Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701External Dacryocystorhinostomy; Success Rate and Causes of Failure in Endoscopic and Pathologic Evaluations1891942423410.30699/ijp.2017.24234ENHassan GhasemiDept of Ophthalmology, Medical School, Shahed University, Tehran, IranSajedeh Asghari AslDept of Otolaryngology, Medical School, Shahed University, Tehran, IranMohammad Ebrahim YarmohammadiDept of Otolaryngology, Medical School, Shahed University, Tehran, Iran0000-0001-8520-7526Farhd JafariDept of Otolaryngology, Medical School, Shahed University, Tehran, IranPupak IzadiDept of Otolaryngology, Medical School, Shahed University, Tehran, IranJournal Article20160219<strong><em>Background and Objectives</em></strong><strong>:</strong> External dacryocystorhinostomy (DCR) is the method of choice to treat nasolacrimal duct (NLD) obstruction and the other approaches are compared with it, with a failure rate of 4% to 13%. The current study aimed to assess the causes of failure in external DCR by postoperative endoscopic and pathological evaluation.<br /> <strong><em>Methods</em></strong>: The current retrospective cross sectional study followed-up113 patients with external DCR and silicone intubation for three months. Silicone tubes were removed after the third months. Failure was confirmed based on the clinical findings and irrigation test. Paranasal sinus computed tomography (CT) scanning, and endoscopic and pathological evaluations were performed in the failed cases.<br /> <strong><em>Results</em></strong><strong>:</strong> Totally, 113 patients underwent external DCR. The patients included 71 females and 42 males. The mean age of the patients was 55.91 years; ranged from 18 to 86. Epiphora was the most common complaint before surgery (90.3%). Clinically, epiphora continued in 17 cases (15%), of which 94.11% had at least one sinus CT abnormality and 82.35% had at least one endoscopic abnormality. The most common endoscopic findings were deviated septum (70.6%), scar tissue (52.94%), concha bullosa (46.9%), septal adhesion (47.05%), enlarged middle turbinate (41.2%), and sump syndrome (11.7%). The failure was significantly associated with the chronicity of the initial symptoms (P-value=0.00). Pathologically, there were significant relationship amongst the failure rate, scar formation, and allergic rhinitis (P-values =0.00 and <0.05, respectively).<br /> <strong><em>Conclusion: </em></strong>Preoperative endonasal evaluation and consultation with an otolaryngologist can improve surgical outcomes and help to have a better conscious to intranasal abnormalities before external DCR surgery.https://ijp.iranpath.org/article_24234_2c54d03d7e6ae8adc7f8703734b0abda.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701The diagnostic value of TTF1, P63, HMWK [34βE12], CK7, and CD56 immunostaining in classification of lung carcinoma1952012504110.30699/ijp.2017.25041ENAmir Hossein JafarianDept. of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Iran0000-0003-4004-262xMasoumeh GharibDept. of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, IranNema Mohammadian RoshanDept. of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, IranSamaneh SherafatniaDept. of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, IranAbbas Ali OmidiDept. of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, IranSahar BagheriDept. of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, IranJournal Article20160222<strong><em>Background & objective</em></strong><strong>: </strong>The histologic distinction of small cell from non-small cell lung carcinoma and correct identification of all subtype<strong>s </strong>of lung carcinoma are very important in treatment management. The main method for histologic classification of lung tumors is based on morphology. However, in small bronchoscopic biopsies in particular, distinction is very difficult upon morphology alone. The current study aimed at evaluating the utility of a panel of antibodies, consisting of thyroid transcription factor (TTF-1), P63, high molecular weight keratin [HMWK (34βE12)], cytokeratin (CK7), and cluster of differentiation (CD56) for accurate distinction of bronchogenic carcinomas.<br /> <strong><em>Methods</em></strong><strong>: </strong>Bronchoscopic biopsies of 60 lung carcinoma cases including 20 small cell carcinomas, 20 adenocarcinomas, and 20 squamous cell carcinomas (SCCs) with typical morphologic features were selected. All these cases were immunohistochemically stained for TTF-1, P63, HMWK (34βE12), CK7, and CD56. All immunostained slides were scored as either positive or negative.<br /> <strong><em>Results: </em></strong>The mean age of the patients was 60 years; ranged from 35 to 81. Sixteen patients were female and 44 were male. All adenocarcinomas were positive for CK7 and most of them (18/20; 90%) were positive for TTF-1. Most of small cell lung carcinomas were positive for TTF-1 (17/20; 85%), and CD56 (18/20; 90%). All squamous cell carcinomas (SCCs) were negative for TTF-1, but most of them were positive for HMWK (34βE12) and P63.<br /> <strong><em>Conclusion</em>: </strong>The obtained data showed that TTF-1, P63, CK7, CD56 and/or 34βE12 represent a useful panel of antibodies to identify lung carcinoma subtypes in small bronchoscopic biopsies.https://ijp.iranpath.org/article_25041_a0b78c4786c88b619d62c298c0d4ec81.