Uropathology
Bita Geramizadeh; Nadereh Shams; Pouya Iranpour; Mohammad javad Rajabi
Abstract
Renal hemangioma is a rare tumor which can be capillary or cavernous. There have been less than 30 renal capillary hemangioma cases reported in the English literature. Herein we will report a case of renal hemangioma which was detected in a 74-year-old man operated with the impression of urothelial ...
Read More
Renal hemangioma is a rare tumor which can be capillary or cavernous. There have been less than 30 renal capillary hemangioma cases reported in the English literature. Herein we will report a case of renal hemangioma which was detected in a 74-year-old man operated with the impression of urothelial carcinoma of hilum.
Maryam Iranpour; Shahriar Dabiri; Mitra Rezazade; Fatemeh Bagheri
Abstract
Background & Objective: Cervical intraepithelial neoplasia (CIN) is a dysmaturation process in squamous cells in epithelial layer, which highly increases the risk of developing cervical cancer. The aim of this study was to compare the expression of three biomarkers, p16, p63, and CK17 in patients ...
Read More
Background & Objective: Cervical intraepithelial neoplasia (CIN) is a dysmaturation process in squamous cells in epithelial layer, which highly increases the risk of developing cervical cancer. The aim of this study was to compare the expression of three biomarkers, p16, p63, and CK17 in patients with CIN and in those with atypical squamous metaplasia (ASM). Methods: In this study, 100 patients underwent a colposcopy-guided cervix biopsy. Immunostaining for the biomarkers was undertaken on tissue samples containing ASM (n=50) and CIN (n=50). Results: Immunostaining for CK7, P63, and P16 in patients with CIN significantly increased compared to ASM subjects. Conclusion: The expression of CK17, P63, and P16 in CIN varied from that in ASM. The mentioned biomarkers were reliable factors to distinguish ASM from CIN; however, all biomarkers could differentiate CIN from its mimics due to their high degree of sensitivity and specificity.
Sonam Sharma; Charanjeet Ahluwalia; Mukul Singh; Ashish Mandal
Abstract
Background and Objective: Liquid-based cytology (LBC) is an emerging pathological method for better establishment of the diagnosis in almost all the organs of the body. It is currently used both for the gynecological and non-gynecological (fine-needle aspirates (FNAs)/fluid) specimens in ...
Read More
Background and Objective: Liquid-based cytology (LBC) is an emerging pathological method for better establishment of the diagnosis in almost all the organs of the body. It is currently used both for the gynecological and non-gynecological (fine-needle aspirates (FNAs)/fluid) specimens in most of the developed and few developing countries. The current study aimed at assessing and illustrating the cytological morphology on SurePath® LBC technique when used on FNAs from head and neck lesions, compared to the conventional smears (CS). Methods: In the current prospective study, a total of 1000 FNAs obtained from swellings of head and neck region were simultaneously processed both by the standard conventional and SurePath® LBC techniques. Both of these preparations were studied, compared witha semi-quantitative scoring system, and statistically analyzed. Pvalue Results: LBC smears were better, compared to CS ones, due to the presence of evenly dispersed cells (P ≤0.001), clearance of obscuring elements / background debris (P≤0.001), and better cellular details (P≤0.001). However, these abilities of LBC often became its own nemesis and made the interpretation difficult. Conclusion: LBC, though costly, is an acceptable, simple, and valuable technique. However, CS still cannot be considered inferior to it, and it is recommended that in most of the cases LBC, along with CS, should be reported before reaching a final diagnosis. This is beneficial especially in the developing countries such as India where most of the centers are devoid of LBC technique and hence, are not familiar with many cytomorphological features and potential diagnostic pitfalls unique to it.
Behrang Kazeminejad; Ali Zare Mirzaie; Majid Gholipour Peinavandi
Volume 4, Issue 4 , September 2009, , Pages 194-196
Abstract
Primary leiomyosarcoma of the heart is extremely rare and found in about 0.2% of all cardiac tumors. Here in a 26-year-old man with progressive dyspnea, which had started since 2 months ago, is presented. Echocardiography revealed a left atrial mass, which was suggestive for a atrial myxoma.On the surgery, ...
