Hossein Hatami; Zhaleh Mohsenifar; Seyed Navid Alavi
Abstract
Background:The diagnostic accuracy of frozen section as an important source of information in surgical pathology is important not only in the management of surgical patients but also as a measure of quality control in surgical pathology. In this study, we evaluated the diagnostic accuracy of frozen sections ...
Read More
Background:The diagnostic accuracy of frozen section as an important source of information in surgical pathology is important not only in the management of surgical patients but also as a measure of quality control in surgical pathology. In this study, we evaluated the diagnostic accuracy of frozen sections over a 6-year period in a teaching hospital in Iran.
Methods: We retrospectively reviewed frozen sections performed in the Pathology Department of Taleghani Hospital (Shahid Beheshti University of Medical Sciences), Tehran, Iran from 2007 to 2013. The results were compared to the permanent sections to evaluate diagnostic accuracy, sensitivity and specificity, of frozen section test. Discordant cases were reassessed to find the reasons for discrepancy.
Results: A total of 306 frozen section specimens from 176 surgical cases were evaluated. In eleven specimens (3.59%) the diagnoses were deferred. Of the remaining 295 specimens, 6 (2.03%) were discordant and 289 (97.96%) were concordant to permanent diagnoses. Specimens were primarily from the head & neck, thyroid, ovary, parathyroid and lymph nodes. The overall sensitivity, specificity, positive predictive value and negative predictive value of the frozen section compared to permanent section (as gold standard) were 92.95%, 99.55%, 98.50% and 97.80% respectively. Of the 6 discordant diagnoses, two (33.3%) were due to sampling error and four (66.6%) were due to interpretative errors.
Conclusion: Frozen section is an accurate and valuable test and can be relied on in surgical managements. The results of this study also confirm that the accuracy of frozen section diagnosis in our institution compares well with internationally published rates.
Dermatopathology
Maral Mokhtari; Farzaneh Mostanbet; Saideh Nekooee Fard; Golsa Shekarkhar; Mozhdeh Sepaskhah; Maryam Sadat Sadati
Abstract
Background & Objective: Thiopurine drugs are considered as a treatment modality in various autoimmune disorders including pemphigus vulgaris (PV). These drugs are metabolized by an enzyme “Thiopurine S-methyl transferase” (TPMT). Various variants of this enzyme may have decreased ...
Read More
Background & Objective: Thiopurine drugs are considered as a treatment modality in various autoimmune disorders including pemphigus vulgaris (PV). These drugs are metabolized by an enzyme “Thiopurine S-methyl transferase” (TPMT). Various variants of this enzyme may have decreased activity leading to serious drug side effects. To investigate the phenotype and genotype of TPMT in PV patients receiving thiopurine drugs. Methods: 50 patients (29 women and 21 men) with pemphigus vulgaris treating with standard dose of Thiopurine drugs were selected. Sex, age, result of liver function test and complete blood count were recorded. Genotyping of two common non-functional allele (TPMT*2 and TPMT*3C) by Allele-specific and RFLP-PCR was performed. TPMT enzymatic level was determined by an ELISA based method. Results: Of patients, 36 (72%) were found to have normal TPMT level; and 12, (24%) had higher level of enzyme and 2, 4% had low TPMT enzyme, but none of the patients showed mutant TPMT*2 and TPMT*3C alleles. None of the patients showed hepatotoxicity and bone marrow suppression. Conclusion: The phenotypic assay based on ELISA method may have false positive and misleading results but genotyping using PCR-RFLP and allele specific PCR is accurate, simple and cost-effective and can be used in patients decided to undergo thiopurine treatment.
GI, Liver & Pancreas Pathology
Masoume Mahmoudi-Nesheli; Reza Alizadeh-Navaei; Laleh Vahedi; Omolbanin Amjadi; Tarang Taghvaei; Iradj Maleki; Ramin Shekarriz; Arash Kazemi; Versa Omrani-Nava; Maryam Alizadeh-Forutan
Abstract
Background & Objective: Leptin is an adipocyte-derived hormone with a critical role in energy balance. As demonstrated by previous investigations, leptin acts as a proliferative and angiogenic factor in cancer cells. However, results regarding its role in colorectal cancer are still inconclusive. ...
Read More
Background & Objective: Leptin is an adipocyte-derived hormone with a critical role in energy balance. As demonstrated by previous investigations, leptin acts as a proliferative and angiogenic factor in cancer cells. However, results regarding its role in colorectal cancer are still inconclusive. We aimed to evaluate serum leptin and tissue expression of leptin receptor (Ob-R) in normal and malignant samples of colorectal.Methods: Serum and tissue samples from pathology-confirmed colorectal cancer patients and normal controls referring to a university hospital of Mazandaran were obtained during 2019-21. ELISA and immunohistochemistry were applied to determine leptin and Ob-R expression respectively.Results: A total of 90 samples belonging to 46 normal and 44 CRC patients were enrolled. Normal and CRC groups included 32 (69.56%) and 21 (47.72%) female subjects respectively. The average leptin concentration in the normal group was 115.80 and, in the patient, group was 124.47 ng/mL (P=0.897). CRC cases showed an insignificantly higher Ob-R detection rate (P=0.086).Conclusion: There was no significant difference in leptin and Ob-R expression between CRC patients and normal subjects. Thus, leptin and its receptor may not be useful as a biomarker of CRC.