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701The Core Needle and Surgical Biopsy Concordance to Detect Estrogen, Progesterone, and Her-2 Receptors in Breast Cancer: A Comparative Study2022082504210.30699/ijp.2017.25042ENFereshteh EnsaniDept. of Pathology, Cancer Institute Hospital, Tehran University of Medical Sciences, Tehran, IranRamesh OmranipourSurgical Oncology Center Institute Hospital, Tehran University of Medical Science, Tehran, Iran0000-0003-4785-281XIsa JahanzadDept. of Immunohistochemistry, Cancer Institute, Tehran University of Medical Science, Tehran, IranAzadeh JafariDept. of Pathology, Cancer Institute Hospital, Tehran University of Medical Sciences, Tehran, IranShima NafarzadehDept. of Oral and Maxillofacial Pathology, Babol University of Medical Sciences, Tehran, IranPouyan AminishakibDept. of Oral and Maxillofacial Pathology, Tehran University of Medical Sciences, Tehran, Iran0000000-0002-2185-00Journal Article20160621<strong><em>Background &Objectives</em></strong><strong>: </strong>Evaluation of estrogen receptor (ER), progesterone receptor (PR), and (human epidermal growth factor receptor-2) Her-2 on core needle biopsies (CNBs) is increasingly in use to diagnosis early breast cancer, but its concordance with surgical excision (SE) is not well documented.<br /> <strong><em>Methods:</em></strong> The study included 100 formalin fixed, paraffin-embedded specimens of invasive breast carcinoma archived in Pathology Department of Cancer Institute, Tehran, Iran, from 2011 to 2014. Immunohistochemistry was applied to detect ER, PR, and Her-2.<br /> <strong><em>Results</em></strong><strong>: </strong>The current study findings indicated a significant correlation of 90% between CNB and SE specimens for <em>ER</em> expression. The correlation between CNB and SE specimens was estimated as 81% and 97.3% for PR and Her-2, respectively.<br /> <strong><em>Discussion</em>: </strong>CNB can be performed confidently to determine ER and Her-2. For PR, results obtained from CNB should be considered<strong>.</strong>https://ijp.iranpath.org/article_25042_d9d52819e8185fe15f5f155b5f857544.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Differentiating and Categorizing of Liposarcoma and Synovial Sarcoma Neoplasms by Fluorescence in Situ Hybridization2092172504310.30699/ijp.2017.25043ENFarhad ShahiDept. of Hematology and Medical Oncology, Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IranRazieh AlishahiDept. of Biology, Faculty of Sciences, International Pardis, University of Guilan, Rasht, IranHossein PashaiefarDept. of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, IranIsa JahanzadDept. of Pathology, Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IranNaser KamalianDept. of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranArdeshir GhavamzadehHematology, Oncology and Stem Cell Transplantation Research center, Tehran University of Medical Sciences, Tehran, IranMarjan YaghmaieHematology, Oncology and Stem Cell Transplantation Research center, Tehran University of Medical Sciences, Tehran, IranJournal Article20160608<strong><em>Background & Objective</em></strong><strong>: </strong>Soft tissue sarcomas (STS) constitute an uncommon and heterogeneous group of tumors of mesenchymal origin and various cytogenetic abnormalities ranging from distinct genomic rearrangements, such as chromosomal translocations and amplifications, to more intricate rearrangements involving multiple chromosomes. Fluorescence in situ hybridization (FISH) can be used to identify these chromosomal translocations and amplifications, and sub classify STS precisely. The current study aimed at investigating the usefulness of FISH, as a diagnostic ancillary aid, to detect cytogenetic abnormalities such as <em>MDM2</em> (murine double minute 2<em>)</em> amplification and <em>CHOP</em>(C/EBP homologous protein) rearrangement in liposarcoma, as well as <em>SYT</em> (synaptotagmin<em>)</em> rearrangement in synovial sarcoma.<br /> <strong><em>Methods</em></strong><strong>:</strong> The FISH technique was used to analyze 17 specimens of liposarcoma for <em>MDM2</em> amplification and <em>CHOP</em> rearrangement, and 10 specimens of synovial sarcoma for <em>SYT</em> rearrangement. The subtypes of liposarcoma and synovial sarcomas were reclassified according to the FISH results and compared with those of the respective histological findings.<br /> <strong><em>Results:</em></strong> According to the FISH results in 17 liposarcoma cases, well-differentiated liposarcoma(WDLPS), dedifferentiated liposarcoma (DDLPS), and myxoidliposarcoma (MLPS)subtypes were 41%, 53%, and 6%, respectively. In different subtypes of liposarcoma, a total of 30% mismatches were observed between pathologic and cytogenetic results. According to the histological findings from FISH analysis, <em>SYT</em> rearrangement was found only in three out of 10 (30%) synovial sarcomas.<br /> <strong><em>Conclusion:</em></strong> The detection of cytogenetic abnormalities in patients with liposarcoma and synovial sarcoma by FISH technique provides an important objective tool to confirm sarcoma diagnosis and sub classification of specific sarcoma subtypes in such patients. https://ijp.iranpath.org/article_25043_ac79674409a98de9ac72f09068eb05fa.