Read More
Primary leiomyosarcoma of the heart is extremely rare and found in about 0.2% of all cardiac tumors. Here in a 26-year-old man with progressive dyspnea, which had started since 2 months ago, is presented. Echocardiography revealed a left atrial mass, which was suggestive for a atrial myxoma.On the surgery, a tumoral tissue in the left atrium and pulmonary veins with attachment to peripheral soft tissue, was seen and incompletely resected. Histologic examination exhibited a hypercellular,necrotic and mitotically active spindle-celled tumor with fascicular arrangement. Immunohistochemistry showed a positive reaction to SMA in tumoral cells. The patient was advised to refer for postoperative chemotherapy, which was rejected. One year later, the patient was brought to hospital with tumor recurrence. Chemotherapy was initiated for the patient immediately, but the patient was expired 3 days later.
Sushma Ramraje; Sameer Ansari; Shantilal Sisodia; Niddhi Chaturvedi; Varsha Bhatia; Aparagita Goel
Volume 8, Issue 3 , July 2013, , Pages 199-203
Abstract
Mucinous carcinoma of the breast is a well differentiated, rare histological type of invasive ductal carcinoma, seen in oldest median age (69 years). We describe a case of a 60 yr old female with large right breast mass of 10 years duration with no nodal involvement. The reasons to present this case ...
Read More
Mucinous carcinoma of the breast is a well differentiated, rare histological type of invasive ductal carcinoma, seen in oldest median age (69 years). We describe a case of a 60 yr old female with large right breast mass of 10 years duration with no nodal involvement. The reasons to present this case are 1) Because of its rarity. 2) Despite having a large tumour size, the axillary lymph node is not involved, hence rendering favourable prognosis. 3) Fine needle aspiration cytology can be used as an important tool in early detection of pure mucinous carcinoma of breast. 4) Careful clinical examination should be performed when suspicious for mucinous carcinoma because lymph node metastasis changes prognosis and treatment modalities .5) Pure mucinous carcinomas should be distinguished from mixed neoplasm, because the latter have a poorer prognosis that is most likely related to the extent of invasive carcinoma lacking extracellular mucin.
Nephropathology
Elham Farahani; Fatemeh Nili; Mehran Moghimian; Isa Jahanzad; Farzaneh sadat Minoo; Alireza Abdollahi; Samaneh Salarvand
Abstract
Background & Objective: The prevalence of glomerular diseases, as the leading cause of chronic kidney disease, is increasing. Renal biopsy is still the gold standard for diagnosis of the most kidney disorders. Data on prevalence of the biopsy-proven kidney diseases in Iran is limited and none of ...
Read More
Background & Objective: The prevalence of glomerular diseases, as the leading cause of chronic kidney disease, is increasing. Renal biopsy is still the gold standard for diagnosis of the most kidney disorders. Data on prevalence of the biopsy-proven kidney diseases in Iran is limited and none of the previously reported studies used electron microscopic (EM) evaluation for the diagnosis. This study was conducted to analyze the prevalence of biopsy-proven kidney diseases in a referral center in Iran.
Methods: The reports of kidney biopsy samples from 2006 to 2018 referred to a pathology center, affiliated with Tehran University of Medical Sciences were reviewed. The prevalence of different disorders was assessed based on the clinical presentation in 3 age categories, including childhood, adulthood, and elderly.
Results: Among 3455 samples, 2975 were analyzed after excluding transplant-related specimens, suboptimal specimens, and those with uncertain diagnoses. Nephrotic syndrome (NS) (39%) was the most common cause of biopsy followed by subnephrotic proteinuria (18%), hematuria in association with proteinuria (15%), renal failure (9%), isolated hematuria (6%), lupus (4%) and the other non-specific manifestations such as hypertetion or malaise (each one less than 2%). The most common diagnoses included membranous nephropathy (MGN) (17.9%), focal segmental glomerulosclerosis (FSGS) (15.9%), lupus nephritis (LN) (13.7%), minimal histopathological findings (unsampled FSGS versus Minimal Change Disease, 12.1%), Immunoglobulin-A (IgA) nephropathy (6.5%) and Alport syndrome (6.1%). MGN was the most frequent disease before 2013, but FSGS became more frequent after that.
Conclusion: NS and proteinuria were the most indications for kidney biopsy. Although MGN was the most common disease, the prevalence of FSGS has been increasing in recent years and making it the most common disease after 2013. LN and IgA nephropathy are the most common causes of secondary and primary GN presenting with proteinuria and hematuria, respectively.
