@article { author = {Mohammadzadeh, Sahand and Jowkar, Zahra and Mirzaee, Mitra and Geramizadeh, Bita}, title = {Epidermal Growth Factor Receptor (EGFR) Gene Mutation Analysis in Adenocarcinoma of Lung, the First Report from Iran}, journal = {Iranian Journal of Pathology}, volume = {14}, number = {1}, pages = {1-7}, year = {2019}, publisher = {Farname Inc in collaboration with Iranian Society of Pathology}, issn = {1735-5303}, eissn = {2345-3656}, doi = {10.30699/ijp.14.1.1}, abstract = {Background and Objective: Epidermal growth factor receptor (EGFR) gene mutation, especially in exons 18 to 21, is an important predictor of the response rate of lung adenocarcinoma to tyrosine kinase inhibitors. There are variable reports from Asian and European countries, as well as North America, about the frequency of the EGFR mutation in lung adenocarcinoma, yet molecular study about this incidence has been published from Iran. In this study, we investigated the frequency of this mutation in our center, which is the largest referral center in the south of country. This report will be the first published article about EGFR mutational analysis from Iran.Methods: During the study period (September 2011 till September 2016) i.e. 5 years, there have been 50 cases of pathologically-confirmed lung adenocarcinoma. These cases underwent mutational analysis for exons 18 to 21 of the EGFR gene by PCR and DNA sequencing. All demographic findings were also extracted from the patients’ charts and recorded.Results: There were 30 male and 20 female patients, with an average age of 58 years. The overall frequency of EGFR mutation was 28% (14 out of 50). The most common mutation was Del 19 (10 of 14, 71.4%), 3 mutations were found in exon 20 and one mutation was found in exon 21. EGFR mutations were more frequent in women than in men (30% versus 26.7%) and in nonsmokers than in smokers (37.9% versus 14.3%).Conclusion: Lung adenocarcinoma with EGFR mutation shows strong association with female non-smokers. Our results showed an intermediate frequency of this mutation, which was higher than results from Western countries and lower than most Asian countries.}, keywords = {EGFR Genes,Mutation,Lung cancer,Iranian}, url = {https://ijp.iranpath.org/article_33633.html}, eprint = {https://ijp.iranpath.org/article_33633_3894ffa22e523b962a7d7fe091c04193.pdf} } @article { author = {Ghasemi, Maryam and Vahedi-larijani, Laleh and Emadian, Omid and Yazdani, Jamshid and Sajadianfar, Ahmad and Abediankenari, Saeid}, title = {Immunohistochemical Investigation of Mutant BRAF V600E in Common Pigmented Skin Neoplasms, Study on a Sample of Iranian Patients}, journal = {Iranian Journal of Pathology}, volume = {14}, number = {1}, pages = {8-16}, year = {1999}, publisher = {Farname Inc in collaboration with Iranian Society of Pathology}, issn = {1735-5303}, eissn = {2345-3656}, doi = {10.30699/ijp.14.1.8}, abstract = {Background & Objective: This study was designed for the first time for the detection of mutant BRAF V600E and its correlation with clinicophathologic features in a sample of Iranian patients with pathologically proved pigmented skin neoplasms.Methods: 82 paraffin-embedded blocks, including melanocytic nevi, malignant melanoma, Basel cell carcinoma, and squamous cell carcinoma were evaluated for BRAF V600E expression by immunohistochemistry in the patients admitted to Ibn Sina Hospital, in the city of Sari, Mazandaran province, North of Iran. The evaluation of immunohistochemical staining was performed by two of the authoring pathologists, and staining intensity was graded from negative (0), weak (1+), moderate (2+) to strong (3+). If twenty percent (or greater) of the tumor cells showed modest to strong cytoplasmic immunoreactivity (score 3+), the neoplasm was considered positive for this tumor marker.Results: Among 82 