فهرست مطالب

Pathology - Volume:12 Issue: 1, Winter 2017

Iranian Journal Of Pathology
Volume:12 Issue: 1, Winter 2017

  • تاریخ انتشار: 1396/01/30
  • تعداد عناوین: 12
|
  • Bita Geramizadeh, Mahsa Marzban, David Owen Pages 1-8
    Background
    Routine screening colonoscopy is on the rise and pathologists have to deal with the ever larger numbers of excised colonic polyps. It is very important to optimize the patients’ individual treatment and further surveillance. Pathologists play a critical role in management, as most of the clinical decisions concerning colonic polyp management are based on pathologic findings. One of the most important clinical issues in colonic adenomas is the diagnosis of malignancy and reporting its different aspects by the pathologist. The histologic type and the extent of carcinoma within a malignant polyp have considerable impact on the decisions of gastroenterologists and surgeons for further management. Therefore, the most recent literature regarding the diagnosis and reporting of the different features of malignant polyps was reviewed.
    Data Acquisition: There is growing literature regarding the different pathologic features and reporting of malignant colonic polyps, and in this review, published articles that are listed on Google Scholar and Pub Med are discussed.
    Conclusion
    Diagnosis of malignant colon polyp requires the presence of tumor cells that are penetrating beyond the muscular mucosa into submucosa (pT1). As well as establishing a diagnosis of malignant polyp, it is very important to report the size of the invasive component, the presence or absence of lymphovascular invasion, the degree of tumor differentiation and the distance of the carcinoma from the line of resection. Other important features that may be reported include: the presence or absence of tumor budding, the depth of tumor cell penetration into the submucosa, and results of immunohistochemistry for mismatch repair proteins and BRAF.
    Keywords: Adenomatous polyp, Malignant, Colon
  • Zaidoon A. Musa, Ban J. Qasim, A.Wahab A.K. Al Shaikhly Pages 9-19
    Background And Objective
    Determination of HER2 gene is crucial in breast carcinoma management and prognosis, as HER2 alterations are linked to a shorter disease-free period, overall survival and resistance to tamoxifen anti-estrogen therapy and other chemotherapy regimens, regardless of the nodal or hormone receptor status. This study aimed to estimate HER2 gene status of infiltrative mammary cancer cases with immunohistochemically equivocal (2) score using Silver DNA in Situ Hybridization(SISH) technique and to investigate its association with clinicopathological variables.
    Methods
    The study included 52 formalin-fixed paraffin embedded tissue blocks from female patients with invasive breast carcinoma with score of 2 (equivocal) HER2 immunohistochemistry. All cases were studied by silver DNA in situ hybridization technique (SISH) for the determination of the amplified HER2 DNA.
    Results
    TheSISH technique showed that HER2 gene was not amplified in 33 cases out of 52 (63.5%); while the rest of 19 cases (36.5%) revealed amplified gene status.According to age, HER2 gene status reported non-significant difference in the age groups between cases with amplified and non-amplified gene status (P=0.173). There was a significant negative association between positive Estrogen (ER) and Progesterone (PR) status and HER2 gene amplification (P= 0.002 and 0.017, respectively).
    Conclusion
    More than half of breast carcinoma cases with equivocal HER2 immunoreactivity showed non-amplified gene status; this needs to be considered by oncologists in their management planning of breast cancer. Amplified HER2 gene is significantly associated with negative ER and PR status that affects patients’ management protocols and future outcome of the disease.
    Keywords: Her2, SISH, Breast carcinoma, Immunohistochemistry, Equivocal
  • Bita Geramizadeh, Fatemeh Jalali Pages 20-24
    Background
    Aggressive fibromatosis is a rare benign tumor with no potential for metastasis; however, its aggressive nature causes treatment failure and episodes of recurrence. There is no report from Iran about the treatment of this tumor, and all published articles are single-case reports, therefore in this study, we report our experience from two of the largest referral centers of the South of Iran.