Indranil Chakrabarti; Nilanjana Ghosh
Volume 7, Issue 3 , July 2012, , Pages 203-206
Abstract
Eosinophilic granuloma is benign end of the spectrum of the Langerhans cell histiocytosis (LCH) which is characterized by solitary or multiple lesions in bones, skin, lung, lymph node etc. Here, we present a case of a 13-year old boy with pain and swelling in the right parietal region of skull with no ...
Read More
Eosinophilic granuloma is benign end of the spectrum of the Langerhans cell histiocytosis (LCH) which is characterized by solitary or multiple lesions in bones, skin, lung, lymph node etc. Here, we present a case of a 13-year old boy with pain and swelling in the right parietal region of skull with no other complaint. A computerized tomography (CT) scan and subsequent fine needle aspiration cytology (FNAC) revealed solitary eosinophilic granuloma which was subsequently confirmed by histopathology. Minimally invasive procedures like imaging and FNAC usually suffice for diagnosing and following up of patients with this rare disease.
Fahimeh Asadi Amoli; Masoumeh Mohebbi; Amir Hossein Sina
Volume 6, Issue 4 , September 2011, , Pages 224-228
Abstract
Chloroma or granulocytic sarcoma (GS) is a malignant neoplasm of myeloid lineage that occur in a variety of anatomic sites other than the bone marrow including soft tissue, bone, lymph node, nasal fossa, skin and sometime in the orbit. In the subconjunctiva it is rarely reported. A 4-year-old ...
Read More
Chloroma or granulocytic sarcoma (GS) is a malignant neoplasm of myeloid lineage that occur in a variety of anatomic sites other than the bone marrow including soft tissue, bone, lymph node, nasal fossa, skin and sometime in the orbit. In the subconjunctiva it is rarely reported. A 4-year-old girl with a history of treated acute myelogenous leukemia was referred to Farabi Eye Hospital, Tehran, Iran for the evaluation of subconjunctival mass that was appeared since one month ago. Cell blood count (CBC) of the patient was normal except for Hb=7gm/dl. General physical examination was normal except for the signs of anemia. Histopathological evaluation of subconjunctival mass showed a malignant large round cell neoplasm. Immunohistochemical studies confirmed granulocytic sarcoma. When confronting a large cell or undifferentiated round cell neoplasm, the possibility of myeloid sarcoma should be investigated. Myeloperoxidase (MPO), cluster designation (CD) molecules such as CD34, CD45, CD15, CD68 and lysozyme positivity or Leder staining are useful in this regard.
Nasser Rakhshani; Arman Morakabati; mohsen Ayati; mahshid hoormazdi
Volume 3, Issue 4 , September 2008, , Pages 225-228
Abstract
Endometriosis is the presence of benign endometrial glands and stroma outside the uterus. Urinary system involvement by endometriosis is a rare occurrence accounting for only 1.5 % of all endometriosis cases. Case 1. The patient was a 41 years old woman admitted for right flank pain. The physical ...
Read More
Endometriosis is the presence of benign endometrial glands and stroma outside the uterus. Urinary system involvement by endometriosis is a rare occurrence accounting for only 1.5 % of all endometriosis cases. Case 1. The patient was a 41 years old woman admitted for right flank pain. The physical and gynaecologic examination was unyielding. Intravenous urography (IVU) revealed stenosis in distal part of right ureter, unfortunately associated with hydronephrosis. Case 2. A 26 years old woman who suffered from colic pain in low abdomen and pelvis. The only positive finding was microscopic hematuria. Abdominal sonography showed hydronephrosis of right kidney and proximal part of ureter. Ureterolysis by an open surgical procedure performed for both patients and histologic examination revealed endometriosis of ureter. Endometriosis of ureter is mainly asymptomatic and unfortunately ends in functionless kidney due to prolonged hydronephrosis. Early diagnosis needs high index of suspicion and intended use of paraclinic aids to save patients normal renal function. An individualized therapy plan depending on the patient's age and the extent of the endometriosis should be attempted.
Teresa Pusiol; Maria Grazia Zorzi; Doriana Morichetti; Beniamino Brancato; Michele Scialpi
Volume 9, Issue 3 , July 2014, , Pages 234-235
Shweta Rana; Puja Sharma; Pawan Singh; Rahul N Satarkar
Abstract
Leiomyomas are benign tumors that originate from smooth muscle cells. Leiomyomas are well known to be the commonest neoplasm arising from the uterus but leiomyomas originating from the scrotum is a rare entity. They originate from the subcutaneous tissue or tunica dartos and can be solitary or multiple. ...