studied patients, 12 cases (60%) of the malignant melanoma group revealed a high intensity of immunostaining for BRAF V600E, while a significant expression of this marker did not occur in the other investigated skin neoplasm. A great relation between BRAF (V600E) expression and the histologic type of skin cancer was noted. No significant relationship with other parameters such as gender, age, and the grade differentiation of the non-melanoma skin cancer was found. BRAF V600E was weakly correlated with the Clark level of cutaneous malignant melanoma.Conclusion: This data provided further}, keywords = {RAF gene,Mutation,Immunohistochemistry,Pigmented skin neoplasm}, url = {https://ijp.iranpath.org/article_33634.html}, eprint = {https://ijp.iranpath.org/article_33634_807b5b1938047a3b8d4c456db881a1a3.pdf} } @article { author = {Kosari, Farid and Jamali, Raika and Ramim, Tayeb and Musavi Jahan Abad, Ebrahim}, title = {The Correlation between Serum Zinc Level and Liver Histology in Non-Alcoholic Steatohepatitis}, journal = {Iranian Journal of Pathology}, volume = {14}, number = {1}, pages = {17-25}, year = {2019}, publisher = {Farname Inc in collaboration with Iranian Society of Pathology}, issn = {1735-5303}, eissn = {2345-3656}, doi = {10.30699/ijp.14.1.17}, abstract = {Background & Objective: The aim of this present study was to assess the relationship between serum zinc levels and liver histopathological findings in non-alcoholic steatohepatitis (NASH) patients.Methods: This case-control study was performed in consecutively selected NASH patients who had been referred to a general hospital. The control group consisted of age and sex-matched individuals with normal physical examinations, laboratory findings, and liver ultrasounds. Serum zinc level was measured using atomic absorption spectrophotometry. Liver histopathological findings were determined based on non-alcoholic fatty liver activity score.Results: A cohort of eighty biopsy-proven NASH patients and eighty controls were enrolled in the study. The mean serum zinc level was significantly lower in the NASH group compared with the controls. The mean serum zinc concentration was significantly lower in moderate and severe lobular inflammation groups than the mild group. After multiple adjustments for potential contributing variables, serum zinc level was associated with the severity of lobular inflammation. Nonetheless, it was not associated with liver steatosis and fibrosis. A serum zinc value of 89 (µg/dl) yielded a sensitivity and specificity of 93% and 86%, respectively, characterizing patients with lobular inflammation of less than two inflammatory foci per high-power field (HPF) from more advanced groups. Furthermore, a value of 79.55 (µg/dl) yielded a sensitivity and specificity of 87% and 100%, respectively, distinguishing those with a lobular inflammation grade of less than four foci per HPF from more advanced cases. Conclusion: Serum zinc level might be associated with the severity of lobular inflammation in NASH.}, keywords = {Non-alcoholic Fatty Liver Disease Zinc,Oxidative stress,Lobular inflammation,Fibrosis}, url = {https://ijp.iranpath.org/article_33635.html}, eprint = {https://ijp.iranpath.org/article_33635_d1569e405a998474184555ae27260e0f.pdf} } @article { author = {Sanei, Mohammad Hossein and Mirmosayyeb, Omid and Chehrei, Ali and Ansari, Jamshid and Saberi, Elahe}, title = {5-Year Survival in Gastric Adenocarcinoma with Epithelial and Stromal Versican Expression}, journal = {Iranian Journal of Pathology}, volume = {14}, number = {1}, pages = {26-32}, year = {2019}, publisher = {Farname Inc in collaboration with Iranian Society of Pathology}, issn = {1735-5303}, eissn = {2345-3656}, doi = {10.30699/ijp.14.1.26}, abstract = {Background & Objective: Gastric cancer is the second most frequent cause of cancer death