فهرست مطالب

Iranian Journal Of Pathology
Volume:4 Issue: 4, Autumn 2009

  • تاریخ انتشار: 1388/06/11
  • تعداد عناوین: 12
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  • Mohammad Rakhshan, Azadeh Rakhshan Page 147
    of diagnosis in palpable masses of various sites. This study was conducted to evaluate the usefulness of FNAC as a diagnostic tool in the management of patients with cervical lymphadenopathy.Patients and
    Methods
    Totally 178 patients admitted to Loghman-Hakim Hospital, Tehran,Iran, with cervical masses, were included in this study. They had undergone FNA and subsequently excisional biopsy of the same neck mass in which a lymphoid tissue lesion had been established.
    Results
    Reactive lymphadenitis, metastatic neoplasm, Hodgkin’s lymphoma, and non-Hodgkin’slymphoma constituted 59.6%, 17.9%, 14.6% and 7.8% of total cases, respectively. In 27 cases(15.2%), the FNA findings were nondiagnostic. Diagnostic accuracy of FNAC was about 88%.Sensitivity, specificity, positive and negative predictive values were 75.8%, 96.6%, 94% and 85.1%,respectively.
    Conclusion
    FNAC has a high accuracy in the diagnosis of malignancies of cervical lymph nodes,but due to the existance of false negative cases, the benign results should be further evaluated if highclinical suspicion of malignancy exists.
  • Mohsen Mirzaee, Parviz Owlia, Mohammad Reza Mehrabi, Amir Gharib Page 151
    Background And Objectives
    The most common problems limiting the medical use of aminoglycosides have been the nephro- and oto-toxicities as well as the increasing bacterial resistance.Encapsulation of drugs into liposomes enhances their efficacy while reducing their toxicities. Theaim of this study was to evaluate the antimicrobial activity of free and liposomal amikacin.
    Material And Methods
    Encapsulated amikacin into liposome was prepared by sonication. Thedrug contained in the liposome was measured by HPLC after lysis of vesicles by 0.2% Triton X-100.The amikacin kinetic released from liposomes in the presence of normal human pooled plasma was also evaluated. The MICs of this drug for Pseudomonas. aeruginosa (ATCC 27853), Escherichia. coli (ATCC 25922), Streptococcus. faecalis (ATCC 29212) and Staphylococcus. aureus (ATCC 29213)were determined and compared to those of the respective free drug using a broth dilution method.
    Results
    In the presence of plasma, liposomal retention of amikacin was 80.25 ± 0.55% (P ≤ 0.05)after 1 h of incubation and then remained nearly constant over a 24 h period of the study. The encapsulation efficiency of liposomal preparation was 24.36% ± 0.14 (P ≤ 0.05) of the initial amount of the drug in solution. The MICs of liposomal amikacin against all bacterial strains tested were lower than MICs of free amikacin.
    Conclusion
    The amikacin appears a promising approach in the management of bacterialinfections and should be further evaluated in vivo experiments.
  • Ahmad Talebian, Zarichehr Vakili, Safar Ali Talar, Seyede Mahbobeh Kazemi, Gholam Abbas Mousavi Page 157
    Background And Objectives
    Febrile convulsion is one of the most common types of seizure inchildhood. Its pathogenesis is unknown, so studying its cause is valuable. The purpose of this study was to determine the serum level of zinc and magnesium in children with febrile convulsion (F.C)(3 months to 6 years age).Patients and
    Methods
    In this analytical case-control study, serum level of zinc and magnesium in 60 children with F.C in Shahid Beheshty Hospital of Kashan, center of Iran, was determined. Thecontrol group was composed of febrile children with no seizure. All children in both groups were 3 months to 6 yr of age and had not any background of disorders. Serum level of zinc & magnesium was determined by biochemical methods in all groups. Finally, the data were analyzed by SPSS and t test.
    Results
    The mean serum level of zinc and magnesium in case group, was lower than that of zinc & magnesium in control group (P<0.05). There was no relationship between sex, type and time of seizure with serum level of zinc or magnesium in children in case group.
    Conclusion
    There was a relationship between serum level of zinc & magnesium and the presence of F.C in children. So, it is suggested to use supplements of zinc and magnesium in diet of affected children for prophylaxis of febrile seizure recurrences.
  • Authors: Horieh Saderi, Parviz Owlia, Maryam Eslami Page 161
    Background And Objectives
    Staphylococcus aureus is an important cause of nosocomial and community-acquired infections in every region of the world. Clindamycin is one of the alternativeagents used to treat S. aureus infections and accurate identification of clindamycin resistance is important to prevent therapeutic failure. Unfortunately, inducible clindamycin resistance is not detected by standard susceptibility tests. This study aimed to determine the prevalence of the macrolides-lincosamides-streptogramins B (MLSB) resistance in S. aureus isolated in four university hospitals in Tehran, Iran.