    Methods
    During five years (2007-2011), among more than 20000 surgical pathology specimens, 25 cases of fibromatosis were identified. Clinicopathologic findings were recorded for all of the cases, and follow up history according to the patients’ charts and direct contact by phone call were extracted.
    Results
    There were 25 cases of fibromatosis, with female predominance, especially in the reproductive ages. All of the tumors had been located in the abdominal area, lower extremity, and head and neck area. Twenty-three cases had been operated for surgical excision. Fifteen cases had at least one episode of recurrence, mostly located in the abdominal area. No death or metastasis occurred.
    Conclusion
    Clinicopathologic findings of desmoid tumor in Iran are very similar to other countries, however, there is still much controversy about the method of treatment for fibromatosis, and there are many challenges for patients, regarding multiple episodes of recurrence and the infiltrative aggressive nature of fibromatosis.
    Keywords: Aggressive fibromatosis, Single center experience
  • Reza Ranjbar, Afsar Tabatabaee, Payam Behzadi, Rohollah Kheiri Pages 25-34
    Background
    Escherichia coli is a commensal-pathogenic organism, which includes a wide range of strains. Despite several advanced molecular-genomic technologies for detecting and identifying different strains of E. coli, Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR) technique is a quick, sharp and cost effective fingerprint method. The major purpose of the present study was to determine the distribution of ERICs within E. coli strains isolated from different healthy animal stool specimens including hens, sheep, and cows, as an appropriate and quick molecular-genomic tool.
    Methods
    The animal stool samples were obtained during 1 year (October 2012 to October 2013), from animal husbandries around Tehran and Alborz provinces, Iran. After screening processes, the E. coli bacteria were isolated and cultured via standard microbiological methods. The DNA molecules of E. coli bacteria were harvested and Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR) was applied for bacterial molecular genotyping. The ERIC-PCR products were run on 1% gel electrophoresis. The final images regarding gel electrophoresis banding patterns were used for dendrogram generation via the GelClust software.
    Results
    Of 120 isolated samples, 115 different strains were recognized as E. coli. The fingerprint patterns involved 380 to 3280 bp bands. The predominant bands included 2900 bp, 1200 bp, and 1200 bp in stool samples of hens, sheep, and cows, respectively. The highest frequencies and diversities were seen among E. coli strains isolated from hens and sheep stool samples.
    Conclusion
    The DNA profiles were clearly detectable via specific fingerprint patterns. The ERIC-PCR seemed to be a good approach for molecular typing of E. coli strains isolated from different animal sources.
    Keywords: Escherichia coli, Consensus Sequence, Polymerase Chain Reaction, DNA Fingerprinting
  • Amir Sohrabi, Massoud Hajia Pages 35-44
    Background
    The accuracy of diagnostic assays in Human Papillomavirus (HPV) genital infection and cervical cancer has remained a clinical challenge in diagnosis. Evidence indicates that a large proportion of cervical cancer can be prevented through organized care for HPV and testing. Countries with low per capita income, such as Iran and its neighbours, have no national organized program for cervical cancer screening and vaccination. The aim of this study was to review recent published papers in this region for evaluating the efficacy of released data regarding HPV genotyping system in genital infections and cervical cancer
    Methods
    Investigating various medical search engines retrieved 46 reports, mostly after 2010, consisting of either home brew protocols or commercial technologies in this field.
    Results
    Summarized results demonstrated that except a few cases, all reports were limited studies performed in confined populations focusing on attending patients at clinics for regular checkups. In the present study, 52.8% of papers were from Iran and the rest belonged to other countries. The rate of HPV infection was reported in the range of 0.62% to 25% in the normal population, while it varied from 18.75% to 100% in females with cervical cancer. In HPV genotyping surveys, only 26.1 % (12/46) of reports had validated and World Health Organization (WHO) proficient procedures. Also, multiple infections were not mentioned in 56.52% (25/46) of researches.
    Conclusions
    Employing reliable genotyping methods is the best way for regular screening of cervical cancer related to HPV and precancerous diseases in females of these areas. The focus of most surveys was to come up with the best national policies for establishing a preventive program in Iran and Persian Gulf area.
