Evaluation of squamous cell carcinoma antigen 1 expression in oral squamous cell carcinoma (tumor cells and peritumoral T-lymphocytes) and verrucous carcinoma and comparison with normal oral mucosa

Abstract Background: Squamous cell carcinoma antigen (SCCA) is used as a prognostic marker for recurrence of squamous cell carcinoma in various sites, including head and neck. Studies suggest that its high serum levels are correlated to some clinical features, such as nodal metastasis. However, it is still unknown if high SCCA in patients with SCCA tissue expression in tumor cells are related to peripheral T-lymphocytes. Therefore, we did this study to evaluate SCCA expression in squamous cell carcinoma and verrucous carcinoma and to compare it with normal oral mucosa, also investigating the correlation between serum-based and tissue-based antigen levels. Methodology: In this study, the immunohistochemistry (IHC) technique was used to determine the SCCA1 expression pattern in 81 specimens divided into 3 groups, including oral squamous cell carcinoma, verrucous carcinoma, and normal oral mucosa. Serum-based and tissue-based antigen levels of 20 oral squamous cell carcinoma cases were compared by the western blot assay. SCCA expression was also evaluated and compared in both tumor cells and peripheral T-lymphocytes by the immunofluorescence assay. Results: Our results showed that the SCCA levels in SCC specimens were significantly lower than in verrucous carcinoma and normal and hyperplastic oral mucosa specimens. We found no correlation between the IHC expression of SCCA and serum levels. SCCA was well expressed in both tumor cells and peripheral T-lymphocytes. Conclusion: Decreasing SCCA in SCC specimens suggested that SCC tumor cells may affect more than the serum levels of SCCA in some patients. In addition, expression of SCCA in peripheral T-lymphocytes showed that both tumor cells and T-lymphocytes may cause serum SCCA.

Demographic and histopathologic study of Kaposi's sarcoma in a dermatology clinic in the years of 2006 to 2011

Kaposi's sarcoma is a low-grade vascular tumor that its prevalence is increasing all around the world due to the increasing prevalence of HIV and organ transplantations. In this study, we assessed risk factors of Kaposi's sarcoma among Iranian patients were referred to Dermatopathology Department of Razi Hospital of Tehran University of Medical Sciences between the years of 2006 to 2011. Also, disease stages have been assessed on pathologic specimens. Thirty four patients diagnosed with Kaposi's sarcoma entered the study. Of the 34 patients, 29% were female, and 71% were male, mean age was 66 years and average disease duration was 6 months. The most common patient's pathologic stages were reported: patch 32%, patch to plaque 24%, plaque 12%. The most prevalent location of involvement was lower extremity [88%], and upper extremity was involved in 24%. At presentation time, the mean number of lesions was 3 to 4. 15% of patients had a history of smoking and 15% had a history of immunosuppressive drugs. HIV infection did not observe in the patients. Based on the present study, Kaposi's sarcoma is a disease of elderly and is higher in older men. The most common site of Kaposi's sarcoma involvement is lower extremity, and the most common pathologic stage was the patch to plaque

Cutaneous leiomyoma: novel histologic findings for classification and diagnosis

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

Clinicopathological study of 1016 consecutive adnexal skin tumors

Adnexal tumors [ATs] are primary skin tumors with benign or rarely, malignant behavior. They have been classified based on differentiation towards hair follicle, sebaceous, apocrine or eccrine gland. Few large-scale studies have focused on ATs. To determine the prevalence of ATs and to assess clinical and histopathological trend of ATs. A retrospective descriptive study of all ATs diagnosed in Razi hospital between 2006 and 2010 was performed. A total of 30,000 pathology records were reviewed, and 1016 ATs were included. The prevalence of ATs was 3.3%. 518 patients [51%] were female, with a mean age of 34.5 years. 953 tumors [93.8%] were benign. ATs were most commonly located in the head and neck area [822, 83.5%]. The most common histopathological origin of ATs was sebaceous gland [536, 52.7%]. Sebaceous nevus of Jadassohn was the most prevalent single tumor type [40.6% of all ATs]. In 63.6% [646] of tumors, ATs were clinically suspected by the clinician prior to biopsy. The most common malignant AT was sebaceous carcinoma [23, 36.5% of all malignant ATs]. ATs are infrequent lesions, most commonly occurring in 3rd and 4th decade of life. Diagnosis of ATs is made by histopathological studies as they often express indistinctive clinical features. Malignant ATs are rare, occur at an older age, and are often hard to recognize clinically

