Systematic Review
Head and Neck Pathology
Sahar Assar; Sepideh Assar; Heidar-Ali Mardanifard; Zohreh Jaafari-Ashkavandi
Abstract
Background & Objective: There is no consensus on the prevalence of salivary gland tumors (SGTs) in Iran. Thus, we systematically reviewed the literature about the prevalence of SGTs in Iran and applied the last world health organization (WHO) classification.Methods: The systematic literature search ...
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Background & Objective: There is no consensus on the prevalence of salivary gland tumors (SGTs) in Iran. Thus, we systematically reviewed the literature about the prevalence of SGTs in Iran and applied the last world health organization (WHO) classification.Methods: The systematic literature search was performed in EMBASE, Scopus, PubMed MEDLINE, Google Scholar, Scientific Information Database (SID), and Magiran; we searched for "salivary gland," "tumor," "prevalence," and "Iran" until 1 March 2021. The studies included were written in the English and Farsi languages. The weighted mean prevalence of SGTs was calculated as prevalence (%) * (N/the sum of all N). We used the unpaired Two-sample T-test to compare the weighted means.Results: A total of 17 studies, including 2870 patients, were selected for the data synthesis. The weighted mean prevalence of benign and malignant tumors was 66% (95% CI: 59-73) and 34% (95% CI: 27-41), respectively. The patients' mean age was reported in 10 out of the 17 studies. The weighted mean age of the patients was 40 (95% CI: 37-42) and 49 (95% CI: 43-55) years for benign and malignant tumors, respectively (P=0.01). Pleomorphic adenoma (PA), followed by Warthin's tumor (WT), was the most prevalent benign tumor. Moreover, the most common malignant tumors were mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (AdCC).Conclusion: More than one-third of SGTs in Iran were malignant, which is higher than the reports from Middle Eastern countries. Information about risk factors and the burden of SGTs in Iran is insufficient. Thus, further well-designed longitudinal studies are warranted.
Original Research
Dermatopathology
Abinaya Sundari Amirthakatesan; Sharmila Devi Chandramohan; Uma Maheshwari Gurusamy
Abstract
Background & Objective: Fetal growth restriction (FGR) is one of the leading causes of perinatal morbidity and mortality. Our study aimed to analyze the gross and histopathological changes in the placentas of growth-restricted fetuses.Methods: Placentas of fifty growth-restricted fetuses received ...
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Background & Objective: Fetal growth restriction (FGR) is one of the leading causes of perinatal morbidity and mortality. Our study aimed to analyze the gross and histopathological changes in the placentas of growth-restricted fetuses.Methods: Placentas of fifty growth-restricted fetuses received in the Department of Pathology for 3 years were studied. Clinical data including ultra-sonographic findings were obtained. The received placentas were photographed and the details were documented in a prepared template. The relevant tissues were processed, analyzed, and correlated with the clinical findings.Results: The study demonstrates distinctive gross and histological abnormalities in the placentas of growth-restricted fetuses. More than two-thirds of the placentas had shorter gestational age (preterm), seen as commonly associated with maternal co-morbidities such as oligohydramnios and pregnancy induced hypertension (PIH). The predominant gross lesions observed were the umbilical cord abnormalities, infarcts, and intervillous thrombus. Maternal vascular malperfusion (MVM) and fetal vascular malperfusion (FVM) were the two common histologic findings. Characteristic placental lesions with a significant risk of recurrence identified were distal villous immaturity (DVI), villitis of unknown etiology (VUE), and massive perivillous fibrin deposition (MPVFD). The unusual placental causes included villous capillary lesions and histological chorioamnionitis.Conclusion: Although a diverse etiology can cause FGR, the severity depends on the cumulative effects of multiple placental lesions. Hence, a meticulous placental examination is crucial for the effective management of growth-restricted fetuses in the current and subsequent pregnancies.
