فهرست مطالب ata abbasi

Churg-Strauss syndrome (CSS), recently named eosinophilic granulomatosis with polyangiitis (EGPA), is a rare form of systemic vasculitis with extravascular granulomas occurring in patients with asthma and tissue eosinophilia. We represent a large left ventricular granuloma, confirmed by histopathologic evaluation, detected as a ventricular mass by echocardiography in a 45-year-old asthmatic male who was admitted for a cerebrovascular accident. Paraclinical and histopathologic findings confirmed the diagnosis of EGPA. As cardiac involvement in patients with EGPA is associated with poor prognosis, routine echocardiographic evaluation of these patients is suggested.

Multiple myeloma (MM) is a hematologic malignancy with a variable clinical course. We investigated the prognostic role of routine laboratory factors including CBC indices and serum vitamin D levels to predict MM recurrence after receiving an autologous stem cell transplant (ASCT). 29 patients were enrolled. Before ASCT, demographic data and CBC, serum Cr, and Vit D levels were obtained. Patients underwent bone marrow aspiration (BMA) and biopsy (BMB) before ASCT and pretransplant plasma cell counts were also evaluated. Patients were followed for 6 months and BMA and biopsy were done in the 3rd and 6th month of the follow-up to detect recurrence. Overall, 9 patients were reported to have recurrence. The patient's WBC count mean was 13.3±11.6. WBC count was lower in patients with overall recurrence (P=0.005). Patients were divided into 2 groups according to WBC count (<5.5 109/L and ≥5.5 109/L) and we found that WBC count <5.5 109/L was associated with increased risk of recurrence by 15.2 times (Odds ratio: 15.2, 95%CI: 1.4-168, P=0.005). We also evaluated Wbc to Hb ratio (Wbc/Hb) and found that Wbc/Hb <1 had a significant statistical relationship with overall recurrence (P=0.026) as patients with WBC/Hb <1 were in 9.8 times increased risk of recurrence (Odds ratio:9.8, 95% CI: 2-93.5, P=0.026). pretransplant WBC <5.5 109/L and WBC/Hb <1 were associated with 9.8 and 15.2 times increased risk of myeloma recurrence and could be useful predictive factors for a patient's short-term recurrence.

Breast cancer is the most common malignant tumor and cause of death in women. Factors that play role in tumor metastasis are lymph node involvement, lack of tumor differentiation and hormone receptor expression, high proliferation rate, and angiogenesis. In the present study, we tried to evaluate the microvessel density (MVD) using Immunohistochemistry for the CD34 marker to investigate the amount of angiogenesis in breast cancer and its relationship with other histopathological parameters and compare it with normal tissue.

58 paraffin-embedded samples of breast cancer were enrolled. All blocks were sectioned and stained for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2(HER 2/neu), ki67, and CD34 by immunohistochemistry (IHC) method.

The mean age of patients in this study was 49.6 ± 10.6 years. Statistically, there was a significant relationship between the grade of the tumor (P = 0.01), absence of expression of estrogen receptor (P = 0.008), and progesterone receptor (P = 0.003) with MVD.

Due to the association between MVD, tumor grade, and absence of ER and PR expression, this valuable marker can play an important role in the prediction of prognosis in breast cancer patients and can lead to new targeted therapy in the future.

Synchronous (simultaneous) malignant lesions in different organs of a patient are very rare finding. Gastric and colon adenocarcinomas are the most common cancers worldwide but their synchronous occurrence is rare and only four percent of gastric cancer patients have simultaneous colon adenocarcinoma. Here, we report a 64-year-old woman with simultaneous gastric and colon adenocarcinoma presented by abdominal pain and hematemesis.

Death due to coronary artery disease (CAD) is twice higher in men than women, and older men are more susceptible to the disease. Serum testosterone levels decrease with increasing age.

In this study, we aim to study the association between serum testosterone levels and Gensini scores in men.

This cross-sectional study was conducted on 60 men above 40 years who had undergone coronary angiography. Thirty of them had normal coronary vessels, and 30 had coronary artery disease. For each group, the Gensini score was calculated.

