Microbiology
Samaneh Salarvand; Alireza Abdollahi; Pegah Afarinesh Khaki; Mahsa Norouzi Shadehi; Mohammad Taghi Beigh Mohammadi; Seyed Amir Miratashi Yazdi; Elham Nazar
Abstract
Background & Objective: Antibiotic resistance, especially in the form of multidrug-resistant (MDR), is a big problem, especially in intensive care units (ICUs). This study aimed to evaluate antibiotic resistance and MDR patterns among patients hospitalized in the ICUs in one of the large referral ...
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Background & Objective: Antibiotic resistance, especially in the form of multidrug-resistant (MDR), is a big problem, especially in intensive care units (ICUs). This study aimed to evaluate antibiotic resistance and MDR patterns among patients hospitalized in the ICUs in one of the large referral centers in Iran.Methods: The present study was conducted at Imam Khomeini Hospital in Tehran (a great referral hospital), which admits critically ill patients requiring ICU services. To determine the rate of positive cultures for resistant strains, the patient’s blood specimens were sent to the laboratory of the hospital for inoculation on proper culture media within 2 hours of extraction. Antimicrobial susceptibility tests were done using the Bauer–Kirby disk diffusion method.Results: A total of 1,755 samples were collected from the patients to assess microbial strains and antibiotic resistance. The most common microbial strains detected in the cultures extracted from peripheral blood samples were Klebsiella pneumonia (22.1%), Staphylococcus epidermidis (7.9%) and another coagulase-negative Staphylococcus (15.0%). The antibiogram test showed antibiotic resistance in 1,509 cases, leading to a resistance prevalence rate of 85.9%. The most common antimicrobial resistance observed was against cotrimoxazole (61.7%), ciprofloxacin (51.3%), imipenem (50.0%), and ampicillin (49.6%). The rate of MDR was found to be 96.3%.Conclusion: In Iran’s ICUs, a significantly high level of antibiotic resistance may be seen especially the MDR pattern, which indicates the need to change the pattern of prescribing and managing these drugs in ICU centers.
Endocrine Pathology
Fakhrieh Kalavari; Parin Tanzifi; Tahereh Yosefi; Maryam Lotfi; Elham Nazar
Abstract
Background & Objective: Viral infections are associated with the pathogenesis and progression of human malignancies. Several studies have suggested the role of viral infections in papillary thyroid carcinoma (PTC). However, the results are still conflicting, and the potential role of viruses in PTC ...
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Background & Objective: Viral infections are associated with the pathogenesis and progression of human malignancies. Several studies have suggested the role of viral infections in papillary thyroid carcinoma (PTC). However, the results are still conflicting, and the potential role of viruses in PTC tumorigenesis remains to be elucidated. In the present study, we aimed to investigate the presence of parvovirus B19, cytomegalovirus (CMV), herpes simplex virus types 1 and 2 (HSV-1/HSV-2), and human papillomavirus (HPV) types 16 and 18 in PTC.Methods: In this cross-sectional study, paraffin-embedded tissue blocks of 40 patients with PTC were used. Tissue blocks were studied for the presence of the virus genome using real-time polymerase chain reaction (PCR).Results: Of the 40 patients with PTC, there was 1 positive case of HPV (2.5%), while 6 cases were positive for parvovirus B19. HSV and CMV DNAs were not detected in any cases.Conclusion: Correlations among HSV, CMV, and PTC are unexpected in our patient population. But parvovirus B19 and, to a lesser extent, HPV DNA genomes were detected in PTC using real-time PCR.
GI, Liver & Pancreas Pathology
Seyed Amir Miratashi Yazdi; Elham Nazar
Abstract
Background & Objective: Lymphovascular tumoral invasion is a typical histopathological feature of gastric carcinomas and supports the recognition of high-risk patients for the recurrence. We aimed to study the CD31 expression in diverse subtypes of gastric carcinomas and to show its association with ...
