noushin afsharmoghadam

The goal of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is to standardize the reporting of salivary gland cytology and guide treatment decisions. Considering the newness of this system and the need for more studies in this regard, the aim of this study was to evaluate the concordance of cytological findings based on the Milan system with histological findings in salivary gland masses.

evaluating salivary gland tumors’ cytological findings of Milan system with histopathological findings.

This diagnostic study was conducted on 94 patients with salivary gland masses were referred to the pathology department of Imam Hossein hospital in 2022. FNA was performed for all patients and cytological classification was done based on the latest classification of the Milan system. Cytological findings were compared with histological findings.

In this study 10.6% were diagnosed as non-neoplastic, 18.1% with AUS, 37.2% benign neoplasm, 20.2% with SUMP, 5.3% suspicious for malignancy, and 8.5% were diagnosed as malignant. In the pathology results, 18.1% of patients were non-neoplastic, 56.4% had benign neoplasm, and 25.5% had malignant mass. The agreement coefficient between the two methods based on the Kappa coefficient was 40%, which indicates arelatively good agreement. The correlation coefficient between the two methods was 0.70.

It is concluded that there is a relatively good agreement between the Milan system in the cytology of salivary gland neoplasms with pathology findings.

Paratubal cysts account for 5-20% of all adnexal lesions. Malignant modifications seldom arise in the paratubal cysts that are usually known as primary carcinomas of fallopian tube. Paratubal borderline tumors are very infrequent conditions and until now only sixteen cases of primary paratubal borderline tumors have been previously reported in the literature. Herein, we describe a rare paratubal serous borderline tumor occurring in a woman of reproductive age and provide insights into its management. A 32-year-old woman referred to Imam Hussein Hospital, Tehran with chief complaint of amenorrhea for the last year and transvaginal sonography (TVS) report indicating a 68×74 mm persistent right adnexal cyst from 10 months ago. The patient was candidate for laparotomy and due to the report of paratubal serous borderline tumor in frozen section she underwent right total salpingectomy and infracolic omentectomy. No evidence of recurrence or metastasis was observed after 3 years of follow up. Persistent adnexal cysts need to be evaluated precisely even in young women in order to rule out the malignancy of fallopian tubes.

Endometrial stromal sarcoma is a rare condition, constituting nearly 0.2% of all reproductive tract malignancies. The condition mainly affects the peri-menopausal population; however, it can occasionally be found in younger women and adolescents. Here, this is a case of a 20-year-old primiparous female who was referred to us with the main complaint of vaginal bleeding (menometrorrhagia), ongoing for 6 months after delivery. Her sonography report indicated a 5 cm intra-cavitary mass suspicious for myoma or placental polyp. Given the pathology report of low-grade endometrial stromal sarcoma (LGESS) on samples obtained through hysteroscopy and D&C, she underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO). Endometrial stromal sarcoma is a rare uterine malignancy of mesenchymal origin that should be considered, even in very young patients.

Human papillomavirus infection is one of the most common genital infections. More than 100 types of the virus have been identified, most of which can infect the genital mucosa. The virus is associated with cancerous and precancerous lesions of the cervix. Some types, such as human papillomavirus 16 and 18, are highly carcinogenic; some other types, such as human papillomavirus 6 and 11, are mildly carcinogenic, with HPV 31.33 in between. This study describes the relationship between different types of HPV infection and the findings of a Pap smear. In this prospective study, 1,500 samples from patients who admitted to a private Pathology Laboratory in Isfahan were collected during the years 2019-2020. Two samples were collected from each patient, one for Pap smear study and the other for polymerase chain reaction (PCR) test to detect different types of human papillomavirus (HPV) infection. In a study of 1,500 samples, 236 were positive for Papillomavirus (HPV) infection in Pap smear. By examining the genotype of positive examples, it was found that 14.8% of the samples were infected with type 16, and 1.7% were infected with type 82. HPV infection is common in Iran and is almost similar to European countries such as Germany and Spain. We also found that using a polymerase chain reaction (PCR) method to detect HPV viruses in vaginal secretions could be very useful. Our findings also show which disease is most associated with each type of HPV.