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701High Expression of Sphingosine Kinase 1 in Estrogen and Progesterone Receptors-Negative Breast Cancer2182242504910.30699/ijp.2017.25049ENAzadeh Sadat NazouriDept. of Biology, Science Faculty, Shahid Beheshti University, Tehran, Iran Pathology and Stem Cell Research Center, Pathology Department, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, IranOmolbanin AsadpourDept. of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranShahriar DabiriPathology and Stem Cell Research Center, Pathology Department, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran0000-0002-5922-3976Bahram PourseyediSurgery Department, Kerman University of Medical Sciences, Kerman, IranMohamad Reza LashkarizadehSurgery Department, Kerman University of Medical Sciences, Kerman, IranHamid ZeinalyneghadSurgery Department, Kerman University of Medical Sciences, Kerman, IranJournal Article20160115<strong><em>Background & objective</em></strong><strong>: </strong>Breast cancer is the leading cause of cancer related death in females. Sphingosine kinase 1 (SPHK1) and its product sphingosine-1-phosphate (S1P) are the essential key regulator molecules in breast cancer through their ability to promote cell proliferation, angiogenesis, cell proliferation, and lymphagiogenesis. <em>SPHK1</em> is overexpressed in multiple types of cancer including breast cancer and is associated with resistance to treatment. The current study aimed at investigating the expression of <em>SPHK1</em> in estrogen and progesterone receptors (ER, PR) negative in comparison to ER, and PR positive breast cancer and their normal controls, and also finding the relationship between <em>SPHK1 </em>expression and high body index (BMI) in the selected groups with breast cancer.<br /> <strong><em>Methods: </em></strong>A total of 120 human breast cancer tissue specimens were analyzed for <em>SPHK1</em> expression using quantitative real–time polymerase chain reaction (q RT-PCR) assay. Detection of hormonal status of breast cancer tissue samples was conducted by immunohistochemical assay.<br /> <strong><em>Result: </em></strong>The current study findings showed that the level of <em>SPHK1</em>expression in the breast cancer tissue was significantly higher in patients with estrogen and progesterone negative receptors, compared to the ones without them (P-value< 0.05). The obtained data confirmed that the obesity in patients with ER negative was higher than the ones with positive receptors (BMI> 25).<br /> <strong><em>Conclusion:</em></strong> The current study showed that expression of <em>SPHK1</em>gene was higher in the patients with ER and PR negative breast cancer and high BMI, compared with other groups.https://ijp.iranpath.org/article_25049_246222ab6de884234b89ebe7bfc8ddc0.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Correlation of vascularization and inflammation with severity of oral leukoplakia2252302504410.30699/ijp.2017.25044ENFatemeh MashhadiabbasDept. of Oral and Maxillofacial Pathology, Dental school, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0003-3789-1727Masoume Fayazi-BoroujeniShahrekord University of Medical Sciences, Shahrekord, IranJournal Article20160725<strong><em>Background & objective</em></strong><em>: </em>Changes in submucosal vascularization and inflammation, determined by immunohistochemistry staining, were shown to be correlated with the development of dysplasia and invasiveness of epithelial cells in premalignant and malignant lesions. This study evaluated changes in sections routinely stained with Hematoxylin and Eosin (H&E) in order to investigate vascular density and intensity of inflammatory cells infiltration during the progression of oral leukoplakia with mild dysplasia to Squamous Cell Carcinoma (SCC).The aim of the research was to determine whether changes in sub-mucosal vascularity and inflammatory infiltration of leukoplakia in routine H&E-stained sections could contribute to the assessment of severity of the lesion.<br /> <strong><em>Methods</em></strong><strong><em>: </em></strong>In this cross-sectional, comparative and descriptive study, vascular density and inflammation intensity of 125 available samples of H&E-stained sections, consisting of 35 cases of mild and moderate dysplasia, 38 severe dysplasia and carcinoma in situ, and 52 SCC, were investigated. To analyze the data, chi-square test, Mann-Whitney test, Kruskal-Wallis test, Tukey’s post hoc test, and cumulative ordinal logistic regression were conducted.<br /> <strong><em>Results</em></strong><strong><em>:</em></strong> There was a significantly higher vascular density in cases with severe dysplasia, in situ carcinoma, and SCC compared to those with mild to moderate dysplasia (<em>P</em><0.0001). However, the difference in vascularity was not statically significant between severe dysplasia, carcinoma in situ, and SCC (<em>P</em>=0.78). Intensity of inflammatory cells infiltration in the underlying connective tissue was significantly different among the three groups (<em>P</em><0.0001), and the highest intensity of inflammatory cells infiltration was seen in the SCC group.<br /> <strong><em>Conclusions: </em></strong>Increased submucosal vascularization and inflammatory cells infiltration can contribute further to predicting more aggressive epithelial dysplasia.https://ijp.iranpath.org/article_25044_c3be0c4e897bc2c403995f1a72306189.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Expression of Apoptosis Related and Proliferative Proteins in Malignant Lympho-Proliferative Disorders2312402505110.30699/ijp.2017.25051ENZeeba JairajpuriDept. of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, IndiaRekha GhaiNational Institute of Pathology, Indian Council Of Medical Research, Safdarjung Hospital Complex, New Delhi IndiaSumita SalujaDept. of Haematology Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IndiaSujala KapurNational Institute of Pathology, Indian Council Of Medical Research, Safdarjung Hospital Complex, New Delhi IndiaK.T BhowmickDept. of Radiotherapy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IndiaJournal Article20160508<strong><em>Background & objective</em></strong><em>: </em>The current study aimed to perform an immunohistochemical analysis of patterns of apoptotic and cell proliferative related protein expression in different histological grades and immune phenotypes of malignant lymphomas and other lymphoproliferative disorders<br /> <strong><em>Methods:</em></strong>This observational study was carried on 60lymph node biopsies of lymphoproliferative disorders. The biopsies were analyzed histologically and immunohistochemically.