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Background & Objective: Lymphovascular tumoral invasion is a typical histopathological feature of gastric carcinomas and supports the recognition of high-risk patients for the recurrence. We aimed to study the CD31 expression in diverse subtypes of gastric carcinomas and to show its association with the histopathologic findings of the carcinoma to assess the prognosis.Methods: This cross-sectional study was conducted on 40 established patients of gastric adenocarcinoma from radical gastrectomy. The patients were classified according to the pathology assessments. Tumoral tissues were assessed by immunohistochemical staining for the CD31 expression. Malignant behavior was estimated by the histopathological evaluations.Results: CD31 positivity was described in 23 (57.5%) of all evaluated patients. The assessment of CD31 expression and tumor features presented no significant association between the CD31 expression and patients’ age, sex, tumor site, size, grade and stage, subtypes of carcinoma, perineural invasion, and also lymphovascular invasion (P>0.05).Conclusion: Lymphovascular invasion makes valuable additional evidence that might be useful to detect gastric carcinoma patients at high risk for the recurrence, who could be candidates for more supplementary therapies. However, in our society, the CD31 expression did not show any association with the aggressive histopathologic features of this tumor.
Molecular Pathology
Seyed Amir Miratashi Yazdi; Elham Nazar
Abstract
The etiology of parathyroid carcinoma (PC) is largely unknown. Associations have been made with several inherited syndromes and with specific genetic lesions. The management of PC is challenging for clinicians. The complexity of molecular phenotypes increases with tumor aggressiveness. Lack of parafibromin ...
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The etiology of parathyroid carcinoma (PC) is largely unknown. Associations have been made with several inherited syndromes and with specific genetic lesions. The management of PC is challenging for clinicians. The complexity of molecular phenotypes increases with tumor aggressiveness. Lack of parafibromin on immunohistochemistry staining and HRPT2 mutation present capable consequences in differentiating carcinoma from adenoma. Lack of parafibromin expression, the gene product of HRPT2 is now used as a diagnostic, prognostic and predictive marker for parathyroid carcinoma. The epigenetic alteration, for example, DNA methylation and modifications in the chromatin structure, are known as significant events that are the reason for parathyroid tumorigenesis. We suggest that adjuvant genetic and epigenetic target therapy should be considered in treating PC patients.
Bone & Soft tissue Pathology
Elham Nazar; Shabnam Mashadi; Golnaz Moradi
Abstract
Chondrosarcoma of the cranium is a rare malignancy. The result of treatment is challenging to assess because the slow-growing rate means that there is a long interval previously discovering the recurrence and last long time to diagnosis of recurrence. This report describes a 38-year-old man who presented ...
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Chondrosarcoma of the cranium is a rare malignancy. The result of treatment is challenging to assess because the slow-growing rate means that there is a long interval previously discovering the recurrence and last long time to diagnosis of recurrence. This report describes a 38-year-old man who presented with a generalized seizure 2 months before his referral. The patient underwent excisional surgery. The histological examinations revealed a cartilage developing tumor compatible with chondrosarcoma. The radiologic and histologic correlation established the diagnosis. But, the patient had two episodes of recurrence after surgery. We determined that intracranial chondrosarcoma must be comprised in the differential diagnosis of a mass with calcification on cranial imaging. Accurate diagnosis is obligatory for supplementary patient managing, and a recurrence is more common in patients only treated by surgery.
Uropathology
Hedieh Moradi Tabriz; Leila Aghapour Sabaghi; Amirreza Nabighadim; Elham Nazar; Seyed Mohammad Kazem Aghamir
Abstract
Background & Objective: Some certain markers, including prostatic specific antigen (PSA), are being used to screen prostate cancer (PC), but none of them have sufficient sensitivity and specificity for evaluation of prognosis. Currently, genetic variants have found their place in the prognosis of ...
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Background & Objective: Some certain markers, including prostatic specific antigen (PSA), are being used to screen prostate cancer (PC), but none of them have sufficient sensitivity and specificity for evaluation of prognosis. Currently, genetic variants have found their place in the prognosis of PC. ETS-related gene (ERG) expression and its intensity have contradictory evidence regarding ERG expression with PC incidence or associating outcome. Our purpose was to survey the relationship of ERG expression and its intensity with PC and relative clinical outcome.Methods: We studied the immunohistochemichal (IHC) expression of ERG in 101 radical prostatectomy specimens with PC of different histologic grades. All samples were chosen from pathology department of Sina hospital in Tehran-Iran from 2011 to 2018. Positive ERG expression and its association with Gleason score, preoperative PSA, metastasis status, stage and grade of tumors was evaluated.Results: In total, ERG expression was observed in 42 cases (41.58%) and of these, 7 (16.66%) were categorized as weak, 13 (30.95%) moderate and 22(52.38%) as strong. There was no significant correlation between ERG expression and age, preoperative PSA, Gleason score, lymph node involvement, metastatic pattern, stage, and grade of the tumor (P>0.05). ERG expression frequency in the two groups of survived and expired patients was 42.85% and 0%, respectively; despite the noticeable difference, it was not statistically significance (P=0.264).Conclusion: Evaluation of ERG expression and its intensity may have no essential role as an acceptable prognostic factor in Iranian’s population for anticipating whether PC itself or the outcomes accompanied. This relation is vigorously under the influence of geographical/ethnical features.
