Original Research
Forough Hashemi; Pegah Babaheidarian; Soheila Dabiran
Abstract
Background: Meningioma is among the most common slow growing central nervous neoplasms, which recurs locally despite the benign histologic features. The aim of this study was to evaluate osteopontin and ki67 expressions in different histologic grades of meningioma in a group of Iranian people. Methods: ...
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Background: Meningioma is among the most common slow growing central nervous neoplasms, which recurs locally despite the benign histologic features. The aim of this study was to evaluate osteopontin and ki67 expressions in different histologic grades of meningioma in a group of Iranian people. Methods: In this cross-sectional study, first, the paraffin blocks with the definite pathological diagnosis of meningioma in 70 patients were cut by microtome, in 4-5 micron sizes and stained for immunohistochemical markers of osteopontin and ki67. Then, all samples were evaluated for positive immunoreactivity and contributing factors. Results: Among 70 pateints studied, the mean for the Ki67 level was 8.6±12.3 and the mean for the osteopontinm IHC score was 45.2±77.9. There was a high correlation between markers, tumor recurrence and grade (P<0.001). In addition, there was a significant direct correlation between ki67 and osteopontin levels (P<0.001, r=0.760). In other words, as OPN and ki67 expressions increased, the chance of tumor recurrence increased. Conclusion: ki67 and osteopontin expressions in patients with meningioma can be used as good prognostic markers for tumor recurrence and for distinguishing the grade of meningiomas.
How to cite this article: Hashemi F, Babaheidarian P, Dabiran S. Are Osteopontin and Ki67 Expressions Different in Various Histologic Grades of Meningioma? An Iranian Experience. Iran J Pathol. 2015; 10(4): 253 - 257.
Original Research
Microbiology
Abdolmajid Ghasemian; Shahin Najar Peerayeh; Bita Bakhshi; Mohsen Mirzaee
Abstract
Background:Isolates of Staphylococcus aureus express a myriad of adhesive surface proteins that play important role in colonization of the bacteria on nasal and skin surfaces, beginning the process of pathogenesis. The aim of this study was to screen several of the Microbial Surface Components Recognizing ...
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Background:Isolates of Staphylococcus aureus express a myriad of adhesive surface proteins that play important role in colonization of the bacteria on nasal and skin surfaces, beginning the process of pathogenesis. The aim of this study was to screen several of the Microbial Surface Components Recognizing Adhesive Matrix Molecules (MSCRAMMs) genes among the isolate of S. aureus from hospitalized children.
Methods:A totalof 22 S. aureus isolates were collected from hospitalized children in Tehran from 2012 to 2013. Detection of the mecA and several adhesive surface proteins genes including clfA, B (encoding clumping factors A, B); fnbA, B (encoding finronectin binding proteins A, B); fib (encoding fibrinogen binding protein); eno (encoding laminin binding protein); cna (encoding collagen binding protein); ebps (encoding elastin binding protein) and bbp (encoding bone sialo-protein binding protein), was performed by PCR.
Results: The clfAB genes were detected among all the isolates. The prevalence of fnbA, fnbB, fib, eno, cna, ebps and bbp was 63%, 6%, 50%, 59%, 82%, 63%, 9% and 0%, respectively.
Conclusion: The high prevalence of these genes is important for future plans in vaccine designation. MRSA and MSSA isolates similarly can produce adhesive surface proteins for colonization.
Original Research
Microbiology
Horieh Saderi; Parviz Owlia
Abstract
Background: This study was done to detect multidrug resistant (MDR) and extremely drug resistant (XDR) of Pseudomonas aeruginosa among strains isolated from patients in Tehran, Iran, due to importance of these phenotypes in treatment of human infections. Methods: Eighty eightP. aeruginosa were isolated ...
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Background: This study was done to detect multidrug resistant (MDR) and extremely drug resistant (XDR) of Pseudomonas aeruginosa among strains isolated from patients in Tehran, Iran, due to importance of these phenotypes in treatment of human infections. Methods: Eighty eightP. aeruginosa were isolated from patients in Tehran, Iran, and identified by routine methods and PCR for oprL gene. Their antimicrobial susceptibility to 16 antimicrobial agents from 7 antimicrobial categories (aminoglycosides, carbapenems, cephalosporins, fluoroquinolones, penicillins/ß-lactamase inhibitors, monobactams, polymyxins) were determined by disk diffusion method, according to recommendation of Clinical and Laboratory Standards Institute. Characterization of P. aeruginosa isolates as MDR and XDR was done according to standardized international terminology presented by European Centre for Disease Prevention and Control as well as the Centers for Disease Control and Prevention in 2011. MDR was defined as acquired non-susceptibility to at least one agent in ≥3 antimicrobial categories and XDR was defined as non-susceptibility to at least one agent in ≥6 antimicrobial categories. Results: The rates of susceptibility to antimicrobials were as follows: gentamicin 27.3%, tobramycin 54.5%, amikacin 56.8%, netilmicin 36.4%, imipenem 55.7%, meropenem 55.7%, doripenem 60.2%, ceftazidime 63.6%, cefepime 56.8%, ciprofloxacin 59.1%, levofloxacin 60.2%, ticarcillin-clavulanic acid 37.5%, piperacillin-tazobactam 63.6%, aztreonam 43.2%, colistin 90.9%, polymyxin 95.5%. Altogether, 48 (54.5%) and 29 (33%) isolates were characterized as MDR and XDR, respectively. Discussion:The high frequency of antibiotic resistance in clinical isolates of P. aeruginosa in Iran makes epidemiological surveillance of susceptibility of this bacterium more essential for the best selection of empirical antibiotics.