Microbiology
Hassan Ehteram; Mohaddeseh Sadat Mousavian; Tahereh Mazoochi; Tahereh Khamehchian; Mohammad Karimian
Abstract
Background & Objective: Squamous cell carcinoma (SCC) is the second most common non-melanoma skin cancer that may be caused by Human papillomavirus (HPV), especially in immunosuppressed patients. However, the role of the mucosal types of HPV in SCC patients with normal immunity has not been extensively ...
Read More
Background & Objective: Squamous cell carcinoma (SCC) is the second most common non-melanoma skin cancer that may be caused by Human papillomavirus (HPV), especially in immunosuppressed patients. However, the role of the mucosal types of HPV in SCC patients with normal immunity has not been extensively confirmed. The aim of this study was to investigate the association of some high-risk mucosal types of HPV with cutaneous SCC in an Iranian population. Methods: Sixty-five formalin-fixed, paraffin-embedded tissue specimens with a diagnosis of cutaneous SCC as the case group and sixty-five healthy skin specimens as the control group were included in our case-control study. Genomic DNA was extracted from tissue samples and then PCR was used for the detection of HPV genotypes by a commercial kit. Result: Our data revealed that 6 out of 65 SCC samples (9.2%) were infected by high-risk mucosal types of HPV whereas none of the 65 control samples were infected by the mentioned HPVs. Statistical analysis showed a significant association between these types of HPV infection and SCC risk in our studied population (P=0.028). Conclusion: These findings suggested that some high-risk mucosal types of HPV are significant risk factors for cutaneous SCC.
Pranjali Sejwal; Milan Jaiswal; Surbhi Pandey
Volume 13, Issue 3 , July 2018, , Pages 340-347
Abstract
Background and Objective:The current study aimed at observing the cytomorphological patterns in patients presenting with enlarged cervical lymphnodes, diagnosed by fine needle aspiration cytology (FNAC), their distribution with respect to age and gender, and determining the accuracy of FNAC as a diagnostic ...
Read More
Background and Objective:The current study aimed at observing the cytomorphological patterns in patients presenting with enlarged cervical lymphnodes, diagnosed by fine needle aspiration cytology (FNAC), their distribution with respect to age and gender, and determining the accuracy of FNAC as a diagnostic procedure incases with cervical lymphadenopathy.Methods: Out of all patients presenting with cervical lymphadenopathy from September 2015 to September 2016, in the Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India 100 consecutivecases were enrolled into the current study, following the exclusion of all cases where FNAC smears were inadequate or suboptimal for diagnostic interpretation. Histopathological examination was conducted on small excision biopsy specimens/radical neck dissection, where ever possible and diagnostic efficacy of FNACwas evaluated. Results: Theoverall age range of the enrolled patients, presentingwith enlarged cervical lymph nodes, was 1-72 years withthe mean age of 35.7 years and male-femaleratio of 1.6:1.Out of the 100 cases, benign and malignant lesions comprised 77 and 23 cases, respectively.The most common observed benign lesion was reactive hyperplasia(29%), while squamous cell carcinoma was the most common malignant lesion.The overall sensitivity, specificity, positive predictive value, negative predictive value,andthe diagnostic accuracy was 100%, 91.67%, 92%, 100%, and 95.7%, respectively.Conclusion: FNAC in the diagnoses of inflammatory and neoplastic diseases serves as a reliable,low-cost, rapid diagnostic tool with reasonably good accuracy that caninfluence patient management in terms of early diagnoses, treatment, and prevention of unnecessary surgery in patients.
Biochemistry
Alireza Abdollahi; Zoreh Nozarian
Volume 11, Issue 4 , October 2016, , Pages 363-369
Abstract
Background: Accumulation of pleural and peritoneal fluid is seen in some diseases. In order to diagnose the disease and start the treatment, one of the most important actions will be to differentiate between exudates and transudates. The objective of this study was to determine the diagnostic value of ...
Read More
Background: Accumulation of pleural and peritoneal fluid is seen in some diseases. In order to diagnose the disease and start the treatment, one of the most important actions will be to differentiate between exudates and transudates. The objective of this study was to determine the diagnostic value of measuring the specific gravity of the fluid through refractometer and strip in differentiation of exudates from transudates. Methods: The serum of patients was evaluated for protein, LDH, cholesterol, bilirubin and albumin. The fluid was evaluated for the number of white blood cells, protein, LDH, cholesterol, bilirubin and albumin. Then the fluids were divided into exduate and transudate categories based on Light and Gradient criteria. Finally, the specific gravity of the fluids was measured by refractometer, Erma, Japan and Medi-Test Combi II. The categorized fluids were compared with Gold Standards (final diagnosis) so that the sensitivity and specificity of Light and Gradient criteria in the transudate-exudate differentiation were specified. Results: In comparison with Light criteria, the cut off level of 1022 specific gravity measured by refractometer for pleural effusion has sensitivity, specificity of 92.1%, 68.1%respectively. In evaluation of peritoneal fluid considering cut off point 1023, measured by refractometer has reliable sensitivity 92.4%, specificity 70.4 compared with standard gradient method. Conclusion: Differentiating transudate from exudates by measuring its special gravity by refractometer will have acceptable sensitivity and specificity, and when rapidity is necessary or access to lab equipment is limited, this method could be used.
