2024-03-29T15:06:07Z
https://ijp.iranpath.org/?_action=export&rf=summon&issue=6027
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
1
Characterization of Immunophenotypic Aberrancies in Adult and Childhood Acute Lymphoblastic Leukemia: Lessons from Regional Variation
Mitra
Rezaei
Sandra
Refoua
Najme
Esfandiari
Masoud
Shamaei
Background & Objective:Although the antigen expression patterns of acute lymphoblastic leukemia (ALL) are well known, this study attempted to evaluate commonly used immune markers for immunophenotyping of acute leukemia to set the minimum of necessary diagnostic panels by flow cytometry.Methods:This study evaluated 89 patients referred from all over the country to the Iranian Blood Transfusion Organization (IBTO) in Tehran from 2013 to 2015. We compared the immunophenotype patterns of childhood and adult ALLs including 69(77.5%) B-cell lymphoblastic lymphoma (B-LBL), 2(2.2%) Burkitt’s lymphoma (BL), and 18(20.2%) T-cell lymphoblastic lymphoma (T-LBL) cases using flowcytometry with broad antibody panel.Results:CD19 and CD79a were the most frequent markers for B-LBL while CD7 was the most sensitive marker in T-LBL; the frequency of CD7, CD3, and CD5 antigens were 100%, 38.9%, and 88.9%, respectively. TdT+/CD34+ was significantly higher in adult B-LBLs than children, which indicates blast cells are more immature in adults. In addition, CD10 and cCD79a were significantly higher in children with B-LBL like as CD5 and CD8 in children with T-LBL. Aberrant phenotypes including CD13, CD33, CD7, and CD117 were found in 7(10.1%) cases of B-LBL. These phenotypes were CD117, HLA-DR, and CD33 in 7(38/9%) cases of T-LBL. Expression of CD117 aberrant myeloid antigen was significantly more associated with T-LBL than with B-lineage ALL.Conclusion:Significant differences were observed in antigen-expression patterns between adult and childhood ALLs. Further studies are needed to correlate specific markers with recurrent cytogenetic abnormalities and prognosis with therapeutic response.
Aberrant phenotype
Acute lymphoblastic leukemia
flow cytometry
Immunophenotyping
2019
12
06
1
7
https://ijp.iranpath.org/article_37523_550bf1df5e6697849b52e7803ff97b12.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
1
Estrogen Receptor Expression in Glial Tumors of Iranian Patients: A Single Center Experience
Masoumeh
Shafiei
Ahmad
Mafi
Yalda
Nilipour
Ainaz
Sourati
Pegah
Sasanpour
Morteza
Tabatabaeefar
Background & Objective:Gliomas are the most common type of primary intracranial tumors in adults. The expression of estrogen receptors varies in different grades of glial tumors, and some studies have suggested that this expression might have a prognostic value. It seems that estrogen receptor expression negatively correlates with the histological grade of gliomas. In the present study, we aimed to determine the expression of estrogen receptor in different glial tumors in Iranian patients and to find a possible correlation between its expression and the grade of glial tumors.Methods:The brain tumors pathology reports from 2014 to 2017 in the Pathology Department of Shohaday-e Tajrish Hospital in Tehran, Iran were evaluated and 104 different gliomas: 79 cases of astrocytoma and 25 cases of oligodendroglioma were selected. All the samples were re-evaluated by a neuropathologist in order to accurately determine the tumor grade. The immunohistochemistry was carried out to detect the expression of estrogen receptor alpha and beta on brain tumors.Results:None of the samples expressed estrogen receptor alpha. In the case of estrogen receptor beta (ERβ), all samples showed various degrees of positivity: 9% weak, 40% moderate, and 51% strong expressions. The level of ERβ expression was found to be conversely correlated with tumor grade.Conclusion:Our study demonstrated that ERβ is expressed in the majority (if not all) of the glial tumors and its expression was conversely related to the tumor grade. Because of well-tolerability and acceptable adverse effects, ER agonists might be considered as therapeutic agents for the patients with glial tumors.