Original Research
Molecular Pathology
Fatemeh Hoseini Tabatabaie; Seyed Younes Hosseini; Seyed Mohammad Ali Hashemi; Akbar Safaie; Jamal Sarvari
Abstract
Background & Objective: Epstein-Barr virus nuclear antigen-1 (EBNA1) is one of the most important proteins of Epstein-Barr virus (EBV) that might be mutated in various related cancers. The purpose of this study was to compare EBNA1 mutations in the C-terminal region between patients with cervical ...
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Background & Objective: Epstein-Barr virus nuclear antigen-1 (EBNA1) is one of the most important proteins of Epstein-Barr virus (EBV) that might be mutated in various related cancers. The purpose of this study was to compare EBNA1 mutations in the C-terminal region between patients with cervical and ovarian cancer and healthy individuals.Methods: As test and control groups, 18 EBV-positive paraffin-embedded samples of cervical and ovarian cancer and 10 age- and gender-matched healthy volunteers who did not have cancer but were EBV-positive were both used. Utilizing a commercial DNA extraction kit, total DNA was extracted following deparaffinization. The entire C-terminal region of the EBNA1 sequence was amplified using an in-house nested PCR. Phylogenetic analysis and Sanger sequencing were used to analyze the sequences using MEGA 7 software and through NJ method.Results: Sequence analysis revealed that the P-Ala subtype of EBNA1 was present in all samples. In two and one samples, respectively, of cervical cancer patients, the mutations A1887G and G1891A were found. The G1595T mutation was also detected in four sequences taken from ovarian cancer patients. No statistically significant difference could be found between the frequency of mutations in patients and controls (P>0.05). No known amino acid substitutions were found in the USP7-binding region and the DBD/DD domain.Conclusion: The findings showed that P-Ala is the predominant EBV subtype across all samples. Additionally, as the sequence of EBNA1's C-terminal region is so stable, it's possible that it had little impact on the pathogenesis of ovarian and cervical malignancies. It is advised to conduct additional research to verify these findings.
Original Research
Transfusion Medicine
Sujata Mallick; Mahasweta Mallik; Puskar Shyam Chowdhury
Abstract
Background & Objective: Background and objective: Perioperative blood transfusion (PBT) during radical urological surgeries has been associated with an increased incidence of complications. The present study analyzes the outcome of perioperative blood transfusion (PBT) and the prognostic implications ...
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Background & Objective: Background and objective: Perioperative blood transfusion (PBT) during radical urological surgeries has been associated with an increased incidence of complications. The present study analyzes the outcome of perioperative blood transfusion (PBT) and the prognostic implications after radical surgeries on patients with malignant urological tumors.Methods: Our retrospective study included 792 cases of partial or radical nephrectomy /cystectomy/prostatectomy surgeries for kidney/bladder/ prostate carcinoma from 2012 to 2022. Data on preoperative, intraoperative, and pathological parameters were evaluated. PBT was taken as a period of transfusion of allogenic RBC during/preoperative/postoperative surgeries. The effect of PBT on oncological parameters like recurrence-free survival (RFS), overall survival (OS), and cancer-free survival (CSS) was compared using univariate cox regression analysis (Odds ratio, Hazard ratio).Results: PBT was applied on 124 (20.6%) patients of nephrectomy, 54 (46.5%) patients of cystectomy, and 23 (31%) patients of prostatectomy. The baseline characteristics of the cohort study found symptomatic patients with older age and other co-morbidities to be transfusion-dependent. Also, the patients undergoing radical operations with more blood loss and advanced tumor stage were more likely to receive PBT. PBT was significantly associated with survival outcomes (P<0.05) in nephrectomy and cystectomy cases but independent of association in prostatectomy cases.Conclusion: The result of this study concludes that in nephrectomy and cystectomy operations, PBT had a significant association with cancer recurrence and mortality; however, in prostatectomy cases, no significant correlation was noted. Thus, proper criteria to prevent the unnecessary use of PBT and more defined parameters for transfusion are needed to improve postoperative survival. Autologous transfusion should be considered more frequently. However, more extensive studies and randomized trials are needed in this area.