Microbiology
Khashayar Mohseni; Reza Mirnejad; Vahab Piranfar; Shiva Mirkalantari
Abstract
Background & Objective: Since the symptoms of Brucellosis are often atypical and nonspecific, using clinical signs alone to diagnose brucellosis is not advised; therefore, the diagnosis relies predominantly on laboratory testing. Currently, molecular, serological, and microbiological methods are ...
Read More
Background & Objective: Since the symptoms of Brucellosis are often atypical and nonspecific, using clinical signs alone to diagnose brucellosis is not advised; therefore, the diagnosis relies predominantly on laboratory testing. Currently, molecular, serological, and microbiological methods are used for diagnosis of this disease. In this study we examined ELISA, PCR and serum agglutination (SAT) methods on human patient serum samples. Methods:A total of 100 serum samples were collected from suspected patients. Fifty serum samples gave a positive result with the Wright test. The ELISA method was first employed on all samples for the detection of IgG and IgM antibodies against Brucella. Subsequently, the rapid PCR methodology was used to identify presence of Brucella genome in 500 µL of each serum sample. The B4/B5 primer pair was used for PCR amplification. Results:Out of the 100 serum samples obtained from patients with suspected brucellosis, 50 samples tested positive by SAT and displayed high titers of 1/160. Of these 50 positive samples, 49 samples were positive as per the ELISA test whereas one sample tested negative. The PCR test was conducted on all 100 serum samples and results showed that the 45 serum samples that gave a positive agglutination test were also positive by PCR. Conclusions: Various laboratory methods have beenused or introduced for the detection of Brucella. Molecular methods such as PCR, a rapid and sensitive method for detection of bacteria, have also been reported. Based on the results of this study, we propose that the simultaneous use of serology and molecular techniques has the potential to overcome limitations of detection thereby enabling the selection of appropriate treatment for the patient.
Amir Tajbakhsh; Faezeh Ghasemi; Seyedeh Zohre Mirbagheri; Mastoureh Momen Heravi; Mehdi Rezaee; Zahra Meshkat
Volume 13, Issue 4 , October 2018, , Pages 429-437
Abstract
Background and Objectives: The incidence of rifampin-resistant strains of Mycobacterium tuberculosis has attracted more attention than the tuberculosis infection due to laborious treatment and control. Recognizing the Mycobacterium tuberculosis genotypes involving in drug resistance via multiplex PCR, ...
Read More
Background and Objectives: The incidence of rifampin-resistant strains of Mycobacterium tuberculosis has attracted more attention than the tuberculosis infection due to laborious treatment and control. Recognizing the Mycobacterium tuberculosis genotypes involving in drug resistance via multiplex PCR, a simple and rapid genotyping method, is an emergency for better treatment and control of tuberculosis. This study was designed to specify the frequency of rifampin-resistant strains of Mycobacterium tuberculosis isolated from patients by multiplex allele-specific Polymerase Chain Reaction assay (MAS-PCR).Methods: In this study, 88 Mycobacterium tuberculosis positive samples were included from Qaem Hospital, Mashhad. MAS-PCR was used to detect the rifampin resistance associated mutations in rpoB gene. Results: Mutations in three codons of rpoB gene causing rifampin resistance were detected in 51 isolates (58.96%). The detected mutations in codons 531, 526, and 516 were 55.68%, 38.63%, and 13.63%, respectively. The simultaneous mutations were detected in 11 isolates (12.50%) in codons 531, 526 and 516, in 21 isolates (23.86%) in codons 531 and 526, and in one isolate (1.13%) in codons 526 and 516. Conclusion: According to the results of this study, the frequency of rifampin-resistant strains of Mycobacterium tuberculosis isolated from Khorasan province patients (North-East of Iran) was high. The developed MAS-PCR assay can be used for rapid detection in clinical diagnostic laboratories in areas with high prevalence of multidrug-resistant Mycobacterium tuberculosis strains. In this respect, MAS-PCR is simple, rapid, and highly sensitive method for drug susceptibility tests for detecting multidrug-resistant Mycobacterium tuberculosis.
Uropathology
Purwa Patil; Bhushan Warpe
Volume 11, Issue 5 , October 2016, , Pages 448-451
Abstract
Amyloidosis of urinary bladder is a rare condition and may be primary or secondary in nature. A case of primary localized vesical amyloidosis (VA) in a 40-yr-old man is described confused with neoplasm by cystoscopic, urographic. Surgical specimens obtained by transurethral resection (TUR) were diagnostic ...
Read More
Amyloidosis of urinary bladder is a rare condition and may be primary or secondary in nature. A case of primary localized vesical amyloidosis (VA) in a 40-yr-old man is described confused with neoplasm by cystoscopic, urographic. Surgical specimens obtained by transurethral resection (TUR) were diagnostic and histologically revealed amyloid deposits in sub-epithelial stroma with chronic inflammatory and giant-cell reaction. Congo-red positivity of the deposit was retained even after pre-treatment with KMnO4, confirming AL protein and primary nature of the amyloidosis.