    Material and Methods
    Two hundreds and forty-four non-duplicate clinical isolates of S. aureus [133 methicillin resistant S. aureus (MRSA) and 111 methicillin susceptible (MSSA) S. aureus] were collected in 2008. Antimicrobial susceptibilities were determined by the D-test.
    Results
    Altogether, 68% and 61.1% of isolates were resistant to erythromycin and clindamycin,respectively; with higher resistance in MRSA isolates compared to MSSA isolates. The constitutive MLSB (cMLSB) resistance phenotype was recognized in 61.1%, while 5.3% had shown inducible MLSB (iMLSB) resistance phenotype. Constitutive MLSB resistance phenotype predominated over inducible MLSB resistance phenotype and susceptible phenotype (83.9, 9.3 and 6.8%, respectively) among the MRSA isolates, whereas susceptible phenotype predominated over constitutive MLSB resistance phenotype and inducible MLSB resistance phenotype (62.6, 31.3 and 2%, respectively)among the MSSA isolates.
    Conclusion
    Considering the higher prevalence of clindamycin resistance in MRSA isolates compared MSSA isolates, routine D-test of MRSA isolates is strongly recommended to prevent treatment failure.
  • Nasrin Shayanfar, Shahriar Zohourian Shahzadi Page 167
    Background And Objective
    Neuroendocrine differentiation has not been proved to have effectsin behavior of colorectal carcinomas. The aim of this study was Immunohistochemical evaluation ofneuroendocrine differentiation in colorectal cancer.Patients and
    Methods
    In this cross-sectional study, 83 paraffin blocks from patients admittedin Rasoul-e-akram Hospital, Tehran, Iran, during 2003 to 2008, were evaluated in PathologyDepartment. All sections were stained with immunohistochemistry method for neuron specificenolase (NSE) and Chromogranin A(CgA). Data were analyzed using SPSS 12.0.
    Results
    Median age of patients was 56 yr. Forty four cases (53%) were female. According toTNM staging system, 11% of cases were in stage I, 29% in IIa, 7% in IIb, 2% in IIIa, 23% in IIIb,24% IIIc and 2% were in stage IV. Thirteen cases (16%) were NSE positive, 15 cases (18.1%)were CgA positive. Two, 8 and 5 percent of the patients in grade I, II and III were CgA positive,respectively. Two, 6 and 5 percent of the patients in grade I, II and III were NSE positive. In gradesII and III, NSE and CgA were significantly higher than grade I (P<0.001). CgA incidence washigher significantly in mucinous carcinomas (P<0.05).
    Conclusion
    Less than 20% of colorectal cancers showed neuroendocrine differentiation. Therewas no significant relationship between NSE and CgA incidence with stage or tumor site. There wasa relationship between histologic grade and above-mentioned markers; this finding may help us inour knowledge about tumor behavior.
  • Zohreh Yousefi, Nourieh Sharifi, Farnoosh Sadatmand, Soodabeh Shaid Salles Page 172
    Background And Objective
    Histopathological evaluation of granulosa cell tumors (GCT) of the ovary may be confused morphologically with a wide variety of the tumors. Immunohistochemical staining for inhibin and calretinin can be used for better diagnosis. Although it has been suggested that inhibin can be a sensitive marker for GCT, it maybe had negative results in some cases. In addition, caltrinin has been proposed as a marker for GCT. The aim of this study was to investigate the immunohistochemical methods (IHC) including a comparison of calretinin and inhibin markers in the diagnosis of these tumors.Patients and
    Methods
    This prospective study carried out from 2000 to 2009 at Ghaem and Omid hospitals, Mashad University of Medical Sciences, Iran. A total of 23 ovarian GCT specimens were immunostained with commercially available antibodies to find out calretinin and inhibin immunoreactivity. Data were analyzed by descriptive statistical method. A P value of =<0.05 was considered significant.
    Results
    For diagnosing GCT, the sensitivity of calretinin was 100% and that of the inhibin was almost 73.9%. The extent and severity of staining was more extensive for calretinin compared to inhibin P<0.001.
    Conclusion
    Calretinin is a more sensitive biomarker for GCT than inhibin.
  • Pezhman Fard, Esfahani, Peyman Mohammadi, Torbati Page 177
    Background And Objectives
    Making stacking gels for polyacrylamide gels in the laboratory by conventional methods is laborious and time consuming. Considering the role of temperature in polyacrylamide gels with respect to electrical resistance and viscosity, we assumed that decreasing the temperature would cause an increase in electrical resistance and viscosity. Ultimately, a downward temperature gradient imposed in the first phase of polyacrylamide gel running time would supposedly improve the migration of macromolecules. This project analyzed the effect of temperature gradient on the migration of macromolecules in the continuous gels (without stacking)and compared it with results obtained using stacking gels.