Consumption of the epidermis in malignant melanoma

Consumption of the epidermis [COE] is defined as thinning of the epidermis with attenuation of the basal and suprabasal layers and loss of rete ridges in areas of direct contact with malignant melanocytes. The aim of this study was to investigate the importance of COE as an additional diagnostic criterion for malignant melanoma and to evaluate its relationship to clinicopathological findings. The age, gender, localization of the lesion and the histopathological parameters such as tumor type, Breslow thickness, ulceration, and Clark's level were recoeded in 90 malignant melanoma cases. In contrast to other studies, we found that COE was more common in tumors with an acral localization and in the acral lentiginous melanoma. Although COE can be used as a pathological criterion in the diagnosis of malignant melanoma, but no correlation no of COE with ulceration and other prognostic factors were found

Incidence of incomplete excision in surgically treated cutaneous squamous cell carcinoma and identification of the related risk factors

Squamous cell carcinoma [SCC] is the second most common type of skin cancer with potential risks for metastasis and recurrence if left untreated or incompletely excised. This case series study was designed to determine the frequency of incompletely excised SCCs and the related risk factors. A total of 273 SCCs [253 patients] excised in Razi dermatology hospital of Tehran from 2006-2008, were evaluated and were analyzed by Chi-square or t-test. The incidence of incomplete excision was 17.58% and deep margin involvement was observed in 73% of lesions. Risk factors associated with incomplete excision of SCCs were being female, location of the tumors [in particular the lesions on lateral canthus, upper lip, foot, forehead, cheek, neck, nose and ear], large lesions and grafting method of repair. There was no statistically significant difference for the age, degree of histological differentiation, childhood history of radiotherapy for tinea capitis and the type of anesthesia. More care should be taken for high risk SCCs as complete excision avoids potential risk of recurrence and metastasis

Description of some dermatoscopic features of acral pigmented lesions in Iranian patients: a preliminary study

Proper differentiation between acral malignant melanoma and benign pigmented lesions like melanocytic nevi is of great value. To avoid unnecessary biopsies, dermatoscopy has been introduced as a non-invasive modality and has improved the clinical diagnostic accuracy in recent decades. We aimed to describe dermoscopic patterns of acral pigmented lesions of patients in the clinic of dermatology in Razi Hospital, Tehran, Iran. This study was conducted as a descriptional study among a total of 62 pigmented lesions located on volar skin of palms and soles. After initial clinical evaluation, lesions were examined entirely by dermoscopy. All the patterns within a lesion were described, and lesions suspicious of malignancy [clinically or dermatoscopically] were selected for histopathological evaluation. Of our 62 lesions, three lesions were not melanocytic. According to our final clinicopathological diagnosis, 47 lesions were benign melanocytic nevi and 12 lesions were malignant melanoma. Parallel furrow pattern was the most frequent among our benign lesions [51.1%] followed by lattice-like pattern [23.4%] and acral reticular pattern [21.3%]. Diffuse multi-component pattern, parallel ridge pattern and abrupt edge were respectively most common patterns among malignant melanomas. Acral benign melanocytic nevi and malignant melanomas respectively have well distinctive characteristics in dermatoscopy among our patients

[Comparison of the frequency of antinuclear antibodies in patients with pemphigus vulgaris and a control group]

Pemphigus vulgaris [PV] is an autoimmune blistering disease which is specific for skin and mucosal membranes. Its association with connective tissue diseases has already been reported. Considering this association, presence of Anti Nuclear Antibodies [ANAs] in PV patients will not be surprising. The aim of this study was to compare the frequency of ANA positive cases in patients suffering PV with a control group. In this case-control study, the cases were selected from the patients with PV whom were hospitalized at Razi Hospital, Tehran. The controls were chosen from patients who did not have PV. The data were collected using a questionnaire, which was designed for gathering information on participants' age, sex, PV phenotypes, and the result of ANA test. ANA positivity was assessed using indirect immunofluorescence, HEP2. In 8 [26.7%] of 30 PV patients and 3 [10.0%] of 30 controls ANA was positive [P=0.095]. The most common ANA positive patterns among cases and controls were homogeneous and speckled patterns, respectively [P=0.26]. Although in this study the frequency of positive ANA result among controls was similar to what were reported in previous studies, the frequency of this finding among PV patients was different from the previous reports. Differences in the sensitivity of the laboratory kits used in different studies as well as in the threshold for ANA positivity, and differences in the patients' eligibility criteria in different studies may explain the observed discrepancies. Clinical follow up of the PV and requesting an ANA test in the case of appearance of the signs of connective tissue diseases is recommended