Serum testosterone levels in the CAD group and the control group were 4.04 ± 2.56 and 5.59 ± 2.20 ng/mL, respectively (P < 0.05), and free testosterone levels in the CAD patients and the control groups were 7.32 ± 5.24 and 12.91 ± 3.27 pg/mL respectively (P < 0.001). Sex hormone binding globulin (SHBG) levels in the CAD and the control groups were 28.88 ± 15.30 and 38.2 ± 19.9 nmol/mL, respectively (P = 0.04). Univariate analysis showed a significant association between Gensini score and total and free testosterone levels. The receiver operating characteristic curve (ROC) showed that the cut-off point of 7.97 had a sensitivity of 73.3% and specificity of 90% in predicting a high Gensini score (AUC = 0.799, P < 0.001).

Findings of our study demonstrated that serum free testosterone levels have a significant correlation with Gensini score and CAD severity.

Breast cancer is the most common malignant tumor in women. Some factors, including histological grade, vascular invasion, and metastasis, are known prognostic factors. Many studies have been performed to find more predictive factors such as urokinase plasminogen activator system markers. Here, we tried to evaluate the relationship between Urokinase-type plasminogen activator receptor expression and other histopathologic parameters. 62 malignant breast tumors were enrolled. UPAR immunohistochemistry staining was performed on paraffin blocks. We evaluated the relationship between UPAR expression and histopathologic factors, including tumor size, tumor type, histologic grade, lymph node status, lymphovascular and perineural invasions, and hormone receptors status (ER, PR, and HER2). The patient's mean age was 46.18±10.35 years. We found a positive relationship between UPAR expression and the presence of carcinoma insitu (P=0.027). A negative relationship was observed between UPAR expression and lymph node involvement (P=0.01), the number of involved lymph nodes (P=0.027), and also intensity and percentage of UPAR positivity in the case with lymph node involvement (P=0.005 and 0.029, respectively). UPAR expression is associated with lymph node metastasis which is one of the most important predictors of prognosis in breast cancer. So, it could be used as a favorable prognostic factor in breast cancer.

Several factors contribute to the development of gastric erosions, including corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, and stress. These factors can cause or worsen gastrointestinal ulcers by activating inflammatory pathways or by altering gastric mucosal blood flow. Dapsone is an antimicrobial compound with anti-inflammatory properties. The aim of this study was to evaluate the protective effects of dapsone against gastric erosions-induced by alcohol, stress, or indomethacin. Gastric damage was induced in male rats in different three experimental models:  ethanol (5 ml/kg, p.o.)-, water-immersion stress-, and indomethacin (30 mg/kg, p.o.)- induced ulcer. Rats in each of these three experimental models were divided into 5 groups: Normal group, 2. Control group (gastric damage + vehicle), 3. Gastric damage+ dapsone 1 mg/kg, 4. Gastric damage+ dapsone 3 mg/kg, 5. Gastric damage+ dapsone 10 mg/kg. In this study, the J- score ulcer index and histopathological assessment were performed. In addition, inflammatory cytokines levels, NF-κB expression and MPO activity were determined. Dapsone reduced the tissue injuries and erosion area in all three experimental groups compared to the control group. In addition, serum levels of inflammatory cytokines, TNF-alpha and IL-1β were reduced in the dapsone treatment groups. The expression of NF-κB and tissue concentration of myeloperoxidase (a marker of neutrophil activation) was also reduced in rats given dapsone. To conclude, dapsone exhibits significant protective effects against the development of experimental gastric erosions in rats and these effects seem to be related to its anti-inflammatory and antioxidant properties.