worldwide, despite differences in incidence around the world. The majority of gastric cancer cases concern gastric adenocarcinoma, which has a fairly high 5-year survival rate when coupled with early-stage diagnosis. Versican, a member of the aggregating chondroitin sulfate proteoglycans family, is accumulated predominantly in the tumor stroma. The aim of our study was to investigate versican expression in gastric adenocarcinoma. Methods: In this study we investigated 80 patients with gastric adenocarcinoma who underwent gastrectomy. Each sample was obtained from paraffin-embedded resected specimens of the stomach after histopathological diagnosis. Patient follow-up was performed every 3 months after the beginning of data collection. Survival analysis was calculated using the Kaplan-Meier method for univariate analysis.Results: Out of 80 patients with gastric adenocarcinoma, 76 cases (76.3%males and 23.7% females) completed the follow-up period. Positive versican expression in tumor epithelial and stromal cells was found in 39.5% and 22.4% of tumors, respectively. Shorter survival was observed among patients whose gastric adenocarcinoma expressed epithelial or stromal versican.Conclusion: In summary, the present study suggests that versican is likely a prognostic biomarker that predicts a poor outcome in patients with gastric adenocarcinoma. Comprehensive studies with larger sample sizes are needed.}, keywords = {Stomach Neoplasms Adenocarcinoma,Survival,Versican}, url = {https://ijp.iranpath.org/article_33636.html}, eprint = {https://ijp.iranpath.org/article_33636_f40052f47835c1b8d89a5dcc682ef466.pdf} } @article { author = {Saadatnia, Geita and Saremi, Aboutaleb and Salehian, Behrouz and Salehian, Pirooz}, title = {Uterine Leiomyoma and Reproductive Tract Infections Detected by Polymerase Chain Reaction}, journal = {Iranian Journal of Pathology}, volume = {14}, number = {1}, pages = {33-40}, year = {2019}, publisher = {Farname Inc in collaboration with Iranian Society of Pathology}, issn = {1735-5303}, eissn = {2345-3656}, doi = {10.30699/ijp.14.1.33}, abstract = {Background and Objective: For nearly a century, it has been suspected that reproductive tract infections play an etiologic role in uterine leiomyoma. However, no epidemiologic study of leiomyoma has used the polymerase chain reaction (PCR) to compare uterine tissues from cases and non-cases, and to investigate associations between uterine leiomyoma and infections detected by PCR.Methods: In this case-control study, 92 leiomyoma tissues from cases, and 94 myometrial tissue from controls were screened by PCR for cytomegalovirus, Chlamydia trachomatis, herpes simplex virus-1, 2, and human papillomavirus typed as 16/18 or another strain. Multivariable analysis used age-adjusted logistic regression, and generalized linear regression as appropriate.Results: In the uterine tissues of cases and unmatched controls, the prevalence of infection was: cytomegalovirus (32.6%, 7.4%), C. trachomatis (23.9%, 37.2%), herpes simplex virus-1,2 (25.0%, 13.8%), human papillomavirus 16/18 (13.0%, 10.5%). Leiomyoma was associated with cytomegalovirus (Odds Ratio (O.R.) 6.10; 95% confidence interval (C.I.), 2.40, 15.55) and Chlamydia (O.R. 0.47; 95% C.I. 0.23, 0.97). Likewise, the log count of leiomyoma was higher with cytomegalovirus (+0.65, 95% C.I. +0.34, +0.95) and lower with Chlamydia (-0.71, 95% C.I. -1.12, -0.29).Conclusion: This first application of PCR to leiomyomata and control uterine tissues from non-cases reveals that cytomegalovirus is associated with the presence, number, and volume of uterine leiomyoma, while C. trachomatis is inversely associated with leiomyoma, but only in the absence of cytomegalovirus. Current findings provide preliminary evidence that common reproductive tract infections contribute to the growth and control of at least some cases of uterine leiomyoma.