Researcher:
Bulutay, Pınar

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Pınar

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Bulutay

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Bulutay, Pınar

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2017 - 201992020 - 202321

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    Is alveolar spread may be predictive with PET CT scanning?
    (Elsevier Science inc, 2017) Zeren, Handan; Selçukbiricik, Fatih; Mandel, Nil Molinas; Tanju, Serhan; Falay, Fikri Okan; Bulutay, Pınar; Zeren, Emine Handan; Erus, Suat; Dilege, Şükrü; Faculty Member; Faculty Member; Faculty Member; Teaching Faculty; Teaching Faculty; N/A; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; 202015; 194197; 214690; 246484; 133565; N/A; 175565; 22573
    Background: In this study we aim to investigate predictability of alveolar spread in primary lung cancer by using preoperatively scanning methods. Method: In order to re-evaluate alveolar spread, pathology preparations of 45 patients had operated for primary lung cancer diagnosis and scanned preoperatively with PET CT all in our hospital which interpreted by same nuclear medicine specialists implicated in this study. As using the patients pet CT findings, CTV (computerized tomography volume), MTV (metabolic tumor volume), TLG(total lesion glycolysis), SUDmax, SUDort values and their relation with alveolar spread analyzed. Result: Preoperatively PET-CT scanned all in our hospital 45 patients has included and cause of couldn't reach their pathological preparations, 6 of them exluded from the study. 21 of 39 patients were men (53.8%) , 18 of them were women (46.2%) and mean age was 66.67/+-7.88 (42-80). We didn't detect any relation between CTV, MTV, TLG, SUDmax, SUDort values and alveolar spread (p>0.05). However when the CTV/ MTV ratio analyzed, alveolar spread was statistically more common in the group of patients had ratio lower than 1. (62.9% versus 0%, p:0.01). Conclusion: High local recurrence risk in sublober rejected patients with alveolar spread has indicated in various studies. Regarding this matter, we recommend re-evaluation of the patients for sublober rejections whose CTV/MTV ratio is lower than 1.
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    The role of adjuvant chemotherapy in resected stage I non - small cell lung cancer: a Turkish Oncology Group Study
    (Imprimatur Publications, 2021) Ak, Naziye; Özkan, Berker; Yenigün, Mustafa B.; Yılmazbayhan, Dilek; Toker, Alper; Ferhatoğlu, Ferhat; Yaşar, Arzu; Sak, Serpil Dizbay; Kılıçkap, Sadettin; Önder, Sevgen; Dikmen, Erkan; Alan, Özkan; Yumuk, Perran F.; Bozkurtlar, Emine; Laçin, Tunç; Yıldızeli, Bedrettin; Özturk, Akın; Ürer, Nur; Oyan, Başak; Aydıner, Adnan; Demirkazık, Ahmet; Eralp, Yeşim; Kocatürk, Celalettin; Karapınar, Kemal; Tanju, Serhan; Dilege, Şükrü; Erus, Suat; Bulutay, Pınar; Fırat, Pınar Arıkan; Mandel, Nil Molinas; Faculty Member; Faculty Member; Faculty Member; Teaching Faculty; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 214690; 122573; 175565; 133565; 207545; 194197
    Purpose: The benefit of adjuvant chemotherapy for tumors smaller than 4 cm is not clear. We aimed to evaluate the prognostic impact of adjuvant platin-based chemotherapy in high-risk stage I patients with non-small cell lung cancer (NSCLC). Methods: This cooperative group study included 232 NSCLC patients who underwent curative surgery for stage I disease with tumor size 2-4 cm. Results: Median age at presentation was 63 years (range 18-90). The mean tumor size was 29.6 +/- 7.3 mm. The frequency of patients with specified risk factors were: visceral pleural effusion (VPI): n: 82 (36.6%); lymphovascular invasion (LVI): n: 86 (39.1%); Grade 3: n: 48 (32.7%); Solid micropapillary pattern (SMP): n: 70 (48.3%). Adjuvant platin-based chemotherapy was administered to 51 patients. During a median follow-up period of 50.5 months 68 patients (29.3%) developed recurrence, 54 (23.3%) died from any cause and 38 (16.4%) of them died of lung cancer. Patients who received chemotherapy compared with the non-chemotherapy group had a longer 5-years relapse-free survival (RFS) (84.5 vs. 61.1%). Also on multivariate analysis, adjuvant chemotherapy was a significant independent prognostic factor for RFS. Conclusion: Adjuvant platin-based chemotherapy should be considered for patients with small tumors with adverse risk factors.