    Keywords: HPV, Cervical cancer, Genital Infection, Genotyping Assay, Iran, Persian Gulf
  • Ali Reza Khalatbary, Behrooz Mohammadnegad, Ghazaleh Goudarzi, Ali Fazlollahpour Balef Pages 45-52
    Background
    There is accumulating evidence that a polyphenol present in olive oil, oleuropein, has antioxidant, anti-inflammatory and anti-apoptotic effects. This study aimed at determining the anti-apoptotic effect of Oleuropein (Ole) on dexamethasone-induced apoptosis of mouse thymocytes.
    Method
    Mice were randomly divided to four groups as follow: Dexamethasone (Dex)-treated group (20 mg/kg; single dose), Ole-treated group (20 mg/kg per day), Dex plus Ole-treated group, and vehicle group. Sections of thymus were taken 16 hours after dexamethasone injection and studied for histopathological and immunohistochemistry assessment.
    Result
    Further characteristics of degeneration in thymocytes were observed in the Dex group compared with the Dex plus Ole group. Compared with the Dex group (10.94±3.35), positive staining for Bax in thymocytes decreased in Dex plus Ole group (2.64±1.26), but remained higher than the Ole (0.65±0.30) and vehicle (0.67±0.29) groups. Compared with the Dex group (2.94±0.42), positive staining for Bcl-2 in thymocytes increased in Dex plus Ole group (12.24±1.84) yet was lower than the Ole (14.94±1.54) and vehicle (18.93±3.54) groups.
    Conclusion
    Our results suggest that dexamethasone-induced apoptosis is subsided by oleuropein.
    Keywords: Dexamethasone, Thymocyte, Apoptosis, Oleuropein
  • Shadi Shahsavan, Parviz Owlia, Abdolaziz Rastegar Lari, Bita Bakhshi, Maliheh Nobakht Pages 53-61
    Background
    Shigella spp. are gram negative bacteria, which are of global public health importance. The growing of multidrug-resistant Shigella isolates are a major problemaround the world.
    Methods
    Overall, 50 isolates of Shigella spp. from children diarrheic stools were studied. The isolates were identified and confirmed using biochemical, serological and molecular methods (ipaH, wbgZ and rfc genes). Antimicrobial susceptibility test was done according to the Clinical and Laboratory Standards Institute (CLSI) guidelines against minocycline, tetracycline, doxycycline, ampicillin, streptomycin, trimethoprim-sulfamethoxazole, nalidixic acid, norfloxacin, ciprofloxacin and levofloxacin. Also, the role of efflux pump in defense of Shigella against tetracycline was investigated by Minimum Inhibitory Concentration (MIC) with and without an efflux pump inhibitor. Detection of tetA, tetB, tetC and tetD genes in Shigella was evaluated by conventional Polymerase Chain Reaction (PCR) and real time PCR.
    Results
    Molecular identification revealed a prevalence of 14% for Shigella flexneri and 86% for Shigella sonnei. Minimum Inhibitory Concentration (MIC) of 90% of resistant isolates was changed in the presence CCCP.Results of conventional PCR exhibited that 66% of isolates were positive for tetA, while according to real time PCR method, 90% of isolates carried tetA. Positive results for tetB were12% and 18% by conventional and real time PCR methods, respectively. No positive results were detected for tetC and tetD. Also, tetB was detected only in S. flexneri while tetA was detected in both S. flexneri and S. sonnei.
    Conclusion
    It seems that efflux-mediated tetracycline resistance to tetracycline in S. flexneri can be related to tetB, however resistance in S. sonnei can be related to the expression of tetA.