<br /> <strong><em>Results:</em></strong>A total of 60 lymph node biopsies were included in the study, of which 81.6% were of malignant lympho-proliferative lesions. The majority of the biopsies were B-cell (66%) and were grouped in the intermediate grade. Bax and BCL-2 protein expression was presented by percentage of immune positive neoplastic cells per 10fields and graded on a scale of 1 to4. A Bcl-2, Bax Protein Ratio (BBPR) was determined for each case by dividing the estimated Bcl-2 protein (percentage of Bcl-2 positive cells x Bcl-2 staining intensity) by the estimated Bax protein (percentage of Bax positive cells x Bax immunostaining intensity). The mean BBPR was found to be significantly higher in indolent lymphomas (2.64 ± 1.3) as compared to aggressive lymphomas (0.47 ± 0.9) (P<0.01). The expression of P53 and PCNA in 35 biopsies of Non Hodgkin Lymphomas (NHL) was found to increase from low to high grade tumors.<br /> <strong><em>Conclusions</em>: </strong>A significant correlation was found between BBPR and predicted biological behavior of indolent and aggressive lymphomas. This indicates the important role of Bcl-2 and Bax in biological behavior of lymphomas. Furthermore, P53 and PCNA expression were found to increase from low to high-grade tumors suggesting their prognostic value in NHL.https://ijp.iranpath.org/article_25051_9ab586e95005b1017c5d4d3d532387a7.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Basic Characteristics of Oligodendrogliomas: The Shohada-e Tajrish Hospital Experience (2008-2014)2412472505010.30699/ijp.2017.25050ENMahsa AhadiCancer Research Center, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0002-0995-3102Afshin MoradiCancer Research Center, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0003-1544-0992Azadeh RakhshanCancer Research Center, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranAlireza ArefianCancer Research Center, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranMitra RafizadehCancer Research Center, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranHanieh ZhamCancer Research Center, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20160827<strong><em>Background and Objectives</em></strong><strong>:</strong> Gliomas are the most prevalent subgroup of primary brain tumors with a relatively high mortality. However, oligodendrogliomas have a better prognosis compared to other subtypes due to their sensitivity to chemotherapy. Considering the low incidence and the resulting lack of information about oligodendrogliomas, particularly in Iran, this study aimed at assessing their basic characteristics.<br /> <strong><em>Methods</em></strong><strong>:</strong>In this descriptive retrospective study, patients with definite diagnosis of oligodendroglioma were identified by reviewing the archives of pathology reports at the department of pathology of Shohada-e Tajrish Hospital during years 2008 to 2014. Age, gender, location, and the grade of the tumor were extracted and entered to the SPSS statistical software for analysis.<br /> <strong><em>Results</em></strong><strong>: </strong>A total of 182 patients, including 115 males (63.2%) and 67 females (36.8%), were included with a mean age of 38.5±13.36 years. Frontal lobe was involved in 53 patients (29.1%), parietal lobe in 31 (17.0%), temporal lobe in 22 (12.1%), frontoparietal area in 15 (8.2%), parieto-occipital area in 11 (6.0%), temporoparietal and frontotemporal areas each in 9 subjects (4.9%), occipital lobe in 5 (2.7%), and the brainstem in 4 (2.2%). Furthermore, 108 cases (59.3%) had grade-2 and the remaining74 patients (40.7%) had grade-3 anaplastic oligodendrogliomas. The mean age of subjects with brainstem oligodendrogliomas was significantly lower than the other patients (p=0.025).<br /> <strong><em>Conclusion</em>: </strong>Oligodendrogliomas commonly effects the frontal lobe, followed by the parietal and temporal lobes. The mean age of subjects with brainstem lesions was significantly lower than other patients. Age, gender or location of the tumor did not independently predict a higher grade lesion.https://ijp.iranpath.org/article_25050_2537827a5dd7e7d2e3e8979e38d2ec37.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Comparison of Interferon-Gamma (IFNG) +874 T/A Single Nucleotide Polymorphism in Hepatitis C Virus Infected Patients and Non-Infected Controls in Mashhad, Iran2482562504610.30699/ijp.2017.25046ENSina RostamiDept. of Laboratory Medicine, Children's and Women's Health, NTNU - Norwegian University of Science and Technology, NO-7491 Trondheim, NorwayAlireza PasdarDept. of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Division of Applied Medicine, Medical School, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UKSina GerayliDept. of Biology, University of Western Ontario, London, Ontario N6A5BF, CanadaHamed HatamiDept. of Immunology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranSamaneh SepahiTargeted Drug Delivery Research Centre, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IranFatemeh NateghApplied Biotechnology Research Center, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, IranMojtaba MeshkatIslamic Azad University, Mashhad Branch, Mashhad, IranSeyed Mousalreza HoseiniDept. of Internal Medicine, Qaem Hospital, Mashhad University of Medical Sciences, Mashhad, IranMitra AhadiDept. of Internal Medicine, Qaem Hospital, Mashhad University of Medical Sciences, Mashhad, IranHamid Reza SimaDept. of Internal Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, IranHasan