    Material And Methods
    Electrical resistance was calculated using Ohm’s law. Subsequently, to examine the effect of temperature change on macromolecules separation, conformation sensitive gel electrophoresis (CSGE) was used as a model and specimens were run under three different conditions, one of which was prepared with a stacking gel.
    Results
    The electrical resistance showed an inverse relationship with temperature in this study.Separation of the DNA molecules in the continuous gels (with no stacking) was comparable with the conventional method (with stacking).
    Conclusion
    Using a temperature gradient against time may be an alternative method for stacking gels.
  • Shirin Niroumanesh, Fatemeh Mirzaei Page 182
    Background And Objectives
    The diagnosis of pregnancy associated adnexal masses is rising due to routine utilization of sonography in prenatal care. The purpose of this study was to describe pregnancy associated adnexal masses over a period of 10 years.Patients and
    Methods
    A retrospective study was reviewed hospital records of all pregnant women with adnexal mass that underwent surgical resection in Mirza Kuchak Khan Hospital in Tehran from January 1996 to March 2006. The collected data included maternal age, parity, gestational age at diagnosis, surgery and delivery, presenting symptoms and treatment. The pregnancy outcome complications and histological findings were reviewed.
    Results
    Totally 29220 deliveries were performed in our institution; adnexal masses were detected in 0.01% of pregnancies. Antepartum surgery was performed in 4 (10.3%) patients. The mean gestational age at delivery in patients undergoing surgery during pregnancy was 36 weeks (ranged 3637- weeks) while in patients with cystectomy during cesarean delivery was 38 weeks (range: 33- 40) (P=0.04). There were no statistically significant differences in birth weight between the patients undergoing surgery during pregnancy and those with surgery at cesarean delivery (P=0.176). Themean cyst diameter was 11 cm (range 416- cm) for patients operated during pregnancy while it was 4 cm (2.512- cm) for those undergoing surgery during cesarean delivery (P=0.006). The most common diagnosis was benign serous cyst (23.1%) followed by benign Dermoid cyst (20.5%).
    Conclusion
    Patients undergoing laparotomy for adnexal mass during pregnancy had higher risk of preterm labor but there were no difference in birth weight.
  • Farid Kosari, Hedieh Moradi Tabriz, Sanaz Saniee Page 186
    In Riedel’s thyroiditis, a rare chronic inflammatory disease of thyroid gland, fine needle aspirationis usually non-diagnostic because most often only follicular cells are obtained and not the fibrousmaterial characteristic of this type of thyroiditis. Therefore the diagnosis is often only establishedby histopathologic study of the surgically obtained biopsy. The illustrated case is a 46-year-oldfemale who presented with a firm, non-mobile thyroid nodule of the left lobe. Fine needle aspirationwas performed, demonstrating fragments of fibrous tissue and few inflammatory cells includingneutrophils and lymphocytes, findings that could be representative of Riedel’s thyroiditis. Frozensection examination during subsequent surgery and later histopathologic study confirmed thediagnosis. Fine needle aspiration of the thyroid, if successfully done, could be highly suggestive forRiedel’s thyroiditis.
  • Afsaneh Rajabiani, Hossein Vakili Page 190
    Primary fallopian tube carcinoma is a rare tumor that histologically and clinically resemblesepithelial ovarian cancer. Here we introduce a case of tubal carcinoma in a postmenopausal woman.The diagnosis of primary fallopian tube carcinoma is rarely considered preoperatively and is usually first appreciated by the pathologist. Because of low frequency of tubal carcinoma, there are few systemic pathological reports of its mode and extent of spread. Surgical staging and management as the use of chemotherapy follow the concepts used in epithelial ovarian cancer. In contrast to epithelial ovarian cancer, it is the importance of early lymphatic spread in this disease. The earlier diagnosis of primary fallopian tube carcinoma leads to an apparent better survival compared with its ovarian counterpart. However, as with epithelial ovarian carcinoma, stage and residual tumor are the most important prognostic variables. Only with more extensive clinical researches, ovarian carcinoma management principles should be used in clinical practice of this tumor.
  • Behrang Kazeminejad, Ali Zare Mirzaie, Majid Gholipour Peinavandi Page 194
    Primary leiomyosarcoma of the heart is extremely rare and found in about 0.2% of all cardiac tumors. Here in a 26-year-old man with progressive dyspnea, which had started since 2 months ago, is presented. Echocardiography revealed a left atrial mass, which was suggestive for a atrial myxoma.On the surgery, a tumoral tissue in the left atrium and pulmonary veins with attachment to peripheral soft tissue, was seen and incompletely resected. Histologic examination exhibited a hypercellular,necrotic and mitotically active spindle-celled tumor with fascicular arrangement.Immunohistochemistry showed a positive reaction to SMA in tumoral cells. The patient was advised to refer for postoperative chemotherapy, which was rejected. One year later, the patient was brought to hospital with tumor recurrence. Chemotherapy was initiated for the patient immediately, but the patient was expired 3 days later.