Review Article
Mehdi Nassiri
Volume 2, Issue 1 , January 2007, Pages 1-6
Abstract
Correct diagnosis and classification of lymphoid neoplasms depends on the integration of morphologic, immunophenotypic and molecular genetic features. The mature small B cell lymphomas despite their overlapping histomorphologies, have different clinical behavior and treatment. In this review, differential ...
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Correct diagnosis and classification of lymphoid neoplasms depends on the integration of morphologic, immunophenotypic and molecular genetic features. The mature small B cell lymphomas despite their overlapping histomorphologies, have different clinical behavior and treatment. In this review, differential diagnosis of this category of tumors and a practical approach based on biomarkers evaluation is discussed.
Original Research
Parvin Rajabi; Mohammad Aboutalebdokht; Mitra Heidarpour; Ali Asilian; Fatemeh Rajabi
Volume 2, Issue 1 , January 2007, Pages 7-10
Abstract
Background and Objective: Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are two common tumors of the skin. In some cases, distinction between BCC and SCC can be difficult. This study aimed to clarify this uncertainty through immunohistochemical analysis. In this respect, epithelial membrane ...
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Background and Objective: Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are two common tumors of the skin. In some cases, distinction between BCC and SCC can be difficult. This study aimed to clarify this uncertainty through immunohistochemical analysis. In this respect, epithelial membrane antigen (EMA) and Ber-Ep4 are the two immunohistochemical markers on which we focus in differentiating skin BCC from SCC. Materials and Methods: Archived paraffin-embedded tissue samples of BCC (n = 40) and SCC (n=40) were stained immunohistochemically using Ber-Ep4 and EMA antibodies. Results: It was found out that 37 (92.5%) out of the BCC samples stained positive for Ber-Ep4 and 2.5% of SCC samples showed positive staining. The majority of SCC group (37 out of 40) expressed EMA, while 5% of BCC samples showed positive staining. Conclusion: Distinction of BCC and SCC of the skin can be readily achieved through Ber-Ep4 and EMA immunohistochemical markers. Regarding potential false positive and negative results through immunostaining techniques, we may recommend the use of these two antibodies together.
Original Research
Ali Eslamifar; Farrokh Tirgari; Rasool Hamkar; Amitis Ramezani; Hossein Frootan pishbigar; Shahrum Mirmomen; Azin Nahvigoo; Vahideh Shahnazi; Zahra Deljoodokht; Shifteh Vahidi; Arezoo Aghakhani
Volume 2, Issue 1 , January 2007, Pages 11-16
Abstract
Background and Objective: Human papillomavirus (HPV) is one of the possible etiologic factors in development of esophageal squamous cell carcinoma (ESCC). In this study we aimed to study the role of HPV in ESCC.
Patients and Methods:In this study, 140 cases of ESCC were analyzed for the ...
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Background and Objective: Human papillomavirus (HPV) is one of the possible etiologic factors in development of esophageal squamous cell carcinoma (ESCC). In this study we aimed to study the role of HPV in ESCC.
Patients and Methods:In this study, 140 cases of ESCC were analyzed for the HPV DNA by polymerase chain reaction (PCR) using GP5+/GP6+ primers for L1 open reading frame (ORF) to amplify a 150-bp segment of HPV L1 ORF. This region was subsequently sequenced to identify the type of HPV.
Results:A total of 140 patients enrolled in our study. In this respect, 50.7% of them were females and 49.3% were males, aged between 20 and 81 years old. In addition, 33 tumor specimens (23.6%) and 12 (8.6%) non-involved tumor margins were HPV positive. In HPV positive tumor cases, 36% were also positive in tumor margins. The HPV positive cases were 21.7% males and 25.3% females. There was no correlation between the presence and types of HPV with patients’ sex and age. The frequency of HPV subtypes in tumoral regions were as follow: HPV-16: 60.6%, HPV-18: 30.3%, HPV-33: 6.1%, and HPV-31: 3 %. We found only HPV-16 in tumor margins.
Conclusion:Our results support a causal association between HPV infection and ESCC which is consistent with HPV studies conducted in other high-risk areas.
Original Research
Issa Jahanzad; Amir Hossein Sadrzadehrafie; Reza Rafie; Masoud Rahmanian; Mohammad Reza Hayeri; Ali Reza Rezaee; Babak Gharaei; Majid Sadeghizadeh; Ali Mohammad Ahadi
Volume 2, Issue 1 , January 2007, Pages 17-22
Abstract
Background and Objective: The association of EBV with Hodgkin Lymphoma (HL) has been intensely investigated over the last few years. EBV is also associated with several other malignancies. On the other hand, Ki67 molecule serves as a widely accepted proliferation marker. Several studies were previously ...
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Background and Objective: The association of EBV with Hodgkin Lymphoma (HL) has been intensely investigated over the last few years. EBV is also associated with several other malignancies. On the other hand, Ki67 molecule serves as a widely accepted proliferation marker. Several studies were previously performed about the expression of Ki67 in HD. This study tried to detect the correlation between Ki67 expressions with chronic EBV infection in HD patients of Iran by attenuating confounding factors.
