فهرست مطالب

Pathology - Volume:11 Issue: 4, Autumn 2016

Iranian Journal Of Pathology
Volume:11 Issue: 4, Autumn 2016

  • تاریخ انتشار: 1395/08/16
  • تعداد عناوین: 15
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  • Soussan Irani Pages 302-322
    Many types of cancers develop in the oral and maxillofacial region. Squamous cell carcinoma is the most common cancer and constitutes over 90 percent of these tumors. Malignant transformation is a genetic process, which later makes a phenotyping change at the cellular level. Some cancers such as oral squamous cell carcinomas (OSCCs) develop from pre-malignant lesions and conditions. Despite advances in the treatment of OSCC, the 5-year survival rate remains approximately 50% due to inability of early detection of OSCC and precursor lesions. Early detection of oral cancer, especially in the premalignant stage, can decrease mortality and morbidity significantly. This article reviews some clinical, histopathological features and etiopathogenesis of pre-cancerous lesions of the oral cavity and skin of face and lip vermilion. A relevant English literature search in Pubmed, Science Direct, and Google Scholar was performed from 1930 to 2015. Full text of 191 articles met the specific inclusion criteria for this review.
    Keywords: Face, Head, Leukoplakia, Mouth, Neoplasm, Precancerous condition, Skin
  • Alireza Abdollahi, Masoud Etemadian, Saeed Shoar, Zohreh Nozarian Pages 323-327
    Background
    The optimal treatment is not possible yet for chronic prostatitis due to the unknown etiology of the diseases. We aimed to investigate the association of Helicobacter pylori infection with chronic prostatitis.
    Methods
    In this prospective case-control study that conducted in Imam Hospital Complex affiliated to Tehran University of Medical Sciences in Tehran, Iran from 2014 to 2015, patients with diagnosis of chronic prostatitis according to the criteria of National Institute of Health (NIH) were enrolled. Control group constituted of consecutive healthy patients.Blood samples were obtained for each patient and control and evaluated for serum levels of anti H. pylori IgG, A. Data analysis was carried out using SPSS, version 18. Values of P
    Results
    Mean ± SD age of patients was 59.5 ± 3.08 yr in the case group and 56.88 ± 3.20 yr in the control group with no significant difference (P>0.05). Mean ± SD levels of anti H. pylori IgG and IgA in the control group were 9.36 ± 7.45 U/ml and 6.25 ± 7.29 U/ml, respectively compared with 20.94 ± 16.98 U/ml and 18.63 ± 15.65 U/ml in the case group, respectively both of which revealed statistically significant (P
    Conclusion
    Chronic prostatitis is associated with H. pylori infection. Both anti H. pylori IgG and IgA are increased in patients with chronic prostatitis. Therefore, treatment of HP infection could be effective in the prostatitis cure.
    Keywords: Chronic Prostatitis, Helicobacter pylori infection
  • Masoomeh Sofian, Mohammad Banifazl, Masoomeh Ziai, Arezoo Aghakhani, Ali, Asghar Farazi, Amitis Ramezani Pages 328-333
    Background
    The household transmission of hepatitis B virus (HBV) is a major health problem. High incidence of HBV infection is observed within the household contacts of HBV carriers. We aimed to evaluate serological markers of hepatitis B infection among family members of HBV carriers in Arak, central Iran.
    Methods
    Data were collected from the 100 chronic HBV carriers (subjects with positive HBsAg for at least 6 months period) as index cases and 700 members of their family. Then, we checked serologic markers of hepatitis B [hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc) and hepatitis B surface antibody (anti- HBs)] using the ELISA test.
    Results
    The prevalence rate of HBsAg, anti-HBs and anti-HBc among household members was 23.3%, 20.4% and 23% respectively. Isolated anti-HBc (positive anti-HBc with negative HBsAg and anti-HBs) found in 0.4% of family members. Mothers and children with 47.6% and 17.2% had the highest and lowest rates of HBV infection, respectively (P=0.00). There was a significant difference between mothers and spouses of index case (47.6% and 29.8%) regarding HBsAg positivity (P=0.03).
    Conclusion
    The low rate of HBV infection reported in children reveal the effective prevention of HBV transmission with the universal vaccination programs and also importance of pregnant women screening for HBV serological markers.