}, keywords = {Leiomyoma,Chlamydia trachomatis,Cytomegalovirus,Herpes simplex virus,Human papillomavirus,Polymerase chain reaction}, url = {https://ijp.iranpath.org/article_33638.html}, eprint = {https://ijp.iranpath.org/article_33638_3a118b6a082c989500c70f7cee0596f0.pdf} } @article { author = {Mojibi, Parisa and Tafvizi, Farzaneh and Bikhof Torbati, Maryam}, title = {Cell-bound Exopolysaccharide Extract from Indigenous Probiotic Bacteria Induce Apoptosis in HT–29 cell-line}, journal = {Iranian Journal of Pathology}, volume = {14}, number = {1}, pages = {41-51}, year = {2019}, publisher = {Farname Inc in collaboration with Iranian Society of Pathology}, issn = {1735-5303}, eissn = {2345-3656}, doi = {10.30699/ijp.14.1.41}, abstract = {Background and Objective: The aim of this study was to compare the cytotoxic effects of local probiotic bacteria, including Lactobacillus paracasei, Lactobacillus brevis, while isolated from “Tarkhine” food and the induction of apoptosis in the HT–29 human colon adenocarcinoma cell line and normal fibroblasts. Methods: HT–29 and L–929 cell lines were treated with cell-bound exopolysaccharide extract (cb-EPS) from L. paracasei and L. brevis. The MTT assay was used to analyze cell viability. Cellular apoptosis was examined by flow cytometry and DNA fragmentation assay.Results: The cb-EPS from both probiotic bacteria prevented the proliferation of HT–29 colon cancer cells. In addition, the cytotoxic and anti-proliferative effects of the exopolysaccharide extract from both bacteria in L–929 fibroblasts were much lower than HT–29 cells. The induction of apoptosis in HT–29 cells was observed at 48h compared with 72h. It seems that the exopolysaccharides extracted from both bacteria have a greater effect on the induction of apoptosis at 48h. The cb-EPS of L. brevis showed more potent anti-proliferative and apoptotic properties than the cb-EPS of L. paracasei. The ladder pattern of DNA fragmentation confirmed the induction of apoptosis in cancer cells. Conclusion: The results of the MTT assay and apoptosis indicate that the induction of apoptosis by the exopolysaccharide from bacteria depends on the dose, time, and strain of bacteria. Further studies may contribute toward the understanding of using these probiotic bacteria as biological products to treat and prevent cancers.}, keywords = {Lactobacillus,Probiotic,Apoptosis HT-29 Cells}, url = {https://ijp.iranpath.org/article_33639.html}, eprint = {https://ijp.iranpath.org/article_33639_37448b3c82eab01dc60da0e4f16b4a35.pdf} } @article { author = {Rajabi, Parvin and Hydarpoor, Mitra and Maghsoudi, Ahmadreza and Mohaghegh, Fatemeh and Dehghani Mobarakeh, Maryam}, title = {The Study for Diagnostic Value of β-Catenin Immunohistochemistry Marker in Distinction of Aggressive and Non-Aggressive Basal Cell Carcinoma}, journal = {Iranian Journal of Pathology}, volume = {14}, number = {1}, pages = {52-60}, year = {2019}, publisher = {Farname Inc in collaboration with Iranian Society of Pathology}, issn = {1735-5303}, eissn = {2345-3656}, doi = {10.30699/ijp.14.1.52}, abstract = {Background & Objective: Basal cell carcinoma (BCC) is a common skin cancer arising from the basal layer of the epidermis and its appendages. They are locally invasive, aggressive, and destructive of skin and the surrounding structures. β-Catenin is a multifunctional protein located to the intracellular side of the cytoplasmic membrane coded by the CTNNB1 gene, which maps to chromosome 3p22.1. It has a critical role in cell-to-cell adhesion by linking cadherins to the actin cytoskeleton and has a central role in transcriptional regulation in the Wnt signaling pathway. We evaluated the diagnostic value of the Beta catenin immunohistochemistry marker in distinction of aggressive and non-aggressive Basal