Materials and Methods: Hodgkin patients were divided into two groups regarding their EBV infection status. The case and control groups were matched for the stage of the disease. Immunohistochemical methods were used to detect Ki67 expression while DNA extraction and PCR amplification were performed to indicate chronic EBV infection.
Results: Clinicopathologic criteria of two groups including male to female ratio, age, presence of B symptoms, and pathologic subtypes were not significantly different. Ki67 expressed in 21% of EBV infected cells while 30% of EBV negative cells had this marker. There was also no statistically significant difference between these two groups.
Conclusion: After omitting the possible effect of confounding factors such as the presence of other malignancies and advanced disease stage, there was no correlation between Ki67 expression and EBV infection in Hodgkin patients in this study.
Original Research
Alireza Nateghian; Joan L. Robinson; Simin Rezaii; Mahnaz Kefayati; Naser Rakhshani; Safa Sianati
Volume 2, Issue 1 , January 2007, Pages 23-28
Abstract
Background and Objective: The diagnosis of typhoid fever in children is a challenge due to the non-specific clinical picture. The current role of the Widal test for diagnosis in developing countries has not been clear. Materials and Methods: Charts were reviewed on all children ≤ 15 years of age discharged ...
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Background and Objective: The diagnosis of typhoid fever in children is a challenge due to the non-specific clinical picture. The current role of the Widal test for diagnosis in developing countries has not been clear. Materials and Methods: Charts were reviewed on all children ≤ 15 years of age discharged from 5 pediatric teaching hospitals in Tehran from 1991 to 2004 with a diagnosis of typhoid fever. The Widal test was performed on 58 children with confirmed and 40 children with probable typhoid fever and as control groups, 40 febrile children admitted with infections other than typhoid fever, and 40 afebrile children admitted for elective surgery. Results: For the confirmed cases of typhoid fever, 33 (57%) were male and the mean age was 7.5 ± 3.5 years. Fever was present in 56 cases (97%) and the mean duration of fever before admission was 14 ± 8 days. Other symptoms included tachycardia (60%), anorexia (60%), vomiting (60%), diarrhea (57%), abdominal pain (48%), and headache (34%). Hepatomegaly was present in 55% of cases, splenomegaly in 44%, and Rose spots in 14% of them. Positive cultures were from blood (45/58), stool (18/58), and bone marrow (12/17) with 4 cases having only positive bone marrow cultures. Positive titers of at least 1:40 for anti “O” and/or anti “H” agglutinins were found in 78% of confirmed cases, 65% of possible cases, 12.5% of febrile controls, and no afebrile controls. Conclusion: The Widal test remains a useful test for diagnosis of typhoid fever in developing countries where blood cultures may not be available or may be negative because of prior antibiotic therapy. A titer of at least 1:40 for anti “O” and/or anti “H” agglutinin should be considered a positive titer in Iranian children.
Original Research
Shahla Ansari; Parvaneh Vossogh; Ali Tabarok
Volume 2, Issue 1 , January 2007, Pages 29-32
Abstract
Background and Objective: Germ cell tumor (GCT) accounts for approximately 2-3% of all malignancies in children. In this respect, about 20% of patients with GCT are still resistant to therapy. Materials and Methods: The cross-sectional strategy of this survey was undertaken on 57 patients with germ cell ...
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Background and Objective: Germ cell tumor (GCT) accounts for approximately 2-3% of all malignancies in children. In this respect, about 20% of patients with GCT are still resistant to therapy. Materials and Methods: The cross-sectional strategy of this survey was undertaken on 57 patients with germ cell tumor who admitted to Ali Asghar Children hospital during the years 1990- 2003. In this study, information regarding sex, age, pathological findings, clinical signs, treatment, and survival (event-free survival) were gathered in order to have better treatment and follow-up. The obtained data were analyzed using SPSS software. Results: The findings showed that the mean age of patients was 4.9 ± 0.1 years (1 months-14 years). Meanwhile, 54% and 46% of patients were male and female respectively with a ratio of 1.1. Regarding site of involvement, 57.8% and 42% of patients had sacrococcygeal and gonadal tumors respectively. In addition, regarding their pathological typing, 61.4%, 12.2%, 14%, and 10.5% of them had yolk sac tumor, dysgerminoma, malignant teratoma, and embryonal carcinoma respectively. The most common clinical signs were buttock mass, testicular mass, an abdominal mass, and abdominal pain in 31.5%, 28%, 17.5%, and 10.5% of patients respectively. All of the patients were treated with chemotherapy (bleomycin, vinblastin, cisplat). Mean duration of followup was 48.4 months. In this regard, 31.5% of the patients were alive, no information was available for 15.7% of them, and 52.6% of cases were expired. Meanwhile, 70% of the patients had tumor relapse. In this regard, event-free survival (EFS) for patients was 42%. Conclusion: The analysis of the treated patients showed that extragonadal location of primary tumor (especially sacrococcygeal), level of AFP above 10 ng/ml in patients, an age equal to or greater than 6 months, and metastatic disease were the most unfavorable factors for overall survival .