Read More
Leiomyomas are benign tumors that originate from smooth muscle cells. Leiomyomas are well known to be the commonest neoplasm arising from the uterus but leiomyomas originating from the scrotum is a rare entity. They originate from the subcutaneous tissue or tunica dartos and can be solitary or multiple. We present a case of solitary scrotal leiomyoma in a 75 years old male who presented with a slowly growing, painless, firm, mobile 4cm lump in right side of scrotum. Clinically, it was provisionally diagnosed as sebaceous cyst and was excised. Histopathology and Immunohistochemistry (IHC) showed findings consistent with Leiomyoma. There was no cytological atypia or mitosis. The final diagnosis of scrotal leiomyoma was given. How to cite this article: Rana S, Sharma P, Singh P, N Satarkar R. Leiomyoma of Scrotum: a Rare Case Report. Iran J Pathol. 2015;10(3):243-7.
Fatemeh Nili; Nakisa Niknejad; Mohammad Shirkhoda
Abstract
Malakoplakia is a rare granulomatous disease of the genitourinary system. Gastrointestinal tract is the second most common site of involvement. It usually mimics a malignancy but its association with adenocarcinoma has been rarely reported. A 59-year-old male patient with the history of weight loss ...
Read More
Malakoplakia is a rare granulomatous disease of the genitourinary system. Gastrointestinal tract is the second most common site of involvement. It usually mimics a malignancy but its association with adenocarcinoma has been rarely reported. A 59-year-old male patient with the history of weight loss and rectal bleeding for two months prior to administration was referred to our hospital. Pre-operative CT scan revealed a large sigmoid colon mass with the extension and invasion to the serosal surface as well as multiple regional metastatic lymph nodes. The patient underwent sigmoidectomy with the primary pathologic diagnosis of adenocarcinoma. Pathologic examination revealed a moderately differentiated adenocarcinoma invading peri-colic adipose tissue and inflammatory reaction compatible with malakoplakia at the invasive borders of the tumor with the extension to the serosal surface.In the patients with gastrointestinal malakoplakia, the presence of possible adjacent malignancy should be screened. The possibility of over-staging should also be considered for adenocarcinoma cases in association with malakoplakia
Hamid Galehdari; Raheleh Tangestani
Volume 7, Issue 4 , September 2012, , Pages 262-266
Abstract
Wilson disease is a metabolic disorder with an autosomal recessive genetic pattern and occurs in 1-4 of every 100000 individuals. Inactivation of the ATP7B gene leads to accumulation of the toxic copper to liver and brain causing hepatic and neurological complication. Therefore, most patients suffer ...
Read More
Wilson disease is a metabolic disorder with an autosomal recessive genetic pattern and occurs in 1-4 of every 100000 individuals. Inactivation of the ATP7B gene leads to accumulation of the toxic copper to liver and brain causing hepatic and neurological complication. Therefore, most patients suffer from chronic hepatic inflammation and central nervous system disorder. Nowadays, up to 500 mutations were found in the ATP7B gene that weaken or fully disrupt the function of the gene product. Recurrent mutations were found in different population. We found a homozygous pathogenic missense mutation at codon 778 (R778W) in an individual from southwest Iran. This mutation has been reported in previous studies in the continents America and Europe. The present study is the first report from Wilson disease that has been diagnosed in southwest Iran. This mutation has been shown in previous studies in patients from continents America and Europe.
Shamsa Shariatpanahi; Shahryar Pourfarzam; Mohammad hosein Gheini
Volume 11, Issue 3 , July 2016, , Pages 265-271
Abstract
Macrophage Activating Syndrome (MAS) is a life-threatening disease seen in autoimmune diseases including lupus erythematosus, rheumatoid arthritis, Still's disease, polyarteritis nodosa. It is characterized by fever, pancytopenia, liver failure, coagulopathy, and neurologic symptoms and high serum ferritin. ...