Nasrin Shayanfar; Mitra Rezaei; Mehdi Ahmadi
Volume 5, Issue 1 , January 2010, , Pages 34-39
Abstract
Background and Objective: To evaluate extended spectrum betalactamase (ESBL) positive strains of Klebsiella pneumonia and Escherichia coli in positive bacterial cultures. Materials and Methods: In this analytical cross-sectional study, between March 2006 and March 2007, 170 bacterial isolates ...
Read More
Background and Objective: To evaluate extended spectrum betalactamase (ESBL) positive strains of Klebsiella pneumonia and Escherichia coli in positive bacterial cultures. Materials and Methods: In this analytical cross-sectional study, between March 2006 and March 2007, 170 bacterial isolates including 133 cases of E. coli and 37cases of K. pneumonia were examined. All cases underwent double disk diffusion for ESBL. Demographic data were assessed and all data analyzed accordingly. Results: Patients’ mean age was 55±26.63 yr. Ninety six cases (56.5%) were female and 74 cases (43.5%) were male. Clinical presentation of infection were 118 cases UTI (96.4%), 15 cases septicemia (8.8%), 16cases wound infection (9.4%), 7 cases pneumonia (4.1%), 1 case meningitis (0.6%) and 13 cases other presentations (7.6%). Frequency of ESBL positive in E. coli isolates was 38 cases (28.6%) and in K. pneumonia isolates was 10 cases (27%). There was no significant correlation between ESBL positivity and age, gender, ward or clinical presentation of infection. Conclusion: Incidence of ESBL positive isolates of E. coli and K. pneumonia was high. These results should be considered in administration of broad-spectrum antibiotics by clinicians.
Babak Sayad; Peyman Eini; Hosein Hatami; Alireza Janbakhsh; Siavash Vaziri; Mandana Afsharian; Maryam Rezabeygi
Volume 1, Issue 1 , January 2006, , Pages 35-39
Abstract
Objectives: Immunodeficiency duo to HIV infection can produce unusual diseases in infected individuals & CD4 count is the main predictor of disease progression. In this study clinical syndromes resulting in admition, are considered according to CD4 count for the beter diagnosis and treatment of clinical ...
Read More
Objectives: Immunodeficiency duo to HIV infection can produce unusual diseases in infected individuals & CD4 count is the main predictor of disease progression. In this study clinical syndromes resulting in admition, are considered according to CD4 count for the beter diagnosis and treatment of clinical problemes in HIV infected patients. Materrial & Methods: This is a cross - sectional study that was performed since March 2002 to March 2003 in Kermanshah Sina Hospital. HIV infection was confirmed with positive duble ELI SA and Western Blot. CD4 count was measured by flucytometery, clinical syndromes were collected with final diagnosis, and the rest of the data were gathered according to the patients' interviews. Statistical analysis was performed by SPSS 11.5. Results: During this study, 72 out of 215 admssions were enrolled. All of them were male with the mean age of 33.4 9.1 years. 64 cases (88.9%) were addicted and 40 cases (55.6%) had prison history. Clinical and/or laboratory indicators of AIDS were observed in 32 cases (44.4%). The average of CD4 count was 356/μL.Patients with lymphadenopathy, neurologic and pneumonia syndromes had the least count of CD4 with the averages of 90, 241 and 269/μL and patients with sepsis , endocarditis and hepatitis syndromes had the highest CD4 average count of 646, 394 and 373/μL respectively. Statistically correlations were observed between pneumonia syndrome with CD4<200/μL(Pvalue=0.005), and addiction history(Pvalue =0.0001). Suffering from hepatitis syndrome was also statistically correlated with being at prison. Conclusion: High prevalence of AIDS in our study was a trait which means high prevalence of asymptomatic HIV infection in general population .Also in patients with CD4<200/μL, especially those who are addicted, pneumonia syndrome may occur. Lymphadenopathy, neurologic and pneumonia syndromes are more common in CD4<300/μL whereas sepsis, Endocarditis and hepatitis syndromes are common in CD4> 300/μL, that shows the effect of CD4 count in appearance of clinical syndrpmes. Unsafe injections in prisons may cause acquisition of viral hepatitis in these patients.
Alireza Abdollahi; Farid Azmoudeh Ardalan; Hossein Foroutan; Firouzeh Moradkarami
Volume 3, Issue 1 , January 2008, , Pages 35-39
Abstract
Background and Objective: Long period risk of gastric carcinoma in people affected with chronic Helicobacter pylori gastritis is 5 times more than normal people. Perhaps histological changes due to helicobacter pylori infection could be used for screening people at risk of gastric carcinoma and ...