Pseudomyxoma peritonei (PMP) is characterized by mucinous ascites in the peritoneal cavity and might involve the omentum and peritoneum. The PMPs originating from the ovary are mostly caused by ruptured ovarian mature teratomas and mucinous ovarian carcinomas. The present case is a rare advanced mucinous borderline ovarian tumor and late recurrence in PMP in a 52-year-old menopaused woman. She presented with gradual abdominal enlargement and cystic abdominopelvic lesion with internal septa and ascites. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, infracolic omentectomy, lymphadenectomy, and appendectomy. Histopathologic examination revealed mucinous borderline tumors. About 5.5 years after the first surgery, she presented with abdominal bloating and a sonography report of peritoneal seeding in the abdomen and pelvis. Abdominal exploration showed gelatinous-mucinous ascites and disseminated peritoneal carcinomatosis. The final histopathologic evaluation indicated PMP. Although the recurrence of mucinous borderline tumors is in an average of two years, the present case had relapsed after 5.5 years as pseudomyxoma with borderline pathology.

For replacement of the lost tissue due to trauma and burns, several methods were used; tissue expander in one of them, but few studies has been done about it. This study aimed to compare vascular density in the expanded tissue versus normal tissue in patients with missing tissue.
In a clinical trial study in 2015-2016, 25 candidates for tissue expander were enrolled. Subcutaneous tissue expander was placed and after completion of treatment, at the time getting expanders out of the body, 5 samples were given from expanded capsule, subcutaneous of expanded tissue, subcutaneous of not-expanded tissue, expanded skin, and not-expanded skin. Vascular density of the samples were determined by a pathologist and were compared with healthy tissue of adjacent area.
Findings: The mean vascular density in expanded capsule, subcutaneous of expanded tissue, and subcutaneous of not-expanded tissue were 8.96 ± 4.73, 7.36 ± 3.29, and 5.08 ± 2.40 per mm2, respectively; vascular density of subcutaneous of expanded and not-expanded tissue was statistically different (P Using expanded tissue for destroyed tissue replacement is an efficient method in patients who need it; developing tissue with this method leads to development of vascularity in expanded tissue.

Although meningiomas are common tumors of the central nervous system, primary extracranial meningiomas are extremely rare. These tumors constitute approximately1% of all meningiomas. This study has reported a very rare case of meningioma on the left carotid sheath that presented as a left neck mass. We performed a core biopsy of the mass. Subsequently, the tumor was excised and histopathologic examination confirmed the diagnosis of primary extra cranial meningioma.

This study aimed to determine the diagnostic values of frozen section compared with permanent pathology results for detection of characteristic of head and neck tumors.
In a cross-sectional study, 88 patients suffered from head and neck tumors and operated during 2010-2015 in Alzahra hospital, Isfahan, Iran, were enrolled. The results of frozen section and permanent pathology were extracted from hospital records and sensitivity, specificity, false negative, false positive, and negative and positive predictive values were calculated for frozen section.
Findings: Sensitivity, specificity, false negative, false positive, positive predictive value, and negative predictive value were as 89.8%, 94.4%, 5.6%, 10.2%, 95.7%, and 87.2%, respectively; and the accuracy of frozen section was 91.8%.
Frozen section test during surgeries is a good and valuable method for detection of characteristic of head and neck tumors. But, enough pathologist experience and precision of sampling by surgeon can lead to increase the accuracy rate of frozen section which finally leads to decrease of reoperation and relapse of disease, and better prognosis.

Statement of the Problem: Peripheral and central giant cell granuloma are two common benign lesions of the oral cavity. In spite of histopathological similarities, they have different clinical behaviors. Cathepsin D is a lysosomal enzyme which has different functions on the basis of protein and applied peptide cleavage.
This research aimed to evaluate and compare the expression level of Cathepsin D in these two lesions to find the reasons for the differences in clinical and biologic characteristics.
The expression of Cathepsin D was investigated by using the immunohistochemistry method in 20 samples of peripheral giant cell granuloma and 20 samples of central giant cell granuloma. The percentage of stained giant cells (labeling index), the intensity of staining of giant cells, and staining-intensity-distribution in both groups were calculated and compared.
The labeling indices of Cathepsin D in peripheral giant cell granuloma and central giant cell granuloma were 95.9±4.03 and 95.6±2.34, respectively. There was no significant difference in the percentages of stained giant cells between the two groups (p= 0.586). The intensity of staining of giant cells in central giant cell granuloma was stronger than that of peripheral giant cell granuloma (p> 0.001). Staining- intensity- distribution of giant cells in central giant cell granuloma was significantly greater than that of the peripheral type of lesion (p= 0.001).
The higher expression level of Cathepsin D in central giant cell granuloma compared to peripheral type of lesion can explain more aggressive behavior of central giant cell granuloma.

