Iranian Journal Of Pathology
Volume:8 Issue: 2, Spring 2013

Tuberculosis is one of the greatest health problems in Iran. The distribution of the disease is not equal in all parts of the country. The aim of this study was to evaluate the frequency of positive results for Mycobacterium tuberculosis in samples referred to an academic hospital in an 8 year period. The samples from different wards of Qaem Hospital, Mashhad and samples referred to Outpatient Clinic during the years 2001-2008 and 75 samples from the prison in the same period were analyzed with direct microscopy of smear and culture methods for M. tuberculosis. Basic descriptive statistics were performed using SPSS 11.5 software. A total 26817 samples were analyzed and the results showed that the frequency of Mycobacterium positive samples in hospitalized patients’ samples was 2412 (9%) with microscopy and 1573 (6%) with culture method. In the outpatients, it was 897 (10.2%) and 417 (4.7%) with microscopy and culture methods, respectively. Form 75 samples from the prison, 9 (12%) were positive with microscopy method. Culture method yielded only one (1.3%) positive result in these samples. The frequency of M. tuberculosis was relatively high in the study groups. Therefore it seems continues surveillance is essential to monitor the M. tuberculosis in hospitals and community.

Opportunistic infections are the leading cause of death among patients subjected to the human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS). The aim of this study was to compare the seroprevalence of Cytomegalovirus (CMV) and toxoplasmosis infection in newly diagnosed HIV infected patients with healthy controls and it’s correlation with CD4+ cell counts (CD4+). A case controlled study was carried out to investigate CMV and toxoplasmosis serology among newly diagnosed HIV infected patients referred to University affiliated hospital in Tehran and compared them to healthy subjects as control. A total of 100 HIV positive patients and 100 healthy controls were recruited. Clinical characteristics and CD4+ cell counts were evaluated. The statistical package SPSS 17 for windows was used for analysis. Patients with HIV infection had a significantly higher positive serology for CMV than healthy controls (100% vs. 93% p<0.05). There was no significant difference between HIV positive and HIV negative patients in terms of toxoplasmosis serology. There was no significant difference between males and females with respect to CMV or toxoplasmosis serology. CMV and toxoplasmosis infection are highly prevalent among HIV infected patients and also healthy controls, with a higher seropositive rate of CMV in HIV cases.

Since it is essential for the research policy makers to acquire knowledge about the global ranks of their countries in in Pathology and Forensic Medicine subject areas, scientometrics experts have been always ranking and analyzing countries on the basis of ‘total number of papers’, ‘total number of citations’ and ‘citations per paper’, etc. The data in SCImago has been used to analyze and evaluate the global ranks of Iran, Turkey, Saudi Arabia, India, Pakistan, South Korea and South Africa. These countries had a similar growth trend in many indicators of science and technology in the past. This article mainly deals with the extent of presence of these countries in Pathology and Forensic Medicine subject areas, their international global ranks and comparing them with each other. Furthermore, data show that these countries had a different situation considering “citations per Document”; because it did not match with their “number of Document” and “total number of citations” to their papers and did not increase accordingly. “Citations per Document” is considered as one of the most important indicators which show the average number of citations to each document. The situation of Iran under the study seemed to be better in some areas such as ‘Cite per Documents’ than their situation in other areas; however, this point should be taken into consideration that they did not have an equal presence in all areas.

Abdominal cutaneous and subcutaneous nodules are uncommon lesions which may be benign or malignant. Majority of the malignant nodules are metastatic in origin and may be the initial presentation of primary malignancy, hence an early diagnosis is important. Our aim was to find out the spectrum of lesions (both non-neoplastic and neoplastic) that present as cutaneous and subcutaneous abdominal wall nodules and to assess the efficacy of fine needle aspiration cytology (FNAC) in early diagnosis of all such lesions so that need for histopathology can be minimized. The study was conducted on 46 patients of all age groups, presenting with various palpable cutaneous and subcutaneous abdominal wall nodules. FNAC was performed, smears stained with May Grunwald- Giemsa stain and Pap stains. Special stains were applied wherever required. Cytological diagnosis was subsequently correlated with histopathological diagnosis. Out of 46 FNAC cases; there were 13 non-neoplastic lesions, 15 benign neoplasms and 17 malignant lesions. One case was inadequate for opinion that on histopathology turned out to be metastatic deposits from renal cell carcinoma. The rate of unsatisfactory FNAC was 2.2% and the sensitivity was 89.47%. The specificity and positive predictive value was 100%. FNAC is a simple, minimally invasive, highly accurate and cost effective technique for quick diagnosis of malignant metastatic abdominal wall nodules, thus minimising the need for histopathology and for deciding mode of treatment

Failure to thrive (FTT) is a sign that describes a particular problem rather than a diagnosis and explain growth failure or more advanced failure to gain weight appropriately. The aim of this study was to determine the prevalence and type of chromosomal abnormalities in patients presented with FTT. One hundred FTT cases with clinical impression of having chromosomal abnormality referred for cytogenetic study during a period of 5 years (2007-2011) with age range from 5 month to 15 years. Chromosomal analysis was carried out for them. The standard protocol for peripheral blood lymphocyte culture was followed by metaphase chromosome preparation and conventional analysis of G-banded chromosomes. All analyses were performed using the SPSS soft ware package, version 18 Fifteen cases showed karyotypic abnormality. The most common karyotype abnormality was aneuploidy resulted from monosomy of the chromosome X in girls. Turner syndrome with various forms of chromosomal complement is the most common chromosomal abnormality causing growth failure in girls.

