Iranian Journal of Pathology

Abstract

Abstract   Background and Objectives: To compare pathologic complete response (pCR) in patients with advanced rectal cancer receiving neoadjuvant chemoradiotherapy (NACT) by 5-FU or Xeloda (capecitabine) with and without Eloxatin (oxaloplatin injection). Materials and Methods: Seventy-five consecutive patients with the diagnosis of advanced rectal adenocarcinoma were included. Two basic chemotherapy regimens were used: one drug (5-FU or Xeloda) or two-drug (5-U or Xeloda with Eloxatin). Endpoints were pCR and preservation of sphincter during surgery through low anterior resection (LAR). All analyses were done using SPSS software version 17.0 (SPSS Inc., Chicago, IL). Results: There were no significant differences between the group of patients who received one-drug regimen with those who received two-drug regimen regarding the pCR (four cases (23.5%) versus 25 vases (43.1%)) state or the type of surgery performed [nine cases (52.9%) versus 36 cases (62.1%)]. Conclusion: Adding Eloxatin to the standard treatment of rectal adenocarcinoma (5-FU based) did not yield in a higher pCR or a higher chance to preserve the anal sphincter.  

Abstract Background and Objectives: Involvement of lymph nodes is an important prognostic factor in the most cancers, including colorectal cancer. In the recent years, invasion to blood and lymphatic vessels has been shown to predict involvement of lymph nodes and the number of involved nodes has been less studied issue. The aim of this study was determination of the relationship between the size of colorectal adenocarcinoma and lymph node involvement. Materials & Methods: In this cross-sectional study, 116 patients were enrolled with colorectal cancer from Rasoul-e-Akram and Mehr Hospitals in 2002-2008. Data analysis was performed by SPSS-15 software. Results were expressed as frequency, percent, and mean ±SD. We used Chi2, student t-test and correlation tests for statistical analysis. Results: 54.3% of patients were male and 45.7% were female. Mean age of them was 59.4± 12.9 years. Mean of tumor size (longest diameter) was 5.4± 2.2 (range: 1.5 to 12) cm. Mean number of involved lymph nodes was 4.9± 3.5(range: 1-14). There was no correlation between number of lymph node involvement and tumor size. There was no correlation between lymph node involvement and tumor and age group, sex, location and depth of tumor. Poorly differentiated tumor significantly correlated to lymph node involvement (P=0.001). Conclusion: There is no correlation between tumor size and number of involved lymph node in colorectal cancer. However, poor histopathologic grade is associated with lymph node involvement.  

Abstract Background and Objectives: We aimed at evaluating the efficacy of fine needle aspiration biopsy (FNA) in comparison with histopathology and demonstrating whether cytological study could be a proper diagnostic tool in orbital mass lesions. Materials and Methods: In a cross sectional study during 36 months, patients referred to our ophthalmologic center affiliated to Tehran University of Medical Sciences, for evaluation of orbital masses, were selected for FNA. After the surgery, the results of FNA were compared against histopathologic diagnoses as our gold standard method. Finally, the frequencies of specimen adequacy, the accuracy of FNA in distinguishing benign and malignant lesions and in the exact definitive diagnosis of the disorders were reported. Results: In 27.4% of the total 62 cases, the specimens were inadequate for cytologic evaluations. The rate of specimen adequacy in malignant and benign lesions was 82.6 % and 66.66%, respectively. From the morphologic point of view, the rate of the exact definitive diagnosis of malignant and benign disorders in the total 62 cases was 78.2% and 38.46% and; in the adequate specimens, it was 94.73% and 57.69%, respectively. There was no false positive FNA result for malignant cells and only in one malignant case, the FNA report was falsely negative. All data wee analyzed by SPSS software and p value Conclusion: FNA was considered more beneficial in the diagnosis of malignant lesions. FNA is a relatively noninvasive, rapid, specific, and accurate method for the preoperative primary diagnosis of orbital mass lesions and especially in malignant lesions and in some conditions, specific diagnoses can be achieved.  

