Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease the etiology and pathomechanism of which remain unclear.This case report presents the diagnostic difficulties caused by the atypical manifestation of SLE in a nine-year-old girl.The finding of an isolated increase in liver enzymes initiated the differential diagnosis of liver disease.The occurrence of additional symptoms in the following months, such as recurrent episodes of urticaria, followed by joint pains, formed the basis for further search for the cause of the presenting complaints.Finally, a diagnosis of SLE was established on the basis of clinical symptoms and laboratory results, including the detection of a lupus anticoagulant.The treatment was initiated with good outcome.This case illustrates how diverse and atypical clinical manifestations with uncharacteristic laboratory results SLE can present with, which can cause diagnostic difficulties and contribute to delays in making a correct diagnosis and starting effective treatment.

Small cell lung carcinoma (SCLC) is characterized by rapid growth and an aggressive clinical course. Standard therapy regimes have limited effects on disease course; therefore theprognosis ofSCLC is poor. In thecurrent study, thefrequency ofprogrammed death ligand 1 (PD-L1) expression in SCLC and its correlation with clinico-pathological features were evaluated. Thestudy included 100 cases ofSCLC wherein testing for PD-L1 was done with theSP263 clone on theVentana benchmark XT system. Cases with > 1% PD-L1 expression in tumour cells or immune cells were categorized as positive. PD-L1 expression was identified in 14% ofcases using thecut-off of≥ 1%. Thetumour proportion score was 10% and theimmune proportion score was 9.78% using acut-off of≥ 1%. PD-L1 positive expression was more frequent in themale population with age > 40 years. All thepatients with positive PD-L1 expression were smokers. In thePD-L1 positive group, presence ofnecrosis was identified in 71.4% ofcases and when compared with thePD-L1 negative subgroup this finding was statistically significant (p = 0.010). Personalized targeted therapy for cases ofSCLC is still under evaluation. Theuse ofimmunotherapeutic targets, such as PD-L1, may help to define anew treatment strategy for SCLC. Development ofnew treatment strategies may improve prognosis and survival.

Although BRCA genes are well-known breast cancer genes, theclinicopathological features ofbreast cancer patients carrying BRCA1/2 pathogenic variants have not been adequately defined. Thegoals ofthis study were to determine thedistribution ofBRCA1/2 variants in theTurkish population and its correlation with clinicopathological features. Clinical data of151 women who underwent BRCA1/2 gene testing at Mersin University Medical Faculty Hospital between 2016 and 2019 were retrospectively analyzed. BRCA1/2 variants were detected as pathogenic (n = 11), variants ofuncertain significance (n = 5), likely benign (n = 3), and benign (n = 81) in breast cancer cases. TheBRCA1/2 pathogenic variant carriers had ahigher histological grade, rate oftriple- negative type, Ki-67 proliferation index, and rate ofno special type carcinoma than thegroup without mutation (p = 0.03, 0.01, 0.04, and 0.02 respectively). We analyzed thedistribution ofvariants we detected in women living in our region and found that pathogenic variants in patients with breast cancer were associated with high histological grade, triple-negative type, high Ki-67 proliferation index, and histological type. Studies in diverse populations are needed to establish aclinicopathological relationship with variants more easily.

This research paper evaluates theefficacy ofco-testing in precluding cervical cancer, with aparticular focus on distinguishable outcomes ofthehuman papillomavirus (HPV) vs. cytology tests. Aretrospective review of5948 patients, who tested positive for high-risk HPV but showed negative cytologic findings, revealed that 15.006% tested positive in subsequent screenings. Acomparative analysis ofvarious commercial HPV tests highlighted theprecision ofmRNA-based HPV testing by Aptima (Hologic) in reducing thelikelihood offalse-negative cytology. Thepaper challenges theconviction that anegative cytology alone suffices advocating for acondensed testing interval in instances ofpositive HPV outcomes, thereby facilitating earlier intervention and optimal preventive care. These findings unveil an exigency for reconsidering preventive strategies based on test outcomes.