[Detection and analysis of BTNL2 gene mutations in patients diagnosed with skin sarcoidosis]

Sarcoidosis is a non-caseous granulomatous disease that can involve several organs such as lung, kidney, liver, heart and skin. In systemic sarcoidosis, skin lesions occur in 20-35% of patients. Cutaneous sarcoidosis with no systemic involvement was found in about 25% of patients. Mutation within Butyrophilin-like 2 [BTNL2] gene, rs2076530 was reported in systemic sarcoidosis. However, there is no report of evaluation of mutation in BTNL2 gene with the diagnosis of skin sarcoidosis. In this study ten patients with skin sarcoidosis were evaluated for the mutation of rs2076530 allele in exon 5 of BTNL2 gene. This assessment was performed by the single strand conformation polymerase chain reaction [SSCP-PCR] in which the existing mutations with positive shift were deteced using directl sequence analysis. Data from sequence analysis were evaluated and blusted by means of Choroms computer software. Our results showed the BTNL2 G->A transition of rs2076530 in seven patients and three patients were normal. This pilot study concludes the presence of a mutation at rs2076530 in exon 5 of BTNL2 gene in patients with skin sarcoidosis. Larger studies are needed to evaluate the role of this finding

Microscopic nikolsky's sign: Is it useful for diagnosis of pemphigus vulgaris?

Pemphigus vulgaris [PV] is an autoimmune blistering disease, caused by autoantibodies against desmoglein [Dsg] 3 and/or Dsg 1 which induce the loss of adhesion between keratinocytes. Nikolsky's sign is the ability to induce peripheral extension of a blister as a consequence of applying lateral pressure to the border of on intact blister. If the weakening of the intercellular adhesion is present but not marked, then the damage may be demonstrated only microscopically [microscopic Nikolsky's sign and can increase the sensitivity of the histopathological studies. We studied 40 patients and divided them randomly into two groups [A, B]. Group A were subjected to the tangential pressure over the perilesional skin before a biopsy specimen was taken from that site; group B patients were subjected to a biopsy without the tangential pressure technique. Histopathological changes of pemphigus vulgaris were present in 30% of the patients in group A and 5% of the patients in group B. They were not statistically different. The presence of microscopic Nikolsky's sign was significantly higher in patients with generalized disease. Microscopic Nikolsky sign can increase the sensitivity of histologic diagnosis of PV

epidemiologic study on basal cell carcinoma and its related risk factors in patients referred to Razi hospital tumor clinic in autumn 2005-2006

Basal cell carcinoma [BCC] is the most common cutaneous malignancy UV light is an important risk factor for BCC, as well as X-ray and other ionizing radiations. The aim of this study was evaluation and risk factor assessment of BCC cases referred to Razi hospital tumor clinic. Patients referred from general clinics with skin biopsies consistent with Basal Cell Carcinoma were enrolled. A questionnaire including epidemiologic data, risk factor exposure and specification of skin lesions was completed for each patient. From October 2005 to October 2006, a total of 476 patients with cutaneous malignancy referred to Tumor clinic of Razi hospital. Of them, 367 patients had BCC. 215 were male [58%] and 152 were female [42%]. Mean age of patients was 62 [ +/- 12.7] and 62 [ +/- 13.4] years for men and women, respectively. The most common risk factors for BCC were radiotherapy and chronic sun exposure. The most common tumor sites were scalp, nose and ears. Of different clinico-pathologic types, nodulo-ulcerative type was the most common. It seems that radiotherapy is an important risk factor in Iranian BCC patients and it is useful to have a screening program for case finding and treating patients in early stages