[Survey the association between tissue eosinophil counts and prognostic factors of esophageal SCC]

According to World Health Organization reports, the esophageal Squamous Cell Carcinoma [SCC] is most frequent in north-east of Iran. Infiltration of inflammatory cells, such as eosinophils, may play an important role in biologic behaviors of tumors. Survey the association between tissue eosinophil counts and prognostic factors of esophageal SCC. This analytical cross-sectional study was conducted applying a convenience sampling. The archive of pathology department of Imam-Reza Hospital, Mashhad, between 2005-2007 was standard method of Tumor-Associated Tissue Eosinophilia. Mean numbers of eosinophils and mastocytes between different groups of prevascular or preneural invasion, lymph node metastases, tissue differentiation status and depth of invasion were tested statistically. Twenty-five [61.0%] men and 16 [39.0%] women with a mean [Standard Deviation, SD] age of 53.6 [ +/- 14.78] were studied. Mean [SD] number of eosinophils and mastocytes were 115.4 [ +/- 88.16] and 30.7 [ +/- 26.03] respectively. Mean number of eosinophils was higher in patients with prevascular invasion [183.2 vs. 86.9] [p=0.002]. No other statistically significant association was found. Excess number of tissue eosinophils indicates the tendency towards more prevascular invasion. It is recommended to follow these patients intensively

Markel cell carcinoma on mustard Gas scar: a case report

Merkel cell carcinoma [MCC] is a rare primary neuroendocrine carcinoma of the skin in elderly individuals, on sun exposed areas of the body, with the head and neck being the most common sites. Excessive ultraviolet exposure may play an etiologic role in the development of it. Exposure to mustard gas can cause skin reactions and increase risk of skin neoplasms and probably MCC. The Aim of this study was to report this interesting case and review the published literature on MCC. In this article a 60 year old man with a history of exposure to chemical warfare sulphur Mustard gas in Iraq-Iran conflict and development of a hemorrhagic nodular mass with a duration of 3 months on his scalp, that based on histology, immunohistochemical staining and was diagnosed as MCC is presented. This was the first reported case of Merkel cell carcinoma in Iran exposed to sulphur Mustard gas. Sulphur Mustard gas can be an etiologic factor for this tumour

[ case of marfan syndrome with severe kyphoscoliosis in recessive autosomal from of inheritance]

Marfan syndrome is known as an autosomal-dominant connective tissue disorder which affects the skeletal, ocular and cardiovascular systems. The present case is a 14 year old girl who was suffering from severe hyphoscoliosis and blindness. She was born as a result of first cousin marriage. Ophthalmic examinations showed left iris cloboma with subluxation of lens and total retinal detachment of both eyes. Severe pectus excavatum with increasing the C/T ratio and severe and joint laxity in thumb fingers of both hands were also observed. The ability to join thumb and fifth finger around the wrist [Walker-Murdock sign] and Steinberg thumb sign were both positive. In her family history, three case of Marfan syndrome were diagnosed. Two of them were her cousins. One of her cousins died due to the aortic dissection at 18 years of age and the other was a 2 year old boy who had myopia, mild skeletal deformity, arachnodactyly and mitral valve prolapse. The case's brother also had clinical features like his cousins. The inheritance pattern of Marfan syndrome is recessive autosomic with unusual symptoms such as severe skeletal deformity and blindness

[ correlation of urine and serum P53 protein in patients with transitional cell carcinoma of urinary bladder]

P53 is a tumor suppressor gene which is mutated in 50% of human cancers. The purpose of this study was to evaluate the association between the protein status in the serum / urine and tumors of bladder cancer. This descriptive study was done on 38 patients with transitional cell carcinoma of bladder who had no history of chemo- or radiotherapy or immune system disease. The sera and urine of these patients were analyzed for P53 protein by Enzyme Linked Immunosorbent Assay [ELISA] and tissue P53 by Immunohistochemical Technique. Individul and laboratory data were collected in questionnaire and analyzed by descriptive statistics and frequency distribution tables. Tissue P53 was detected in 29 of 39 [74.4%] patients, serum and urine P53 protein were detected in the serum and urine of 20 of 39 [51.3%] and 27 of 39 [69.2%] patients, respectively. The mean serum and urine P53 level in positive Tissue P53 patients were 1.45 and 2.27 U/ml respectively, which was significantly higher when compared with mean serum P53 level in negative tissue P53 patients [p< 0.01]. In patients with positive serum P53 [n=20] tissue P53 was positive in 18 [90%] patients and negative in 2 [10%], which was statiscally unsignificant. In negative serum P53 patients [n=19], tissue P53 was negative in 8[42%] patients and positive in 11 [58%]. In patients with positive urine P53 [n=27], tissue P53 was positive in 25 [93%] patients and negative in 2 [%7], which was statiscally unsignificant. Statiscally significant correlation was observed between tissue P53 with pathologic grade of tumor [p= 0.05], but for serum and urine P53 such correlation was not seen. This study shew a strong relationship between tissue P53 protein overexpression and level of P53 protein in serum and urine of TCC patients. Therefore both serum and urine of patients with TCC were found to have significant clinical accuracy for determination of P53 gene status in patients with TCC of bladder