VosughiniaDept. of Internal Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, IranMohammad Reza SarvghadDept. of Infectious Diseases, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, IranAbbas EsmaeelzadeDept. of Internal Medicine, Qaem Hospital, Mashhad University of Medical Sciences, Mashhad, IranHosein NomaniAntimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, IranHoman Mosanan MozafariDept. of Internal Medicine, Qaem Hospital, Mashhad University of Medical Sciences, Mashhad, IranFariba Rezai TalabDept. of Internal Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-3836-0944Mohammad Taghi ShakeriDept. of Biostatistics, Public Health School, Mashhad University of Medical Sciences, Mashhad, IranZahra MeshkatAntimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20160720<strong><em>Background and Objectives</em></strong>: Interferon-gamma is an important cytokine, which facilitates immunity against intracellular pathogens. Several factors, including genetic variations of cytokine-producing genes have been shown to influence the progression and severity of Hepatitis C virus (HCV) infection.<br /> <strong><em>Methods</em></strong><em>: </em>Between January and December 2012, 87 HCV-infected individuals and 89 individuals without HCV infection were recruited for the study of Single Nucleotide Polymorphism (SNP) at Interferon Gamma <em>(IFNG)</em> +874 T/A. After extraction of genomic DNA from Peripheral Blood Mononuclear Cells (PBMCs) in blood sample of the individuals, Amplification Refractory Mutation System (ARMS) polymerase chain reaction was performed to evaluate the SNP at this position.<br /> <strong><em>Results</em></strong><em>: </em>The frequency of genotype TA was 62.1% in the HCV-infected group, while it was 47.2% for the control group (p=0.033). However, after adjusting for confounders (including alcohol consumption, drug addiction, transfusion, and tattoos), the genotypes at this position did not show any statistically significant association with HCV infection (adjusted P values were above 0.05). The frequency of allele A was slightly higher in patients than the controls (55.2% versus 48.3%).Carriers of A allele were more frequent in patients with HCV infection compared to the control group (55.17% in patients versus 48.31% in the control group; P=0.02). However, after adjustment for confounders, the results were no longer statistically significant (P=0.2).<br /> <strong><em>Conclusion</em></strong><em>:</em> A carrier status for certain alleles and genotypes at Interferon Gamma <em>(IFNG)</em> +874 T/A may lead to higher susceptibility to HCV infection in a certain population.https://ijp.iranpath.org/article_25046_d601b9dcfa93371eb8aabba7f426fbee.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Evaluation of Association Between the Serum Levels of MMP-9 and MMP-9/TIMPs With Soluble Forms of Selectins and Itching Induced by Sulfur Mustard2572642564610.30699/ijp.2017.25646ENNayere AskariDept. of Biology, Faculty of Basic Sciences, Shahid Bahonar University of Kerman, Kerman, IranTooba GhazanfariImmunoregulation Research Center, Shahed University, Tehran, IranMohammad Mehdi NaghizadehImmunoregulation Research Center, Shahed University, Tehran, IranAthar MoinImmunoregulation Research Center, Shahed University, Tehran, IranAli KhamesipourCenter for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, IranShahryar PourfarzamImmunoregulation Research Center, Shahed University, Tehran, IranZuhair Mohammad HassanDept. of Immunology, Tarbiat Moddares University, Tehran, IranJournal Article20160208<strong><em>Background & objective</em></strong><strong>:</strong> Pruritus is the most frequent chronic dermal complication of sulfur mustard (SM), which negatively influences the quality of life. Exact pathophysiology of SM-induced itching is unknown. The current study aimed at evaluating the possible association between SM-induced itching and the serum levels of matrix metalloproteinase (MMP)-9 and their endogenous inhibitors, and serum levels of soluble forms of selectins (sL-, sP-, and sE-selectins) as adhesion molecules involved in the development of different inflammatory reactions.<br /> <strong><em>Methods</em></strong><strong>:</strong> Serum levels of MMP-9, MMP-9/ tissue inhibitors of metalloproteinases (TIMPs), and selectins were measured by the enzyme-linked immunosorbent assay (ELISA), and compared between the groups (n=368) with and without itching, and matched control groups (n=126).<br /> <strong><em>Results</em></strong><strong>:</strong> Serum levels of MMP-9 were significantly higher in the SM exposed group with itching, compared with that of the group without itching (medians: 894 and 624 pg/mL respectively; P-value =0.034). There was no relationship between the serum levels of MMP-9/TIMP-1, MMP-9/TIMP-2, MMP-9/TIMP-4, and itching in the patients exposed to SM. Median serum levels of sE- and sL-selectins in the exposed group with itching were higher than those of the exposed group without itching. These differences were statistically insignificant (P-values =0.084 and 0.095, respectively).<br /> <strong><em>Conclusion</em>:</strong> According to the results of the current study, the increased serum levels of MMP-9 and selectins 20 years after exposure may play role in the pathogenesis and persistence of SM-induced itching in the exposed individuals.https://ijp.iranpath.org/article_25646_79aae9948481ca0ccf4be0736da1ae93.