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    A practical method for accurate coordination between the plastic surgeon and the pathologist: the clockwork technique
    (Korean Soc Plastic & Reconstructive Surgery, 2018) N/A; N/A; N/A; N/A; N/A; N/A; N/A; Sezgin, Billur; Kapucu, İrem; Yenidünya, Bahar Güliz; Bulutay, Pınar; Armutlu, Ayşe; Özmen, Selahattin; Yavuzer, Cahit Reha; Faculty Member; Researcher; Undergraduate Student; Teaching Faculty; Teaching Faculty; Faculty Member; Other; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 133762; 327602; N/A; N/A; 133565; 133567; 125951; N/A
    Cooperation between the surgeon and the pathologist is essential for the correct diagnosis and treatment of skin tumors [1]. Precise communication between these two specialties allows for the precise evaluation of the tumor borders by the pathologist, which in turn reduces the amount of unnecessary tissue removed, thereby improving functional preservation and the aesthetic outcomes of surgery. Although not every skin tumor excision requires a high level of interdisciplinary interaction, the location and the type of tumor are key elements that can make such a collaboration necessary. This is especially true for tumors located near critical facial aesthetic subunits such as the eyelids, nostrils, and mouth, and for locally aggressive tumors that spread in unpredictable patterns. Mohs micrographic surgery (MMS) is an alternative to conventional surgery in such cases, and allows tissue preservation to be maximized without compromising adequate surgical excision of the tumor [2]. MMS remains an effective, yet not commonly accessible option, as it can only be performed by pathologically trained surgeons. Nevertheless, regardless of the surgical method, establishing the orientation of the specimen is always critical, and accuracy in this regard can be achieved by various techniques, such as using sutures in different lengths or color codes for each side. Surgeons may use hand-drawn pictures, printed maps of the areas in question, and photographs to guide the patholoCOMMUNICATION A practical method for accurate coordination between the plastic surgeon and the pathologist: The clockwork technique Billur Sezgin1 , Irem Kapucu1 , Guliz Yenidunya1 , Pinar Bulutay2 , Ayse Armutlu2 , Selahattin Ozmen1 , Reha Yavuzer1 Departments of 1 Plastic, Reconstructive, and Aesthetic Surgery and 2 Pathology, Koc University School of Medicine, Istanbul, Turkey Correspondence: Billur Sezgin Department of Plastic, Reconstructive, and Aesthetic Surgery, Koç University Hospital, Maltepe Mh., Davutpasa cad. No 4, Topkapı, 34010 Zeytinburnu, Istanbul, Turkey Tel: +90-850-250-8250–20201, Fax: +90-0442-232-5300, E-mail: bsezgin@ku.edu.tr This article was presented as a poster at the 38th Congress of the Turkish Society of Plastic, Reconstructive and Aesthetic Surgeons on 27–30 October, 2016 in Antalya,Turkey. gist. Tissue nicks or poly-angulated drawings can also be used to improve the orientation [3]. These markings are especially useful when determining the need for re-excision; thus, precision is key for minimizing further tissue loss while obtaining tumor-free margins. We present an easily applicable technique that has been developed to increase the precision of surgical margin evaluation in various skin tumors. The ‘clockwork technique’ uses a clock face template for the orientation of the specimen. This method ensures accurate coordination between the surgeon excising the tumor and the pathologist who guides the surgeon in re-excision until tumor-free margins are achieved. The first step is to determine the type of the lesion via biopsies if necessary, as the safety margin will be adjusted according to the characteristics of the primary tumor. Lesions involving facial subunits may be an exception, as the required margin may not be planned accordingly in certain critical locations. The second step is to outline the approximate borders of the visually apparent tumor and to draw a safety margin that will serve as the clock face for the orientation of the specimen. Then, the periphery of the circle is numbered through 12 as in a clock (Fig. 1). The hourly markings go through both the excised specimen and the healthy tissue, so that the surgeon knows which part of the excised tissue corresponds to which ‘hour.’ The lesion is excised as a complete circle and a single suture is placed at a pre-determined hourly interval as a guide if the marking is disrupted. After microscopic examination, the pathologist can state which hour slice corresponds to a tumor-positive margin, and further excision can be carried out only in the area of that hour slice. Plastic surgeons need to work very meticulously alongside pathologists, as every millimeter of skin preserved can be used to achieve better aesthetic and functional outcomes. The clockwork technique can be applied to any type and size of lesion. It is also beneficial for tumors that have unpredictable growth patterns, where it is not possible to agree on a standard optimal safety margin, such as dermatofibrosarcoma protuberans. Moreover, in areas where aesthetic and functional preservation are concerns, it helps to preserve more healthy tissue, as further re-excision can be carried out in only onetwelfth of the excisional border. In conclusion, this technique is advantageous because it is an easily applicable and fast method that facilitates optimal communication between the surgeon and pathologist regarding specimen borders, allowing precise re-excisions that can be limited to intervals corresponding to one-twelfth of the surgical margin.
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    F-18-FDG PET/CT texture analysis of anthracotic lymph nodes detected with EBUS and comparison with cytological findings
    (Hellenic Soc Nuclear Medicine, 2022) N/A; N/A; Falay, Fikri Okan; Meriçöz, Çisel Aydın; Demirtaş, Elif; Bulutay, Pınar; Seymen, Hülya; Fırat, Pınar Arıkan; Demirkol, Mehmet Onur; Çağlayan, Benan Niku; Teaching Faculty; Teaching Faculty; Master Student; Teaching Faculty; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; Graduate School of Health Sciences; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 246484; 162418; N/A; 133565; 350778; 207545; 196946; 230719
    Objective: Lymph node metastasis is the most important factor both in the selection of treatment since many alternatives have been created in recent years, and in the evaluation of prognosis in lung cancer. The most unpredictable cause of lymph node false positivity in fluorine-18-fluorodeoxyglucose (F-18-FDG) positron emission tomography/computed tomography(PET/CT) is anthracosis. The aim of this study is to compare F-18-FDG PET/CT texture information of anthracotic (ALN) and metastatic (MLN) lymph nodes, after reevaluation of the cytological samples obtained from anthracotic lymph nodes by EBUS-TBNA. Subjects and Methods: Ninety nine patients, 78 of whom had primary lung cancer were included in the study. Two hundred and three lymph nodes from 99 patients sampled by EBUS-TBNA and diagnosed cytologically as ALN or MLN were evaluated retrospectively. All ALN were classified as grades 1, 2 and 3 cytologically. Volume of interest (VOI) of 203 lymph nodes was re-drawn and maximum standardized uptake value (SUVmax), metabolic tumor volume (MN) and total lesion glycolysis (TLG) values were recorded. Results: There was a statistically significant difference in MTV and TLG values in MLN and all ALN grades. However, only grade 1-2 ALN could be differentiated from MLN with SUVmax, and no statistically significant difference was found in grade 3 ALN and MLN. Metabolic tumor volume and TLG values over 4.10cm(3) and 26.57 showed 60% and 59% sensitivity and 83% and 94 specificity respectively for the identification of MLN. Conclusions: The contribution of MTV and TLG values of F-18-FDG PET/CT to the differential diagnosis of ALN is much more valuable than SUVmax values, especially for grade 3 anthracosis. It was thought that cytological reporting of only grade 3 ALN could make a better contribution to the F-18-FDG PET/CT evaluation analysis.