    Keywords: Hepatitis B virus_Intra_familial_Transmission
  • Maryam Alsadat Hashemipour, Fatemeh Sadat Fatah, Mohammad Javad Ashraf, Mehrnaz Tahmasebi Pages 334-344
    Background
    In cancers of prostate, breast, oropharynx, lung, hypopharynx and skin, human tissue kallikreins has been demonstrated as a main role in these problems. There are many research works in which some human tissue kallikreins are expressed in salivary glands. In the present study, the main goal was to determine expression of human tissue kallikreins 4, 8, 10, 11 and 13 in pleomorphic adenomas and mucoepidermoid carcinomas.
    Methods
    Sixty-six specimens (45 cases of pleomorphic adenomas and 21 cases mucoepidermoid carcinomas) were selected for final analysis by immunohistochemistry. For doing association test, clinical parameters obtained from the patients’ medical charts, which included age, gender were used and the nonparametric tests employed for statistical analyses.
    Results
    The expression of human kallikreins 4, 8, 11 and 13 was more prominent in benign and malignant tumors compared to that in normal tissues and the difference was significant. In addition, the expression of human kallikreins 4, 8, 10 and 11 in malignant tumors was more than that in benign tumors, with statistically significant differences.
    Conclusion
    The differences in the levels of human kallikreins 4, 8, 11 and 13 suggest that kallikreins may benefit in determining tumor behavior of salivary gland tumors.
    Keywords: Human kallikreins, Benign, Malignant, Salivary gland tumors
  • Helia Ostad Asadolah, Malayeri, Mojdeh Hakemi, Vala, Kambiz Davari Pages 345-353
    Background
    This study aimed to evaluate the role of efflux pump regulator and OXA-23 genes in imipenem resistance Acinetobacter baumannii strains isolated from hospitalized patients in Tehran, Iran.
    Methods
    This study was conducted on 60 A. baumannii isolates collected from patients admitted to the Shahid Motahari and Taleghani Hospitals in Tehran during 2013-14. Antibiotic susceptibility tests (AST) and minimal inhibitory concentration (MIC) was determined by broth micro dilution methods according to CLSI 2014 guidelines. The frequency of efflux pump adeRS and OXA-23 genes were detected by PCR and further sequencing.
    Results
    The resistance of A. baumannii isolates to tested antibiotics was 100% to cefotaxime, ceftazidime, ceftriaxone, ciprofloxacin, cefepime, piperacillin, meropenem, co-trimoxazole and piperacillin/tazobactam, 97% to imipenem, 94% to gentamicin, 83% to amikacin, 76% to tetracycline, and 0.0% to colistin. The MIC of 58 (96.6%) strains to imipenem was highly decreased in the presence of efflux pump inhibitor (PaβN), by 4 to 64 folds. The adeR and adeS genes were detected in 36 (60%) and 59 (98.3%), respectively and the frequency of OXA-23 gene was 57 (95%) of isolates.
    Conclusion
    Existence of adeRS and OXA-23 genes in more than 50% of A. baumannii isolates in this study shows the presumptiverole of efflux pump in simultaneous of carbapenemase production. Therefore, using new strategies are required in order to stop the vertical or horizontal exchanges mentioned genes from the resistant A. baumannii isolates to sensitive strains.
    Keywords: Acinetobacter baumannii, Antibacterial drug resistance, Efflux pump genes, Carbapenemase, OXA, 23
  • Tahereh Tahmasebi, Rahim Nosrati, Hamed Zare, Horieh Saderi, Reyhaneh Moradi, Parviz Owlia Pages 354-362
    Background
    Glutathione (GSH) is a non-protein thiol compound, which plays an important role in the response to oxidative stress and nutritional stress. The aim of this study was to isolate indigenous S. cerevisiae strains capable of effectively produce GSH.
    Methods
    One hundred-twenty sweet fruit samples were collected. The strains were isolated on yeast glucose chloramphenicol (YGC) agar medium and identified. The isolates were evaluated for GSH producing on yeast malt (YM) medium. Concentration of glutathione was investigated by recording absorbance of all samples at wavelength 412 nm (Ellman’s method). In addition, optimization of glucose and peptone concentration in culture medium and the effects of various environmental conditions such as temperature (20–35 °C), agitation rate (150–250 rpm), and initial pH (4.0–6.0) were assessed on producing of GSH.