Chronic lymphocytic leukemia (CLL) is one of the most common hematologic neoplasms leading to immunosuppression. It is characterized by absolute lymphocytosis with clonality of mature B cells. Therefore, they are vulnerable to various infections especially COVID-19. Little is known about the COVID-19 infection when it unmasks CLL.We reported a 90-year-old man who presented with signs and symptoms of anorexia, weakness, and loss of consciousness, and lymphocytosis which in further workup COVID-19 confirmed with real-time PCR. Due to lymphocytosis, peripheral blood smear (PBS) and flow cytometry were performed and CLL was diagnosed. His lymphocyte count increased to 1.5-fold during hospitalization. The patient recovered after 11 days as the symptoms were alleviated.Lymphocytosis is an unexpected finding in patients diagnosed with COVID-19 infection, and an increase in lymphocytes may indicate other conditions. In these cases, secondary causes of lymphocytosis, such as malignancy or other infections, should be considered

We aimed to determine the frequency of Octamer binding transcription factor 4 (Oct4) expression in human invasive ductal carcinoma. 72 paraffin-embedded samples of breast cancer were enrolled. All blocks were stained for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2(HER 2/neu), ki67, and Oct4 by immunohistochemistry (IHC) method. Of 72 enrolled cases, the mean age was 49.6±1.42 years. 18 (25%) of cases were luminal A, 14 (19.4%) were Her2 positive, 31 (43%) were luminal B, and 9 (12.5%) were triple-negative. IHC staining for Oct4 revealed no Oct4 expression in breast cancer samples. The staining was repeated twice, and seminoma was used as a positive control in each run. The results of both repeats were the same, and none of the examined samples showed Oct4 expression. We found no Oct4 expression in breast cancer samples examined in our study. We also did not find Oct4 expression in normal breast tissue. Our study is one of the few studies which has evaluated Oct4 expression in human breast cancer on tissue samples and is one of the least that has reported no expression of Oct4 in breast cancer.

Polyp is a protruding mass into the intestinal tract, which can be pedunculated or not. It is believed that most of colorectal cancers arise from adenomatous polyps.

In this cross-sectional study pathology reports of 246 patients were evaluated.

In our study 64.2% of patients were male and 35.8% were female. The mean age of patients was 52.54±17.6 years old. The mean age for male patients was 54.99±18.3 and for female patients was 53.74±16.61. Most of the polyps were seen in the age group of 50-60 years old. Adenomatous polyps were the most frequent type (188 cases), 80 cases had juvenile polyps, 16 cases had inflammatory polyps, 12 had retention polyps, 19 had hyperplastic polyps, and 3 cases had mixed adenomatous and hyperplastic polyps. Most of the observed polyps were on the left side colon as 48.2% were in the rectum, and 35.6% were in sigmoid.

Adenomatous polyps were the most frequent polyps in this study. Considering their premalignant nature, performing screening colonoscopies can play a significant role in reducing colorectal cancers.

  Various studies have shown increased relative risk for breast cancer in patients with different kinds of non-malignant breast diseases. The aim of this study was to evaluate histologic changes in non-tumoral areas of mastectomy specimens of patients with breasts cancer.

232 consecutive cases of breast carcinoma were enrolled. Histopathology slides of all 232 cases were evaluated by light microscopy for tumor type, size and grade, lympho-vascular invasion (LVI), perineural invasion and also benign changes of nontumoral breast tissue including hyperplasia, inflammation, atypia, adenosis, sclerosing adenosis, apocrine metaplasia, lactating change, calcification, fibrosis and cyst formation.

We found no significant association between nontumoral changes and histologic subtypes of the tumor. Our results showed that in cases with apocrine metaplasia the frequencies of lymph node involvement and lymphovascular invasion were significantly lower than cases without apocrine metaplasia (p=0.04 and 0.01, respectively). Apocrine metaplasia was also associated with tumor grade. It was more frequent in low grade tumors than high grade ones (p=0.02). Considering Her2 expression, apocrine metaplasia was seen in only 7% (3/43) of Her2 negative cases in contrast to 29.4% (5/17) in Her2 positive cases (p=0.02).

It seems that some of the benign nontumoral changes have a probable relationship with breast carcinoma. So we suggest that follow up of the patients with benign breast changes could be useful in preventing or early diagnosis of breast cancer.