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    Scrape cytology and radiological solid size correlation can be used in the intraoperative management of subsolid lung nodules
    (Wiley) N/A; N/A; N/A; N/A; N/A; N/A; Bulutay, Pınar; Atasoy, Kayhan Çetin; Erus, Suat; Tanju, Serhan; Dilege, Şükrü; Fırat, Pınar Arıkan; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 133565; 189220; 175565; 214690; 122573; 207545
    Background: The term radiologic subsolid lung nodule (SLN) represents a heterogeneous group of non-neoplastic and neoplastic lesions. Intraoperative evaluation (IO) is often required to differentiate and diagnose. The current study aims to investigate the feasibility and reliability of scrape cytology (SC) and radiologic solid size correlation for the IO diagnosis of SLNs.Methods: Sixty-eight patients with SLN signs were eligible to take part in the study due to intraoperatively prepared SC slides. We managed to complete the blind radio logic solid size measurement and cytologic evaluation retrospectively. Cases were grouped into three categories based on their cytological features: Group-0 (Benign), Group-1 (mild atypical features), and Group-2 (severe atypical features/unequivocally carcinoma). IO diagnoses were given by combining the radiologic solid size and cytological findings.Results: Cytological features of Group-1 were observed in 100%, 93%, 32.5%, and 17% of the AIS, MIA, IA, and benign lesions, respectively. Cytological features of Group-2 were observed in 67.5%, and 7% of the IA and MIA, respectively. By combining cytology with radiologic solid size, 100%, 85%, 71%, and 83% of the AIS, IA, MIA, and benign lesions respectively were diagnosed correctly. Fifteen (15%) percent of the IA cases were underdiagnosed as MIA since their radiological solid sizes were less than 0.5 cm with cytological features of Group-1. Conversely, 29% of the MIA cases were overdiagnosed as IA since their radiological solid sizes were greater than 0.5 cm. Conclusion: SLNs should be handled with caution in terms of IO management. SC and radiologic solid size correlation both provide a practical and tissue-protecting approach for the IO evaluation of SLNs, ensuring a high consistency between IO and definitive diagnosis.
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    Sweet's syndrome induced by granulocyte colony-stimulating factor: case report
    (Türkiye Klinikleri, 2017) N/A; N/A; Gökalp, Hilal; Bulutay, Pınar; Doctor; Teaching Faculty; Koç University Hospital; School of Medicine; N/A; 133565
    Sweet's syndrome (SS) is a neutrophilic dermatosis presenting with sudden onset of tender erythematous papules and plaques. It is a febrile disease, more commonly seen in females, 30-50 years of age. Neutrophilic leukocytosis and extensive dermal neutrophilic infiltration are prominent. Although pathogenesis is not clear, hypersensitivity reaction associated with infections, pregnancy, autoimmune/inflammatory diseases, malignancies and drugs thought to have a role. Various antibiotics, antiepileptics, retinoids, antihypertensive agents, oral contraceptives, azathiopurine and granulocyte colony stimulating factor (G-CSF) have been implicated as the causes of drug-related SS. We present a case with SS that occurred after the treatment of G-CSF in a patient with splenic marginal zone lymphoma.