Original Research
Head and Neck Pathology
Dalia Nabil Abdelhafez; Maram Mostafa Ayoub; Samira A. Mahmoud; Hala M. El-hanbuli
Abstract
Background & Objective: One of the most prevalent endocrine system cancers is papillary thyroid carcinoma, with complicated predisposing factors and pathogenesis. YAP1 (Yes-associated protein 1) is a well-known oncogene; its activity is increased in a variety of human malignancies and has recently ...
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Background & Objective: One of the most prevalent endocrine system cancers is papillary thyroid carcinoma, with complicated predisposing factors and pathogenesis. YAP1 (Yes-associated protein 1) is a well-known oncogene; its activity is increased in a variety of human malignancies and has recently been paid great attention. The present study examines YAP1 and P53 immunohistochemical expression in papillary thyroid carcinoma and investigates the association of their expression with the available clinicopathological risk factors to assess their possible prognostic role.Methods: The current study used paraffin blocks of 60 cases of papillary thyroid carcinoma, which were immunohistochemically assessed for YAP1 and p53 expression. The study examined the association of their expression with clinicopathological characteristics.Results: YAP1 expression was observed in 70% of papillary thyroid carcinoma cases. A statistically significant relation was observed between YAP1 expression and tumor size, tumor stage, tumor focality, lymph node metastases, and extrathyroidal extension (P-values were =0.003, > 0.001, 0.037, 0.025, and 0.006), respectively. p53 expression was observed in 85% of papillary thyroid carcinoma cases. A statistically significant relation was observed between p53 expression and tumor size (P=0.001) and tumor stage (P>0.001). A statistically significant relation was noticed between YAP1 and P53 expression (P=0.009).Conclusion: YAP1 expression was found to be associated with many high-risk clinicopathological characteristics in patients with papillary thyroid carcinoma and with p53 expression; thus, it seems that YAP1 may have a specific impact on the patient's outcome.
Original Research
Gynecologic Pathology
Fatemeh Nili; Soheib Fathi; Mansoureh Tavakoli; Elham Mirzaian; Maryam Lotfi
Abstract
Background & Objective: Clear cell carcinoma (CCC) is an uncommon histopathologic subtype of ovarian and endometrial carcinoma. Due to the morphologic overlapping with other subtypes of ovarian and endometrial carcinomas, an accurate diagnosis is crucial.Methods: In this study, 31 cases of ovarian ...
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Background & Objective: Clear cell carcinoma (CCC) is an uncommon histopathologic subtype of ovarian and endometrial carcinoma. Due to the morphologic overlapping with other subtypes of ovarian and endometrial carcinomas, an accurate diagnosis is crucial.Methods: In this study, 31 cases of ovarian clear cell carcinoma (OCCC), 28 endometrial clear cell carcinoma (ECCC), and 80 non-CCC subtypes (33 high-grade serous carcinomas of the ovary, 2 low-grade serous carcinomas, 10 ovarian endometrioid, 3 serous carcinomas and 29 endometrioid carcinomas of the endometrium) were investigated for immunohistochemical expression of AMACR. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the distinction of OCCC and ECCC from other histopathologic subtypes were calculated.Results: Positive AMACR staining was seen in 18 OCCCs (58%) and 10 ECCCs (35.7%). In the non-clear cell group, 44 cases of ovarian (98%) and 25 cases of endometrial carcinoma (78%) showed negative results. Only one case of ovarian endometrioid carcinoma and 7 cases (22%) of endometrial endometrioid carcinomas revealed a positive reaction (P<0.05). Collectively, sensitivity, specificity, PPV, and NPV of AMACR expression, for the diagnosis of OCCC were calculated as 58%, 98%, 94.7%, and 77.2%, respectively. The sensitivity, specificity, PPV, and NPV were shown to be as 35.7%, 78.1%, 58.8%, and 58.1%, respectively in the endometrium.Conclusion: AMACR may be a highly specific immunohistochemical marker for the distinction of serous and clear cell carcinoma. A small percentage of endometrioid carcinoma may show positive staining. The sensitivity of this marker may not be higher than the other well-known Napsin-A IHC marker.