Gliomas
Estrogen receptor alpha
Estrogen receptor beta
Brain tumor grade
2020
01
01
8
12
https://ijp.iranpath.org/article_37611_e042b69dac94b243899d216f55601248.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
1
Assessment of Ki67 in Breast Cancer: A Comparison Between the Eye-10 Method, Stepwise Counting Strategy, and International System of Ki67 Evaluation
Maryam
Kadivar
Fatemeh
Aram
Background & Objective:Ki-67 evaluation is an essential tool to define luminal A and B breast cancers, which is not yet systematized. The International Ki67 in Breast Cancer Working Group suggests the counting of 500 or 1000 cancer cells, which is a time-consuming process. Therefore, novel methods, such as the Eye-10 method and stepwise counting strategy, are proposed to facilitate measurement. Methods:Immunohistochemical staining of Ki67 was performed on 100 hormone-receptor-positive invasive ductal carcinoma specimens. Ki67LI was evaluated for each case, and then results were dichotomized by a cut-off point of 20%. Next, for each sample, an expert pathologist visually assessed percentages of Ki67-positive cells in 10% intervals at a glance (Eye-10 method). Finally, by using a dynamic process with rejection regions, Ki67 was defined so if the estimate belonged to the upper or lower rejection region, the Ki67 status had been determined and if the rejection region could not be reached after counting the maximum number of 400 tumor cells, the specimen was regarded as equivocal (stepwise counting strategy).Results:The comparison between Eye-10 and Ki67LI revealed almost perfect agreement (kappa coefficient =0.889), and the concordance between the stepwise counting strategy and Ki67LI was substantial (kappa coefficient =0.639).Conclusion:Both two methods left some results in the gray/intermediate zone, which is unavoidable. Both methods are much faster and simpler than evaluation of Ki67LI and are also reliable. Regarding the gray zone in both methods, further improvements in the methodology, as well as more analytical studies, are needed.
Breast
Carcinoma
Ductal
Immunohistochemistry
2020
01
01
13
18
https://ijp.iranpath.org/article_37612_1697f5c169582817895779fdde660e90.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
1
Can the Decreased Expression of Human Leukocyte Antigen Class Ⅰ and Ⅱ by Spermatozoa Lead to Recurrent Spontaneous Abortion?
Nasrin
Sereshki
Alireza
Andalib
Ataollah
Ghahiri
Ferdos
Mehrabian
Roya
Sherkat
Abbas
Rezaei
Background & Objective:Unexplained recurrent spontaneous abortion (URSA) is defined as an unknown cause of occurrence of three or more clinically detectable pregnancy losses before 20 weeks of gestation, but it occurs presumably as a result of the immune system dysfunctions. We supposed that the disruption of semen or spermatozoa might be responsible for the dysfunction of the immune system in women with URSA. Semen and spermatozoa (as antigens) induce female reproductive tract (FRT) immunity. This stimulated immunity is necessary for pregnancy occurrence. The disruption of semen or spermatozoa can be a result of altering a variety of surface molecules on spermatozoa, especially polymorphic human leukocyte antigen (HLA) molecules or antigens. Despite the importance of HLA antigens in reproduction, to the best of our knowledge, no one has studied the relation of HLA expression between spermatozoa and URSA. Therefore, this paper aims to assess this relation.Methods:Semen samples were collected from 15 URSA couples and 20 normal couples. After purification of normal spermatozoa, the HLA class I and II expressions were evaluated by flow cytometry methods.Results:Results showed that the expression of both HLA class I and II by spermatozoa, in URSA couples, was significantly less than the control couples.Conclusion:The decreased expression of polymorphic HLA class Ⅰ and Ⅱ by spermatozoa can be related to URSA occurrence.