Pathological findings of osteoarthritis in sternoclavicular joint

The sternoclavicular joint [SCJ] is the only synovial articulation between the upper extremity and the trunk. This joint is one of the most frequently used joints, so osteoarthritis [OA] should be very common. However, there are few studies about OA in this joint. In this study, 48 sternoclavicular joints from the left and right joints of 23 cases and two left joints from two further cases were studied. Right and left sternoclavicular joints were removed together in an unselected sequential autopsy series. Ninety two blocks were prepared by cutting every SCJ to superior and inferior parts. Using histological staining, the articular surfaces of the SCJs were assessed microscopically. Contact radiography was done to help assessing the presence or absence of osteoarthritis. The features of normal joints were found in 18 blocks. Osteoarthritis changes were seen in 82 of the 92 blocks. There was no significant correlation between age and osteoarthritis. No differences in the degenerative changes were found between the sexes. Severe osteoarthritis changes were more common in the right SCJ and inferior part of the joint than in the left and superior parts respectively. The osteoarthritis changes were severe in 36.6% of cases and mild to moderate in 48.8%. OA was very common in these SCJs, which is not related to age and sex of the cases. There are clear changes in structure and glycan expression in the articular cartilage of the osteoarthritic sternoclavicular joint, which allow a distinction to be made between mild, moderate, and severe osteoarthritis and normal cartilage. Histochemical staining of the joints can lead to accurate diagnosis of this disease

[ rare case of primary orbital yolk sac tumour [YST]]

The endodermal sinus tumor [EST] or yolk sac tumor [YST] is a malignant germ cell neoplasm that usually arises in gonads, but on rare occasion occurs in extragonadal sites such as mediastinum, retoperitoneum and intra cranium. Orbit is an extremely rare location for this tumor. In this report a primary yolk sac tumor in the orbit of a 17 months old child is presented. Patient had a rapidly progressive proptosis and high level of serum alpha fetoprotein [12500 IU/ml]. After surgical biopsy and histopathological diagnosis, the patient treated with 4 courses of a 3 drugs chemotherapeutic regimen. A period of 6 months follow up did not reveal any sign of recurrence. Although yolk sac tumor is very rare in orbit, a rapid and correct histopathological diagnosis in conjuction with immunohistochemical and other paraclinical evaluation and at last, effective chemotherapeutic regimens can provide a good prognosis and even cure for the patient

[ accuracy determination of the Naegele's rule and Sonography for estimating the delivery date]

Estimation of the gestational age [G.A] and the estimated date of confinement [EDC] are of paramount important factors in prenatal care units. Naegle's rule is a usual method for determining GA and EDC based on the LMP in which 7 days added and 3 months subtracted. Nowadays sonography is one of the routine methods for estimating date of delivery and gestational age. The aim of this study was to determine the accuracy of Naegele's rule and sonography for estimating of delivery date. In this analytic-descriptive study, a total of 260 pregnant women from the Yazd prenatal care clinic were equally divided into second and third trimester. The EDCs of these ladies were determined by Naegele's rule and sonographic BPD and FL measurement. The values of these two methods were then compared with actual onset of the spontaneous labor. The difference between EDC based on the Naegele's rule and actual onset of labor was [-5] - [+8] days. However, this value changed to [-1] - [+18] when performed sonography was based on EDC. The derived means were 2.21 days for the Naegele's rule and 4.32 days for sonography at the second trimester, and at the third trimester, these figures were 2.42 days and 9.20 days respectively. The results suggest that the Naegele's rule is more accurate than sonography for the determination of EDC, and these methods especially sonography become less accurate with increasing gestational age

Frequency of macroprolactinemia in hyperprolactinemic patients with simple polyethylene glycol precipitation test

Hyperprolactinemia is seen not only in pregnancy but also in several pathological conditions, However, some patients with hyperprolactinemia are diagnosed as idiopathic, because the causes are unknown. They are subjected to repeated radiological examinations to find a microadenoma, to a long term treatment with bromocriptine, and even to a surgical intervention. There is evidence that macroprolactinemia, in which most circulating PRL form large protein complexes [>150 KDa], is a major cause of idiopathic hyperprolactinemia. Macroprolactinemic patients are clinically characterized by lack of or less hyperprolactinemia - related symptoms. The objective of this study was to assess the prevalence of macroprolactinemia in hyperprolactinemic patients. Prolactin was measured before and after precipitation of macroprolactin by polyethylene glycole in 113 hyperprolactinemic [PRL>28 micro g/L patients. In 23% of the patients, macroprolactinemia was found. Considering the high prevalence of macroprolactinemia and to avoid diagnostic and therapeutic pitfalls, the screening for macroprolactinemia in all hyperprolactinemic patients is recommended

[Comparing the prevalence of mast cells out the stroma of basal cell carcinoma and control group]

