Iranian Journal Of Pathology
Volume:6 Issue: 1, Winter 2011

Human papillomavirus (HPV) is one of the most common causes of sexually transmitted diseases worldwide and is the etiological agent of cervical and other anogenital malignancies. Since HPVs have been shown to possess oncogenic potential, an association between HPV infection and prostatic cancer (PCa) has been suggested. There are conflicting reports on the impact of HPV infection on the development of prostate cancer. The aim of this article is to review the studies that investigated the association between HPV and PCa. The results of this review demonstrated the divergent frequencies of HPV positivity in PCa in different geographic areas.

Epstein Barr Virus (EBV) is one of the members of herpesviridae family and a sub-category of Gamma herpes virinae. EBV, which normally has CR2 or CD21 receptors on B-lymphocytes, has mutagenic features for them. The virus plays an important role in causing some malignant cancers. About 30% of the cases with non-Hodgkin’s lymphoma are diffuse large B-cell lymphoma (DLBCL). In the present study, the incidence rate of EBV in DLBCL was evaluated. Immunohistochemistry (IHC) and PCR methods were used for studying the relationship between EBV and DLBCL. Paraffin blocks of 116 patients from Sina & Shariati hospitals, Tehran, Iran, with DLBCL diagnoses in 2005-2009 were collected. EBV-LMP in IHC and PCR virus genome in PCR were examined. Findings of the PCR method showed that 28 cases of the total 116 patients with DLBCL were EBV positive (the frequency of EBV positivity was correspondingly 40% and 60% in females and males) and this shows a 25.8% EBV frequency in DLBCL. IHC findings showed that six cases were EBV positive. The compatibility of positive IHC and PCR responses was two cases and there are four conflicting cases. It seems that PCR is a more appropriate method for diagnosing EBV and IHC cannot solely prove the presence of EBV in DCBCL patients.

The reliability and validity of monitors for self-monitoring of blood glucose are debated. We evaluated the analytical performance of Accu-check Active (Boehringer Mannheim, Roche) which is one of the most commonly used monitors in Iran. We compared the monitor readings with the reference values by percentage of values within certain intervals of the reference method, regression analysis, and difference plot. We used operational process specification charts to determine the probability that different QC rules would detect an analytical error. In addition, we assessed the quality on the sigma scale. This meter met International Organization for Standardization’s criteria but not the American Diabetes Association’s stringent criteria. The monitor produced precise readings throughout the concentration range and results correlated closely with the reference method. The measured total error was 6.39% (less than allowable total error of 10%). The method reached 6 sigma at glucose levels of 6.66 and 18.87 mmol/L and a sigma of 3 to 4 at glucose level of 2.49. Repeatability and intermediate precision were acceptable. We concluded that the overall performance of this instrument is reasonable but in hypoglycemic range, multiple control rules and control materials are required to assure the desired quality is achieved

Preterm birth occurs in 8% to 11% of all pregnancies and is responsible for 75% to 80% of all neonatal deaths. Cytokines may be involved in the etiology of preterm birth through their stimulation of prostaglandin synthesis. Cytokines may be released into cervicovaginal fluid during the breakdown of the chorio-decidual adhesion or from an inflammatory reaction in the same area. The aim of this study was to determine whether the values of interleukin 8 and 6 in cervical secretions could predict spontaneous preterm birth in asymptomatic high-risk pregnant women. Levels of interleukin 6 and 8 in cervical samples, collected from 100 pregnant women between 22 to 28 weeks of gestation were measured by ELISA test in Mostafa Khomeini and hazrat-zeinab university hospitals in Tehran, from December 2006 to July 2007. Gestational age at time of delivery was recorded. Receiver operator characteristic curve analysis was used. There were 4.8, and 4.4, -fold increase in cervical interleukin 8 and 6 concentrations in early preterm versus term delivery. A single interleukin 8 >751.25 pg/ml, and l interleukin 6 >157 pg/ml, was identified early preterm versus term delivery. Sensitivity, specificity, positive and negative predictive values of interleukin 8 in early preterm birth were 89%, 83%, 69%, 94% and for interleukin 6 as 89%, 78%, 63%, 88%, respectively. Cervical interleukin 8 and 6 is a sensitive and specific predictor preterm delivery.