Polymorphic HLA class Ⅰ and Ⅱ
Spermatozoa
Unexplained recurrent spontaneous abortion
2020
01
01
19
22
https://ijp.iranpath.org/article_37614_80b6c66ddbaa852ad0eaba8efee8041b.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
1
The Insulin-like Growth Factor-1 (G>A) and 5,10-methylenetetrahydrofolate Reductase (C677T) Gene Variants and the Serum Levels of Insulin-like Growth Factor-1, Insulin, and Homeostasis Model Assessment in Patients with Acne Vulgaris
Sakineh
Zinati-Saeed
Ebrahim
Shakiba
Ziba
Rahimi
Mona
Akbari
Fariba
Najafi
Fariborz
Bahrehmand
Asad
Vaisi-Raygani
Zohreh
Rahimi
Ali
Ebrahimi
Mehrali
Rahimi
Background & Objective:To find an association between gene variants of insulin-like growth factor-1 (IGF-1) and 5,10-methylenetetrahydrofolate reductase (MTHFR) with the risk of acne vulgaris (AV).Methods:In a case-control study, we investigated 150 AV patients and 148 healthy individuals (aged 18-25 years) for the IGF-1 G>A and MTHFR C677T polymorphisms, as well as the serum levels of IGF-1, insulin, and the homeostasis model assessment of insulin resistance (HOMA-IR). The serum biochemical parameters and the genotypes of IGF-1 G>A and MTHFR C677T were detected by using appropriate kits and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods, respectively.Results:The frequencies of IGF-1 and the MTHFR polymorphisms were not significantly different comparing patients and controls. The serum level of IGF-1 was 179.8±72.8 µg/L in AV patients compared to 164.6±63.7 µg/L in controls (P=0.056). The serum level of insulin in female patients was significantly higher than controls. The HOMA was 3.54±5.6 in patients compared to 1.16±1.4 (P<0.001) in controls. Significantly higher levels of fasting blood sugar (FBS), total cholesterol, and low-density lipoprotein-cholesterol (LDL-C) were detected in female patients than controls. However, the level of estradiol was significantly lower in female patients than in controls. In females, the presence of the MTHFR T allele was associated with significantly higher levels of FBS and LDL-C, as well as a significantly lower level of estradiol compared to those carriers of the C allele.Conclusion:We found the absence of an association between IGF-1 and MTHFR polymorphisms with the risk of AV. However, increased insulin, IGF-1, and HOMA levels in AV patients indicated the effect of insulin and insulin resistance in the risk of AV and its severity.
Acne vulgaris
Methylenetetrahydrofolate reductase
Insulin-like growth factor-1
Insulin
Homeostasis model assessment
2020
01
01
23
29
https://ijp.iranpath.org/article_37616_f4b6725a5f2ca9290f029e96b394f607.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
1
Epstein-Barr Virus and Human Herpesvirus 8 in Idiopathic Pulmonary Fibrosis
Amir Hossein
Jafarian
Nema
Mohammadian Roshan
Hossein
Ayatollahi
Abbas Ali
Omidi
Masoumeh
Ghaznavi
Masoumeh
Gharib
Background & Objective:Idiopathic pulmonary fibrosis (IPF) is a chronic and uniformly fatal interstitial lung disease with incompletely understood pathogenesis. Several studies have given the evidence for and against viral cofactors in the pathogenesis of Idiopathic pulmonary fibrosis. In this study Epstein-Bar Virus (EBV) and Human Herpesvirus 8 (HHV-8) have been studied for a possible role in the pathogenesis of IPF.Methods:Polymerase chain reaction (PCR) was employed for the detection of EBV and HHV-8 in 58 formalin-fixed paraffin-embedded lung tissue specimens (29 controls and 29 IPF specimens).Results:EBV DNA was present in the lung tissue of 6 out of 29 (20.7%) IPF specimens compared with 1 out of 29 (3.4%) controls (P=0.102). The HHV-8 gene was identified in 3 out of 29 (10.3%) cases of IPF specimens. The control group showed no evidence of HHV-8 gene (P=0.227).Conclusion:Although multiple studies are strongly suggestive of a role for EBV and HHV-8 in the development of IPF, there was no statistically significant difference in the prevalence of EBV and HHV-8 DNA in the IPF specimens and controls in this study.