cell carcinoma.Methods: This cross sectional and descriptive-analytical study was done on archived formalin fixed, paraffin embedded tissue blocks in pathology library of Al-Zahra hospital in Isfahan city. We used immunochemistry to determinate the role of β-Catenin in aggressiveness in BCC with higher rate of relapse.Results: A total of 76 samples were evaluated in two groups (aggressive &none aggressive). The mean percentage of cytoplasmic β-Catenin staining in aggressive group was more significant than the other group (sensitivity: 86.8% specificity: 81.6%, PPV: 81.5% and NPV: 86.1%) and the mean percentage of membranous β-Catenin staining in non-aggressive group were significant more than the aggressive group. Intensity of membranous staining in both groups significant less than normal epithelium.Conclusion: Cytoplasmic β-Catenin staining in aggressive BCC is more significant than non-aggressive subtypes, so this indicates that the use of β-Catenin IHC marker maybe helpful in the diagnosis of aggressive BCC.}, keywords = {beta-Catenin,Carcinoma,Basal Cell,Aggressive Phase,Sensitivity,Specificity}, url = {https://ijp.iranpath.org/article_33640.html}, eprint = {https://ijp.iranpath.org/article_33640_619aa9ff861ca085e7aabcda70b70e08.pdf} } @article { author = {Yousefipour, Mehdi and Rasoulinejad, Mehrnaz and Hadadi, Azar and Esmaeilpour, Negin and Abdollahi, Alireza and Jafari, Siroos and khorsand, Atieh}, title = {Bacteria Producing Extended Spectrum β-lactamases (ESBLs) in Hospitalized Patients: Prevalence, Antimicrobial Resistance Pattern and its Main Determinants}, journal = {Iranian Journal of Pathology}, volume = {14}, number = {1}, pages = {61-67}, year = {2019}, publisher = {Farname Inc in collaboration with Iranian Society of Pathology}, issn = {1735-5303}, eissn = {2345-3656}, doi = {10.30699/ijp.14.1.61}, 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 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.}, keywords = {beta-Lactamase,Antibiotic Resistance Hospital-Patient}, url = {https://ijp.iranpath.org/article_33641.html}, eprint = {https://ijp.iranpath.org/article_33641_57a86b702dd8ec6027469719f805550c.pdf} } @article { author = {Bavand, Anahita and Aghakhani, Arezoo and Mohraz, Minoo and Banifazl, Mohammad and Karami, Afsaneh and Golkar, Majid and Babaie, Jalal and Saleh, Parviz and Mamishi, Setareh and Ramezani, Amitis}, title = {Prevalence of Toxoplasma gondii Antibodies and DNA in Iranian HIV Patients}, journal = {Iranian Journal of Pathology}, volume = {14}, number = {1}, pages = {68-75}, year = {2019}, publisher = {Farname Inc in collaboration with Iranian Society of Pathology}, issn = {1735-5303}, eissn = {2345-3656}, doi = {10.30699/ijp.14.1.68}, abstract = {Background & Objective: Toxoplasma gondii infection has public health importance and can lead to serious diseases in immunosuppressed patients, such as HIV cases. Appropriate control of T. gondii infection in HIV patients requires information about the prevalence of T. gondii antibodies and DNA in different population. In this study, we aimed to determine the prevalence of Toxoplasma gondii antibodies and DNA in HIV patients in Tehran, Iran.Methods: A total of 149 HIV patients from the Iranian Research Center for HIV/AIDS, Tehran, Iran were enrolled in the study. Anti-Toxoplasma IgG and IgM were detected by ELISA and T. gondii DNA was evaluated by PCR and quantitative real-time PCR. IgG positive samples were also assessed for their avidity. Results: Anti-Toxoplasma IgG and IgM were positive in 46.3% and 2.7% of cases respectively. 