Peutz–Jeghers syndrome is a rare autosomal dominantly inherited condition, characterized by the presence of hamartomatous gastrointestinal polyps and mucocutaneous pigmentation. Patients with this syndrome can be associated with other neoplasms such as ovarian neoplasms known as sex-cord tumor with annular tubules that are associated in one third of the cases with this syndrome and other types of malignancies. We report a 42-year-old woman with a history of Peutz–Jeghers Syndrome and bilateral breast cancer that presented with abnormal uterine bleeding. Total abdominal hysterectomy with bilateral salpinooophorectomy was done and an ovarian sex cord tumor with annular tubules was incidentally diagnosed. By reviewing literatures and in agreement with previous studies we suggest routine screening for malignancies in patients with Peutz–Jeghers syndrome.

After the first description of Kaposi sarcoma in 1872, many cases of this tumor were reported worldwide. This tumor is multifocal and laryngeal involvement is considered to be as unusual site. Kaposi sarcoma is almost always are associated with classical skin lesion, and only about 5% of non-acquired immune deficiency syndrome Kaposi sarcomas are reported to be located in the larynx. We report a kidney transplant recipient diagnosed with solitary laryngeal Kaposi sarcoma 21 months after transplantation, who was treated with combined surgery, chemotherapy, and immunosuppressive modification.

Epidemic levels of obesity and overweight in today's world are leading to a higher number of mortality and morbidity, especially due to cardiovascular diseases (CVDs). Body fat distribution contributes a great amount to atherosclerosis formation and therefore increased CVD incidence. The present study used the autopsy of 40 healthy-appearing adults who died due to non-cardiac causes to explore the association between atherosclerosis and body fat distribution indices including abdominal fat, visceral fat, subcutaneous fat, and pericardial fat. This cross-sectional study examined the autopsy of 40 individuals of 20 to 50 years old who died due to non-cardiac causes, mostly car accidents, and were sent to the forensic center. Measurement of abdominal fat, visceral fat, subcutaneous fat and heart weight/height ratio as a pericardial fat index in the cadavers was followed by atherosclerosis assessment in the carotid artery, left and right internal and external carotid arteries, as well as right coronary artery (RCA), left anterior descending (LAD) and left circumflex (LCX) coronary arteries based on American Heart Association (AHA) criteria. In order to evaluate the relation between atherosclerosis development and body fat distribution indices, SPSS version 19 was used for multinomial logistic regression analysis in the crude and adjusted models (for age, smoking, LDL-c, HDL-c, HBA1c, and CVD history). The effectiveness of body fat distribution variables along with age, smoking, LDL-c, HDL-c, HBA1c, and CVD history on atherosclerosis was also determined by stepwise forward regression analysis. The average age of the subjects was 29.97 ± 9.84 years. Among 40 performed autopsies only 3 were women. Coronary and carotid atherosclerosis were observed in 50% and 85% of the cadavers, respectively. Logistic regression analysis revealed no link between carotid atherosclerosis and body fat distribution indices. Although, the correlation found between heart weight/height ratio and atherosclerosis in the crude model did not remain significant after the adjustment of other indices, stepwise forward regression analysis resulted in OR = 9.461 and confidence interval = 1.199-74.650. Our results indicated a link between coronary atherosclerosis and heart weight/height ratio. Since coronary and carotid atherosclerosis were not found to be correlated with subcutaneous and visceral fat, further investigation is suggested.

Recently autologous fat tissue transfer has gained much popularity. On the other hand, applying the transferring methods with a higher survival rate is still controversial. The aim of this study is to compare dermis-fat graft and dermal-fascia-fat graft. This animal study was conducted in 2008-2009. 12 dogs underwent fat graft transfer in forms of free fat, dermis-fat and dermal-fascia-fat. Two months post operation the grafts were removed and analyzed microscopically and macroscopically. The most significant weight loss was observed in circular free fat while, dermal-fascia-fat graft had the least. According to microscopical analysis the most considerable angiogenesis was improved in dermal-fascia-fat graft. Dermis-fat graft had a higher survival rate than free fat graft. Considering the higher angiogenesis and collagen synthesis used in the dermal-fascia-fat group, it seems that fat graft has more maintenance in the presence of fascia. To determine the influences of fascia further studies are recommended.