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Acute Myeloid Leukemia as the Main Cause of Pancytopenia in Iranian Population2652712564710.30699/ijp.2017.25647ENHasan JalaeikhooAJA Cancer Research Center (ACRC), AJA University of Medical Sciences, Tehran, IranSeyed Mohammad Hossein KashfiGastroenterology and Liver Diseases Research center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, IranPedram AzimzadehGastroenterology and Liver Diseases Research center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, IranAhmad NarimaniAJA Cancer Research Center (ACRC), AJA University of Medical Sciences, Tehran, IranKatayon Gouhari MoghadamAJA Cancer Research Center (ACRC), AJA University of Medical Sciences, Tehran, IranMohsen RajaeinejadAJA Trauma and Surgery Research Center, AJA University of Medical Sciences, Tehran, IranMehdi ArianaAJA Trauma and Surgery Research Center, AJA University of Medical Sciences, Tehran, IranManouchehr KeyhaniHematology and Oncology Research Center, Vali Asr Hospital, Tehran University of Medical Science, Tehran, IranJournal Article20160110<strong><em>Background & objective</em></strong><strong>:</strong> 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.<br /> <strong><em>Methods</em></strong>: 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.<br /> <strong><em>Results</em></strong>: 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%).<br /> <strong><em>Conclusion</em></strong>: 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.https://ijp.iranpath.org/article_25647_5a9118ef5878bb93fdc314106eb2df44.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Duodenal Metastases From Renal Cell Carcinoma Presented With Melena: Review and Case Report2722762568710.30699/ijp.2017.25687ENRamesh OmranipourCancer Institute of Tehran University of medical science, Tehran, IranHabibollah MahmoudzadehFarabi Hospital, Tehran University of Medical Science, Tehran, IranFreshteh EnsaniResearch Center of Cancer, Tehran University of Medical Science, Tehran, IranSamira YadegariCancer Institute of Tehran University of Medical Science, Tehran, IranSeyed Rohollah MiriCancer Institute of Tehran University of Medical Science, Tehran, IranJournal Article20151220Renal cell carcinoma (RCC) metastasis to duodenum is very rare and only a few case reports are available in the literature. We here reported a patient with solitary duodenal metastasis presented with melena six years after right nephrectomy. The patient underwent upper gastrointestinal endoscopy showing ulcerative mass at the second portion of duodenum and biopsy of this mass was consistent with metastatic RCC. Metastasis work up did not find any other site of malignancy, thus Whipple’s operation (Pancreaticoduodenectomy) was performed. In conclusion metastasis from RCC should be considered in mind in patients with history of nephrectomy presenting with gastrointestinal symptoms and a complete evaluation, especially endoscopic examination followed by biopsy, is suggested.https://ijp.iranpath.org/article_25687_bed934950c921b90b8a226ed6a9e7019.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701A Carcinoid Tumor in the Urinary Bladder With Uncommon Clinicopathological Presentation2772802568810.30699/ijp.2017.25688ENKrishnendu MondalDept. of Pathology, Sonoscan Healthcare, Malda, India0000-0003-3056-044XRupali MandalDept. of Pathology, Sonoscan Healthcare, Malda, IndiaJournal Article20160412<strong><em>Background:</em></strong> Carcinoid tumors usually originate from the enterochromaffin cells located in gastrointestinal tract and bronchopulmonary system. They may rarely arise in the urinary bladder, where this can be eventually miscued as any other commoner bladder neoplasms. The current study was conducted to connote an uncommon clinicopathological presentation by a carcinoid tumor in the urinary bladder.<br /> <strong><em>Case:</em></strong> A 52-year-old male, who initially experienced obstructive urinary symptoms, underwent cystourethroscopy to remove a tumor in the urinary bladder. The tumor exhibited insular, trabecular, and organoid architecture on histology without any necrosis or mitosis, stained positively with chromogranin A, and thereby, confirmed the diagnosis of a pure carcinoid tumor.<br /> <strong><em>Conclusion:</em></strong> Carcinoid tumors rarely arise in the urinary bladder and other genitourinary organs. But, several other and relatively more common bladder neoplasms may often deceptively simulate it. This dilemma could be resolved easily with the application of proper immunohistochemistry (IHC) in neuroendocrine tumors.https://ijp.iranpath.org/article_25688_91cf900c3a6f7a1c6967baff025382af.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Immunohistochemical Expression of Nuclear β-Catenin and STAT-6 in a Solitary Fibrous Tumor of the Soft Palate: A Case Report and Review of the Literature2812852568910.30699/ijp.2017.25689ENIvonne A. Montes-MojarroSurgical Pathology Department, The American British Cowdray Medical Center, Mexico city 01120, MexicoJavier Baquera-HerediaSurgical Pathology Department, The American British Cowdray Medical Center, Mexico city 01120, MexicoJuan Felipe Sanchez-MarleHead and Neck Surgery Department, The American British Cowdray Medical Center, Mexico city 01120, MexicoCarlos Ortiz-HidalgoSurgical Pathology Department, The American British Cowdray Medical Center, Mexico city 01120, MexicoJournal Article20160317The solitary fibrous tumors (SFT) are rare tumors in the head and neck region and there have been only 5 cases reported in the literature in the soft palate. The current paper presents a unique case of a 62-year-old male with TFS arising in the soft palate. The tumor was highly cellular, composed of bland looking haphazardly arranged spindle cells. The signal transducer and activator of transcription (STAT)-6 and nuclear β-catenin were reactive by immunohistochemistry (IHC). The current case highlights the importance of the STAT-6 and the β-catenin as IHC markers to make a differential diagnosis with other entities. In summary, the paper presents the first reported case of a SFT of the soft palate in a male patient with nuclear expression of STAT-6 and β-catenin.https://ijp.iranpath.org/article_25689_9edebe408d43b71a34f9b0b6dcc01c16.