Uropathology
Elham Nazar; Zohre Shabanzadeh; Amir Ahmadi; Niloofar Rostami
Abstract
Primary leiomyosarcoma in testis is an uncommon tumor with few cases reported. It generally develop after radiotherapy or long term taking anabolic steroid medication . We report a 53-year-old male patient with primary testis leiomyosarcoma who presented with painless testicular enlargement ...
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Primary leiomyosarcoma in testis is an uncommon tumor with few cases reported. It generally develop after radiotherapy or long term taking anabolic steroid medication . We report a 53-year-old male patient with primary testis leiomyosarcoma who presented with painless testicular enlargement without any known predisposing factors. Ultrasound revealed a large heterogeneous left testicular solid lesion. Alpha-fetoprotein (AFP) and beta-human chorionic gonadotrophin (beta-HCG) levels in serum were normal. Left radical orchidectomy following with histology assessment established a diagnosis of primary leiomyosarcoma of testis. No data of cancer metastasis was established. The patient didn’t receive any adjuvant therapy. There wasn’t any evidence of recurrence after 1 year follow-up. Leiomyosarcoma must be one of the differential diagnoses of seronegative tumors in testis. The motivation for this paper is the extreme infrequency of the situation and the differential diagnosis by all expansive inguinoscrotal tumors.
Uropathology
Hedieh Moradi Tabriz; Elham Nazar; Seyed Ali Ahmadi; Esmaeil Azimi; Fazeleh Majidi
Abstract
Background and Objective: Urothelial neoplasm (UN) of bladder is a potentially lethal malignancy, particularly in locally advanced or metastatic cases. Development of molecular markers such as HER2 and Survivin may provide useful information on diagnosis and prognosis in UN of bladder. Materials and ...
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Background and Objective: Urothelial neoplasm (UN) of bladder is a potentially lethal malignancy, particularly in locally advanced or metastatic cases. Development of molecular markers such as HER2 and Survivin may provide useful information on diagnosis and prognosis in UN of bladder. Materials and Methods: We studied the immunohistochemical (IHC) expression of HER2 and Survivin in 84 radical/partial cystectomy and transurethral resection (TUR) specimens with different histologic grades and stages. All samples were obtained from pathology department of Sina Hospital in Tehran, Iran from 2014 to 2018. Results: From the total number of 84 UN samples, 10 cases (11.9%) had papillary neoplasm of low malignant potential, 30 cases (35.7%) had low-grade papillary urothelial neoplasm, and 44 cases (52.4%) had high-grade papillary urothelial neoplasm. HER2 and Survivin expressions were seen in 44 (52.4%) (p =0.610) and 9 (10.7%) patients (p =0.046), respectively.Survivin expression showed a mild increase in high grade UN. Conclusion: Our findings suggest that the IHC expression of Survivin and HER2 are not well associated with histological grades of Urothelial neoplasms of bladder. This may be partly due to relatively small sample size and various factors such as patient characteristics or antibody specifications.
Neuropathology
Arezoo Eftekhar Javadi; Elham Nazar; Hedieh Moradi Tabriz
Abstract
Introduction: Chondroma is a benign cartilaginous tumor. It is found very rarely in the head and neck. Case presentation: This report describes a 25-year-old woman who presented with generalized headache from 4 months ago. The patient underwent excisional surgery. The histological examinations revealed ...
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Introduction: Chondroma is a benign cartilaginous tumor. It is found very rarely in the head and neck. Case presentation: This report describes a 25-year-old woman who presented with generalized headache from 4 months ago. The patient underwent excisional surgery. The histological examinations revealed benign cartilage forming tumor, compatible with chondroma. The radiologic and histologic correlation confirmed the diagnosis. Based on the diagnosis, the patient received no more treatment. Conclusion: We concluded that intracranial chondroma should be included in the differential diagnosis of a calcified mass on skull imaging. Proper diagnosis is necessary for further patient management.