (n=2) hurtle cell carcinoma, and 1.7% (n=2) follicular tumor of uncertain malignancy potential. The sensitivity, specificity, positive predictive value, and negative predictive value for TI-RADS were 80%, 56%, 72%, and 67%, respectively, and that for ATA were 80%, 64%, 76%, and 69%, respectively. Conclusion: The TI-RADS and ATA showed similar rates of sensitivity, specificity, NPV, and PPV. Our observed risk of malignancy was higher than expected for the ACR TI-RADS 3–5 categories and the very low, low, and intermediate suspicion risk strata in the ATA guidelines. We found no difference between observed and expected malignancy risk for the ACR TI-RADS 2’s and ATA\"s high suspicion categories.Publication Open Access Infiltration pattern predicts metastasis and progression better than the T-stage and grade in pancreatic neuroendocrine tumors: a proposal for a novel infiltration-based morphologic grading(2022-06-01) BAĞCI ÇULÇİ, PELİN; BOZKURTLAR, EMİNE; Taskin O. C. , Reid M. D. , Bagci P., Balci S., Armutlu A., Demirtas D., PEHLİVANOĞLU B., Saka B., Memis B., BOZKURTLAR E., et al.© 2021, The Author(s), under exclusive licence to United States & Canadian Academy of Pathology.The advancing edge profile is a powerful determinant of tumor behavior in many organs. In this study, a grading system assessing the tumor-host interface was developed and tested in 181 pancreatic neuroendocrine tumors (PanNETs), 63 of which were <=2 cm. Three tumor slides representative of the spectrum (least, medium, and most) of invasiveness at the advancing edge of the tumor were selected, and then each slide was scored as follows. Well-demarcated/encapsulated, 1 point; Mildly irregular borders and/or minimal infiltration into adjacent tissue, 2 points; Infiltrative edges with several clusters beyond the main tumor but still relatively close, and/or satellite demarcated nodules, 3 points; No demarcation, several cellular clusters away from the tumor, 4 points; Exuberantly infiltrative pattern, scirrhous growth, dissecting the normal parenchymal elements, 5 points. The sum of the rankings on the three slides was obtained. Cases with scores of 3–6 were defined as \"non/minimally infiltrative\" (NI; n = 77), 7–9 as \"moderately infiltrative\" (MI; n = 68), and 10–15 as \"highly infiltrative\" (HI; n = 36). In addition to showing a statistically significant correlation with all the established signs of aggressiveness (grade, size, T-stage), this grading system was found to be the most significant predictor of adverse outcomes (metastasis, progression, and death) on multivariate analysis, more strongly than T-stage, while Ki-67 index did not stand the multivariate test. As importantly, cases <=2 cm were also stratified by this grading system rendering it applicable also to this group that is currently placed in \"watchful waiting\" protocols. In conclusion, the proposed grading system has a strong, independent prognostic value and therefore should be considered for integration into routine pathology practice after being evaluated in validation studies with larger series.Publication Open Access Reappraisal of T1b gallbladder cancer (GBC): clinicopathologic analysis of 473 in situ and invasive GBCs and critical review of the literature highlights its rarity, and that it has a very good prognosis(2023-02-01) BAĞCI ÇULÇİ, PELİN; Pehlivanoglu B., Akkas G., Memis B., Basturk O., Reid M. D., Saka B., Dursun N., Bagci P., Balci S., Sarmiento J., et al.There are highly conflicting data on relative frequency (2–32%), prognosis, and management of pT1b-gallbladder carcinoma (GBC), with 5-year survival ranging from > 90% in East/Chile where cholecystectomy is regarded as curative, versus 90%, similar to findings in the East. This supports the inclusion of pT1b in the \"early GBC\" category, as is typically done in high-incidence regions. Pathologic mis-staging of pT2 as pT1 is not uncommon. Cases should not be classified as pT1b unless extensive, preferably total, sampling of the gallbladder to rule out a subtle pT2 is performed. Critical appraisal of the literature reveals that the Western guidelines are based on either SEER or mis-interpretation of stage IB cases as \"pT1b.\" Although the prognosis of pT1b-GBC is very good, additional surgery (radical cholecystectomy) may be indicated, and long-term surveillance of the biliary tract is warranted.