Read More
Macrophage Activating Syndrome (MAS) is a life-threatening disease seen in autoimmune diseases including lupus erythematosus, rheumatoid arthritis, Still's disease, polyarteritis nodosa. It is characterized by fever, pancytopenia, liver failure, coagulopathy, and neurologic symptoms and high serum ferritin. A 27 yr. old female patient was admitted in shahid Mostafa Khomeini Hospital (Tehran-Iran) in May 2011 because of lower extremities edema and ascites and fever from 1.5 month ago. In physical examinations she had generalized lymphadenopathy, splenomegaly and pleural effusion. In laboratory tests she had pancytopenia, positive ANA and Anti DNA (ds), hypocomplementemia, hypertriglyceridemia and high ferritin level. Gradually she had signs of RPGN and ARDS. The patient had no skin and musculoskeletal signs of SLE and no liver failure nor coagulopathy of MAS. Her lymph node biopsy was reported as Castleman syndrome. Unlike other studies, the patient showed MAS before treatment with cytotoxic for lupus nephritis.
Hematopathology
Hasan Jalaeikhoo; Seyed Mohammad Hossein Kashfi; Pedram Azimzadeh; Ahmad Narimani; Katayon Gouhari Moghadam; Mohsen Rajaeinejad; Mehdi Ariana; Manouchehr Keyhani
Abstract
Background & objective: Pancytopenia is the reduction in the number of all 3 major cellular elements of blood and leads to anemia, leukopenia, and thrombocytopenia. A wide variety of etiologies result in pancytopenia including leukemia, aplastic anemia, and megaloblastic anemia. The current study ...
Read More
Background & objective: Pancytopenia is the reduction in the number of all 3 major cellular elements of blood and leads to anemia, leukopenia, and thrombocytopenia. A wide variety of etiologies result in pancytopenia including leukemia, aplastic anemia, and megaloblastic anemia. The current study identified the different etiologies of pancytopenia based on bone marrow examination in Iranian patients with pancytopenia. Methods: A total of 683 cases of pancytopenia with various etiologies were selected for this retrospective study. Bone marrow biopsy was performed with the standard technique using Jamshidi needle. The inclusion criteria for patients with pancytopenia were hemoglobin (Hb) 9/L, and platelet count 9/L. Results: In the present study acute leukemia was the first most common etiology detected in 235 (35.4%) patients in which acute myeloid leukemia (AML) comprised the majority of cases 142 (21.4%), followed by myelodysplastic syndrome (MDS) 100 (15%). In patients less than 20 years old, acute leukemia was also the commonest cause identified in 56 (57.7%) cases in which acute lymphoblastic leukemia (ALL) with 38.7% was the most common etiology; however in adults (>45 year old), AML accounted for the majority of cases 76 (53.5%). Conclusion: Since acute leukemia was the commonest etiology in both young and adults in which AML accounted for the majority of cases with pancytopenia in Iranian population, there was an urgent need to identify the underlying molecular or genetic mechanism of this malignancy for better further medical management and patients` survival.
Arghya Bandyopadhyay; Krishnendu Mondal; Mimi Gangopadhyay; Mamata Sinha Guha Mallick; Amita Giri
Volume 8, Issue 4 , October 2013, , Pages 277-280
Abstract
Histoid Leprosy (HL) is a rare variant of Lepromatous Leprosy, occurring in long-standing cases, mostly in a background of acquired drug resistance. Patients usually present with sudden onset multiple nodules and plaques, most often involving the skin and subcutaneous tissue of trunk and lower limbs. ...
Read More
Histoid Leprosy (HL) is a rare variant of Lepromatous Leprosy, occurring in long-standing cases, mostly in a background of acquired drug resistance. Patients usually present with sudden onset multiple nodules and plaques, most often involving the skin and subcutaneous tissue of trunk and lower limbs. Here we report an unusual case of de novo (without any history of prior anti-leprotic therapy) HL, arising as multiple nodules in the face. The histopathology of the lesion showed collection of spindled macrophages in the dermis, oriented in a storiform-like pattern. A possibility of HL was considered and the diagnosis was confirmed by performing a modified ZN stain (Wade-Fite stain) on the biopsy material, which revealed the presence of acid-fast bacilli (AFB) with a bacillary index of 6. Then the patient was put on multibacillary multi-drug chemotherapy and was thereby cured.
Atin Singhai; Suresh Babu; Parul Jain; Sujata Dev
Volume 9, Issue 4 , October 2014, , Pages 291-292
Gynecologic Pathology
Fatemeh Bagheri; Somayyeh Rahmani; Somayyeh Azimi; Jamileh Bigom Taheri
Abstract
Giant Cell Fibroma (GCF) was described as a new entity of fibrous hyperplastic soft tissue. It seems that stimulus from an unexplained origin can have a role in its etiology. Histopathologically GCF is consisted of multinucleated fibroblasts that have oval shape nuclei within the eosinophilic cytoplasm. ...