    Results
    From 120 samples, 80 isolates were identified by morphological, biochemical and molecular tests as S. cerevisiae. Five isolates were capable to produce effectively GSH. The optimal culture conditions were agitation rate, 200 rpm; temperature, 30 °C; initial pH, 6; glucose, 30 g/l; and peptone concentration, 5 g/l. In optimal conditions, the amount of derived glutathione was improved compared to YM basal medium and highest GSH concentration (296.8 mg/l) was obtained after cultivation with shaking for 72 h.
    Conclusion
    The possibility of obtaining S. cerevisiae cells with a high GSH intracellular content can be considered an interesting opportunity of furthering the range of application and utilization of this molecule.
    Keywords: Glutathione, Saccharomyces cerevisiae, yeast
  • Alireza Abdollahi, Zoreh Nozarian Pages 363-369
    Background
    Accumulation of pleural and peritoneal fluid is seen in some diseases. In order to diagnose the disease and start the treatment, one of the most important actions will be to differentiate between exudates and transudates. The objective of this study was to determine the diagnostic value of measuring the specific gravity of the fluid through refractometer and strip in differentiation of exudates from transudates.
    Methods
    The serum of patients was evaluated for protein, LDH, cholesterol, bilirubin and albumin. The fluid was evaluated for the number of white blood cells, protein, LDH, cholesterol, bilirubin and albumin. Then the fluids were divided into exduate and transudate categories based on Light and Gradient criteria. Finally, the specific gravity of the fluids was measured by refractometer, Erma, Japan and Medi-Test Combi II. The categorized fluids were compared with Gold Standards (final diagnosis) so that the sensitivity and specificity of Light and Gradient criteria in the transudate-exudate differentiation were specified.
    Results
    In comparison with Light criteria, the cut off level of 1022 specific gravity measured by refractometer for pleural effusion has sensitivity, specificity of 92.1%, 68.1%respectively. In evaluation of peritoneal fluid considering cut off point 1023, measured by refractometer has reliable sensitivity 92.4%, specificity 70.4 compared with standard gradient method.
    Conclusion
    Differentiating transudate from exudates by measuring its special gravity by refractometer will have acceptable sensitivity and specificity, and when rapidity is necessary or access to lab equipment is limited, this method could be used.
    Keywords: Specific Gravity, Refractometry, Dipstick, Transudate, Exudate, Pleural, Peritoneal Fluid
  • Hossein Koupahi, Sahar Honarmand Jahromy, Mohammad Rahbar Pages 370-376
    Background
    Methicillin resistant Staphylococcus aureus (MRSA) has been emerged as a nosocomial and community acquired pathogen worldwide. There are many challenges for laboratory detection of MRSA. The aim of this study was to compare different phenotypic methods with PCR based method as a gold standard for detection of mecA gene.
    Methods
    A total of 220 clinical isolates of S. aureus which were isolated from various clinical specimens from September 2013 until the June of 2014 in Milad Hospital of Tehran, Iran was subject of our study. Methicillin resistance was determined by oxacillin and cefoxitin disks, oxacillin screen agar and CHROMagar™ MRSA medium. The results of these methods were compared with mecA gene based PCR method as a gold standard method.
    Results
    Among 220 isolates from S. aureus, 105 (47.72%) isolates were positive for mecA gene by PCR method. The results of cefoxitin disk diffusion method with 100% sensitivity and specificity was the same as PCR method .CHROMagar™ MRSA medium had 98.13% sensitivity and 100% specificity. Oxacillin disk diffusion and oxacillin screen agar had 95.42% and 97.22% sensitivity respectively.
    Conclusion
    Result of cefoxitin disk diffusion method with 100% sensitivity and specificity was the same as PCR method for detection mecA gene. Cefoxitin disk diffusion method can be used as an alternative method of PCR for detection of MRSA.