Rapid and accurate detection of methicillin resistant Staphylococcus aureus (MRSA) is an important role of clinical microbiology laboratories to avoid treatment failure. The aim of this study was to compare conventional methods against the E-test minimum inhibitory concentration (MIC) method to determine the best phenotypic method. Methicillin resistance was studied among clinical isolates of S. aureus from April to October 2009 in Milad Hospital of Tehran. These methods included E-test MIC, oxacillin screen agar, oacillin disk diffusion, cefoxitin disk diffusion, and CHROMagar- MRSA methods. Out of 294 isolates of S. aureus, one hundred and six (36%) strains of MRSA were isolated from clinical specimen. Oxacillin screen agar and CHROMagar-MRSA showed both 110 MRSA isolates. The sensitivity and specificity for these two methods were 100% and 97.9%, respectively. The sensitivity and specificity of oxacillin disk diffusion method was similar to those of oxacillin screen and CHROMagar-MRSA. One hundred and eight strains of S. aureus were MRSA by cefoxitin disk diffusion method. The sensitivity and specificity of cefoxitin disk diffusion method was 100% and 98.1% respectively. All isolates including MRSA were susceptible to vancomycin. Nearly al MRSA isolates were resistant to erythromycin, clindamycin, chloramphenicol, tetracycline, ceftriaxone and ciprofloxacin. All phenotypic methods had high sensitivity and specificity for detection of MRSA. However, cefoxtin disk diffusion method in comparison to other methods had higher specificity.

Ependymomas accounts for about 2%–6% of CNS and 60%–70% of spinal cord tumors. Several histological patterns of these neoplasms are well known, but little attention has been devoted to a variant composed of giant cells. In spite of apparently “worrisome” histology, giant cell ependymoma seems to be a neoplasm with a relatively good prognosis. This report presents a case of giant cell ependymoma of the filum terminale in a 24-year-old woman and highlights the morphological diagnostic criteria for this rare tumor.

Clear cell variant of ependymoma is almost exclusively located in the supratentorial region. Only few cases of this tumor that located in the spinal cord have been reported. Here we report one case of intramedullary clear cell ependymoma of the lumbar spinal cord. In microscopic examination, the tumor cells were round to oval with moderate amounts of clear cytoplasm and centrally located large nuclei, resembling oligodendroglioma. Typical features of ependymoma, such as ependymal clefts, perivascular pseudorosettes, as well as nuclear pseudoinclusions and grooves were identified. Albeit being rare, clear cell ependymoma could be mentioned in differential diagnosis of clear cell tumors in this area.

The gastric inflammatory fibroid polyp (IFP) is a rare benign tumor of unknown etiology that is localized mainly in the antrum and presents endoscopically as submucosal mass. The lesion manifests as abdominal pain, weight loss, bleeding, dyspeptic symptoms, and iron deficiency anemia. We report a case of gastric IFP presented with microcytic anaemia, dyspepsia, malena and weight loss. Endoscopy revealed presence of a sessile gastric antral polyp. A clinical diagnosis of gastric malignant polyp was suspected. Microscopic examination revealed the presence of mononuclear fusiform fibroblast like cells, arranged in fascicles and whorl formation around vessels, in an inflammatory background rich in eosinophils. The fusiform cells appeared uniform and had abundant cytoplasm with pale spindle shaped nuclei. We highlight the case because of its rarity amongst the different types of gastrointestinal polyps and its unusual presentation like anaemia and weight loss with clinical suspicion of malignant gastric polyp.

Primary Hepatic Lymphoma (PHL) is rare and possibly associated with viral hepatitis and autoimmune diseases. Scleroderma could exceptionally be complicated by lymphoma. We describe PHL occurring in a 52-year-old female suffering scleroderma for eight years, with no history of cytotoxic or high-dose glucocorticoid therapy. CT scan, performed to work-up abdominal discomfort, constipation, and elevated alkaline phosphatase, showed a liver mass. Following left hepatic lobectomy, diffuse large B-cell lymphoma was diagnosed by pathological evaluations. Shortly after operation, chemotherapy began. The patient is alive and free of disease eight years after diagnosis of primary hepatic lymphoma. To the best of our knowledge, this is the first case of Primary Hepatic Lymphoma occurring in the setting of long-standing scleroderma. The fact that our patient had no history of immunosuppressive/ high-dose glucocorticoid therapy may indicate that similar immunologic abnormalities have pathogenetic role in both scleroderma and non- Hodgkin’s lymphoma.