Read More
Giant Cell Fibroma (GCF) was described as a new entity of fibrous hyperplastic soft tissue. It seems that stimulus from an unexplained origin can have a role in its etiology. Histopathologically GCF is consisted of multinucleated fibroblasts that have oval shape nuclei within the eosinophilic cytoplasm. Surgical excision is the treatment of choice and recurrence is very rare. Here we report a case of relatively large GCF in a 54-year-old man. Gingiva is the common location of GCF. As in our case, it may be mistaken as irritation fibroma especially if it is on the buccal mucosa, the most common location for fibroma. Correct diagnosis is based on biopsy and clinical examination to see surface texture roughness. To minimize bleeding because of its large size an excisional biopsy with Diod laser was performed under local anesthesia for this patient.
Hematopathology
Amir Hossein Jafarian; Melika Kooshki forooshani; Hossein Reisi; Nema Mohamadian roshan
Abstract
Background & Objective: Matrix metalloproteinases-9 (MMP-9) is one of the most important enzymes to breakdown extracellular matrix which plays a major role in tumor invasion and metastasis. This study aimed to determine tumor MMP-9 expression in non-small-cell lung carcinoma (NSCLC) and ...
Read More
Background & Objective: Matrix metalloproteinases-9 (MMP-9) is one of the most important enzymes to breakdown extracellular matrix which plays a major role in tumor invasion and metastasis. This study aimed to determine tumor MMP-9 expression in non-small-cell lung carcinoma (NSCLC) and whether it is associated with histopathologic factors and has prognostic value to affect overall survival (OS). Methods: The specimens of 92 patients with NSCLC diagnosis were included. Tumor sections were stained by immunohistochemistry method. Using scores for the percentage of cells positively stained and the intensity of staining, MMP-9 expression total score was classified as low-score (scores of 0 to 2), moderate-score (scores of 3 to 5), or high-score (scores of 6 or 7). OS was defined as the time interval since the diagnosis of NSCLC to the status at the last follow-up (dead or alive). The follow up period was up to 70 months. Results: About 74% of undifferentiated specimens (grade III tumors) showed high scores for MMP-9 expression which was significantly higher than moderately differentiated tumors (25% had high scores for MMP-9 expression) and well differentiated ones which did not have high scores (p <0.001). A total of 74 patients (80.4%) died during the follow-up period. Of this, 36% had high scores for MMP-9 expression. In contrast, none of the patients who were alive at the last follow-up had high scores for MMP-9 expression (p <0.001). Median OS was significantly lower in high score group (6 months) compared to moderate score (9 months) and high score group (15 months) (p <0.001). Conclusion: MMP-9 expression may serve as a significant prognostic factor for mortality and overall survival in NSCLC. Undifferentiated tumors significantly express higher MMP-9 immunohistochemically.
Breast Pathology
KUMARGURU B N; RAMASWAMY A S; ARATHI C A; SWATHI D
Abstract
Background & Objective: Invasive breast carcinoma (IBC) is the most commonly diagnosed cancer among women in India. The conventional visual method of evaluation of Tumor-Stroma Ratio (TSR) and Stromal Tumor-Infiltrating Lymphocytes (sTIL) appears to be subjective. The present study aims to evaluate ...
Read More
Background & Objective: Invasive breast carcinoma (IBC) is the most commonly diagnosed cancer among women in India. The conventional visual method of evaluation of Tumor-Stroma Ratio (TSR) and Stromal Tumor-Infiltrating Lymphocytes (sTIL) appears to be subjective. The present study aims to evaluate the utility of the indigenously designed square grid method for the evaluation of tumor-stroma ratio and stromal tumor-infiltrating lymphocytes in invasive breast carcinoma by assessing the inter-observer variability.
Methods: This was a retrospective study conducted at a rural tertiary care referral institute from July 2018 to June 2020. In each case, microphotographs were taken from 10 representative fields in H&E-stained sections for evaluating TSR in low-power and sTIL in high-power. Both the parameters were evaluated employing an indigenously designed square grid applied onto microphotographs in the power-point slides by making use of principles of the Pythagorean theorem. Both parameters were separately evaluated by two pathologists. Cohen kappa statistics was the statistical tool used to analyze inter-observer variability.