Basal cell carcinoma is the most frequently observed neoplasm of human skin. Many genetic and environmental factors contribute to pathogenesis of skin. It is shown that mast cell-derived histamine is an important mediator of systemic immunomodulation caused by UVB. The aim of this study was to compare the prevalence of dermal mast cells in BCC patients and control subjects with not inflammatory lesions in sunlight exposure site. Biopsy samples from sun-exposed skin were obtained from 40 BCC patients and 10 control subjects. Histological sections were prepared using H and E and Giemsa stains. Mast cells were counted in the whole specimen and mean number of mast cells per high power field [x40] was determined. We found a significant increase in the number of peritumoral mast cells comparing those in control group. [p< 0.001, student t-test] No significant association was found between the frequency of mast cells and age or gender. The association between high dermal mast cell prevalence and BCC development support for the concept that mast cells may be important to UVB-induced systemic immunosuppression in human. The results can be used as the baseline for future studies and development of new methods for medical treatment leading to prevention, suppressing the development and invasion, or eventually elimination of the tumor

[ case of polypoid sygmoid endometriosis like to colon cancer]

Ntestinal endometriosis is a rare but clinicaly significant complication. The most commonlly involved sites are the rectosigmoid and rectovaginal septum. Although serosal involvement is not uncommon in women of child bearing age. The mucosal involvement is rare and differential diagnosis from colon cancer may be difficult due to the lack of pathogonomonic symptoms and the poor diagnostic yield of colonoscopy and colonic biopsies. We present a case of a 31-year young woman with sigmoid endometriosis is presented with rectal bleeding in which the initial diagnostic workup suggested colon cancer. Histological evidence obtained from a colonoscopy along with clinical history Led to the final diagnosis of intestinal endometriosis

[Epithelial mesothelioma with desiduoid features a case report]

Deciduoid mesothelioma is an unusual morphologic variant of epithelial mesothelioma that closely simulate peritoneal decidusis, florid mesothelial hyperplasia and peritoneal metastatic carcinoma. We reported a rare case of epithelial mesothelioma with deciduoid features in a 12 years old girl with abdominal tightness and swelling and weight loss without history of asbestos exposure. CT scan and Sonography showed severe ascitis and multiple masses in peritoneal cavity. In the time of surgery very much fluid was evacuated and a multicystic huge mass occupying the pelvis was resected. In histopathologic examination malignant desiduoid epithelial neoplasm with psammoma bodies was seen which cells were positive for Vimentin, Cytokeratin, EMA, Calretinin

Chronic meningitis in acute promyelocytic leukemia [a case report]

The occurrence of extramedullary disease [EMD] at presentation or at relapse has long been considered a rare event in Acute Promyelocytic Leukemia [APL]. Our purpose from recent reports of EMD at presenting in APL have raised increasing concern about one of causes of chronic meningitis. This study describe a case of acute promyelocytic leukemia [APL] in 25 years old female patient admitted in Emam Reza hospital, presenting with severe headache and vomiting and showed signs of meningeal irritation as well as papilledema. Cytocentrifuge examination of CSF showed an excess of promylocytes, but peripheral blood didn't show any abnormal cell or blasts where as BMA showed increase of promyelocyte with multiple auer rod. After 2 weeks of aleukemic phase, this patient developed hematologic picture of APL diagnosed myeloid origin cells with myelopperoxidase stain. She was diagnosed as having leukemic meningitis and after 3 weeks in spite of chemotherapy, she dead Leukemic relapse or first presentation of leukemia may be the etiology of aseptic meningitis. Rarely central nervous. system leukemia and leukemic meningitis are associated with normal bone marrow and sometimes patients at Aleukemic phase present with meningitis. therefore we suggested that in patients with aseptic meningitis cerebrospinal fluid cytospine smear should be evaluated for neoplasic and leukemic cells

[Rapid preparation of tissues sections by microowave and comparison with routine method]

Microwave energy is produced from electricity energy via a magnetron which is discovered about 60 years ago and according to its several capabilities, is used in most industries. One of them is laboratory utility, especially in pathology laboratory, which was introduced in 1980 decade by Boon et.al. Microwave doesn't use in IRAN because ofexpensivity. Histoprocessing in pathology laboratory takes time about 24 hours and diagnosis is delayed one working day. For reducing time in diagnosis and decreasing hospital and insurance costs, and introducing an applicable way, the aim of this study is microwave oven usage in optimal tissue processing. ln this study, each level of processing was done separately and finally all the levels were combined then results were verified. According to details of tissue processing total time for all levels was 70 minutes. Distinction between each paithem was impossible and in many of them, microwave processing slides were better. Microwave processing could be used simply by pathology laboratories for reducing time ofhistoprocessing if correct calibration and setup is done

case report of limpomeningioma

Lpomeningioma is a rare benign tumor of meninges that contains mature adipose tissue. The heterogeneous enhancement visualized on CTscan, mimic necrotic malignant tumors. In this article a patient that presented with a frontoparietal mass lesion and in histopathologic examination revealed a benign meningothelial neoplasia with adipose differentiation, characterizing a lipoblastic meningioma, is described