Objectives: For optimal histomorphological examination, adequacy of kidney biopsy tissue should be obtained. In this study, the effect of a pathologist informing the radiologist about tissue adequacy during the biopsy procedure on obtaining tissue adequacy was examined. Furthermore, we aimed to determine the criteria that the pathologist considered in determining tissue adequacy and the conditions affecting the decision to increase the number of core biopsies, as these have not been previously examined in the literature. Materials and Methods: Tissues containing less than 10 glomeruli were considered inadequate. In some patients, a pathologist accompanied the radiologist during the procedure. Tissue adequacy ratios and biopsy sample numbers were calculated between the two conditions. In the samples taken with the pathologist, the factors affecting the locality decision of the pathologist (cortex/medulla amount, presence of glomerular pathology(global, segmental, crescentic glomeruli) presence of tubular injury, proteinuria; interstitial inflammation and interstitial fibrosis/tubular atrophy ratios, account of normal glomeruli) were examined. Results: Giving tissue adequacy information during the biopsy procedure had a positive effect on tissue adequacy. The amount of cortex is one of the qualification criteria for the pathologist. The presence of proteinuria and 50% or more inflammation in tissues with sufficient cortex increased the number of biopsy samples. Conclusion: Determination of tissue adequacy during kidney biopsy is an important and necessary method. The amount of cortex is one of the important parameters in tissue adequacy.
Introduction: Malignant pleural mesothelioma (MPM) is an aggressive malignant disease with a poor prognosis, which affects the surface mesothelium of the pleural cavity. Immune checkpoints are responsible for controlling the immune system to avoid autoimmunity and prevent tissue damage. In this study, we aimed to investigate the expression of cytotoxic T lymphocyte antigen-4 (CTLA-4), programmed death ligand 1 (PD-L1), and programmed death ligand 2 (PD-L2) immuno-control receptors in MPM patients and the relationship of the expression with tumour types and prognostic parameters. Material and methods: In this study, we evaluated 50 MPM cases. Immunohistochemically CTLA-4, PD-L1, and PD-L2 were detected by using monoclonal anti-CTLA-4, anti-PD-L1, and anti-PD-L2. Real-time polymerase chain reaction (RT-PCR) analysis was performed with the primers CTLA-4, PD-L1, and PD-L2. Results: Statistically, no significant relation was determined between the PD-L1, PD-L2, and CTLA-4 expressions (immunohistochemical and RT-PCR methods) and the MPM histological type. Interestingly significant correlation was observed between the mean survival time and immunohistochemical PD-L2 expression; thus, long-term survival was observed in cases with PD-L2 expression. Conclusions: Programmed death ligand 1, PD-L2, and CTLA-4 expression were observed in some MPM cases, suggesting that treatments targeting immune checkpoints may be effective. Because immunohistochemical expression of PD-L2 is associated with better prognosis, it may provide useful clues in the follow-up of patients.
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