Multilocular cystic renal cell carcinoma, miss-diagnosed clinically as renal hydatid

Multilocular cystic renal cell carcinoma [MCRCC] is a rare clear cell type of renal cell carcinoma. Although cytologyically and cytogenetically MCRCC is similar to clear cell carcinoma, histology and behavior differ markedly. Prognosis in MCRCC is excellent as the tumour is of consistently low grade and surgical resection is curative. We report here a case of MCRCC in 44 year old female presented with right loin pain, was miss-diagnosed as renal hydatid cyst for 2 years. Local excision of the tumor mass only was done with no recurrence after 30 months of follow up after. The differentiation between renal hydatid cyst and MCRCC may be difficult clinically and radiologically.The tumor grows very slowly.The outcome of the lesion is not affected adversely by large tumor size. There is an increasing belief that MCRCC should be renamed and reclassified to indicate much more favorable prognosis than the conventional clear renal cell carcinoma

detection of neutrophiles in gastric mucosa of patients suspected to be infected with helicobacter pylori using leukostix

Helicobacter pylori has been detected in many populations and associated with inflammation of gastro duodenal mucosa. Colonization of the stomach by Helicobacter pylori occurs in more than half of human population worldwide. It is the principle cause of chronic active gastritis, peptic ulcer and gastric cancer. To detect neutrophiles in homogenates biopsied gastric mucosa semiquantitatively using rapid leukocyte strip test [leukostix]. A total of 115 patients [74 males, 41 females] referred to The Gastrointestinal Tract Center and Gastroscopy Department of Baghdad Medical City and subjected to gastroscopy were included in this study during the period from November 2004 to May 2005. The sensitivity and specificity of leukostix at the initial examination were 95.8%, 88.23% respectively. The leukostix test, using biopsied samples of gastric mucosa was excellent for quantitative determination of neutrophils in patients infected with H pylori

Diaphragm disease of the jejunum

Non-steroidal anti-inflammatory drugs [NSAIDs] are associated with the development of diaphragm disease. We report a 73-year-old male patient with this condition who had used NSAIDs for 2 years. He presented with general weakness, syncopal attacks, and a short history of melena. At laparotomy, multiple areas of constricted bowel were found in the resected proximal jejunum. Gross and microscopic examination confirmed diaphragm disease. The relevant literature is reviewed

Pathogenesis of campylobacter jejuni infection with emphasis on ultra structural changes

Studying comprehensively the pathogenesis of local isolate of C. jejuni in our country with their details by using ultrastructural studies depending on suitable protocol and animal model. Newly local isolate of C. jejuni [CJM6] which isolated from children was used to study the pathogenesis of such bacteria after oral administration of 1.7x10 viable cell /ml for gnotobiotic mice which were as animal model. Under scanning electron microscopy [SEM], the earliest colonization with huge numbers of C. jejuni appear at 24 hours post inoculation [P.I], and early adherence at 48 hours P.I with normal mucosal appearance. The mucosal and edema and loss of microvilli in some areas of epithelial surface were observed 3 and 4 days after inoculation, due to early penetration of C. jejuni. In 5 days after inoculation, the mucosa revealed irregular opening of cecal crypts with reduction of goblet cells numbers as well as destroyed cecal mucosa. While 6 and 7 days P.I revealed patchy erosion and necrosis with persistence adherence and colonization. Under transmission electron microscopy [TEM] the colonization was seen within the mucous environment of cecal epithelium, with normal appearance of cellular details. 3 and 4 days P.I some cases showed mixed healthy cells and other showed abnormalities of microvilli, as well as presence of free invasive C. jejuni, within epithelial cytoplasm, while deeper crypts were seen to be heavily colonized. Degenerative changes included partial loss of surface mucosal microvilli with numerous invasive C. jejuni mucosal goblet cells, while others seen within membrane vacuole in cytoplasmic epithelial cells 5 days P.I. At later stage of infection degenerative changes of microvilli ranged from elongation, fusion swelling, budding to abnormal shortening and microvillous-cytoplasmic extrusion toward C. jejuni within cecal lumen as well as exfoliated microvilli and apical cytoplasm into lumen. Gnotobiotic mice improved to be suitable model for studying pathogenesis by producing transient bacteremia, diarrhea and intestinal lesions resembling that which may occur in human. EM [SEM and TEM] is an important in increasing our understanding of disease pathogenesis which include colonization, adherence, penetration, multiplication and invasion as well as producing several pathological changes

Diagnostic value of cytology and colposcopy in patients with abnormal cervical pap smears