Original Research
Uropathology
Omid Azari; Reza Kheirandish; Mohammad Farajli Abbasi; Shahin Ghahramani Gareh Chaman; Masoud Bidi
Abstract
Background: Renal ischemia reperfusion injury may occur in a variety of clinical situations, following a transient drop in total or regional blood flow to the kidney. This study was performed to investigate the protective effects of different antioxidants such as vitamin C, vitamin E, hydrocortisone ...
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Background: Renal ischemia reperfusion injury may occur in a variety of clinical situations, following a transient drop in total or regional blood flow to the kidney. This study was performed to investigate the protective effects of different antioxidants such as vitamin C, vitamin E, hydrocortisone and combination of these agents against experimental renal ischemia-reperfusion injury.
Method:Thirty male rats were divided into six groups. Group Sham, Group I/R: (45 min of ischemia followed by 1h of reperfusion), Group I/R+Vit C: (50 mg/kg Vit C, IV, immediately after reperfusion), Group I/R+Vit E: (20 mg/kg Vit E, IM, 15 min before reperfusion), Group I/R+Hydrocortisone: (50 mg/kg, IV, immediately after reperfusion), and Group Combination: Ischemia-reperfusion plus combination of Vit C, E and hydrocortisone. After the experiments, the left kidney was removed and the tissues were processed for histopathological examination.
Result: Severe injuries such as necrosis of tubules, atrophy of glomerulus, and hemorrhage were observed in group I/R. Histological scores indicating tissue injury significantly decreased in all treatment groups compared to the group I/R. The renal tissue in group treatment was preserved in comparison with the group I/R. Comparison between the treatment groups showed that group combination was more effective and group vit E was less effective in protecting of renal tissue against I/R injuries.
Conclusion: The results demonstrated simultaneous administration of combination of Vit C, E and hydrocortisone before reperfusion of blood flow to the ischemic tissue could show a synergy against deleterious effects of I/R injuries in kidney.
Original Research
Sabuj Ghana Mukhopadhyay; Krishnendu Mukherjee; Asim Kr. Manna
Abstract
Background: Definite data regarding the incidence and distribution of renal tumours in eastern India is not known. For better management, as it is essential to identify patients with poor prognosis, prognostic factors like stage, nuclear grade and their relationship to molecular markers are also unclear ...
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Background: Definite data regarding the incidence and distribution of renal tumours in eastern India is not known. For better management, as it is essential to identify patients with poor prognosis, prognostic factors like stage, nuclear grade and their relationship to molecular markers are also unclear in this region. The purpose of our study was to assess the spectrum of adult renal tumours with respect to age and sex and to correlate Fuhrman nuclear grading with Ki-67 labeling index in a tertiary care hospital in eastern India.
Methods: All adult patients with kidney tumour referred to our hospital who were preoperatively diagnosed and undergone surgical resection were included. Distribution of histological subtypes of kidney tumours according to age and sex were done by Hematoxylin and Eosin stain. Fuhrman grading, performed by ocular morphometry and derivation of Ki-67 labeling index (LI), were done in malignant cases only. Correlation of Fuhrman grading and KI-67 LI were done individually.
Results: Among total 36 cases, 3 were benign and 33 were malignant. Among the malignant cases: Fifteen, twelve, four and two cases were of Fuhrman grade I, II, III, IV with mean Ki67 labeling index of 6.5, 18.2,44 and 76 respectively. Statistical correlation between mean Ki-67 LI and Fuhrman grading revealed significant correlation between Grade I and II, II and III and combined Grade I,II and III,IV tumours.
Conclusion: Malignant Kidney tumours, especially, grade I RCC were commonest tumour. Fuhrman grading correlated well with Ki-67 labeling index. A 2-tier system for grading is proposed for better correlation with proliferation.
