TGF-β1 role in uterine leiomyoma and endometrial polyp: an insight to drug-based treatment instead of surgical techniques

Objective@#Considering the high prevalence of leiomyoma and endometrial polyps, investigating the contributing factors and determining the pathophysiology of these lesions are essential. Target therapy is now an acceptable method for the treatment of some diseases. We aimed to determine the expression of transforming growth factor (TGF)-β1 in endometrial polyps and leiomyomas to discover a drug-based method to overcome surgical treatments. @*Methods@#In this cross-sectional study, 55 patients with leiomyoma and 55 patients with polyps were included. Prepared slides from leiomyoma and adjacent myometrium or polyp lesions and adjacent endometrium were obtained and investigated for TGF-β1. Then, data were collected and analyzed using SPSS version 22. @*Results@#The mean age of participants was 40.6±5.8 years. Based on their reports, 88.2% (n=97) of patients in the study population had abnormal uterine bleeding with similar distributions among both groups. In contrast, 63.5% of the leiomyoma group did not express TGF-β1. However, in normal myometrium, 23.6% had the highest degree of TGF-β1 expression. Polyp tissue did not show staining for TGF-β1 in any patients. Additionally, 89.1% of non-polypoid endometrium did not express TGF-β1. Normal tissue had a significantly greater amount of TGF-β1 compared to leiomyoma and endometrial polyps. @*Conclusion@#TGF-β1 is expressed more prominently in normal myometrium with mostly high-intensity features compared to leiomyoma. Additionally, polyps showed no staining for TGF-β1, while normal endometrium showed a low-density staining pattern.

Comparison of abnormal cervical cytology from HIV positive women, female sex workers and general population

Sex workers and HIV seropositive women are at high risk of abnormal cervical cytology. The objective of this study was to compare the cervical cytology among three groups of women: active sex workers, HIV-infected women, and general population in Iran. This was a cross-sectional study performed in Hazrat Zeinab, Lavan clinics and drop in center [DIC] in Shiraz, Iran. This study was performed from October 2009 to October 2011. A total of 266 patients were assigned into three groups: sex-workers [85], HIV positive patients [100], and general population [81]. Pap smear was performed for all participants from the exocervix and endocervix, using a plastic Ayres's spatula and cytobrush. The samples were sent to a pathology center, using a liquid-based media. The risk of cervical infection in sex workers and HIV positive women was greater than the general population [OR=5.47, 95% confidence interval [CI]:2.24, 13.40], [OR=3.71, 95% CI:1.52, 9.09], respectively. The frequency of abnormal cervical cytology in the HIV positive and sex worker groups was higher than the general population [OR=6. 76, 95% CI:2.25, 20.32], [OR=3. 80, 95% CI:1.19, 12.07], respectively. Low-grade squamous intraepithelial lesion [LSIL] and high-grade squamous intraepithelial lesion [HSIL] were associated with CD4 cell count<200I106/L, P=0.021 and P<0.001, respectively. Vaginal infections were seen more often in the sex worker group, and abnormal cervical cytology was greater in the HIV positive group

57 year old woman with polypoid gastric mass

A 57-year-old woman was referred with chief complaint of pallor and lethargy for 9 months. Laboratory investigation was notable for anemia and occult blood in the stool exam. Her past medical history was unremarkable. Endoscopy of the upper gastrointestinal tract showed a large fungative reddish mass measuring 7 x 6 cm in the body of the stomach and multiple variable size polyps in the antrum [figure 1]. The patient underwent hemi-gasterectomy. Billroth I. Gross examination of the stomach showed a large polypoid mass measuring 8x7x6 cm [figure 2] with erosive surface in some areas

Adenoid cystic carcinoma of bartholin's gland clinically mimics endometriosis, a case report

Adenoid cystic carcinoma of Bartholin's gland is a rare malignant tumor of female genital tract. We report a case of a 42-year-old woman, presenting a palpable painful mass and burning sensation on the left side of vulva during the preceding two months. Based on examination, a solid fixed painful nodule with intact mucosa was palpated on the left side of the vagina. Histological features were compatible with adenoid cystic carcinoma. Often, such lesion is clinically misdiagnosed as a cyst or inflammation. The present case was carried out with an impression of endometriosis. The possibility of cancer should be considered in any female older than 40 years of age with a lesion near the Bartholin's glands

Value of CD10 expression in differentiating cutaneous basal from squamous cell carcinomas and basal cell carcinoma from trichoepithelioma

Background: In addition to the well-defined histological criteria for squamous cell carcinoma [SCC] and basal cell carcinoma [BCC], immunohistochemical techniques can be used in difficult cases for their differentiation. As differential diagnosis between trichoepithelioma [TE] and BCC is sometimes difficult for the clinician and the pathologist, CD10 may be a useful marker for definite diagnosis. We aimed to evaluate the usefulness of this marker in the differentiation between SCC and BCC and also in the differentiation between BCC and TE

Methods: Fifty-five BCC cases, 50 SCC cases, and 20 cases of benign adnexal tumor with follicular differentiation were retrieved from the archives of the pathology departments of hospitals affiliated with Shiraz University of Medical Sciences. Immunohistochemistry for CD10 was performed on the sections obtained from formalin-fixed, paraffin-embedded blocks. CD10 immunoreactivity in the stroma and/or tumor cells was determined as follows: negative [0]; 1+[10-50% positive cells]; and 2+[>50% positive cells]

Results: Comparison of CD10 expression between the BCC and SCC groups showed a significant difference [P<0.001] in each of the tumor and stromal cells. Comparison of CD10 expression between the BCC and TE groups demonstrated a significant difference in both the tumor and stromal cells [P<0.001]. There was no significant difference in CD10 expression between the stromal and tumor cells of the BCC subtypes

Conclusion: CD10 is a useful adjunct marker in distinguishing TE from BCC. CD10 is suggested to be one of the useful immunohistochemical markers to differentiate BCC from SCC