Original Research
Biology & Genetic
Ali Zare-Mirzaie; Shamim Mollazadehghomi; Seyed Mohammad Heshmati; Amirhosein Mehrtash; Shabnam Mollazadehghomi
Abstract
Background & Objective: Telomere-related tumorigenesis mechanisms in the salivary gland, including mutation in the promoter region of TERT, have been rarely investigated. Therefore, the present study aimed to investigate the mutation in the promoter region of TERT in benign and malignant salivary ...
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Background & Objective: Telomere-related tumorigenesis mechanisms in the salivary gland, including mutation in the promoter region of TERT, have been rarely investigated. Therefore, the present study aimed to investigate the mutation in the promoter region of TERT in benign and malignant salivary gland tumors.Methods: This was a descriptive-analytical cross-sectional study. Tissue samples of 54 patients with primary salivary gland tumors sent to the pathology department of Rasool-e-Akram Hospital from September 2017 to September 2021 were examined. Fifteen samples including two groups of the most common benign tumors (n=5; 3 pleomorphic adenomas and 2 Warthin tumors) and four groups of the most common malignant tumors (n=10; 3 mucoepidermoid carcinomas, 3 adenoid cystic carcinomas, 2 acinic cell carcinoma, and 2 salivary duct carcinoma) were selected. The promoter region of TERT, including well-known hot spot regions, is sequenced using the Sanger sequencing method. Data were analyzed using statistical software R version 4.1.2.Results: Of 15 salivary gland tumor specimens, consisting of 5 benign tumors and 10 malignant tumors after DNA sequencing, TERT promoter region mutation was only seen in one of the adenoid cystic carcinoma samples, located at -146 bp upstream from ATG (chr5: 1,295,250 C>T).Conclusion: TERT promoter mutation was not different in malignant and benign salivary tumors. Nonetheless, there are a few studies that report TERT promoter mutation in adenoid cystic carcinoma of the salivary gland, necessitating the need for further investigations.
Original Research
Breast Pathology
Faeze Shirian; Parvin Kheradmand; Nastaran Ranjbari; Hodjatollah Shahbazian; Seyed Mahmoud Latifi
Abstract
Background & Objective: During the last decade, biological markers of breast cancer have been considered to predict the degree of histology, behavior, and extent of tumor invasion and the possibility of lymph node involvement. The aim of this study was to evaluate the expression of GCDFP-15 in different ...
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Background & Objective: During the last decade, biological markers of breast cancer have been considered to predict the degree of histology, behavior, and extent of tumor invasion and the possibility of lymph node involvement. The aim of this study was to evaluate the expression of GCDFP-15 in different grades of invasive ductal carcinoma, as the most common type of breast cancer.Methods: In this retrospective study, paraffin blocks of tumors of 60 breast cancer patients registered in the histopathology laboratory of Imam Khomeini Hospital in Ahvaz between 2019 and 2020 were reviewed. Information on grade, invasion, stage and lymph node involvement was extracted from the pathology reports and immunohistochemical staining for GCDFP-15 was performed. Data were analyzed by SPSS 22.Results: GCDFP-15 marker expression was observed in 20 out of 60 breast cancer patients (33.3%). GCDFP-15 staining intensity was weak in 7 cases (35%), moderate in 8 cases (40%), and strong in 5 cases (25%). The patient's age and sex showed no significant relationship with the expression of GCDFP-15 and intensity of staining. Expression of the GCDFP-15 marker was correlated significantly with tumor grade, stage, and vascular invasion (P<0.05)) and its expression was higher in tumors with a lower grade, less depth of invasion, and no vascular invasion but unrelated to perineural invasion, lymph node involvement, and tumor size. The intensity of staining for GCDFP-15 showed significant relationship with the tumor grade (P<0.0001) but unrelated to the other factors.Conclusion: GCDFP-15 marker may be significantly associated with tumor grade, depth of invasion, and vascular invasion, thus can be used as a prognostic marker.