Idiopathic pulmonary fibrosis
Epstein - Barr virus
Human herpesvirus 8
Polymerase chain reaction
2020
01
01
30
33
https://ijp.iranpath.org/article_37617_fe83fc61cb5616e771036b9713068725.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
1
Different Immune Responses in Dangerous O Blood Donors
shaghayegh
Arabi
Mostafa
Moghadam
Vida
Maleki
Ali Akbar
Pourfatholah
Afsaneh
Aghaie
Background & Objective:Dangerous O is very important to transfusion medicine and there has been reports by Food and Drug Administration (FDA) regarding some death relating incidences. As high iso-antibody production is closely associated with different immune reactions, a survey on the different immune response of dangerous O donors can lead to understanding their immune response profile. Objectives were to assess different immune responses in dangerous O cases.Methods:Two groups of donors were selected after performing titration as a high titer (>512) and non-high titer (<128). Then CBC, CD markers, total immunoglobulin, complement assay, anti-VZV, -CMV, -EBV, -HSV, -Rubella, -Toxoplasma gondii, -HBV, -ASO, total protein and albumin, protein electrophoresis, lymphocyte proliferation, and gene expression of INF-gamma, IL2/4/10 were evaluated on both study groups.Results & Objective:Total IgG, IgM, and IgA was higher in high titer group. Moreover, after using PHA and LPS, gamma globulins and lymphocyte proliferation were significantly higher in high titer cases. Real-time PCR also showed higher IL-2 production in high titer group. Identification of high responder’s characteristics can be efficient in many complications. Moreover, high titer donors are dangerous for transfusion medicine. This pilot study showed differences in immune responses between HR and LR O blood donors for the first time. So, other aspects of the immune system such as genetic differences can be surveyed.
Dangerous O
Iso-antibody
Immune response
High responder donors
2020
01
01
34
40
https://ijp.iranpath.org/article_37620_9c5c0c570f19aa24d17754f9f4bbbf83.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
1
Solitary Fibrous Tumor of the Prostate: A Diagnostic Challenge: A Case Report
Nilay
Nishith
Monika
Gupta
Nidhi
Kaushik
Rajeev
Sen
Solitary fibrous tumor (SFT) of prostate is an unusual type of mesenchymal neoplasm that can elicit a benign or malignant phenotype. It represents a diagnostic challenge as it can simulate poorly differentiated adenocarcinoma and various mesenchymal neoplasms of prostate. We report a case of prostate SFT in a 54-year-old patient, which was clinically misdiagnosed as nodular hyperplasia of prostate with cystitis. However, on follow-up, he was not relieved by the designated treatment. Furthermore, he complained of exacerbation of symptoms and consequently, had to undergo open prostatectomy. Based on histopathological and immunohistochemical (IHC) assessment, a diagnosis of SFT of the prostate was rendered. Additionally, we have discussed the histological mimics of SFT and the diagnostic and prognostic importance of IHC while evaluating such lesions.
Diagnosis
Immunohistochemistry
Prognosis
Prostate
Solitary Fibrous Tumor
2020
01
01
41
44
https://ijp.iranpath.org/article_37621_a676736c019982a4cd4d9de85d9dacad.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
1
Mature Cystic Teratoma of Spinal Cord in A 16-Year-Old Male: A Case Report
Hiva
Saffar
atieh
khorsand-rahimzadeh
Morteza
Faghihjouibari
Seyed Mohammad
Tavangar
Teratoma is a type of multipotential cell tumor, which includes a mixture of two or three germinal layers of ectodermis, endodermis, and mesodermis. Although neonatal sacrococcygeal teratoma has been frequently reported, its occurrence in older age is not common. In this study, we report a rare case of spinal intradural mature cystic teratoma in a 16-year-old male, emphasizing on considering this unusual condition in differential diagnosis of spinal cord cystic tumors.