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701CD99: A potential Diagnostic Marker for Differentiating Sub-ependymal Giant Cell Astrocytoma From Other Mimickers: A Report of Five Cases2862902570610.30699/ijp.2017.25706ENAlireza SadeghipourDept of Pathology, Iran university of medical sciences, Tehran, IranNavid AbdiDept of Pathology, Iran university of medical sciences, Tehran, IranPegah BabaheidarianDept of Pathology, Iran university of medical sciences, Tehran, Iran0000000194887228Journal Article20160423<strong><em>Background: </em></strong>Tuberous sclerosis (TSC) is inherited as an autosomal dominant disease, characterized by skin lesion and tubers in vital organs, especially brain in three categories including subependymal nodules, cortical tubers and subependymal giant cell astrocytoma. Subependymal giant cell astrocytoma (SEGA) is an indolent neoplasm which usually arises at the cauda thalamic groove near foramen monro, although it occurs usually in the clinical settings of TSC, a few number of SEGA has been reported without such history. Its morphology with special cytoarchitecture could be mistaken with other glial brain tumors with similar morphology. Therefore, investigating new markers for differentiating SEGA from other mimickers seems logical rather than other glioneural immunohistochemical markers introduced before.<br /> <strong><em>Case:</em></strong> We investigated CD99 expression in SEGA as an adjunctive marker for diagnostic purposes. Five reported cases of SEGA were studied and all of them showed CD99 expression besides usual glioneural markers.<br /> <strong><em>Conclusion:</em></strong> CD99 may be a useful adjunctive marker in differentiating SEGA from other mimickershttps://ijp.iranpath.org/article_25706_0732c5ab7e3ecee4393c191ef27a6b8f.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Benign Phyllodes Tumor With Cystic Squamous Metaplasia: A Cytohistological Correlation of a Rare Case2912942583710.30699/ijp.2017.25837ENIndranil ChakrabartiDept. of Pathology, North Bengal Medical College, The West Bengal University of Health Sciences, Siliguri, Darjeeling, West Bengal, IndiaPriyanka AgarwalaDept. of Pathology, North Bengal Medical College, The West Bengal University of Health Sciences, Siliguri, Darjeeling, West Bengal, IndiaPranati BeraDept. of Pathology, North Bengal Medical College, The West Bengal University of Health Sciences, Siliguri, Darjeeling, West Bengal, IndiaSankarshan BhaduriAnadaloke Sonoscan Centre, Siliguri, Darjeeling, West Bengal, IndiaJournal Article20160726<strong><em>Background: </em></strong>Phyllodes tumors (PTs) are uncommon biphasic fibroepithelial neoplasms of the breast occurring in elderly females with a peak incidence between 45 and 49 years. Depending on various histological criteria, they are subdivided into benign, borderline, and malignant forms. Metaplastic changes occur, but are quite infrequent and cystic squamous metaplasia is very rare among the observed metaplastic changes in PT.<br /> <strong><em>Case:</em></strong> The current paper presents the case of a 41-year-old female with a progressively enlarging swelling in the left breast. Subsequent histopathological examination revealed benign PT with cystic squamous metaplasia. The previously done fine needle aspiration smears were also reviewed, which showed important diagnostic clues to this rare entity, but were ignored due to the rarity of the lesion.<br /> <strong><em>Conclusion:</em></strong> The case was presented because of its unique cytological and histopathological morphology and also to determine the role of aspiration cytology to diagnose such a rare occurrence.https://ijp.iranpath.org/article_25837_80126bc415fec05357234430e3893557.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Nosocomial Jejunal Mucormycosis - an Unusual Cause of Perforation Peritonitis2953002584010.30699/ijp.2017.25840ENChandan KumarDept. of Pathology, University College of Medical Sciences, University of Delhi, Delhi, IndiaPragya JainDept. of Pathology, University College of Medical Sciences, University of Delhi, Delhi, India0000-0002-2577-6919Neelam WadhwaDept. of Pathology, University College of Medical Sciences, University of Delhi, Delhi, IndiaPreeti DiwakerDept. of Pathology, University College of Medical Sciences, University of Delhi, Delhi, IndiaNirupma KhanDept. of Pathology, Guru Teg Bahadur Hospital, Shahdra, Delhi, IndiaJournal Article20160808Mucormycosis is a rare but highly invasive opportunistic fungal infection. Gastrointestinal disease although uncommon is highly fatal. We report a case of jejunal mucormycosis in a 24 year old undernourished female with preceding surgical intervention for acute intestinal obstruction of tubercular etiology. On 8<sup>th</sup> post-operative day, she developed oozing from suture line, prompting exploratory laparotomy, bowel resection, jejunostomy and ileal mucus fistula. Resected bowel showed one perforation and several areas of impending perforations. Characteristic broad, pauci-septate hyaline, empty looking hyphae with infrequent branching were found transmurally and showing angio-invasion. Local intestinal tissue trauma coupled with her sub-normal immune status permitted this unusual nosocomial infection. Histopathologic demonstration of the fungus in surgical specimens remains cornerstone of diagnosis of mucormycosis in view of its non-specific symptoms, low isolation rates of mycologic culture and lack of other rapid tests. https://ijp.iranpath.org/article_25840_947fc9a2e4886e2a64642cb879aeba3c.