Basal Cell Carcinoma (BCC) with slow-growing and rarely metastasise character is the most common human neoplasm. Multiple BCCs is mostly raised from germline mutations in the tumour suppressor gene, PTCH with a genetically transmission pattern. Multiple BCCs, as well may be originated from radiodermatitis which is a significant side effect of ionizing radiation exposure delivered to the skin in different skin treatments. PTCH is a critical member of the Sonic Hedgehog signalling pathway and its mutations reported as an important event in 40 to 80 % of skin cancers. The exon number 23 is a critical exon in the function of PTCH protein. Mutations are reported in codon 1315 of PTCH in non-melanoma skin cancers. We assessed the mutations in exon 23 of PTCH gene by polymerase chain reaction and direct sequencing in peripheral blood cells from 10 patients with multiple BCCs. All of the subjects were selected among whom had a history of radiation exposure and subsequent radiodermatitis. Direct sequencing revealed a Cytosine to Thymine mutation in codon 1315 of the PTCH gene in 60% of the patients, from which 50% detected as heterozygotes with both of the C and T allele and 10% were homozygotes for T allele in the same position. Four subjects (40%) were detected as normal homozygotes of C allele, same as the normal population. The mutations with ID: rs 3575564 were detected in codon 1315 which transform the proline amino acid to leucine in the PTCH protein. This transformation may affect the normal function of the PTCH protein as reported previously. Patients with multiple BCC who had a history of radiation exposure show a transformation from Cytosine to Thymine in codon number 1315 of PTCH gene in their peripheral blood cells. Subsequent assessment of the BCC tissues will clarify the somatic mutagenesis effects of the radiation.

CD44 isoforms are known to be possible diagnostic and prognostic markers in colorectal cancer (CRC).
The present study aims at investigating the expression of CD44 standard (CD44s) isoform in CRC by immunohistochemistry (IHC) as well as exploring its clinicopathological correlations.
A total of 102 patients, who underwent surgery for primary colorectal adenocarcinoma, were enrolled in this study. IHC staining for CD44 was performed on pathology samples and defined as: staining 50% as strong/extensive expression level.
The patients’ mean age was 62.8 ± 15.67 years. IHC staining for CD44s demonstrated low expression level in 56%, moderate in 24%, and extensive in 20% of the participants. The only association was found between CD44 expression level and patients’ age (P = 0.03) as 25% of tumors in patients younger than 60 years old expressed CD44 expression strongly in contrast to 16.1% of the patients older than 60 years old. No other association was found between tumor histology, stage, gender, tumor location, lymphovascular invasion, perineural invasion, lymph node metastasis, or tumor subtype (P > 0.05).
No relation was found between CD44s expression and any tumoral characteristics of CRC. It seems that CD44s are not helpful in improving the prognostic or diagnostic power in CRC.

Angiomyolipoma (AML) and oncocytoma are uncommon benign neoplasms of the kidney which their simultaneous occurrence in the same kidney is extremely rare. This study reports a 60-year-old diabetic woman with the rare simultaneous occurrence of three renal masses. Histologic evaluation revealed two angiomyolipomas and one oncocytoma within the same kidney, in a background of histologic features of diabetic nephropathy. Renal angiomyolipoma and oncocytoma are uncommon neoplasms, and their simultaneous occurrence in the same kidney is extremely rare.

Smooth muscle tumors rather benign or malignant can arise wherever the muscular tissue presents but cutaneous leiomyoma is one of the rare benign tumors of the which even the diagnostic criteria from the malignant type of the tumor is still in doubt. This study was aimed to compare the subtypes of cutaneous leiomyoma from different histologic aspects in order to find unique criteria for better classification and diagnosis. The six year data base of our center was reviewed and 25 patients with cutaneous leiomyoma were included in this study. Of 25 patients, 5 were female and 20 were male. 5 patients had angioleiomyoma (ALM) and 20 had pilar leiomyoma (PLM). ALM had following characteristics: dilated vascular canals intermingled with compact smooth muscle bundles; well circumscribe counter and myxoid and hyaline changes through the tumor. In contrast, PLMs had following histologic features: poor defined outline, entrapped hair follicles and eccrine glands, acanthosis and elongated rete ridges with hyperpigmentation and smooth muscle bundles which are interdigitated with elongated rete ridges. Here we introduced some distinct histological features for each subtype of the cutaneous leiomyoma which can lead to create novel criteria for classification and diagnosis of the lesion.