92.7% of our patients showed past infection and 4.3% revealed recently acquired toxoplasmosis based on their IgG avidity test. T. gondii DNA was not detected by PCR but real-time PCR results showed DNA in 4.7% of total patients and 13.1% of the IgG seropositive cases.Conclusion: Our findings indicated that latent toxoplasmosis was relatively prevalent in our study population, but new T. gondii infection had low prevalence. Almost half of our patients were IgG negative and at risk of acquiring toxoplasma infection. Low copy numbers of DNA were detected in 4.7% of the cases without any clinical manifestation. Therefore, detection and monitoring of anti-Toxoplasma antibodies and DNA in HIV patients is substantial to estimate the risk of reactivation and new infection.}, keywords = {Human Immunodeficiency Virus (HIV),IgG,IgM,Toxoplasma gondii,Reactive Inhibition Antibodies}, url = {https://ijp.iranpath.org/article_33642.html}, eprint = {https://ijp.iranpath.org/article_33642_94a16fb885cf80cbc12d37ec05784b86.pdf} } @article { author = {Jaiprakash, Padmapriya and Radhakrishnan, Balaji and Kudva, Ranjini and Valiathan, Manna and Prasad, Seetharam}, title = {Nodular Fasciitis – Fine Needle Aspiration Cytology Diagnosis and Its Pitfalls, with Review of Literature}, journal = {Iranian Journal of Pathology}, volume = {14}, number = {1}, pages = {76-82}, year = {2019}, publisher = {Farname Inc in collaboration with Iranian Society of Pathology}, issn = {1735-5303}, eissn = {2345-3656}, doi = {10.30699/ijp.14.1.76}, abstract = {Background and Objective: Nodular fasciitis (NF) is a self-limiting, transient neoplasm composed of fibroblasts and myofibroblasts. Since it regresses spontaneously, diagnosis by fine needle aspiration (FNA) cytology plays a major role in its management. Methods: We present a series of 8 cases with either FNA or biopsy diagnosis of NF, and study the major cytological features with a review of literature on diagnostic criteria and its pitfalls. Results and Conclusion: The 8 cases occurred in patients between the age of 14 to 72 years, with equal sex distribution. FNA diagnosis concurred in 4 cases. Causes of wrong diagnosis included lack of clinical information and paucicellular smear.FNA cytology is an important tool in the diagnosis of nodular fasciitis, in appropriate clinico-radiological setting.}, keywords = {Fasciitis,Fine-Needle Aspiration Cytological Technic}, url = {https://ijp.iranpath.org/article_33643.html}, eprint = {https://ijp.iranpath.org/article_33643_77b1fb069d80a69a125e8f1c053a11cd.pdf} } @article { author = {P.S., Srilatha and Das, Jayitri and Monappa, Vidya}, title = {Oncocytic Variant Of Medullary Thyroid Carcinoma - A Case Report}, journal = {Iranian Journal of Pathology}, volume = {14}, number = {1}, pages = {83-86}, year = {2019}, publisher = {Farname Inc in collaboration with Iranian Society of Pathology}, issn = {1735-5303}, eissn = {2345-3656}, doi = {10.30699/ijp.14.1.83}, abstract = {Medullary thyroid carcinoma (MTC) is a rare tumor arising from parafollicular C-cells. The oncocytic variant of MTC is an extremely rare diagnosis, with less than 20 cases reported. Here we present the case of a 36-year-old male patient with complaints of neck swelling and dysphagia. On fine needle aspiration cytology (FNAC), a Hürthle cell neoplasm was suggested. Finally with histopathology and immunohistochemistry (IHC), a diagnosis of MTC oncocytic variant was established. This tumor can be easily misdiagnosed for any thyroid Hürthle cell lesions. An accurate diagnosis is important because MTC has different treatment protocols, and its oncocytic variant is expected to be associated with poorer patient survival. Thus, the oncocytic variant of MTC is a difficult diagnosis on FNAC. Histopathology and relevant IHC markers are necessary for a correct diagnosis.