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Gorham’s Disease of the Maxilla and Mandible With Distinctive Cone Beam Computerized Tomographic Features3013062585510.30699/ijp.2017.25855ENRupam SinhaDept. of Oral Medicine & Radiology, Haldia Institute of Dental Sciences and Research, Haldia, West Bengal, IndiaSoumyabrata SarkarDept. of Oral Medicine & Radiology, Haldia Institute of Dental Sciences and Research, Haldia, West Bengal, IndiaTanya KhaitanDept. of Dentistry, Murshidabad Medical College and Hospital, Berhampore, West Bengal, IndiaDeepsikha RamaniDept. of Oral Medicine & Radiology, Haldia Institute of Dental Sciences and Research, Haldia, West Bengal, IndiaJournal Article20160427<span>Gorham’s disease is a rare and atypical disorder epitomized by progressive osteolysis of bone with eventual total disappearance of bone. The etiology is poorly understood with variable clinical presentation.</span><span> <span lang="EN-IN">Most times it is initially misdiagnosed as temporomandibular joint dysfunction, periodontal disease or odontogenic tumors clinically and radiographically in routine dental practice</span></span><span>. Radiographic examination, such as Cone Beam Computerized Tomography (CBCT) play a vital role in diagnosing such disorder resulting in disappearance of the involved bone entirely, which is a definitive distinguishing feature of this condition. Regarding the rarity of the condition, the current study presents a case of Gorham’s disease with distinctive clinical, radiological, and histological, features</span><span lang="EN-IN"> involving maxilla and mandible</span><span>.</span>https://ijp.iranpath.org/article_25855_268bb5f9f26f4c782a00c00e8f61803c.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Placental Mesenchymal Dysplasia With Normal Fetus: A Rare Case Report3073102585610.30699/ijp.2017.25856ENSubrata PalDept. of Pathology, College of Medicine and Sagore Dutta Hospital. Kolkata, IndiaKingshuk BoseDept. of Pathology, Bankura Sammilani Medical College, Bankura, India.Palash Ch MondalDept. of Gynaecology and Obstretics, Bankura Sammilani Medical College, Bankura, IndiaSrabani ChakrabartiDept. of Pathology, Culcutta National Medical College, Kolkata, IndiaMrinal SikderDept. of Pathology, R G Kar Medical College, Kolkata, IndiaJournal Article20160614Placental mesenchymal dysplasia (PMD) is a rare benign placental abnormality. It is characterized by hydropic degeneration of stem villi, placentomegaly, and increased maternal serum alpha-fetoprotein(AFP). It can be associated with different congenital abnormalities, karyotype abnormalities, and feto-maternal morbidities. It is difficult to differentiate PMDfrom partial mole, complete mole with twin pregnancy in ultrasound, and in macroscopic examination. The current paper presentsa rare case of placental mesenchymal dysplasia in a young primigravida mother who delivered a normal fetus withnormal karyotype. https://ijp.iranpath.org/article_25856_86b53d38bcb0d2a51d9dec94bd87faa4.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Dark Chocolate Intake Acutely Enhances Neutrophil Count in Peripheral Venous Blood3113122504710.30699/ijp.2017.25047ENMartina MontagnanaSection of Clinical Biochemistry, University of Verona, Verona, ItalyElisa DaneseSection of Clinical Biochemistry, University of Verona, Verona, ItalyGabriel Lima-OliveiraSection of Clinical Biochemistry, University of Verona, Verona, ItalyGian Luca SalvagnoSection of Clinical Biochemistry, University of Verona, Verona, ItalyGiuseppe LippiSection of Clinical Biochemistry, University of Verona, Verona, ItalyJournal Article20161014Beside the well-established impact on decreasing the risk of cardiovascular diseases (1), recent attention has been paid to the relationship between cocoa-containing foods and the immune system (2), showing that dark chocolate consumption enhances the systemic defense against bacterial (3) and viral (4) infections. Hence, the current study aimed at investigating the acute effect of dark chocolate intake on peripheral blood leukocytes.https://ijp.iranpath.org/article_25047_6e9ee7f191711739b11e312076e1c84d.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530312320170701Current Diagnostic Status of Pheochromocytomaand Future Perspective: A Mini Review3133222626710.30699/ijp.2017.26267ENFatemeh KhatamiChronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IranSeyed Mohammad TavangarDept. of Pathology, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran0000-0002-4253-2385Journal Article20170611Pheochromocytomas (PCCs) are rare neuroendocrine tumors. The current diagnostic tools are based on biochemistry and histopathology results, but heterogeneity of diagnostic markers, signs and symptoms of PCCs bring a lot of difficulties for these two current methods. Unfortunately microscopic understanding of PCCs is not adequate for its confident prognosis and management. There are data linking specific genotypes of PCCs tumors to specific locations, typical biochemical phenotypes or future clinical behaviors. The detection of a germ-line mutation possibly can guide us to an early diagnosis, appropriate treatment, and regular surveillance with better prognosis not only for the patient but also for their family members. Moreover, the latest discoveries in gene sequencing, circulating DNA (ctDNA) and circulating tumor cells (CTCs) will support the exact molecular pathogenesis of PCCs in order to provide an important basis for future PCCs managements.https://ijp.iranpath.org/article_26267_5da06a3b200b12e7a8dca36dfd5f967f.pdf