Original Research
Immunology and Serology
Shokoh Abotorabi; Zohreh Rasooli; Hamideh Pakniat; Fahimeh Baloo
Abstract
Background & Objective: This study was designed to determine the prevalence of serotypes, virulence-associated genes, and antimicrobial resistance of Streptococcus agalactiae in pregnant volunteers attending a major maternity hospital in Iran.Methods: The virulence determinants and antimicrobial ...
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Background & Objective: This study was designed to determine the prevalence of serotypes, virulence-associated genes, and antimicrobial resistance of Streptococcus agalactiae in pregnant volunteers attending a major maternity hospital in Iran.Methods: The virulence determinants and antimicrobial resistance profiles of 270 Group B streptococcus (GBS) samples were assessed in the adult participants. The prevalence of GBS serotypes, virulence-associated genes, and antimicrobial resistance of the isolates was determined.Results: The GBS prevalence in the vaginal, rectal, and urinal carrier rates were 8.9%, 4.44%, and 4.44%, respectively, with no concomitant colonization. The serotypes Ia, Ib, and II were at a 1:2:1 ratio. The rectal isolates, harboring CylE, lmb, and bca genes, were of serotype Ia, susceptible to vancomycin. The serotype Ib from urine samples carrying three distinct virulence genes was susceptible to Ampicillin. In comparison, the same serotype with two virulence genes of CylE and lmb exhibited sensitivity to both Ampicillin and Ceftriaxone. The vaginal isolates belonged to serotype II with the CylE gene or serotype Ib with CylE and lmb genes. These isolates harboring the CylE gene were resistant to Cefotaxime. The overall antibiotic susceptibility range was 12.5-56.25%.Conclusion: The findings broaden our understanding of the pathogenicity of the prevailing GBS colonization and predict different clinical outcomes.
Original Research
Cytology
Mahsa Ahadi; Afshin Moradi; Elham Rabiee; Fatemeh Pourmotahari
Abstract
Background & Objective: Breast cancer is one of the most common cancers in the world. There are some different types of breast cancer and triple-negative breast cancer is the type in which no receptors for estrogen, progesterone, and human epidermal growth factor receptor-2 are expressed. Identifying ...
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Background & Objective: Breast cancer is one of the most common cancers in the world. There are some different types of breast cancer and triple-negative breast cancer is the type in which no receptors for estrogen, progesterone, and human epidermal growth factor receptor-2 are expressed. Identifying factors that can facilitate the diagnosis of triple-negative breast cancer is important. In this study, we decided to investigate the expression of GATA3 and GCDFP15 genes in triple-negative breast cancers.Methods: This is a retrospective descriptive-analytical study that was performed on 50 specimens of samples of triple-negative breast cancer. Data including age and sex, tumor grade, tumor size, types of invasion, GATA-3, and GCDFP-15 were assessed.Results: The mean age of the patients was 48.3±14.17 years. Of the total specimens, 46% were positive for GCDFP15 and 90% were positive for GATA-3. The intensity of GATA3 was evaluated and it was observed that 33(73.3%) of the cells were strongly stained and 12(26.7%) were weakly stained. There were no relationships between GATA-3 and GCDFP-15 with tumor characteristics.Conclusion: GATA-3 and GCDFP-15 may serve as diagnostic markers for triple-negative breast cancers and GATA-3 seems to be more reliable.