Results: Thirty cases were analyzed. Invasive breast carcinoma of no special type (IBC-NST) was the most common histopathological type (26 cases (86.67%)). For TRS evaluation, a Kappa value of 0.78 suggested substantial agreement with an agreement of 91.67%. For sTIL evaluation, a Kappa value of 0.51 suggested moderate agreement with an agreement of 88.33%. The P-values were statistically highly significant (P<0.001).
Conclusion: Square grid method is a novel technique for evaluating TSR and sTIL in invasive breast carcinoma. It can be considered an example of the application of Pythagoras’ theorem in Pathology.
Nephropathology
Arezoo Eftekhar-Javadi; Dorna Motevalli; Ahmad Pourrashidi Boshrabadi; Hedieh Moradi Tabriz; Hoda Asefi
Abstract
Rhabdoid papillary meningioma is an uncommon aggressive variant of meningioma which has the potential to metastasize and spread throughout the brain and even out of the cranium. Herein, we present recurrence of the brain tumor in a 26-year-old woman. The patient had history of the surgery for two lesions ...
Read More
Rhabdoid papillary meningioma is an uncommon aggressive variant of meningioma which has the potential to metastasize and spread throughout the brain and even out of the cranium. Herein, we present recurrence of the brain tumor in a 26-year-old woman. The patient had history of the surgery for two lesions in the right temporal lobe and the left cerebellopontine angle. Imaging showed three lesions in the right temporal lobe, the right occipital horn wall, and the left cerebellopontine angle. These radiologic findings were mostly suggestive of atypical meningioma. In the surgical view, the mass was solid-cystic reddish Cauliflower-shaped in the right temporal lobe attaching to the temporal horn. The microscopic examination showed a cellular neoplasm with the sheet-like and papillary growth pattern. Individual cells had vesicular nuclei some with prominent nucleoli and eosinophilic cytoplasm. The areas of the tumor cells showed round eccentric nuclei and prominent nucleoli with eosinophilic cytoplasm. Immunohistochemistry studies showed diffuse positivity of tumor cells with Vimentin, EMA, and S100. The overall clinical, radiological and histopathological examinations were compatible with high grade rhabdoid-papillary meningiomas. In the present case study, we discuss imaging and histomorphological features of this rare entity of meningiomas.
Uropathology
Kamlesh Suthar; Aruna Vanikar; Rashmi Patel; Kamal Kanodia
Volume 13, Issue 3 , July 2018, , Pages 368-371
Abstract
Prolonged inflammation or irritation due to renal calculi can induce glandular metaplasia of the urothelium and even malignant neoplasm. Primary adenocarcinoma in pelvicalyceal system is a rare tumor in such patients. Here, a case of carcinoembryonic antigen (CEA) positive primary tubulovillous adenocarcinoma ...
Read More
Prolonged inflammation or irritation due to renal calculi can induce glandular metaplasia of the urothelium and even malignant neoplasm. Primary adenocarcinoma in pelvicalyceal system is a rare tumor in such patients. Here, a case of carcinoembryonic antigen (CEA) positive primary tubulovillous adenocarcinoma in pelvicalyceal system is reported. A 57-year-old male with right abdominal pain and microscopic hematuria and the history of nephrolithotomy for recurrent renal calculi referred to our center. Radiological findings showed well-defined lobulated mass with calcification in interpolar region of right kidney extending up to pelvicalyceal system along with calculi in pelvicalyceal system and ureter with moderate hydroureteronephrosis. Laparoscopic right radical nephrectomy was performed. Histopathological examination revealed tubulovillous adenocarcinoma of renal pelvicalyceal system with CEA positivity. Patient was asymptomatic and had no recurrence after one and a half years. Primary tubulovillous adenocarcinoma in renal pelvis though rare, is usually associated with intestinal metaplasia of urothelium induced by prolonged chronic inflammation and renal calculi.
Oral Pathology
Vandana Reddy; Kv Arunkumar; Vijay Wadhwan; Arvind Venkatesh
Abstract
Large, atypical peripheral ossifying fibromas are known as giant peripheral ossifying fibromas. These lesions have often been associated with heterogeneous clinical and radiographic characteristics subsequently leading to their misdiagnosis. Biopsies have been the gold standard for the diagnosis ...