    Keywords: Shigella, Tetracycline resistance, Efflux pump, Real-time PCR
  • Farahnaz Bidari Zerehpoosh, Soheila Nasiri, Sara Zahedifard, Shahram Sabeti Pages 62-66
    Background
    Non-Melanoma Skin Cancer (NMSC), the most prevalent types being Squamous Cell Carcinoma (SCC) and Basal Cell Carcinoma (BCC), is the most common type of malignancy in human beings. These neoplasms are more frequent in the elderly and fair skinned people and mainly occur on sun-exposed sites of the body. Ultraviolet B (UVB) has a well-known effect in induction and promotion of growth of these cancers. The p53 tumor suppressor gene is believed to be an early target in UV-induced skin carcinogenesis. Aggregates of keratinocytes with p53 protein overexpression are frequently identified in normal human skin and are more prevalent in chronically sun-exposed skin, and have been proposed to play a role in skin cancer pathogenesis. The aim of this study was to clarify the potential role of P53 in the development of NMSC.
    Methods
    Immunohistochemical evaluation of p53 expression in peri-lesional skin of 90 cases of SCC, BCC and melanocytic nevi was performed.
    Results
    The well-delineated compact type of p53 clone, but not the strong dispersed type, was significantly more predominant in SCCs in comparison with BCCs and melanocytic nevi (P value=0.001). The size of p53 clones was also significantly greater in SCCs compared to the BCCs (P=0.003) and melanocytic nevi (P=0.001). There was no significant difference between these neoplasms regarding the frequency of P53 clones (P=0.86).
    Conclusion
    This study suggests the possible relationship of epidermal p53 clones with the pathogenesis of SCC.
    Keywords: Carcinoma, Squamous, Basal cell, P53 Antigen, Skin
  • Fatemeh Homaei Shandiz, Azar Fani, Sepideh Shakeri, Maryam Sheikhi, Abouzar Ramezani Farkhani, Arezoo Shajiei, Hossein Ayatollahi Pages 67-73
    Background
    Breast cancer remains the most common and second lethal cancer in females. HER-2/neu is one of the most important amplified oncogene in breast cancer. The amplification of HER-2 is correlated with decreased survival, metastasis, and early recurrence. The amplification of HER-2/neu gene and synthesis of the protein are reported in 10%-34% of breast cancer cases associated with tumor size, advanced tumor stage, high-grade tumor, young age at diagnosis, absence of steroid hormone receptor, and lymph node involvement.
    Methods
    Fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) methods are options to evaluate HER-2 expression. The current study aimed at identifying the correlation between FISH and real-time polymerase chain reaction (PCR) in measuring HER-2 expression.
    Results
    The study investigated the performance of the real-time PCR as measured against FISH method in IHC borderline cases. In a total of 120 IHC 2 samples, 58.3% were negative and 41.6% positive for HER-2 gene, confirmed by FISH as a gold standard method. The real-time PCR ratio was
    Conclusion
    Despite the fact that real-time PCR is a promising method to evaluate HER-2 over expression and a supplementary array to FISH, according to the results of the present study it cannot be utilized instead of gold standard techniques; therefore, additional studies should be carried out to appraise the value of this method to evaluate HER-2 over expression.
    Keywords: Breast Cancer, HER-2, neu gene quantification, Quantitative Real-Time PCR, Fluorescent in situ hybridization
  • Farid Kosari, Sanam Akbarzadeh, Hiva Saffar Pages 74-78
    Background
    Alpha-synuclein is a member of synuclein family of proteins with unidentified function localized in the cytoplasm, mitochondria of neurons, and presynaptic nerve endings. Although it is found in the Lewy bodies in synucleinopathies and in Alzheimer’s disease, the protein could also be considered as a novel marker in diagnosis of diseases related to the hematopoietic system.
    Methods
    The current study evaluated alpha-synuclein expression in bone marrow sections obtained from 9 patients with acute myeloblastic leukemia (AML)-M6, 2 patients with AML-M7, and 56 patients with other forms of AML by immunohistochemical (IHC) analysis
    Results
    Seven out of 9 cases with erythroleukemia (66.7%) and 1 of the 2 cases with M7 (50%) were positive. In contrast; the blasts in 2 out of 56 AML cases with non-M6/M7 (3.6%) showed positive staining. Accordingly, alpha-synuclein was positive in normal erythroid precursors and megakaryocytes (if existing) in these cases; while, it was negative in lymphoid and myeloid precursors.