The endometrial stromal nodule is a benign tumor composed of differentiated endometrial stromal cells arranged as a well circumscribed nodule with smooth non-invasive margins. They are rare neoplasms, diagnosed in most instances by microscopy. Although nodules are benign in nature, hysterectomy is the treatment of choice to enable evaluation of the tumor margins which are well demarcated in endometrial stromal nodule and infiltrative in low grade endometrial stromal sarcoma. We present here a case of a 46 year old female with history of menorrhagia and a preoperative clinical diagnosis of uterine leiomyoma followed by a definitive diagnosis of endometrial stromal nodule. Experience with endometrial stromal nodule is limited, hence we emphasize on the fact that these are rare and benign tumours which should be distinguished from other invasive malignant stromal tumors with a more sinister prognostic course.

There are few reported cases of endobronchial metastasis of pheochromocytoma in pathology literature. We present here a 56-year old woman who underwent left lower lobectomy of lung, following pneumonia with unresolved chest radiographs. Computed tomography showed a lobulated soft tissue mass, measuring, 38×27 mm, at the perivascular space of anterior mediastinum. The resected specimen, showed lobulated tumor arranged in nesting pattern within arcuate vascular network. Immunohistochemistry showed intense positive staining of epitheloid cell (chief cells) for chromogranin and synaptophysin which were negative for cytokeratin. Sustentacular cells were strongly positive for S-100. Although very rare, physicians should keep in mind the possibility of endobronchial metastasis in patients with a history of pheochromocytoma.

Ewing’s sarcoma (ES) is a highly malignant neoplasm of childhood and adolescence seen commonly in both axial and appendicular skeleton but uncommonly in acral region. Ewing’s tumor in the hand is extraordinarily rare. Radiological features are variable and can mimic other common lesions. We present a case of 13 year old female, with complaints of pain and swelling in right hand, which on X-ray showed periosteal reaction, giving a sun burst appearance and provisional diagnosis of osteosarcoma was made. The patient was operated and histopathological diagnosis of ES was confirmed. Histopathological examination remains the mainstay of diagnosis, supported by immunochemistry and cytogenetic studies. Surgical extirpation with chemotherapy is the therapeutic regimen of choice. We intend to report this case, because it is very rare location and the radiological features can mimic other lesions which commonly occur in this location like chronic osteomyelitis so it can be easily missed especially at preliminary evaluations.

Primitive neuroectodermal tumor (PNET) is an uncommon malignancy of bone and soft tissue witch rarely occurs in the kidney. In more than 90% of the cases, the tumor cells relieves a balanced translocation (11; 22) (q24; q12). Immunohistochemical staining may be required for diagnosis of PNET. The cells of tumor express CD99, vimentin, NSE, FL1 but do not express Ck, LCA, myogenin, and WT1. We present a 36-year –old female with left –side tender abdominal swelling, and history of trauma to abdominal. CT imaging confirmed a huge solid mass of kidney, also extending into renal pelvis. Histological section of the lesion showed a malignant proliferation of small round cells in rosette-like pattern with foci of necrosis area. Tumor cells expressed high level of CD 99 antigen. The diagnosis of the lesion was primitive neuroectodermal tumors (PNET). Following-up after 6 months showed no recurrence

Endometrial calcification along with ossification is an uncommon clinical entity. Most of the cases are asymptomatic or present with secondary infertility. Endometrial ossification associated with repeated abortions has been reported very infrequently. Here we report a case of endometrial calcification with ossification due to retained fetal bony tissue in a 38 year old symptomatic female having previous history of two abortions. This case highlights the importance of detailed clinical history, ultrasonographic and endometrial evaluation along with histopathological examination in a patient having repeated abortions. It also emphasizes the need to consider endometrial tuberculosis in the differential diagnosis of endometrial calcification and subsequent ossification especially in areas where tuberculosis is rampant.

In 1991, Handlers and colleagues described the Central odontogenic fibroma (COF) as a distinct entity which is a rare benign odontogenic tumour and up to the present, only 78 cases of it have been published. COF usually occurs in an adult patient and has a predilection for the anterior region of the jaws. A 2.8:1 female to mail ratio is typically noted. This article presents a case of COF in a 50-year-old male in the right side of mandible and discuss about the clinic pathological find-. ings, radiographic feature, differential diagnosis, as well as surgical technique of the COF