Benign metastasizing leiomyoma of the uterus

Herein, we report on a well-characterized benign metastasizing leiomyoma, presented in an unusual site. Up to the knowledge of authors, so far, only 76 cases of benign metastasizing leiomyoma have been reported. The tumor presented as a retroperitoneal mass three years after a hysterectomy Performed for leiomyomatosis of the uterus with extensive areas of hyalinization. Histopathologic and immunohistochemical studies of the resected mass were similar to the uterine leiomyoma, showing moderate cellularity of bland looking smooth muscle cells with minimal atypia, inconspicuous mitosis, and no necrosis in a hyalinized background

Results and complications of endoscopic ultrasound guided-FNA in patients with pancreatic and gastrointestinal submucosal lesions

Linear endoscopic ultrasonography [EUS] is a proven modality for the diagnosis and treatment of different gastrointestinal lesions. The aim of this study was to describe the role of EUS-FNA in the evaluation of pancreatic and submucosal lesions. Over a 1-year period, in a prospective descriptive study, patients referred to Naft Hospital, underwent linear EUS. Of the 40 linear EUS performed, 32 [80%] patients had pancreatic lesions which 26 [81%] of these cases were referred for pancreatic tumor biopsy. The most of these tumors [73%] were in the head of pancreas. EUS-guided fine-needle aspiration biopsy was performed in all 26 patients successfully without complications, which in 16 [61.5%] of them the diagnosis of pancreatic malignancy confirmed cytopathologically. Sensitivity and specificity of this method in pancreatic lesions were 84% and 100%, respectively. Eight patients [20%] were referred because of submucosal upper gastrointestinal lesions which in 7 [87.5%] of them GIST were diagnosed. Sensitivity and specificity of EUSFNA in submucosal lesions was 100%. No adverse effect of EUS-FNA was observed. EUS-FNA is a safe method with an acceptable accuracy in the evaluation and diagnosis of pancreatic and submucosal lesions. The results of this study are similar to that reported previously from other countries. Performing this new method requires more gastroenterologists and pathologists experience as well as more support from different societies [such as gastroenterology and surgery]

[High exposure to polycyclic aromatic hydrocarbons may contribute to high risk of esophageal cancer in northeastern Iran]

The northeastern region of Iran has some of the highest rates of esophageal squamous cell carcinoma [ESCC] in the world. To investigate the role of polycyclic aromatic hydrocarbons [PAHs] in the etiology of ESCC in northeastern Iran, we measured urine 1-hydroxypyrene glucuronide [1-OHPG], a stable PAH metabolite, in 99 inhabitants of this area. Results: The median urine 1-OHPG in participants of this study was 4.2 pmol/ml. Forty-two subjects [42%] had levels ranging from 1 to 5 pmol/ml, indicative of moderate PAH exposure, and 41 [41%] had levels above 5 pmol/ml, indicative of very high exposure. Further analysis showed that 1-OHPG levels were high in all subgroups of our study subjects, including both sexes; rural and urban dwellers; and smokers and non-smokers. Only 15% of the variance in 1-OHPG was explained by age, sex, residence, smoking, nass, or opium consumption. This pattern of PAH exposure parallels with the ESCC incidence pattern seen in this area. We conclude that people in northeastern Iran are exposed to widespread and very high levels of PAH, largely from unknown sources, and this may contribute to the high rates of ESCC observed in this area

[Impact of immunosuppressive treatment on liver fibrosis in autoimmune hepatitis]

Impact of treatment on progression of fibrosis in autoimmune hepatitis [AIH] is unknown. We assessed the changes in liver fibrosis before and after treatment among these patients. Nineteen AIH patients who had paired liver biopsies were studied. Of these, seven had been treated with 6 months of Cyclosporine-A and the rest with 6 months of prednisolone for induction of remission. Thereafter all had been maintained on azathioprine. Biopsy specimens before and after treatment, were reviewed by one pathologist and scored by the Ishak method. Mean fibrosis stage before and after treatment were compared. Also, factors predicting significant fibrosis [stage >/= 3] and cirrhosis [stage >/= 5] at presentation were assessed. Mean interval between biopsies was 3.38 years. Mean fibrosis stage decreased from 4.53 to 2.16 following treatment [p< 0.001]. Mean decrement in inflammatory grade was 8 scores [range: 4-10] in patients in whom fibrosis improved, and 2 scores [range: 0-4] in patients in whom fibrosis did not decrease after treatment [p< 0.001]. ALT to platelet ratio was the best predictor of significant fibrosis and also cirrhosis. Fibrosis commonly improves after immunosuppressive treatment in AIH. ALT to Platelet ratio can predict accurately the presence of significant fibrosis and cirrhosis in AIH