Read More
Background and Objective: Long period risk of gastric carcinoma in people affected with chronic Helicobacter pylori gastritis is 5 times more than normal people. Perhaps histological changes due to helicobacter pylori infection could be used for screening people at risk of gastric carcinoma and peptic ulcer. Materials and Methods: This study has been carried out as a cross-sectional process and we compared histological changes observed in Helicobacter pylori chronic gastritis in 30 patients with peptic ulcer and 30 patients without the ulcer and then classified them according to Sydney scoring system, and after collecting data, we analyzed them by SPSS software. Results: Sixty percent of patients with ulcer were male and forty percent were female. In addition, 56.7% of patients without ulcer were male and 43/3% were female without a statistically significant difference (p = 0.793). Mean age in ulcer group was 56.4 years and in non-ulcer group was 48.9 years that there was no significant statistical difference (p = 0.057). Chronic gastritis frequency increases within people in their sixth decade and after that. There was no significant difference for degree of infection with Helicobacter pylori (p = 0.346), metaplasia (p =0.885), chronicity (p = 0.796) and degree of activity (p = 0.249), atrophy (p = 0.781) in patients with or without ulcer. Conclusion: There was no significant difference in any of the variables of the study including degree of infection with Helicobacter pylori, chronicity, disease activity and intestinal metaplasia between both groups with and without peptic ulcer.
Hiva Saffar; Afsaneh Rajabiani; Naser Kamalian
Volume 6, Issue 1 , January 2011, , Pages 36-40
Abstract
Clear cell variant of ependymoma is almost exclusively located in the supratentorial region. Only few cases of this tumor that located in the spinal cord have been reported. Here we report one case of intramedullary clear cell ependymoma of the lumbar spinal cord. In microscopic examination, ...
Read More
Clear cell variant of ependymoma is almost exclusively located in the supratentorial region. Only few cases of this tumor that located in the spinal cord have been reported. Here we report one case of intramedullary clear cell ependymoma of the lumbar spinal cord. In microscopic examination, the tumor cells were round to oval with moderate amounts of clear cytoplasm and centrally located large nuclei, resembling oligodendroglioma. Typical features of ependymoma, such as ependymal clefts, perivascular pseudorosettes, as well as nuclear pseudoinclusions and grooves were identified. Albeit being rare, clear cell ependymoma could be mentioned in differential diagnosis of clear cell tumors in this area.
Fatemeh Mahjoub; Farhang Ghanipour; Nasrin Samadi
Volume 2, Issue 1 , January 2007, , Pages 37-40
Abstract
Lipoma arborescens, also known as villous lipomatous transformation of synovium is an unusual fatty lesion of joint. This disorder is characterized by a diffuse increase in the quantity of subsynovial fat in supra-patellar region which bulges the overlying synovial lining and produces a villous architecture. ...
Read More
Lipoma arborescens, also known as villous lipomatous transformation of synovium is an unusual fatty lesion of joint. This disorder is characterized by a diffuse increase in the quantity of subsynovial fat in supra-patellar region which bulges the overlying synovial lining and produces a villous architecture. Hereby we report a case of Lipoma arborescens in an eleven year old boy with a history of supra-patellar swelling of left knee since a year ago. Also, he had a vague history of trauma before left knee swelling. Radiological and histopathologic features of our case are discussed alongside full review of literature. This disorder is an unusual lesion and occurs mainly in middle aged men and is rare in pediatric age group.
Etrat Javadi Rad; Azadeh Almasi; Behzad Khoshraftar
Volume 7, Issue 1 , January 2012, , Pages 38-42
Abstract
We describe a rare case of laryngeal fasciitis ossificans. A 58-year-old man presented with hoarseness and a nodule was found in the larynx. Excisional biopsy was performed, and follow-up laryngoscopy showed complete resolution of this reactive lesion, and normal laryngeal function. The 0.6 cm diameter ...
Read More
We describe a rare case of laryngeal fasciitis ossificans. A 58-year-old man presented with hoarseness and a nodule was found in the larynx. Excisional biopsy was performed, and follow-up laryngoscopy showed complete resolution of this reactive lesion, and normal laryngeal function. The 0.6 cm diameter nodule was well circumscribed and histologically, the lesion was composed of uniform woven bone trabeculae with rimming of osteoblasts and cellular stroma. At the periphery, uniform spindle cells actively proliferated in edematous stroma. Spindle cells were immunoreactive for vimentin and α-smooth muscle actin, suggesting myofibroblastic differentiation. Fasciitis ossificans is histologically identical to myositis ossificans, but tends to present no zonation phenomenon. Fasciitis ossificans is a rare form of heterotopic bone formation, commonly presenting with signs of local inflammation or pain. This patient's successful outcome suggests that conservative resection may be both diagnostic and curative.
Ezat Rahimi; Ali Eishi; Behrooz Ilkhanizade
Volume 4, Issue 1 , January 2009, , Pages 38-43
Abstract
Background and Objectives: Bone marrow necrosis (BMN) is a rare and ominous complication of wide variety of diseases including hematologic malignancy. This study was performed to identify frequency and the underlying associated diseases of marrow necrosis. Materials and Methods: In this descriptive ...