    Conclusion
    Alpha-synuclein expression in non-neoplastic and neoplastic erythroid cells and megakaryocytes could be used as a complementary and useful marker for distinction between AML-M6/M7 and other types of AML.
    Keywords: Acute myeloblastic leukemia, AML M6, AML M7, α-Synuclein
  • Omid Maghsoudi, Reza Ranjbar, Seyyed Hesamoddin Mirjalili, Mahdi Fasihi Ramandi Pages 79-87
    Background
    The utility and efficacy of novel materials in tissue regeneration and antimicrobial therapy are contingent upon the employment of either blood derivatives rich in platelets or platelet-poor-plasma (PPP). This effect is largely mediated by the increased or decreased concentration of platelets in the plasma. The current study aimed to analyze and evaluate the impact of platelet-rich (PRP) or PPP on inhibiting the growth of human pathogenic bacteria and compare their effects with those of chloramphenicol and penicillin.
    Methods
    In the current comparative study, PRP–1 was generated using 1-step blood centrifugation method; whereas, for PRP–2 and PPP the 2-step centrifugation protocol was used. The antimicrobial activity of PRP–1, 2, and PPP were tested on Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, Streptococcus agalactiae, Staphylococcus epidermidis, Shigella sp. and Serratia sp.Well diffusion and serial micro-dilution methods were used for this purpose. Chloramphenicol and penicillin susceptibility were tested using the disk diffusion method.
    Results
    While whole blood (WB) and PPP had no discernible impact on the growth parameters of any of the bacteria tested in the current study,PRP-1 reduced the growth rate of a few selected strains. In addition, while PRP-2 clearly inhibited the growth of Shigella sp., E. coli, S. aureus, S. agalactiae, and S. epidermidis, it had no impact on the growth of K. pneumoniae, P. aeruginosa,andSerratia sp
    Conclusion
    It can be claimed that there is a strong correlation between the concentration of platelets and the antibacterial activity of PRP.
    Keywords: Platelet Rich Plasma, Antibacterial effect, infection, MIC, Well Diffusion
  • Zohreh Nozarian, Alireza Abdollahi, Vahid Mehrtash, Hirbod Nasiri Bonaki Pages 88-93
    Background
    The current study aimed at evaluating the association between thyroid-stimulating hormone (TSH) level in upper normal limits with metabolic syndrome, modifiable risk factor for cardiovascular disease, and its components according to Adult Treatment Panel III of National Cholesterol Education Program.
    Methods
    The current cross sectional study recruited 82 patients with euthyroid overweight or obesity. They all had body mass index (BMI) higher than 25 kg/m2. The patients were categorized in 2 groups: Group 1 (patients with metabolic syndrome) and Group 2 (patients with non-metabolic syndrome). Demographic features and anthropometric indices were all appraised by a trained examiner. Metabolic syndrome components, BMI, age, gender, C-reactive protein (CRP), and thyroid function test (TFT) were assessed and compared.
    Results
    Age, triglyceride level, waist circumference, hypertension frequency, BMI and CRP were significantly higher in group 1. The most prevalent metabolic syndrome criterion was low level of serum high density lipoprotein (HDL). Patients with metabolic syndrome had greater TSH level, but it was not statistically significant (P-value=0.636). Euthyroid patients with TSH levels in the range of 3.88-5 mIU/L had 5.89 (95% confidence interval (CI) = 1.02 to 17.64) times higher risk of developing metabolic syndrome than other TSH values. After age adjustment, the relationship between the upper quartile of TSH level and the metabolic syndrome became insignificant (OR=2.97, 95% CI=0.51 to 17.2).
    Conclusion
    TSH in upper normal limits was statistically correlated with metabolic syndrome. However, after adjustment for age, it became insignificant. Relationship between thyroid hormones and metabolic syndrome may be confounded by other important cardiovascular risk factors in euthyroid patients.
    Keywords: Metabolic syndrome, TSH