Exposure to environmental tobacco smoke (ETS) is one of the major factors of predisposing children to develop several hazardous health problems. We decided to investigate the association between nicotinine, one of the nicotine metabolites and esophagitis in children with gastroesophageal reflux disease (GERD). In a case control study 46 children suffering from esophagitis referred to endoscopy ward were recruited. The control group consisted of 45 healthy children. Urine samples were collected and urinary cotinine level (UCL) measured. The mean age of esophagitis and control groups were 5.11±2.93 and 6.72±2.8 respectively. Sixty children were passive smokers; 31 of them had non-smoker parents. In control group, 32 (71.1%) children and in esophagitis group 29 (63%) children had non-smoker parents. The mean value of UCL in patients suffering from esophagitis was significantly higher than those in normal group (P=0.04, 24.98±6.4 ng/ml vs. 15.16 ± 3.9 ng/ml). Considering 50ng/ml as a cutoff point for UCL, it was significantly higher in passive smoker group than in non smoker group (P=0.02). The mean cotinine level differed significantly in esophagitis and control group. Our results indicate the increased risk of developing esophagitis in children with ETS exposure.

To explore the abnormalities in Iranian athlete's electrocardiogram and find any relation with body fat. 239 international athletes were involved in this cross sectional study. Body-fat percentage and resting 12-lead ECGs were recorded from all participants. Of 239 participant athletes, 212 were male and 27 female. 60% of participants had sinus bradycardia. A total of 84% of the athletes demonstrated at least 1 abnormal ECG finding. Average values for the PR, QRS and QT intervals, P-wave duration and QRS axis were in normal range. Frequencies of various ECG abnormal findings in all athletes were as follows: right axis deviation 4.2%, left ventricular hypertrophy 6.2%, sinus arrhythmia 5.8%, right bundle branch block (RBBB) 24.2% (incomplete RBBB 16.8%, complete RBBB 7.4%), ST elevation 72.5%, prolonged QT interval 1.7%, T inversion 3.1% and Mobitz type I 1.2%. The athlete's ECG response to treadmill stress test was normal with no ischemia or arrhythmia. The means of BMI and body-fat percentage were 24.04 ± 3.5 kg/m² and 9.15 ± 2.12%, respectively. Pearson correlation coefficient between body-fat percentage and ST changes was 0.65 (P=0.008) in anterior leads and 0.198 (P=0.017) in lateral leads. Also, the correlation coefficient between the body fat percentage and right bundle branch block was 0.36 (P=0.013). The results of current study support the inclusion of ECG in athlete's cardiac screening before they engage in vigorous exercises in order to detect the potentially fatal arrhythmias.

Linguatula serrata (L. serrata), an aberrant arthropod of the Pentastomida phylum, inhabits the canine respiratory system as its final host. Intermediate hosts include humans and herbivores. Humans can be infected via consumption of raw or under-cooked liver or lymph nodes of sheep, goats, and cattle. A few human cases have been reported from Iran. Here, we have reported a case of pentastomiasis infection in a 55-year-old man who presented with fever, abdominal pain, abdominal distension, and weight loss. Small bowel transit revealed partial obstruction in the small intestine. Abdominal CT scan showed increased small bowel wall thickness. Both laparoscopy and biopsy findings favored parasitic granuloma from a pentastomiasis infection. He was administered praziquantel and albendazole. After two weeks of therapy the patient recovered.

Chondroma is a benign tumor which mostly occurs in extremities but also sometimes in brain. Most intracranial chondromas arise from skull base, but chondroma of falx origin is a rare circumstance. Indeed, the intracranial chondromas rise from falx is mostly in relation with syndromic disorders such as Mafucci''s syndrome or Ollier''s syndrome. Here, we reported a rare case of falxian intracranial chondroma in a young man who has normal physical examination and no signs of any syndromic disorder. The goal of this paper was to raise awareness about chondromas and suggest that chondroma be ruled out in any patient with masses arising from falx.