    Keywords: Staphylococcus aureus, mecA gene, CHOROM Agar MRSA, Oxacillin screen Agar, Methicillin Resistant
  • Mohammed Chaloob, Alaa G. Hussein, Ban Qasim Pages 377-390
    Background
    This research was accomplished to evaluate the IHC expression of p16 (ink4a) and CK17 in low grade cervical intraepithelial lesions (LSIL), high grade cervical intraepithelial lesions (HSIL) and invasive cervical carcinomas and to assess their correlation to HPV (16E6ퟁ).
    Methods
    The study included (127) formalin-fixed paraffin-embedded cervical biopsies; of which 22 cases were chronic cervicitis, 24 cases were LSIL, 28 cases were HSIL and 53 cases were invasive cervical carcinomas. Sections were immunohistochemically stained for p16 (ink4a), CK17 and HPV (16E6ퟁ).
    Results
    The study established a highly significant increase in IHC of expression of p16 (ink4a), CK17 and HPV (16E6ퟁ) from LSIL through HSIL to invasive carcinomas (P-value˂0.001). There was non-significant association between IHC expression of all makers with age of patients; types, grade and stage of cervical carcinomas (P-value˃0.05). HPV (16E6ퟁ) revealed a significantly positive correlation with p16 (ink4a) (P-value˂0.05) and a non- significant correlation with CK17 (P-value˃0.05); in LSIL, HSIL and invasive carcinoma cases.
    Conclusion
    p16 (ink4a) expression directly reflects infection with high risk HPV in cervical lesions and can add a significant diagnostic accuracy in the evaluation of CIN. CK 17 is a good marker of malignant transformation, with increasing in its expression according to the severity of cervical lesions; however, it is not related to HPV infection. Both markers are not related to prognostic variables of patients with cervical carcinoma.
    Keywords: LSIL, HSIL, cervical carcinoma, p16 (ink4a), CK17, HPV(16E6+18E6)
  • Mojtaba Mojtahedzadeh, Farhad Etezadi, Javad Motaharinia, Alireza Abdollahi, Abdorasul Mehrsai, Shadi Ziaie, Soheil Saadat Pages 391-398
    Background
    Delayed graft function is a main complication after deceased donor kidney transplantation that adversely affects graft outcome. Difficulties in prediction and early detection of delayed graft function have hindered the ability to perform proper therapeutic interventions. We investigated whether measuring urinary interleukin 18 and neutrophil gelatinase-associated lipocalin as markers of ischemia reperfusion injury could predict delayed graft function in deceased donor kidney transplant patients.
    Methods
    We studied 69 patients undergoing kidney transplantation from deceased donor during early October 2013 to December 2014 at the Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Serial urine samples at 2, 24, and 48 h after transplantation were analyzed for interleukin 18 and neutrophil gelatinase-associated lipocalin levels.
    Results
    Thirteen patients (18.9%) developed delayed graft function. Urine interleukin 18 to urine creatinine ratio was significantly higher in patients with delayed graft function compared to those with non-delayed graft function, at 2 (P=0.003), 24 (P
    Conclusion
    Urinary interleukin 18 to urine creatinine ratio at 24 h post-transplantation, along with traditional markers such as relative fall in serum creatinine, urine output and other risk factors for delayed graft function, increased the ability to predict delayed graft function.
    Keywords: Kidney transplantation, Deceased donor, Delayed graft function, Interleukin 18, Neutrophil gelatinase, associated lipocalin
  • Eva Ruvalcaba, Limon, Josefina Jimenez, Lopez, Veronica Bautista, Pina, Julio Ramirez, Bollas, Flavia Moralesv., Aacute, Squez, Carlos Dom, Iacute, Nguez, Reyes, Antonio Maffuz, Aziz, Sergio Rodriguez, Cuevas Pages 399-408
    Background
    Phyllodes tumor (PT) of the breast in Hispanic patients is more frequently reported with large tumors and with more borderline/malignant subtypes compared with other populations. The objective of this study was to describe characteristics of patients with PT and to identify differences among subtypes in a Mexican population.
    Methods
    A retrospective study was conducted on patients with PT. Sociodemographic, histopathologic, and treatment characteristics were compared among subtypes, including only surgically treated cases due the complete surgical-specimen study requirement for appropriate WHO classification.