Original Research
Microbiology
Massoud Hajia; Ali Akbar Amirzargar; Mina Nazari; Neda Razavi Davodi; Morteza Karami Zarandi
Abstract
Background: Tuberculous meningitis (TBM) is a severe form of extra pulmonary tuberculosis with high mortality and morbidity rate in all age group patients specific in adults and children. The incidence and prevalence are not exactly known in Iran. In this study, we tried to evaluate the role of rapid ...
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Background: Tuberculous meningitis (TBM) is a severe form of extra pulmonary tuberculosis with high mortality and morbidity rate in all age group patients specific in adults and children. The incidence and prevalence are not exactly known in Iran. In this study, we tried to evaluate the role of rapid diagnosis and to find out the highest risk group patients.
Methods:Totally, 1783-suspected patients with tuberculous meningitis whose CSF specimens were admitted at Noor Pathobiology Laboratory, Tehran, Iran were enrolled in this study from January 2009 until December 2013.All specimens were checked for MTB by direct examination, culture and PCR tests, andfor the adenosine deaminase (ADA).
Results:Confirmed positive cases were aged from 13 to 82 yr old with mean age 46.63 yr (SD±18.84). The number of diagnosed positive MTB was different by the 3 applied protocol, 64 by PCR, 28 by culture and 33 by direct examination. Considering the result of PCR protocol theTBM was approved in 64 patients with rate of 3.59%. Two patients had other infection as well, one 56 years old with VZV and the other patient who was HIV positive was 27 years old. Increased ADA titer higher than cutoff was relevant with other results of positive samples except in two cases.
Conclusion:Analysis of the results proved adults are more at risk for tuberculous meningitis than children in Iran are. It is also confirmed PCR method provide the most efficient, rapid and reliable results for these patients who are at the critical situations.
Original Research
Hossein Hatami; Zhaleh Mohsenifar; Seyed Navid Alavi
Abstract
Background:The diagnostic accuracy of frozen section as an important source of information in surgical pathology is important not only in the management of surgical patients but also as a measure of quality control in surgical pathology. In this study, we evaluated the diagnostic accuracy of frozen sections ...
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Background:The diagnostic accuracy of frozen section as an important source of information in surgical pathology is important not only in the management of surgical patients but also as a measure of quality control in surgical pathology. In this study, we evaluated the diagnostic accuracy of frozen sections over a 6-year period in a teaching hospital in Iran.
Methods: We retrospectively reviewed frozen sections performed in the Pathology Department of Taleghani Hospital (Shahid Beheshti University of Medical Sciences), Tehran, Iran from 2007 to 2013. The results were compared to the permanent sections to evaluate diagnostic accuracy, sensitivity and specificity, of frozen section test. Discordant cases were reassessed to find the reasons for discrepancy.
Results: A total of 306 frozen section specimens from 176 surgical cases were evaluated. In eleven specimens (3.59%) the diagnoses were deferred. Of the remaining 295 specimens, 6 (2.03%) were discordant and 289 (97.96%) were concordant to permanent diagnoses. Specimens were primarily from the head & neck, thyroid, ovary, parathyroid and lymph nodes. The overall sensitivity, specificity, positive predictive value and negative predictive value of the frozen section compared to permanent section (as gold standard) were 92.95%, 99.55%, 98.50% and 97.80% respectively. Of the 6 discordant diagnoses, two (33.3%) were due to sampling error and four (66.6%) were due to interpretative errors.
Conclusion: Frozen section is an accurate and valuable test and can be relied on in surgical managements. The results of this study also confirm that the accuracy of frozen section diagnosis in our institution compares well with internationally published rates.
Case Reports
Zahra Mansouri; Sedigheh Bakhtiari; Robab Noormohamadi
Abstract
Focal epithelial hyperplasia (FEH) or Heck’s disease is a rare viral infection of the oral mucosa caused by human papilloma virus especially subtypes 13 or 32. The frequency of this disease varies widely from one geographic region and ethnic groups to another. This paper reports an Iranian case ...
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Focal epithelial hyperplasia (FEH) or Heck’s disease is a rare viral infection of the oral mucosa caused by human papilloma virus especially subtypes 13 or 32. The frequency of this disease varies widely from one geographic region and ethnic groups to another. This paper reports an Iranian case of extensive focal epithelial hyperplasia. A 35-year-old man with FEH is described, in whom the lesions had persisted for more than 25 years. The lesion was diagnosed according to both clinical and histopathological features. Dental practitioner should be aware of these types of lesions and histopathological examination together and a careful clinical observation should be carried out for a definitive diagnosis.
Case Reports
Smiley Annie George; Suad Abdeen
Abstract
Calcifying fibrous tumor (CFT) is a rare mesenchymal tumor, affecting children and young adults with a predilection for the soft tissue and the abdominal cavity. CFT of the tubular gastrointestinal tract is very rare with less than 20 cases of gastric CFTs reported in English literature. This benign ...