An optimal cancer detection system for preclinical cervical lesions should combine a cytological examination with a colposcopic follow-up examination. Detection at early pre-invasive stage provides an opportunity for treatment to prevent progression to invasive cancer. The present study aimed at evaluation of cytology, colposcopy, and combined cytology and colposcopy in predicting histopathological diagnosis of cervical intraepithelial neoplasia/squamous intraepithelial lesion [CIN/SIL] or other neoplastic changes in patients with abnormal cervical cytological findings. This prospective study was conducted in the Cyto-colposcopy Unit of Teaching Laboratories and Outpatient Department of Medical City Teaching Hospital over a period of one year [Sep. 2001- Sep. 2002]. Eighty-one married females were included in the study. A cervical smear was taken followed by a colposcopic examination of the cervix and then a punch biopsy was taken from the suspected lesions for histopathological study. Estimation and evaluation of the validity parameters of cytology, colposcopy, and combined cytology and colposcopy were performed using different cutoff points by special statistical analysis. Sensitivity, specificity and accuracy of cytology in the diagnosis of CIN/SIL were 73%, 93.2% and 84.0% respectively. The False- negative rate was 27%. Sensitivity, specificity and accuracy of colposcopy in the diagnosis of CIN were 83.3%, 58.5% and 70.1% respectively choosing doubtful findings as a cut-off point. The combination of cytology and colposcopy gave the following results: sensitivity, specificity and accuracy were 94.6%, 61.4% and 76.5% respectively; the negative predictive value [NPV] was 93.1%. When suspicious colposcopic findings were chosen as the cut-off point, the specificity and the positive predictive value [PPV] were higher at the expense of sensitivity and NPV. The conventional Pap smear, a valuable tool in the evaluation of patients with abnormal cervical cytology, was found to be of relatively low sensitivity in predicting CIN/SIL. Colposcopy is a valuable tool too. However, the validity parameters showed variable figures depending on the different cut-off points applied for the diagnosis of CIN/SIL. The ideal cut-off point was when doubtful and higher-grade colposcopic lesions are considered positive. The combination of cytology and colposcopy resulted in an increased sensitivity and NPV. The specificity could be further increased or improved when the threshold was set to distinguish higher-grade lesions [suspicious lesions] from lesser abnormalities

Choledochocele [type 111 choledochal cyst]: case report and literature review

A twenty-nine year old female, presented with intermittent Jaundice and right hypochondrial pain. On laparatomy a cystic mass at the terminal common bile duct found. Histopathological examination revealed Choledochocele [Type III choledochal cyst]. No post operative complications were encountered. Previously 48 similar cases have been reported in the literature

Lallemantia iberica leaves promote wound healing in mice

In folk medicine leaves of Lallemantia iberica have been claimed to promote wound healing. This study was designed to examine this claim. Wounds [10 10 mm] were made on the back of 24 mice. 12 mice were treated daily for 6 days or 9 days with Lallemantia iberica leaves incorporated in a vasaline base [1:4]. Another 12 mice were treated with vasaline alone for the same period. Results show that the wound size decreased significantly after 6 and 9 days of treatment compared to the control group. This results substantiates the folk medicine claims and supports more research into this medicinal plant to extract a useful drug to promote wound healing

Tumors and tumor like lesions of the retroperitoneum

The purpose of this study Is to elucidate the clinicopathological findings in patients with retroperitoneal tumors, A retrospective study on 152 consecutive patients with retroperitonial tumors seen at the medical City Teaching Hospital during the period between January 1987 and December 1989. All H and.E stained slides and pathology reports were reviewed. There were 118 tumors and 34 tumor-like lesions. Renal tumors were the most common [45.5%]. The most common histoIogical type of renal cell carcinoma was clear cell type [55.5%]. The majority of the these carcinomas were moderately differentiated. Liposarcomas and malignant fibrous histocytomas accounted for 50% of soft tissue sarcomas of the retroperitoneum. About 33% of retroperitoneal tumors were seen in children. Nephroblastoma, neuroblastoma and malignant lymphoma were the most common. Classical histological patterns were seen in 82% of patients with nephroblastoma and 60% of patients had favourable histology

Trans-abdominal fine needle aspiration comparison with surgical biopsy

Sixty patients with various abdominal lesions had fine needle aspirations. There were 38 malignant, 19 benign, I suspicious, and 2 inadequate smears. Forty nine patients had subsequent tissue diagnosis. The sensitivity and specificity were 93.8% and 88.2%, respectively. The procedure is accurate and safe. In this study no complication was en countered

FNA of breast lesions-Comparison with open biopsy

Fine needle aspiration[FNA] cytology was performed on 199 patients with various breast lesions seen at the Medical City Teaching Hospital. The age ranged from 15 to 75 years with a mean age of 38.3 years. Fifty three [26.6%] patients had malignant tumours; 25 [12.6%] had atypical cytologic findings, 105[52.8%] had benign lesions, and 16 [8%] had inadequate cytologic material for diagnosis. The cytologic diagnosis was compared with the histologic diagnosis in 84 patients. The sensitivity of FNA of the breast in this study was 88.6%, specificity was 98%, and the overall accuracy was 94.5%. Thus FNA is a safe, accurate, simple, and reliable technique for the diagnosis of breast lesions