Read More
Background and Objectives: Bone marrow necrosis (BMN) is a rare and ominous complication of wide variety of diseases including hematologic malignancy. This study was performed to identify frequency and the underlying associated diseases of marrow necrosis. Materials and Methods: In this descriptive study, totally 850 bone marrow trephine biopsies related to living patients at the Pathology Department of Urmia Imam Hospital from March 1998 to January 2008, were retrospectively reviewed. The reviews included clinical and laboratory findings from files of the patients. Results: Eight cases of bone marrow necrosis were found. Frequency was 0.94 percent. Ages of the patients were between 18 and 85 years, and four of them were female. Prominent symptoms of the patients were bone pain, fever, fatigue, and jaundice. The most common laboratory findings were anemia, cytopenia, elevated lactate dehydrogenase (LDH), and alkaline phosphatase (ALP). Underlying diseases of bone marrow necrosis in our patients includes systemic lupus erythematosus, multiple myeloma, metastatic gastric cancer, acute myeloid leukemia (M4), hairy cell leukemia, lymphoma, chronic myeloid leukemia and sepsis. Conclusion: Our findings suggest that the conditions associated with BMN are varied and malignancy remains common. In cases presented with pyrexia, bone pain, pancytopenia, elevated LDH and ALK, marrow necrosis must be thought. Although prognosis is very bad, supplementary therapy, in addition to the underlying disease must be performed.
Uropathology
Nilay Nishith; Monika Gupta; Nidhi Kaushik; Rajeev Sen
Abstract
Solitary fibrous tumor (SFT) of prostate is an unusual type of mesenchymal neoplasm that can elicit a benign or malignant phenotype. It represents a diagnostic challenge as it can simulate poorly differentiated adenocarcinoma and various mesenchymal neoplasms of prostate. We report a case of prostate ...
Read More
Solitary fibrous tumor (SFT) of prostate is an unusual type of mesenchymal neoplasm that can elicit a benign or malignant phenotype. It represents a diagnostic challenge as it can simulate poorly differentiated adenocarcinoma and various mesenchymal neoplasms of prostate. We report a case of prostate SFT in a 54-year-old patient, which was clinically misdiagnosed as nodular hyperplasia of prostate with cystitis. However, on follow-up, he was not relieved by the designated treatment. Furthermore, he complained of exacerbation of symptoms and consequently, had to undergo open prostatectomy. Based on histopathological and immunohistochemical (IHC) assessment, a diagnosis of SFT of the prostate was rendered. Additionally, we have discussed the histological mimics of SFT and the diagnostic and prognostic importance of IHC while evaluating such lesions.
Fauzia Sadiq; Farzana Yasmeen; Asim Mumtaz; Warda Hussain; Tauqeer Ali Butt; Sajid Azeem Qureshi; Muhammad Ibrahim
Volume 9, Issue 1 , January 2014, , Pages 45-49
Abstract
Background and Objective: Laboratory errors are one of the major factors that affect the diagnosis, prognosis, treatment and monitoring in patients.The objective of study is to evaluate the frequency and type of errors in different phases of testing at the Pathology Department of the Shalamar ...
Read More
Background and Objective: Laboratory errors are one of the major factors that affect the diagnosis, prognosis, treatment and monitoring in patients.The objective of study is to evaluate the frequency and type of errors in different phases of testing at the Pathology Department of the Shalamar Hospital, Lahore and to evaluate the causes of errors.
Methods: This observational study was carried out in Shalamar Hospital Laboratories Lahore from 1st July 2011 to 31st December 2011. Errors detected and documented on daily basis.
Results: A total of 127,500 samples were received and processed during the six months period. Out of the total samples, 1530 (1.2) errors were detected. Among all errors pre-analytical errors were most common, with a frequency of 70.4%, post-analytical 17.5% and analytical 12.1%.
Conclusions: Our study demonstrates the types and frequencies of errors. It is very important to monitor the all phases so to reduce the frequency of error for better reporting of lab results, ultimately which ensures the patient well-being.
Zhaleh Mohsenifar1; Nazanin Mahdavi; Sara Bagheri
Volume 8, Issue 1 , January 2013, , Pages 48-54
Abstract
Lymphoepithelial cyst of oral cavity is a rare cystic lesion that presents as an asymptomatic submucosal mass and is usually discovered during routine dental examinations. The site most commonly affected is floor of the mouth and tonsillar involvement seems to be very rare. Multiple Lymphoepithelial ...
Read More
Lymphoepithelial cyst of oral cavity is a rare cystic lesion that presents as an asymptomatic submucosal mass and is usually discovered during routine dental examinations. The site most commonly affected is floor of the mouth and tonsillar involvement seems to be very rare. Multiple Lymphoepithelial cysts have been reported in parotid of HIV positive patients however in oral cavity they usually present as solitary lesions.We report a case of multiple bilateral Lymphoepithelial cysts of the palatine tonsils in a 72 years old male that presents with fever, pain and obstructive sleep apnea.We didn’t find any bilateral or multiple tonsillar lymphoepiyhelial cysts in the literature and the present paper seems to be the first report. We suggest although lymphoepithelial cysts rarely occur in the tonsils but they should be considered in differential diagnosis of adenotonsillar enlargement and related obstructive sleep apnea.
Zohreh Nozarian; Alireza Abdollahi
Abstract
Background and Objectives: Urinary tract infections (UTI) are one of the most common infectious diseases with different microbial agent and antimicrobial resistant pattern in hospitalized patients and outpatients. In order to assess the adequacy of therapy, knowledge of prevalence and resistance pattern ...