Abstract Background and Objectives:  The aim of this study was to survey the relationship between the level of  creatinine,cardiac troponins serum and the function of  the left ventricle in patients with  kidney insufficiency,without acute coronary syndrome. Materialsand Methods:The sample  was150 patients with nondialysis chronic kidney disease without  acute  coronary  syndrome,  hospitalized  at  Imam  Khomeini  Center through  2008-2009.  All  the patients had serum creatinine (cr) 1.5mgor greater and no symptoms of acute coronary syndrome in the  first  month. Serum  Cr and troponin T and I  were  measured  in  blood samples and patients  left ventricular function (LVEF) were estimated by echocardiography. Then based on the objectives, the findings were analyzed with SPSS soft ware. Results:Serum troponin T levels were significantly higher in patients with greater Cr levels but there was no significant relationship between troponin I and Cr levels. Patients with greater degrees of LV dysfunction  had  significantly upper  levels of troponin T(P=0.0001). In this category, patients with diabetes, old age, cigarette smokers, greater levels of Cr, advanced stages of chronic kidney disease and greater degrees of LV dysfunction showedsignificantly higher levels of troponin T(P=0.0001). Conclusion:To identify chronic kidney disease patients at increased risk for cardiovascular events, serum troponin T can be used. In  high-riskpatients, the evaluation for cardiovascular diseases could be done earlier in the course of chronic kidney disease.  

Abstract Newborns’ bacterial infections due to group B Streptococcus (GBS) happen in two forms including early-onset disease or late-onset disease. In this paper, we report a case of early-onset GBS infection in a male infant. A 22-year-old primigravid woman delivers a term normal looking male infant. Nasal flaring, grunting, and poor feeding presented soon after birth. An empiric treatment with intravenous ampicillin and amikacin initiated. On the second day, he was transferred to Newborn Intensive Care Unit (NICU). The intravenous antibiotics were changed to tazocin and vancomycin in NICU. The blood culture (BC) was positive for GBS. After 48 hours, respiratory distress symptoms disappeared, BC was negative, and ABG and CBC became normal. Finally, the infant was discharged after 15 days.GBS is a normal flora of women's gastrointestinal and genitourinary tracts. Infants with early-onset GBS sepsis need very close observation including repeated vital signs evaluation.

Abstract Breast metastasis of ovarian carcinoma is rare. To date, only 39 cases have been reported in the English-language  literature  so  far.  We  are  herewith  reporting  a  primary  ovarian  papillary  serous  cyst adenocarcinoma metastasing to breast and epsilateral supraclavicular node in a 58 year old female as the first case in our centre, located at North-East India.  The purpose of reporting this case is to emphasize the need of examining breasts in patients of ovarian cancer and the need to exercise meticulous care to exclude second primary at breast from possible secondaries at breast from ovarian can cer.  

Abstract Primitive  neuroectodermal  tumor  (PNET)  of  kidney  is  an  extremely  rare  renal  neoplasm  with only about fifty reported cases in literature.  Presumably,of neural crest origin, these tumors behave  aggressively  and  carry  a  poor prognosis.  We  report  a  case  of  22-year  old  female  patient complaining of left loin pain with recurrent hematuria for last 3 months. On clinical examination, the abdomen was soft and no palpable mass was felt. She underwent ultrasonography and com puted  tomography, which revealed a left renal mass. A left radical nephrectomy was performed. Histopathological examination of the  nephrectomy  specimen showed features of primitive  neu roectodermal  tumor  arising  from  left  kidney,  which was  confirmed  by  immunohistochemistry (IHC). The patient was treated with post-nephrectomy chemotherapy  and was  symptom-free at six-month follow-up.

Abstract Giant cell glioblastoma is an extremely rare variant of Glioblastoma (WHO grade IV) which is characterized by a predominance of bizarre, multinucleated giant cells. These tumors comprise of 0.8% of brain tumors and up to 5% of glioblastomas. In pediatric age group, these tumors are still uncommon with only around 53 published cases since 1952. Here, we report a case of a 12-year old female patient who presented in outpatient clinic with a short period history of headache and seizures. A CT scan showed a large right sided frontal space occupying lesion with areas of calcification. The patient was operated and subsequent histopathology revealed a high-grade astrocytic tumor with increased  cellularity,  atypical  mitosis,  bizarre  multinucleated  giant  cells  along  with  large  areas  of ischemic  necrosis  and  calcification.  A  diagnosis  of  Giant  cell  glioblastoma  (WHO  Grade  IV)  was made. The patient was symptomatically well at 3-month follow-up.  

Abstract A primary intraosseous carcinoma (PIOC) is a squamous cell carcinoma arising within the  jawbone andshould be differentiated from a malignant ameloblastoma.  It  is not due to arising from an odontogenic cyst or tumor. The possibility of the lesion being  a metastasis fromanotherprimary site should be considered, and excluded by a careful history and examination. The diagnosis of a PIOC is rare, but it is often worth considering in any differential diagnosis of  jawradiolucency.  The  prognosis  associated  with  primary  intraosseous  carcinoma of  the  jaws  is  poor  and needs for aggressive treatment. It is common for these patients to present with apparent routine dental.This paper reports a case PIOC of the maxilla. The patient was a 68-year-old woman with a chief complaint of swelling of her hard palate.

Abstract