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    A rare presentation of a rare disease: endobronchial hamartoma with lobar bronchiectasis
    (Turkish Society of Thoracic Surgery, 2020) Kapdağlı, Murat; Yavuz, Ömer; Erus, Suat; Bulutay, Pınar; Tanju, Serhan; Teaching Faculty; Faculty Member; Teaching Faculty; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; 175565; 133565; 214690
    Benign lung tumors are very rare, endobronchial hamartomas -one of which- are even more rare. Endobronchial masses tend to represent themselves via obstruction related symptoms and endobronchial hamartomas are not an exception. It is important to diagnose endobronchial masses before they bring untreatable damage to the lung. It is also important to differentiate endobronchial hamartomas from endobronchial malignancies, such as carcinomas, for they also tend to act mildly symptomatic for a long period of time. In our case, the patient was admitted to our clinic with the symptoms of cough and mild hemoptysis. A computed chest tomography showed total bronchiectasis of right upper lobe along with an endobronchial mass in the right upper lobe bronchus. Bronchoscopic biopsy of the mass revealed no diagnosis. We performed a right upper lobectomy and the pathological examination resulted as endobronchial hamartoma. There are numerous cases about endobronchial hamartomas in the literature which represented with countless symptoms and diseases as persistent cough, recurrent pneumonia, local bronchiectasis and so forth. Our case of endobronchial hamartoma representing with total bronchiectasis of a whole lobe of the lung is the first and only case in the English literature to our knowledge.
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    Reproducibility of morphologic parameters of the international endocervical adenocarcinoma criteria and classification system and correlation with clinicopathologic parameters: a multi-institutional study
    (Lippincott Williams and Wilkins, 2022) Erdem, Özlem; Zeren, Emine Handan; Haberal, Nihan; Özen, Özlem; Ayhan, Ali; N/A; N/A; N/A; N/A; N/A; Bulutay, Pınar; Kulaç, İbrahim; Taşkıran, Çağatay; Vatansever, Doğan; Kapucuoğlu, Fatma Nilgün; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 133565; 170305; 134190; 193687; 7421
    Endocervical adenocarcinomas (ECAs) have been recently reclassified according to their morphologic features linked to etiology by the International Endocervical Adenocarcinoma Criteria and Classification (IECC) and this system is adopted by WHO 2020. This classification separates the ECAs as human papillomavirus (HPV)-associated (HPVA) and HPV-independent (HPVI) subtypes. According to WHO 2020, high risk (HR)-HPV association can be histologically recognized by the presence of luminal mitoses and apoptosis. Therefore, investigating the reproducibility of the morphologic criteria of this new classification will be important in observing the recognizability of tumor types. Full slide sets of 94 ECAs were collected from 4 institutions in Turkey and reclassified on the basis of IECC/WHO 2020 criteria and the presence or absence of HR-HPV. HR-HPV presence was confirmed by HPV DNA in situ hybridization, p16 immunohistochemistry and in conflicted cases with real time-polymerase chain reaction. The final diagnoses were given based on the combination of the histologic evaluation and ancillary test results. Our cohort consisted of 73.4% HPVA and 26.6% HPVI cases. According to the WHO 2020 criteria 92.7% of HPVAs and 88% of HPVIs were easily classified. HPV DNA in situ hybridization was positive in 91.3% of the HPVAs and p16 was positive in all HPVAs, and also positive in 8% of the HPVIs. In conclusion, most of the ECAs can be diagnosed by their characteristic morphologic features by the WHO 2020 criteria. However, we want to emphasize that mitosis/apoptosis criteria may not be helpful especially in mucinous ECAs and ancillary tests for HR-HPV should be used in challenging cases.
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    Could fifty percent tumor viability be a good prognostic factor?
    (Elsevier Science Inc, 2022) Cesur, Ekin Ezgi; Özer, Kadir Burak; Mandel, Nil Molinas; N/A; Erus, Suat; Bulutay, Pınar; Selçukbiricik, Fatih; Tanju, Serhan; Fırat, Pınar Arıkan; Dilege, Şükrü; Faculty Member; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 175565; 133565; 202015; 214690; 207545; 122573
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    Lower BRMS1 expression is associated with high grade histologic subtypes in lung adenocarcinomas
    (Springer, 2019) Zeren, Handan Emine; N/A; N/A; N/A; N/A; N/A; Bulutay, Pınar; Fırat, Pınar Arıkan; Erus, Suat; Tanju, Serhan; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; 133565; 207545; 175565; 214690; N/A
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