Adolescent
Spinal cord
Teratoma
2020
01
01
45
47
https://ijp.iranpath.org/article_37615_981ef8f9c0e866a692e14c0941e2cbc5.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
1
Concurrence of Primary Cutaneous Extra Mammary Paget’s Disease and Squamous Cell Carcinoma in situ of Vulva: A Case Report
Fatemeh
Samiee Rad
Sohayla
Farajee
Extramammary Paget’s disease and vulvar intraepithelial neoplasia are common lesions of vulve, but synchronous occurrence is rare in a same location. Herein we describe a concurrence of primary cutaneous extra mammary Paget’s disease and squamous cell carcinoma in situ of vulva in an Iranian women. A 59 year old woman, initially presented to Kosar teaching hospital gynecology clinic April 2017 with a single, well defined, scaly, white ulcerated mass, 2 cm in diameter on right minor labia, but other examinations were normal. She had no urinary or gastrointestinal symptoms. Incisional biopsies from the mass represented concurrence extramammary Paget’s disease and VIN3. She underwent radical vulvectomy .No evidence of disease recurrence was noted after 16 months follow up. Participant consent was obtained before patient was enrolled in this study. There are lot of diseases that involve genitalia and lead to vulvar lesions. But in this rare case, we diagnosed concurrence of extramammary Paget’s disease and vulvar intraepithelial neoplasia in a same location. Additionally, the clinical presentation as a vulvar mass was found unusual. Therefore, we report the case to sensitize gynecologists and pathologists for uncommon pathologies and their manifestations in vulva.
Extramammary Paget´s disease
Intraepithelial neoplasia
Vulve
2020
01
01
48
52
https://ijp.iranpath.org/article_37618_d1cced162860d9d7af4dffab5f3a9a32.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
1
Carotid Body Paraganglioma with Prominent Lymphocytic Infiltration Mimicking Metastatic Lymph Node: A Case Report
Elham
Jafari
hamid
tabrizchi
Foroogh
Mangeli
Carotid body paraganglioma is a neuroendocrine neoplasm of the mandibular region. Due to its prominent stromal alternations, carotid body paraganglioma is a great emulator of other neoplasms in the head and neck region especially in metastatic tumors and its definite diagnosis is a great challenge. To the best of our knowledge, the most frequently reported variant is sclerosing and paraganglioma with a prominent lymphoplasmacytic infiltration is extremely rare. We report a rare case of a carotid body lymphoplasmacytic paraganglioma presented as a single asymptomatic mass of the right mandibular region in a 45-year-old woman. In order to exclude other possibilities, the use of immunohistochemistry is essential which shows a strong positive immunoreaction for chromogranin and synaptophysin. Surgical resection is the treatment of choice which is replaced with radiotherapy in contraindications. Overall, the tumor has a favorable clinical outcome.
Head and neck neoplasms
Carotid body tumor
Neuroendocrine tumor
2020
01
01
53
56
https://ijp.iranpath.org/article_37619_163df251c71affb2c4611c8aa8e0cfec.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
1
Sarcomatoid Chromophobe Renal Cell Carcinoma with Heterologous Component
Sushma
Bharti
Gautam
Ram Choudhary
Jyotsna Naresh
Bharti
Garg Pawan
Kumar
Arsha
BS
Poonam
Abhay Elhence
Clear cellrenal cell carcinoma (RCC) is the most common malignant renal tumor in adults, while chromophobe RCC (CRCC) is the third most common. Any subtypes of RCC can undergo sarcomatoid differentiation, but heterologous differentiation in sarcomatoid area is very rare in RCC. Here a61-year male is presented with hematuria and palpable mass. Clinicoradiologically, RCC was considered and left radical nephrectomy was performed. A well-circumscribed renal mass located in the upper pole of the left kidney with variegation and extensive areas of bony hard calcification noted, was reported as CRCC with sarcomatoid differentiation containing heterologous component. CRCC subtype has good prognosis but show dismal prognosis when associated with sarcomatous differentiation.We found11 cases of sarcomatoid CRCC containing heterologous elements reported in indexed English literature. CRCC must be differentiated from Conventional RCC and Oncocytoma.The extensive sampling of the tumor is needed. We report a very rare case of CRCC with sarcomatoid differentiation containing heterologous elements.
Chromophobe
Renal cell carcinoma
Sarcomatoid
Kidney neoplasms
Cell Differentiation
2020
01
01
56
60
https://ijp.iranpath.org/article_37622_65f18a4ad792e9cc549f71912aba5415.pdf