فهرست مطالب

  • Volume:15 Issue:1, 2020
  • تاریخ انتشار: 1398/10/29
  • تعداد عناوین: 12
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  • Mitra Rezaei *, Sandra Refoua, Najme Esfandiari, Masoud Shamaei Pages 1-7
    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.

    Keywords: Aberrant phenotype, Acute lymphoblastic leukemia, flow cytometry, Immunophenotyping
  • Masoumeh Shafiei, Ahmad Mafi, Yalda Nilipour, Ainaz Sourati, Pegah Sasanpour, Morteza Tabatabaeefar * Pages 8-12
    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.

    Keywords: Gliomas, Estrogen receptor alpha, Estrogen receptor beta, Brain tumor grade
  • Maryam Kadivar, Fatemeh Aram * Pages 13-18
    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.

    Keywords: Breast, Carcinoma, Ductal, Immunohistochemistry
  • Nasrin Sereshki, Alireza Andalib, Ataollah Ghahiri, Ferdos Mehrabian, Roya Sherkat, Abbas Rezaei * Pages 19-22
    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.

    Keywords: Polymorphic HLA class Ⅰ, Ⅱ, Spermatozoa, Unexplained recurrent spontaneous abortion
  • Sakineh Zinati, Saeed Ebrahim Shakiba, Ziba Rahimi, Mona Akbari, Fariba Najafi, Fariborz Bahrehmand, Asad Vaisi Raygani, Zohreh Rahimi *, Ali Ebrahimi, Mehrali Rahimi Pages 23-29
    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.

    Keywords: Acne vulgaris, Methylenetetrahydrofolate reductase, Insulin-like growth factor-1, Insulin, Homeostasis model assessment
  • Amir Hossein Jafarian, Nema Mohammadian Roshan, Hossein Ayatollahi, Abbas Ali Omidi, Masoumeh Ghaznavi, Masoumeh Gharib * Pages 30-33
    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.

    Keywords: Idiopathic pulmonary fibrosis, Epstein - Barr virus, Human herpesvirus 8, Polymerase chain reaction
  • Shaghayegh Arabi, Mostafa Moghadam, Vida Maleki, Ali Akbar Pourfatholah, Afsaneh Aghaie * Pages 34-40
    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.

    Keywords: Dangerous O, Iso-antibody, Immune response, High responder donors
  • Nilay Nishith *, Monika Gupta, Nidhi Kaushik, Rajeev Sen Pages 41-44
    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.
    Keywords: Diagnosis, Immunohistochemistry, Prognosis, Prostate, Solitary Fibrous Tumor
  • Hiva Saffar *, Atieh Khorsand Rahimzadeh, Morteza Faghihjouibari, Seyed Mohammad Tavangar Pages 45-47

    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.

    Keywords: Adolescent, Spinal cord, Teratoma
  • Fatemeh Samiee Rad *, Sohayla Farajee Pages 48-52
    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.
    Keywords: Extramammary Paget´s disease, Intraepithelial neoplasia, Vulve
  • Elham Jafari, Hamid Tabrizchi, Foroogh Mangeli * Pages 53-56
    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.
    Keywords: Head, neck neoplasms, Carotid body tumor, Neuroendocrine tumor
  • Sushma Bharti, Gautam Ram Choudhary, Jyotsna Naresh Bharti *, Garg Pawan Kumar, Arsha BS, Poonam Abhay Elhence Pages 57-61

    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.

    Keywords: Chromophobe, Renal cell carcinoma, Sarcomatoid, Kidney neoplasms, Cell Differentiation