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Calcifying fibrous tumor (CFT) is a rare mesenchymal tumor, affecting children and young adults with a predilection for the soft tissue and the abdominal cavity. CFT of the tubular gastrointestinal tract is very rare with less than 20 cases of gastric CFTs reported in English literature. This benign hypocellular fibrosclerotic calcifying lesion can resemble other spindle cell tumors particularly sclerosing gastrointestinal stromal tumor of the stomach. Differentiating between these lesions is particularly important for prognostic and therapeutic purposes. Herein a case of gastric calcifying fibrous tumor incidentally detected during bariatric surgery in a 27-year-old woman is described, with a discussion on its clinicopathological features and differential diagnoses.
Case Reports
Varsha Bhatia; Rahul Taksande; Divyaja Sondankar
Abstract
Cystic Hygroma is a well-recognized lesion in paediatric patients but it is very rare in adults. We report here a case of Cervical Cystic Hygroma in a 45 yr old male. The reasons to present this case are 1) Its rarity in adults 2) Unusual age of presentation 3) Simulates various benign and malignant ...
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Cystic Hygroma is a well-recognized lesion in paediatric patients but it is very rare in adults. We report here a case of Cervical Cystic Hygroma in a 45 yr old male. The reasons to present this case are 1) Its rarity in adults 2) Unusual age of presentation 3) Simulates various benign and malignant lesions at this site 4) Is a diagnostic challenge and 5) Role of histology for definitive postoperative diagnosis.
Case Reports
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. ...
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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.
Case Reports
Maryam Rabiee; Jalal-Aldin Shams; Nafiseh Zafargandie
Abstract
Hemoglobin (Hb) H disease is a moderate form of α- thalassemia resulting from various genetic defects. HbH disease is not necessarily a benign disorder as has been generally thought. We present hereby a 25- year-old Iranian pregnant woman whom referred to our hospital for blood transfusion. She ...
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Hemoglobin (Hb) H disease is a moderate form of α- thalassemia resulting from various genetic defects. HbH disease is not necessarily a benign disorder as has been generally thought. We present hereby a 25- year-old Iranian pregnant woman whom referred to our hospital for blood transfusion. She exhibited the clinical and hematological manifestation of HbH disease. Her father carries a common α-thalassemia deletion while her mother was normal in the hematological profile. The object of this report was to provide information about pregnancies affected by HbH disease.
Case Reports
Oral Pathology
Fariba Binesh; Mohammad Hossein Dadgarnia; Yasaman Khaksar; Abbas Mirvakili
Abstract
Paragangliomas are neoplasms of neural crest origin. In the head and neck, they uncommonly involve the larynx. The distinction between paragangliomas and other neuroendocrine tumors can be difficult. Precise diagnosis is important in order to optimize patient treatment. Diagnosis relies mostly on histopathologic ...
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Paragangliomas are neoplasms of neural crest origin. In the head and neck, they uncommonly involve the larynx. The distinction between paragangliomas and other neuroendocrine tumors can be difficult. Precise diagnosis is important in order to optimize patient treatment. Diagnosis relies mostly on histopathologic examination followed by immunohistochemistry. Here we report a 77-year-old woman with laryngeal paraganglioma that initially misdiagnosed as laryngeal carcinoid tumor.
Letters to the Editor
Beuy Joob; Viroj Wiwanitkit
Abstract
Dear Editor-in-Chief
The present global consideration is on the recent outbreak of 2014 Western Ebola virus in West Africa (1 – 3). This viral hemorrhagic fever wide spreads to several countries in West Africa and remote countries (1 - 3). With high death rate, the disease is presently on the ...
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Dear Editor-in-Chief
The present global consideration is on the recent outbreak of 2014 Western Ebola virus in West Africa (1 – 3). This viral hemorrhagic fever wide spreads to several countries in West Africa and remote countries (1 - 3). With high death rate, the disease is presently on the list of public health threatens. The main problem for management of the infection is the limited knowledge on its clinical presentation.
An interesting concern is on the gastroenterology presentation of this new disease. In fact, some new viral diseases such as atypical influenza virus infection can have an important clinical presentation as diarrhea (4). Here, the authors try to summarize on the magnitude of diarrhea in clinical presentation of this new disease. From information reported from 15 confirmed cases from Guinea (1 – 3, 5), 73.3% of the cases primarily present with diarrhea. This rate is considerable high comparing to those observed in other viral hemorrhagic disease such as dengue (rate of diarrhea at presentation < 5% (6).
This calls for the attention that it is necessary to think about new Ebola disease in any febrile illness patient with diarrhea who has history of visiting to outbreak area.