Original Research
Mahjabin Taklif; Maryam Abolhasani
Volume 2, Issue 1 , January 2007, Pages 33-36
Abstract
Background and Objective: Neurofibromas occur as solitary and multiple forms. The solitary ones are extraneural and more common, histologically exhibiting spindle cells with wavy nuclei, scattered among collagen fibers. Multiple neurofibromas are seen in neurofibromatosis (types I and II), including ...
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Background and Objective: Neurofibromas occur as solitary and multiple forms. The solitary ones are extraneural and more common, histologically exhibiting spindle cells with wavy nuclei, scattered among collagen fibers. Multiple neurofibromas are seen in neurofibromatosis (types I and II), including intraneural (plexiform, cutaneous deep circumscribed) and extraneural (cutaneous, deep diffuse) variants and various combinations of the above mentioned forms. In reviewed literature, solitary localized neurofibromas are mentioned to affect the genders equally, most develop in persons between the ages 20 and 30 years and evenly distribute over the body surface. Since Hazrat Fatemeh hospital is the referral center of dermatology, it seemed that evaluation of patients with neurofibroma within 11 years could be helpful. Materials and Methods: The present study included 53 patients with neurofibromas who referred to department of pathology of Hazrat Fatemeh Hospital during the years 1994-2005. Their lesions were diagnosed as neurofibromas by the pathologist. Lesions were categorized into solitary or multiple neurofibromas, then sex and age distributions and the involved areas were compared in each group. Results: In solitary group, neurofibromas were distributed in order of frequency over face (48%), upper extremities (13%), scalp, trunk, and lower extremities each one 9%, and neck (4%). The frequencies of distribution for neurofibromatosis were face (40%), upper extremities (23%), trunk, and lower extremities each one 14%, and scalp and neck each one 6%. Solitary neurofibromas of face, trunk, and upper extremities predominated in females, but lesions of scalp, neck, and lower extremities were more common in males. In contrast, neurofibromatosis of face, scalp, and neck were more frequent in males, the reverse was true for lesions of trunk and extremities. The peak incidence of solitary neurofibroma was within the ages of 15 and 30 years. In comparison, the peak incidence of neurofibromatosis was between 9 and 13 years. One third of neurofibromatosis developed plexiform neurofibromas, but no single case was observed in solitary group. None of the solitary or multiple neurofibromas were transformed to malignancy up to the time of current study. Conclusion: The solitary neurofibromas of head (p<0.04) and multiple neurofibromas of face (p= 0.04) were more prevalent in males, while multiple neurofibromas of upper extremities (p<0.03) were more frequent in females. Age distribution of solitary neurofibromas as compared to references and lower incidence age of neurofibromatosis in the study were in concordance with references.
Case Reports
Fatemeh Mahjoub; Farhang Ghanipour; Nasrin Samadi
Volume 2, Issue 1 , January 2007, Pages 37-40
Abstract
Lipoma arborescens, also known as villous lipomatous transformation of synovium is an unusual fatty lesion of joint. This disorder is characterized by a diffuse increase in the quantity of subsynovial fat in supra-patellar region which bulges the overlying synovial lining and produces a villous architecture. ...
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Lipoma arborescens, also known as villous lipomatous transformation of synovium is an unusual fatty lesion of joint. This disorder is characterized by a diffuse increase in the quantity of subsynovial fat in supra-patellar region which bulges the overlying synovial lining and produces a villous architecture. Hereby we report a case of Lipoma arborescens in an eleven year old boy with a history of supra-patellar swelling of left knee since a year ago. Also, he had a vague history of trauma before left knee swelling. Radiological and histopathologic features of our case are discussed alongside full review of literature. This disorder is an unusual lesion and occurs mainly in middle aged men and is rare in pediatric age group.
Case Reports
Hamid Tabrizchi; Shahriar Dabiri; Alireza Soutodehnejad; Bahram Azadeh; Malcolm M.M. Hayes
Volume 2, Issue 1 , January 2007, Pages 41-44
Abstract
Localized Leishmania Lymphadenitis (L.L.L) is a self limited clinical presentation of cutaneous leishmaniasis. Microscopic findings in L.L.L are very similar to Toxoplasma lymphasenitis. In all cases, an intensive microscopic search should be done for Leishman bodies. In this study, we describe our microscopic ...
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Localized Leishmania Lymphadenitis (L.L.L) is a self limited clinical presentation of cutaneous leishmaniasis. Microscopic findings in L.L.L are very similar to Toxoplasma lymphasenitis. In all cases, an intensive microscopic search should be done for Leishman bodies. In this study, we describe our microscopic findings and results of our immnohistochemical (IHC) study with a panel of monoclonal antibodies against T-Cells, B-Cells, histiocytes, Langerhans cells, and dendritic reticulum cells. Morphologic and immunohistochemical study in this case showed expanded paracortical tissue with many small clusters of epithelioid histiocytes and large reactive B follicles. Immature sinus histiocytosis in subcapsular and trabecular sinuses was also seen.