    Results
    During 10 years, 346 PT were diagnosed; only 307 were included (305 patients), with a mean age of 41.7 yr. Self-detected lump took place in 91.8%, usually discovered 6 months previously, with median tumor size of 4.5 cm. Local wide excisions were done in 213 (69.8%) and mastectomies in 92 (30.1%). Immediate breast reconstruction took place in 38% and oncoplastic procedures in 23%. PT were classified as benign in 222 (72.3%) cases, borderline in 50 (16.2%), and malignant in 35 (11.4%), with pathological tumor size of 4.2, 5.4, and 8.7 cm, respectively (P
    Conclusion
    In comparison with other Hispanic publications, these Mexican patients had similar age, with smaller tumors, modestly higher benign PT, fewer malignant PT, and lower documented relapse cases.
    Keywords: Breast tumors, Fibroepithelial neoplasms, Phyllodes tumor
  • Nasser Rakhshani, Mohammadreza Araste, Farid Imanzade, Mahshid Panahi, Fahimeh Safarnezhad Tameshkel, Masoud Reza Sohrabi, Mohammad Hadi Karbalaie Niya, Farhad Zamani Pages 409-415
    Background
    Hirschsprung disease is a complex genetic disorder of the enteric nervous system (ENS), often called congenital aganglionic megacolon and characterized by the absence of enteric neurons along a variable length of the intestine. The definitive diagnosis of Hirschsprung disease relies on histologic and/or histochemical staining of sections from suction rectal biopsies. Calretinin immunohistochemistry (IHC) may be a useful in its diagnosis. This study aimed to proof the usefulness of immunohistochemical staining for calretinin in rule out of Hirschsprung disease.
    Methods
    Paraffin blocks and slides were retrieved from the pathology archives of Ali Asghar Hospital, Tehran, Iran from 2007 to 2011 with pathology report based on the presence (14 patients) or absence (70 patients) of ganglion cells and transitional zone anatomical region (10 patients). Slides were stained with hematoxylin and eosin method to confirm the initial diagnosis was verification again. After preparing the slides, they were stained by IHC for calretinin. Then, the results were analyzed using SPSS software.
    Results
    In most patients, IHC for calretinin provided highly compatible results with hematoxylin-eosin findings in diagnosis of Hirschsprung disease. The values of specificity and accuracy between calretinin and standard histology (H&E) compared by the Fisher exact test declared calretinin presented significantly higher specificity and accuracy values than H&E staining (P
    Conclusion
    Calretinin IHC overcomes most of the difficulties encountered using the histology hematoxylin-eosin. Then, IHC for calretinin is a good ancillary method used by pathologists in diagnosis of Hirschsprung disease.
    Keywords: Hirschsprung disease, Calretinin, Immunohistochemistry, ganglion cell, intrinsic nerve fibers
  • Antonio An Tung Chuh, Vijay Zawar, Gayatri Karad Pages 416-417
    Lesional histopathological features in pityriasis rosea (PR) are non-specific (1). Our aim here is to investigate whether a histopathological take-off sign (TOS) is associated with PR.
    Keywords: acrally, distributed pityriasis rosea, actinic pityriasis rosea, paraviral exanthem, pityriasis rosea of Vidal, viral exanthem
  • Manas Bajpai, Manika Arora, Betina Chandolia Pages 418-420
    Pilomatrixoma is a benign tumor of hair follicle first described as calcifying epithelium (1). It accounts for 1% of all the benign skin tumors (2). It is a slow-growing, firm, dermal or subcutaneous neoplasm, usually measuring fewer than 3 cm in diameter. Pilomatricomas are considered benign; rarely recur after surgical excision (3). However, cases of pilomatrixoma with local recurrence and local invasiveness have been reported in the literature.
    Keywords: Pilomatrixoma, calcifying epithelioma of malherbe, parotid space, salivary gland tumor
  • Manveen Kaur, Koushik Kar, Varsha Dalal, Fouzia Siraj Pages 421-422
    A 28 yr male was presented in October 2015 at Medicine Outpatient Department, Safdarjung Hospital, New Delhi- India with generalized weakness, fever and cough for preceding 15 days. Clinicoradiologic examination revealed pallor, firm, non-tender splenomegaly measuring 13.7 cm and hepatomegaly (liver span - 16.9 cm). However, no lymphadenopathy was found.
    Keywords: hairy cell, leukemia, young