Histopathologic and immunohistochemical features of Hashimoto thyroiditis.

Background: Intrathyroid lymphoid tissue is accrued in Hashimoto thyroiditis (HT). Histologically, this acquired lymphoid tissue bears a close resemblance to mucosa-associated lymphoid tissue (MALT) and can evolve to lymphoma. Aim: To demonstrate the morphological, and immunohistochemical profiles of Hashimoto thyroiditis and to ascertain the importance of light chain restriction in distinguishing HT with extensive lymphoplasmacytoid infiltrate from MALT lymphoma. Materials and Methods: We studied histopathologically and immunohistochemically (CD20, CD3, Igk, Igl and cytokeratin) 30 cases of HT for evaluation of the lymphoid infiltrate and the presence of lymphoepithelial lesions (LELs). Distinguishing between early thyroid lymphoma and HT was evaluated by light chain restriction. These findings were compared with two cases of primary thyroid lymphoma. Results: The histopathological findings were characteristic of HT. Immunohistochemistry confirmed inconspicuous, rare B-cell LELs as well as a prominent T-lymphocyte population. Testing for light chain restriction showed polyclonal population of plasma cells. The cases of MALT lymphoma had distinct destructive lymphoepithelial lesions, B-cell immunophenotyping and showed kappa light chain restriction in the plasmacytoid population. Conclusions: Hashimoto thyroiditis differs both histopathologically and immunohistochemically from thyroid lymphoma. In suspicious cases, immunohistochemistry could be helpful in reaching a definitive diagnosis.

Cytoplasmic nucleophosmin [cNPM] in acute myeloid leukaemia: Relation to disease characteristics

Nucleophosmin/B23 [NPM] is a 38 kDa molecular phosphoprotein involved in ribosome assembly and transport. Findings have revealed a complex scenario of NPM functions and interactions, pointing to proliferative and growth-suppressive roles. NPM appears to be more abundant in tumour cells than in normal cells. The aim of the work was to identify cytoplasmic localization of NPM using bone marrow clot biopsy and correlate it with disease and patient characteristics and the known prognostic factors, induction chemotherapy response and survival after 12 months of follow up. The present work was undertaken on 50 cases of normal karyotype acute myeloid leukaemia classified according to modified FAB system. Bone marrow aspirates were obtained, clotted and a formalin-fixed, paraffin embedded cell block was prepared. Sections were immunostained for NPM. Twenty-six cases [52%] had cytoplasmic positivity [cNPM+] while the remaining 24 cases [48%] had nuclear restricted NPM [cNPM]. cNPM positivity was significantly variable among the different FAB subtypes being the most prevalent among M5 and M2 cases, was associated with high blast and white blood cell count at diagnosis. It was significantly correlated with CD34 negativity, CD14 positivity but not with FLT3 mutations. Clinically no relation between cNPM positivity and age, sex nor extramedullary involvement of the studied patients was proven. The cytoplasmic positivity for NPM was significantly correlated with increased survival and better outcome after cycles of chemotherapy. So it can be regarded as a good prognostic marker. FLT3 positivity affected the survival of the cNPM negative group of patients remarkably, denoting the importance of combining both their statuses to predict outcome of therapy and survival. Our data confirm that cytoplasmic NPM1 immunoreactivity is predictive of NPM1 mutations and can be included in the routine diagnostic and prognostic workup of AML

Enalapril effect on rat renal changes after whole body irradiation. immunohistochemical and electron microscopical studies

Radiation of the kidney often leads to renal dysfunction associated with morphological alterations. The current study has been performed to investigate the possible protective role of enalapril in minimizing the radiation induced renal injury. The effect of whole body gamma irradiation at 8 Gy [single dose] was compared in rats treated with enalapril with untreated rats. Immunohistochemical and electron microscopic studies were done on rat's kidneys 4 and 10 weeks after irradiation. The results showed that irradiation lead to glomerular and tubular damage and collagen deposition. Enalapril treated irradiated kidneys had less renal damage and less collaged deposition. The present results indicated that enalapril has a protective role against the harmful effect caused by irradiation in both the parenchymatous damage and fibrosis

Duodenogastric reflux and symptomatology before and after cholecystectomy in patients with symptomatic gall stone disease

The aim of this work was to address possible factors that initiate, maintain or worsen the symptoms of duodenogastric bile reflux in patients with gallstones and to evaluate the effect of surgical removal of the gall bladder on the duodenogastric reflux. The study was carried out on 30 female patients with symptomatic gallstone disease who were admitted to Medical Research Institute Hospital for elective cholecystectomy. Preoperative upper GIT endoscopy revealed presence of duodenogastric bile reflux in 70%, gastritis in 53.3% and duodenitis in 46.7%. The mean value of the body mass index [27.69 +/- 3.04] was in the overweight range. patients were parous and high multoparity was associated more with complications[obstructive jaundice and acute cholecystitis] with a strong association between multiparity and duodenogastric bile refulex. Positive family history of gallstone diseasee was associated more with symptoms purely retated to gallstones. Follow up by clinical assessment and endoscopy after 6 months revealed persistence of duodenogastric bile reflux in 76.7%, gastritis in 56.7% and duodenitis in 53.3% with a significant increase in the occrrence of both epigastric and right upper quadrant pain as the main symptom post operatively in 18 patients [60%] compared to 12 patients [40%] preoperatively. We concluded that duodenogastric bile reflux is responsible for the initiation of most of the gallbladder symptoms and most of those symptoms may persist or appear post operatively