Read More
Large, atypical peripheral ossifying fibromas are known as giant peripheral ossifying fibromas. These lesions have often been associated with heterogeneous clinical and radiographic characteristics subsequently leading to their misdiagnosis. Biopsies have been the gold standard for the diagnosis of such lesions. This study reports on an acute presentation of giant peripheral ossifying fibroma, clinically mimicking a malignant lesion due to its atypical presentation along with its characteristic histological features, which led to the establishment of the diagnosis.
Hematopathology
Eva Ruvalcaba-Limón; Josefina Jiménez-López; Verónica Bautista-Piña; Julio Ramírez-Bollas; Flavia Morales-Vásquez; Carlos Domínguez-Reyes; Antonio Maffuz-Aziz; Sergio Rodríguez-Cuevas
Volume 11, Issue 4 , October 2016, , Pages 399-408
Abstract
Background: Phyllodes tumor (PT) of the breast in Hispanic patients is more frequently reported with large tumors and with more borderline/malignant subtypes compared with other populations. The objective of this study was to describe characteristics of patients with PT and to identify differences among ...
Read More
Background: Phyllodes tumor (PT) of the breast in Hispanic patients is more frequently reported with large tumors and with more borderline/malignant subtypes compared with other populations. The objective of this study was to describe characteristics of patients with PT and to identify differences among subtypes in a Mexican population. Methods: A retrospective study was conducted on patients with PT. Sociodemographic, histopathologic, and treatment characteristics were compared among subtypes, including only surgically treated cases due the complete surgical-specimen study requirement for appropriate WHO classification. Results: During 10 years, 346 PT were diagnosed; only 307 were included (305 patients), with a mean age of 41.7 yr. Self-detected lump took place in 91.8%, usually discovered 6 months previously, with median tumor size of 4.5 cm. Local wide excisions were done in 213 (69.8%) and mastectomies in 92 (30.1%). Immediate breast reconstruction took place in 38% and oncoplastic procedures in 23%. PT were classified as benign in 222 (72.3%) cases, borderline in 50 (16.2%), and malignant in 35 (11.4%), with pathological tumor size of 4.2, 5.4, and 8.7 cm, respectively (P<0.001). Patients with malignant PT were older (48 yr), with more diabetics (14.3%), less breastfeeding (37.1%), more smokers (17.1%), with more postmenopausal cases (42.9%), and older age at menopause (51.5 years) compared with the remaining subtypes (P<0.05). Relapse occurred in 8.2% of patients with follow-up. Conclusion: In comparison with other Hispanic publications, these Mexican patients had similar age, with smaller tumors, modestly higher benign PT, fewer malignant PT, and lower documented relapse cases.
Hematopathology
Noushin Pouryazdanpanah; Shahriar Dabiri; Ali Derakhshani; Reza Vahidi; Alireza Farsinejad
Volume 13, Issue 4 , October 2018, , Pages 461-466
Abstract
Background and Objectives: The mesenchymal stem cells derived from peripheral blood (PB) have been recognized as a promising source for allogeneic cell therapy. The aim of this study was to investigate the isolation, growth and differentiation ability of peripheral blood-isolated mesenchymal stem cells. ...
Read More
Background and Objectives: The mesenchymal stem cells derived from peripheral blood (PB) have been recognized as a promising source for allogeneic cell therapy. The aim of this study was to investigate the isolation, growth and differentiation ability of peripheral blood-isolated mesenchymal stem cells. Methods: The mononuclear cells were purified from fresh peripheral blood using density gradient centrifugation then cultured in a suitable medium, expanded and characterized. In the following, these cells were cultured in specific adipogenic and osteogenic differentiation media.Results and Conclusion: In spite of the absence of any stimulating factor, the cells adhered to the flasks and developed a rather homogeneous, spindle-shaped morphology after consecutive passages. The cells were confirmed to have mesenchymal phenotype by expression of specific markers (CD90, CD105, and CD73) and absence of CD45 marker, which is specific for hematopoietic stem cells. They could differentiate into lineage-specific committed cells (osteoblasts and adipocytes). According to the findings, the conventional, labour-intensive and time-consuming approaches are not necessary to obtain an optimal number of cells from peripheral blood. This relatively accessible and minimally invasive source of stem cells may open a new era for practical exploitation in regenerative medicine.