}, keywords = {Medullary Thyroid Carcinoma,Thyroid neoplasm,Fine-Needle Aspiration}, url = {https://ijp.iranpath.org/article_34031.html}, eprint = {https://ijp.iranpath.org/article_34031_82e762b60c4908449633efc28d0131ed.pdf} } @article { author = {Khorsand-Rahimzadeh, Atieh and Khatami, Fatemeh and Sefidbakht, Salma and Saffar, Hiva and Tavangar, Seyed Mohammad}, title = {Dyspnea as the First Manifestation of Silent Renal Cell Carcinoma}, journal = {Iranian Journal of Pathology}, volume = {14}, number = {1}, pages = {87-93}, year = {2019}, publisher = {Farname Inc in collaboration with Iranian Society of Pathology}, issn = {1735-5303}, eissn = {2345-3656}, doi = {10.30699/ijp.14.1.87}, abstract = {Renal cell carcinoma (RCC) accounts for only 3% of adult malignancies, and the lung is the most common site of metastasis of this tumor, which may be accompanied by pleural metastasis. However, solitary pleural involvement is very rare and its presentation with dyspnea as the first manifestation of RCC is extremely rare.We describe a 39-year-old male with episodes of dyspnea dating back 6 months prior to hospital admission. During paraclinical investigations, chest computed tomography (CT) demonstrated pleural effusion and multiple pulmonary nodules, raising the question of primary mesothelioma or metastasis from distant focus. Histopathology and immunohistochemical examinations of pleural biopsy provided evidence of metastatic RCC of the clear cell type. Therefore, an abdominal contrast computed tomography (CT) was performed, revealing a 3 cm right renal mass, which was then removed by partial nephrectomy.Physicians and pathologists should be aware of unusual presentations of RCC with no symptoms attributable to the kidneys, including dyspnea as in our case.}, keywords = {Clear Cell Renal Cell Carcinoma,Neoplasm Metastasis,Pleura,Dyspnea}, url = {https://ijp.iranpath.org/article_33644.html}, eprint = {https://ijp.iranpath.org/article_33644_df0dee56bb52dcb01a848980054b446d.pdf} } @article { author = {Sukkaromdee, Pathoom and Wiwanitkit, Viroj}, title = {False Negative Fecal Occult Blood Test: Prozone Effect}, journal = {Iranian Journal of Pathology}, volume = {14}, number = {1}, pages = {94-94}, year = {2019}, publisher = {Farname Inc in collaboration with Iranian Society of Pathology}, issn = {1735-5303}, eissn = {2345-3656}, doi = {10.30699/ijp.14.1.94}, abstract = {Dear editor, the fecal occult blood test is the presently widely used screening laboratory test for colorectal cancer. At present, the test is usually based on an immunological diagnostic principle (1, 2). A false positive fecal occult blood is common and widely mentioned in literature. Nevertheless, the false negative is little mentioned in the paper. Here, the authors discuss the issue of the fecal occult blood test’s false negative problem. The case is a consultation on a patient’s laboratory aberration. This patient had hemorrhoids and rectosigmoidoscope showed active bleeding. Nevertheless, the stool occult blood test in this patient always showed a negative result. The physician in charge consulted a clinical pathologist for this problem, and the latter noted that this case is that of a false negative due to the prozone effect. The dilutional preparation of the stool sample is done for confirmation. Before dilutional preparation, the result is negative, and is positive afterwards. In fact, the prozone phenomenon is a common but little mentioned problem in clinical diagnosis. The problem can be seen in serological tests. For the fecal occult blood test, the false negative due to prozone effect is little mentioned in the paper, and the practitioner should recognize that there is also a possibility of a false negative in this test. According to the principle behind the fecal occult blood test principle, a hemoglobin concentration above 0.5 mg/mL can cause a prozone effect and a false negative.}, keywords = {prozone,false negative,stool occult blood}, url = {https://ijp.iranpath.org/article_33645.html}, eprint = {https://ijp.iranpath.org/article_33645_63c6cd83de9ea1009b0fa4ff2a915bb5.pdf} }