Original Research
GI, Liver & Pancreas Pathology
Samaneh Salarvand; Farzaneh Bagheri; Mahsa Gholizadeh; Sima Sharifi; Pooneh Panahi; Ebrahim Esmati; Marzieh Lashkari; Amirmohsen Jalaeefar; Mohammad Shirkhoda; Reza Shahsiah; Reza Ghalehtaki
Abstract
Background & Objective: Iran is located in the esophageal cancer geographical belt. As multiple genetic alterations are responsible for the molecular pathogenesis of esophageal squamous cell cancer (ESCC), the role and frequency of HER2 expression, MMR deficiency, and PI3KCA mutation are not well ...
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Background & Objective: Iran is located in the esophageal cancer geographical belt. As multiple genetic alterations are responsible for the molecular pathogenesis of esophageal squamous cell cancer (ESCC), the role and frequency of HER2 expression, MMR deficiency, and PI3KCA mutation are not well defined.Methods: We carried out HER2/neu expression, dMMR/MSI high, and PI3KCA mutation analysis in specimens of patients with ESCC. We accessed archival tissue blocks related to specimens of 68 ESCC cases at the time of surgery following neoadjuvant chemoradiation. These patients underwent surgery during 2013-2018 at the Cancer Institute of Iran affiliated with the Tehran University of Medical Sciences in Tehran.Results: None of the patients showed HER2 expression, dMMR/MSI high, or PI3K mutations.Conclusion: dMMR/MSI-H and PI3KCA mutation and HER2 expression may not be reliable andfrequent targets for systemic therapy in patients with esophageal SCC.
Case Reports
GI, Liver & Pancreas Pathology
Pummi kumari; Ruchi Sinha; Nisha Khanna; Tanmoy Maji
Abstract
Xanthomas are characterized by the presence of foamy lipid-laden macrophages. The gastrointestinal tract is an uncommon site for xanthoma, with the stomach being the most favored location. They have been associated with various premalignant and malignant conditions of the stomach. We present a case of ...
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Xanthomas are characterized by the presence of foamy lipid-laden macrophages. The gastrointestinal tract is an uncommon site for xanthoma, with the stomach being the most favored location. They have been associated with various premalignant and malignant conditions of the stomach. We present a case of a 21-year-old female patient with dyspepsia of 4 months duration. Her lipid profile was mildly altered. On upper gastrointestinal endoscopy, multiple discrete yellow patches were found in the antrum, diagnosed as gastric xanthoma on microscopy. Various published literature has emphasized the frequent association of gastric xanthomas with gastritis, gastric atrophy, intestinal metaplasia, and gastric cancer. Hence, there is a necessity for early recognition, treatment of any coexistent pathology, and close clinical follow-up.
Case Reports
Molecular Pathology
Aparna Devi C; Ashwini Nargund; Geeta V Patil Okaly; Usha Amirtham
Abstract
Angiomatoid Fibrous histiocytoma (AFH) is a rare soft tissue neoplasm that is often misdiagnosed initially. It is commonly encountered in the superficial extremities of children and young adults. It is composed of a nodular proliferation of bland looking spindled to ovoid cells, some with variant histology ...
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Angiomatoid Fibrous histiocytoma (AFH) is a rare soft tissue neoplasm that is often misdiagnosed initially. It is commonly encountered in the superficial extremities of children and young adults. It is composed of a nodular proliferation of bland looking spindled to ovoid cells, some with variant histology and characterized by EWSR1 fusion. We, herein, present three such cases, who presented with swelling in the right leg (case 1), right forearm (case 2), and right thigh (case 3). Case 2 presented in the fourth decade with a large swelling compared to the other two cases that presented in 3rd decade with a small swelling. Histologic examination of case 2 showed extensive myxoid changes making it diagnostically challenging. All three cases showed EWSR1 fusion with a break-apart probe. Follow-up was uneventful in all three cases. AFH, although it is a benign neoplasm, is a great mimicker of various low-grade spindle cell sarcomas. Awareness of this entity with its various histomorphological variants is necessary to accurately diagnose this lesion.