Read More
Background and Objectives: Urinary tract infections (UTI) are one of the most common infectious diseases with different microbial agent and antimicrobial resistant pattern in hospitalized patients and outpatients. In order to assess the adequacy of therapy, knowledge of prevalence and resistance pattern of the bacteria is necessary. The main aim of this study was to evaluate the prevalence and the antimicrobial resistance pattern of main bacterial responsible for UTI in order to establish an appropriate empirical therapy. Methods: All urine samples were referred to Imam Hospital Laboratory, Tehran, Iran during 2011-2012, urine culture isolated and bacteria were identified and the profile of antibiotic susceptibility was characterized. Result: From 1851 urine cultures, UTI was more frequent in woman (68%) E. coli was as usual the most common pathogen implicated in UTI. Most susceptibility was to imipenem (98.9%). nitroforantoin (96%) and amikacin (94.1%) and increased resistance to penicillin (66.6%), nalidixic acid (62.1%) ampicilin (60.1%) and cotrimoxazole 54.3%. Discussion: The most common isolated pathogen was E. coli. According to antibiogram susceptibility, the recommended antimicrobial drugs are nitroforantoin and imipenem. nalidixic acid and cotrimoxazole are not recommended because drug resistance is high.
Katayoun Ziari; Kamyab Alizadeh
Volume 11, Issue 1 , January 2016, , Pages 61-65
Abstract
Ovarian hemangiomas are benign and rare tumors of female genital tract with less than 60 reported cases in the literature. A 38- yr- old woman was admitted to Be’sat Hospital, Tehran, Iran in 2012, due to severe abdominal pain. Ultrasound evaluation revealed a 6 cm left ovarian cystic mass and ...
Read More
Ovarian hemangiomas are benign and rare tumors of female genital tract with less than 60 reported cases in the literature. A 38- yr- old woman was admitted to Be’sat Hospital, Tehran, Iran in 2012, due to severe abdominal pain. Ultrasound evaluation revealed a 6 cm left ovarian cystic mass and serum tumor markers were normal. Then, left salpingo-oophorectomy was performed for the patient. Microscopic examination revealed a follicular cyst and an incidental cavernous hemangioma consisting thin-walled vascular channels filled with blood that lined with flatten endothelial cells. In IHC staining strong immunoreactivity for CD31 and CD34 were seen, finally, the diagnosis of primary ovarian hemangioma, cavernous-type was made. The clinicopathologic presentation of this unusual benign tumor is discussed.
Microbiology
Mehdi Yousefipour; Mehrnaz Rasoulinejad; Azar Hadadi; Negin Esmaeilpour; Alireza Abdollahi; Siroos Jafari; Atieh khorsand
Abstract
Background and Objective: There is a growing concern regarding the lack of new antibiotics, especially for multidrug-resistant bacteria that produce Extended Spectrum β-Lactamases (ESBLs). The present study aims to assess the prevalence of bacteria producing ESBLs, their antimicrobial resistance ...
Read More
Background and Objective: There is a growing concern regarding the lack of new antibiotics, especially for multidrug-resistant bacteria that produce Extended Spectrum β-Lactamases (ESBLs). The present study aims to assess the prevalence of bacteria producing ESBLs, their antimicrobial resistance pattern, and its main determinants among hospitalized patients.Methods: The study population included 383 consecutive patients with a definitive diagnosis of urinary tract infection (UTI). All eligible subjects for the study had a positive culture for gram-negative microorganisms in urine specimens. ESBL producing isolates were characterized phenotypically for ESBL production using the double disc synergy test.Results: In total, 383 specimens were assessed, among which 212 (55.4%) were related to bacteria producing ESBLs (ESBL+). Of those with ESBL + infections, 65.5% were sourced from catheters (as hospital-associated UTIs), and 35.5% were categorized as community-associated UTIs. In the group consisting of bacteria producing ESBLs, the highest sensitivity was observed with Imipenem (72.2%), while the highest resistance was revealed with ceftriaxone (100%). Conclusion: We have shown that our community faces a high prevalence of bacteria producing ESBLs, mostly sourced from the catheterization of hospitalized patients. The highest bacterial sensitivity was observed with Imipenem, nitrofurantoin, and amikacin, while the highest resistance was found with ceftriaxone and cotrimoxazole, suggesting the ineffectiveness of using the two latter antibiotics for eradicating these bacterial infections. On the other hand, a history of urinary catheterization and previous hospitalization were two main determinants of their presence, a finding which emphasizes the importance of avoiding catheterization and hospitalization of patients with UTIs without proper indications.
Dermatopathology
Farahnaz Bidari Zerehpoosh; Soheila Nasiri; Sara Zahedifard; Shahram Sabeti
Abstract
Background:Non-Melanoma Skin Cancer (NMSC), the most prevalent types being Squamous Cell Carcinoma (SCC) and Basal Cell Carcinoma (BCC), is the most common type of malignancy in human beings. These neoplasms are more frequent in the elderly and fair skinned people and mainly occur on sun-exposed sites ...
