Otopsi olgularÕnda mesanenin epitelyal lezyonlarÕnÕn de÷erlendirilmesi

Kadir POLAT,Emre TÜZEL,Fatma AKTEPE,HÜDAVERDİ KÜÇÜKER,İBRAHİM ÜZÜN,Cem GÜLER

Abstract

Objective: This study evaluated the incidence of benign and malignant lesions of the bladder in forensic autopsy cases for the Àrst time in Turkey. Materials and methods: The bladders of 125 (106 men, 19 women) forensic cases who died of trauma or gunshot were obtained at autopsy. For each bladder, 3 samples were taken from the anterior wall, trigon, and posterior wall. The tissues were embedded in ParafÀ n, cut into 5 m sections, stained with hematoxylin and eosin and examined microscopically for the existence of benign and malignant epithelial lesions. Results: The mean and median ages were 57 years and 58 years (range 25-86 years), respectively. None of the cases had any malignant changes, either macro- or microscopicaly. None of the bladders had epithe- lial dysplasia. Benign bladder lesions were detected in 36.8% of the women and 10.3% of the men. These included mucosal metaplastic changes in 6 (5.5%) men and 4 (21%) women, and cystitis in 5 (4.1%) men and 3 (15.7%) women. Of the cystitis cases, 4 were chronic, 2 were follicular, 1 was polypoid, and 1 was hemor- rhagic cystitis. Conclusion: As reported in other series, no bladder cancers were detected in this study. Moreover, none of the benign epithelial lesions detected in our autopsy series showed premalignant changes.

Özet

Amaç: Bu çal×ümada Türkiyede ilk defa adli otopsi olgular×nda mesanenin benign ve malign lezyonlar×n×n s×kl×ù× deùerlendirilmiütir. Gereç ve yöntem: Travma, ateüli silah yaralanmas× gibi sebeplerle hayat×n× kaybetmiü 125 adli vakan×n (106 erkek, 19 kad×n) mesaneleri otopsi ile al×nd×. Her bir mesaneden, anterior duvardan, trigondan ve pos- terior duvardan olmak üzere 3 parça örnek al×nd×. ParaÀne gömülü dokulardan haz×rlanan 5 m kal×nl×ù×n- daki kesitler hematoksilen-eozin ile boyand× ve mikroskopik olarak benign ve malign epitelyal lezyonlar×n varl×ù× araüt×r×ld×. Bulgular: Ortalama ve ortanca yaülar s×ras×yla 57 y×l ve 58 y×l (daù×l×m 25-86 y×l) idi. Makroskopik veya mikroskopik olarak vakalar×n hiçbirisinde malign lezyon izlenmedi. Epitelyal displazi bulgusuna da hiç- bir mesanede rastlanmad×. Benign mesane lezyonlar× ise kad×nlar×n %36.8inde ve erkeklerin %10.3ünde saptand×. Bunlar, 6 (%5.5) erkek ve 4 (%21) kad×nda mukozal metaplastik deùiüiklikler, 5 (%4.1) erkek ve 3 (%15.7) kad×nda sistit idi. Sistit olgular×n×n 4ü kronik, 2si foliküler, 1i polipoid ve 1i hemorajik sistit idi. Sonuç: Bu çal×ümada literatüre uygun olarak hiç mesane kanseri tespit edilmemiütir. Ayr×ca otopsi yap×lan mesanelerde saptanan benign epitelyal lezyonlar×n hiçbirisi premalign deùiüiklikler ile iliükili deùildir.