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    Eosinophilic infiltration in gallbladder pathologies: A clinical dilemma
    (2025) Martlı, Hüseyin F.; Aydın, Arzu H.; Şahingöz, Eda; Er, Sadettin; Akgül, Özgür; Turhan, Nesrin; Tez, Mesut
    Objectives: To determine the clinicopathological features and prevalence of Eosinophilic cholecystitis (EC) with a single-center experience. Eosinophilic cholecystitis is an exceedingly uncommon pathologic issue caused by examining cholecystectomy specimens. Methods: A retrospective analysis was performed on 8,342 cholecystectomy specimens. Of these, 33 pathology results confirmed EC and were re-examined by pathologists. This study obtained demographic data, medical histories, comorbidities, clinical laboratory results, radiological findings, and pathological information from an electronic record system. Results: The average age of the patients was 47 years, with a range of 24 to 82 years. Acute cholecystitis was reported in 5 (15.6%), chronic cholecystitis in 25 (75.8%), and cholelithiasis in 3 (9.1%) gallbladder specimens. Five of the 33 patients had liver hydatid cysts. There was no statistically significant difference in parameters such as blood eosinophil count, eosinophil ratio, eosinophil count in the gallbladder wall, and gallbladder wall thickness between patients with and without liver hydatid cysts who had eosinophilic cholecystitis. Conclusion: Eosinophilic infiltration is a component of inflammatory processes, including acute and chronic inflammation. Importantly, hydatid cysts can be observed in the liver, which relates to EC. In our study, no distinct clinical, laboratory, or radiological findings of EC were identified, and the diagnosis of EC was made pathologically.
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    Evaluation of the necessity of simultaneous cholecystectomy in patients undergoing liver hydatid cyst surgery
    (Elsevier B.V., 2025) Martlı, Hüseyin Fahri; Aydın, Arzu Hazal; Şahingöz, Eda; Duru, Derviş; Er, Sadettin; Turhan, Nesrin; Tez, Mesut
    Liver hydatid cysts remain a significant public health issue in Turkey, the Middle East, East Asia, and Russia. Surgical treatments are often employed for certain stages of this disease. However, the necessity of simultaneous cholecystectomy during these procedures remains unclear. Treating symptoms related to subsequent cholelithiasis can become more challenging. This study investigates the necessity of simultaneous cholecystectomy by following patients who underwent hydatid cyst surgery with or without concurrent cholecystectomy. Materials and methods: Patients who underwent surgery for hydatid cysts between 2019 and 2024 at the General Surgery Clinic of Ankara Bilkent City Hospital were retrospectively reviewed. A total of 97 patients were included, with 56 (54.32 %) undergoing cholecystectomy along with hydatid cyst surgery (Group 1) and 41 (45.68 %) not undergoing cholecystectomy (Group 2). Preoperative clinical, laboratory, and radiological findings, as well as intraoperative data, morbidity, mortality, and postoperative symptoms, were analyzed. Results: Patients in Group 1 had longer hospital stays, higher blood loss, and significantly higher Clavien-Dindo complication scores. In the postoperative follow-up of Group 2, 8 patients (19.51 %) developed stones or sludge, and 1 patient (2.4 %) developed polyps. Four patients (9.75 %) presented to the emergency department with cholecystitis symptoms. A total of 5 patients (12.19 %), including 4 with symptomatic cholelithiasis (9.7 %) and 1 with gallbladder polyps (2.4 %), underwent elective cholecystectomy. Two (40 %) of these cholecystectomies were performed laparoscopically, while three (60 %) were converted to open cholecystectomy. Conclusion: Simultaneous cholecystectomy during liver hydatid cyst surgery may prevent difficulties associated with treating symptoms related to subsequent cholelithiasis.
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    Role of stromal area and tumor:stroma ratio in predicting response to neoadjuvant chemoradiotherapy in rectal cancer patients
    (Springer Wien, 2025) Şahingöz, Eda; Aydın, Arzu Hazal; Turhan, Nesrin; Tez, Mesut
    Neoadjuvant chemoradiotherapy (nCRT) improves outcomes in locally advanced rectal cancer (LARC). However, the response varies, thus necessitating predictive markers. Methods We analyzed 44 LARC patients treated with nCRT followed by surgical resection. Pretreatment biopsies were evaluated for the tumor:stroma ratio (TSR) and stromal area using digital image analysis by two pathologists. Pathological response was graded with the College of American Pathologists Tumor Regression Grade (CAP-TRG). Results Good/partial responders (TRG 0-2) comprised 68.2% of the cohort. Median stromal area was lower in good/partial responders (2.5 mio. px(2) vs. 3.3 mio. px(2); P = 0.006). Median TSR was higher in good/partial responders (0.85 vs. 0.38) but not significantly (P = 0.137). Receiver operating curve (ROC) analysis identified a stromal area cut-off of 2.9 mio. px(2) (area under the curve [AUC] 0.745, sensitivity 80.77%, specificity 64.29%; P = 0.009) for a poor response. Multivariate regression confirmed stromal area (odds ratio [OR] 2.14, 95% confidence interval [CI] 1.12-4.09; P = 0.021) and perineural invasion (OR 3.45, 95% CI 1.33-8.94; P = 0.010) as independent predictors. Conclusion Higher stromal area predicts a poorer nCRT response in LARC, while TSR trends toward significance. Stromal area may guide personalized treatment, pending larger cohort validation and practical implementation in clinical settings.