Read More
Background:Non-Melanoma Skin Cancer (NMSC), the most prevalent types being Squamous Cell Carcinoma (SCC) and Basal Cell Carcinoma (BCC), is the most common type of malignancy in human beings. These neoplasms are more frequent in the elderly and fair skinned people and mainly occur on sun-exposed sites of the body. Ultraviolet B (UVB) has a well-known effect in induction and promotion of growth of these cancers. The p53 tumor suppressor gene is believed to be an early target in UV-induced skin carcinogenesis. Aggregates of keratinocytes with p53 protein overexpression are frequently identified in normal human skin and are more prevalent in chronically sun-exposed skin, and have been proposed to play a role in skin cancer pathogenesis. The aim of this study was to clarify the potential role of P53 in the development of NMSC. Methods: Immunohistochemical evaluation of p53 expression in peri-lesional skin of 90 cases of SCC, BCC and melanocytic nevi was performed. Results: The well-delineated compact type of p53 clone, but not the strong dispersed type, was significantly more predominant in SCCs in comparison with BCCs and melanocytic nevi (P value=0.001). The size of p53 clones was also significantly greater in SCCs compared to the BCCs (P=0.003) and melanocytic nevi (P=0.001). There was no significant difference between these neoplasms regarding the frequency of P53 clones (P=0.86). Conclusion: This study suggests the possible relationship of epidermal p53 clones with the pathogenesis of SCC.
Molecular Pathology
Zohreh Rahimi; Maryam Bozorgi Zarini Bozorgi Zarini; Ziba Rahimi; Ebrahim Shakiba; Asad Vaisi-Raygani; Mohammad Taher Moradi; Kheirolah Yari
Abstract
Background & Objective: Breast cancer (BC) is known to be the most prevalent cancer among women. One-carbon metabolism (OCM) disturbance might play an important role in the etiology of BC. The present study aimed to investigate the thymidylate synthase (TYMS), 5-methyltetrahydrofolate-homocysteine ...
Read More
Background & Objective: Breast cancer (BC) is known to be the most prevalent cancer among women. One-carbon metabolism (OCM) disturbance might play an important role in the etiology of BC. The present study aimed to investigate the thymidylate synthase (TYMS), 5-methyltetrahydrofolate-homocysteine methyltransferase (MTR), and methionine synthase reductase (MTRR) variants as good candidates for studying the role of genetic variants of folate metabolizing enzymes in the risk of BC.Methods: The present case-control study consisted of 100 BC patients and 141 healthy females. The TYMS 2R/3R (rs34743033), MTR c.2756A>G (rs1805087), and MTRR c.66A>G (rs1801394) variants were detected by polymerase chain reaction (PCR), PCR-restriction fragment length polymorphism (RFLP), and a designed amplification-refractory mutation system (ARMS) method, respectively.Results: The 3R allele of TYMS enhanced the risk of BC by 2.84-fold (p <0.001). In the presence of TYMS 3R/3R, compared to TYMS 2R/3R, there was a trend toward enhancing the risk of metastasis by 4.15-fold (95% CI: 0.96-17.85, p =0.055). The frequencies of MTR c.2756A>G and MTRR c.66A>G variants were not significantly different among patients and controls.Conclusion: We observed that the TYMS 3R is a risk allele for susceptibility to BC and this allele tends to increase the BC metastasis.
Biochemistry
Hassan Ghasemi; Nayere Askari; Sakine Moaiedmohseni; Soghrat Faghihzadeh; Susan Kabudanian Ardestani; Elham Faghihzadeh; Tooba Ghazanfari
Abstract
Background and objective Aside from direct toxic effects, Sulfur Mustard (SM) induced serum hormone abnormalities may aggravate ocular complaints, including Ocular Surface Discomfort (OSD) (burning, itching, and redness), dry eye sensation, photophobia, blurred vision, foreign body sensation, and pain. ...
Read More
Background and objective Aside from direct toxic effects, Sulfur Mustard (SM) induced serum hormone abnormalities may aggravate ocular complaints, including Ocular Surface Discomfort (OSD) (burning, itching, and redness), dry eye sensation, photophobia, blurred vision, foreign body sensation, and pain. The aim of the current study was to investigate the possible association of ocular complaints with serum hormone concentrations in chronic phase of Sulfur Mustard (SM) exposure. Methods:As a part of Sardasht Iran Cohort Study (SICS), 372 SM-exposed patients and 128 non-exposed participants were enrolled. Ocular complaints and ocular surface biomicroscopic conditions and serum hormones were compared. Results:The exposed with tearing group had significantly higher mean serum levels of testosterone and prolactin (ng/mL) than controls (5.75 vs. 4.75, P=0.031; 11.71 vs. 8.42, P=0.009). The exposed with OSD group had significantly higher mean serum levels of prolactin than controls (12.48 vs. 6.90, P=0.002). The exposed with photophobia group had significantly higher mean serum levels of testosterone than the matched exposed (6.25 vs. 5.65, P=0.013). The exposed with blurred vision group had significantly higher mean serum levels of Thyroglobulin (Tg) (ng/mL) than the matched exposed (65.73 vs. 32.6, P=0.003). Conclusion: Higher mean serum levels of testosterone (in exposed with tearing and photophobia) and prolactin (in exposed with tearing and OSD) may play protective roles against SM effects. Higher mean serum levels of Tg may deteriorate the tear film integrity and optical surface, which causes blurred vision. In the chronic phase of SM toxicity, some ocular surface problems are associated with alterations in the serum concentrations of testosterone, prolactin, and Tg.
