[ case report of kikuchi's disease]

Kikuchi's disease is a necrotizing lymphadenitis that is prevalent in Japan and is being increasingly recognized in other areas of the world. It usually occurs in women in their late 20s or early 30s and manifests as a posterior cervical adenopathy. It resolves spontaneously, usually over a period of several weeks to 6 months. Its initial clinical appearance is commonly similar to that of a lymphoma, and it can be pathologically misdiagnosed as such. We report a case of Kikuchi's disease that occurred in a 51-year-old Iranian woman. We discuss the clinical features, differential diagnosis, and pathology of this case in an effort to assist otolaryngologists in diagnosing this benign and uncommon entity

Mucoepidermoid carcinoma of the esophagus [case report]

The authors reported a case of mucoepidermoid carcinoma of esophagus, which is a rare primary carcinoma of the esophagus, characterized by a diffuse mixture of squamous and mucin-secreting glandular carcinoma cells. The patient was a 54-year-old man with a five-month history of dysphagia and endoscopic biopsy diagnosis of scc. The patient underwent a curative esophagectomy with a regional lymph node dissection. Histopathologic and histochemical study of specimen showed mucoepidermoid carcinoma of the esophagus

[The expression of e-cadherin in oral squalnous cell carcinoma and its correlation with histopathologic variables]

E-Cadherin is a cell-cell adhesion molecule involved in tumor progression and metastasis. We evaluated the E Cadherin expression pattern in oral SCC and investigated its relationship to histopathological features. The expression of E-Cadherin was evaluated in 43 formalin-fixed, paraffin-embedded specimens of oral SCC by immunohistochemistry. In normal squamous epithelium, E-Cadherin was expressed uniformly at the cell membrane. Abnormal E-Cadherin expression with loss of membranous localization was found in 62.8% cancer specimens. We used a scoring system for semi quantitative comparison of results. Altered E-Cadherin expression was found more often in higher grades than in lower grades [p=0.000] There was not any significant correlation between E-cadherin expression and muscular invasion [P>0.1]. There was not significant correlation between sex and E-cadherin expression. Abnormal expression of E-Cadherin occurs frequently in oral squamous cell carcinoma and correlates with dedifferentiation of tumors. Moreover, E-Cadherin expression is not associated with muscular invasion. We concluded that loss of normal E-Cadherin expression might serve as a differentiation marker in oral squamous cell carcinoma. Short running title: E-Cadherin Expression in Oral SCC

[p16/INK4a promoter hypermethylation in serum, blood and tumor of patients with esophageal squamous cell carcinoma]

Esophageal squamous cell carcinoma [ESCC] is one of the most common malignancies in Iran. ESCC patients are asymptomatic until later stages of disease which makes most interventions unsuccessful with survival rate of 5-20%. New tumor markers for early detection and/or identification of predisposing factors in ESCC may improve the life expectancy for this disease. p16, an inhibitor of cyclin D-dependent protein kinases, is a tumor-suppressor gene, with mutation and deletion reported in a variety of tumors. p16 promoter methylation is an important mechanism for inactivation of this gene and may be studied in serum DNA of cancer patients as a tumor marker. DNA isolated from serum, blood and endoscopic tissue of 30 ESCC patients and 30 normal volunteers were examined for p16 hypermethylation in province of Khorasan, North east of Iran. DNA sequences of methylated and unmethylated genomic regions after bisulfite conversion was distinguishable by sequence-specific PCR primers using methylation specific PCR [MSP]. p16 hypermethylation was found in 8/30 [26.6%] in serum samples, 13/30 [43.3%] in blood samples and 22/30 [73.3%] in tissue samples and none [0%] in normal volunteers. The 8 cases with aberrant p16 methylation in their serum DNA showed similar changes in their blood and tumor tissues. These results indicate that p16 hypermethylation may be found in the circulation with the origin of esophageal tumor DNA. Because methylation abnormalities have been found in many other genes and tumor types, this approach may have implications for noninvasive detection of a wide variety of cancers and this assay offers a potential means for the blood and serum-based detection and for monitoring of ESCC

[Detection of occult lymph node metastatic carcinoma by Immunohistochemical method and cytokeratin marker]

Immunohistochemical staining with an anticytokeratin antibody is useful in identifying isolated carcinoma tumor cells in lymph nodes missed in routine hematoxylin - eosin staining. The aim of this study was to determine the frequency of occult lymph node microscopic metastases by the immunohistochemically method in patients with various carcinoma. By a retrospective study at the university medical center [GHAEM Hospital] twenty eight patients who had carcinoma in various organs were investigated. 132 negative lymph nodes as determined by HxE staining and conventional microscopic examination were selected. All of these underwent additional sectioning and staining with HxE and an Immunohistochemical stain. All of the specimens were reevaluated by two pathologist, Immunohistochemical sating was performed using pancytokeratin AE1/AE3 antibody and these results were concluded. Examination of 132 1ymph nodes from 28 specimens revealed 19 micrometastases [%14.3]. The most numerous positive lymph nodes were in gastric carcinoma [%27], and the least positive lymph node was seen in colonic carcinoma [%3.3]. The location of tumoral cells in lymph nodes in five cases were sinusoidal, one case in subscapular and 13 cases in both sinusoidal and subscapular. According to results of this study the Immunohistochemical method is recommended for diagnostic use in negative lymph nodes for metastasis reported by routine hematoxylin-eosin staining. According to the results of this study we believe that Immunohistochemical methods enhance of the detection of occult micrometastases in lymph-node beside different tumors and are recommended for diagnostic use in patients who have been diagnosed node negative on routine hematoxylin-eosin staining

[Diagnostic value of AgNOR staining in differentiation between small cell carcinoma and benign lymphocyte in bronchial biopsy]

In some bronchial biopsies, differentiation between small cell carcinoma and severe lymphocytic infiltration of bronchial mucosa may be difficult. The aim of our study was to evaluate usefulness of AgNOR [Argyrophilic Nucleolar Organizer Region] staining method in this differentiation. Formalin fixed paraffin embedded tissues of 30 cases of small cell carcinoma and 30 cases of bronchial mucosa with benign lymphocytic infiltration were selected. Three microscopic slides from each case were prepared and stained for AgNOR, LCA [leukocytic Commn Antigen] and cytokeratin using Immunohistochemical method for the last two. In small cell carcinoma the mean number of AgNOR count was 4.97 per cell, and in lymphocytes it was 1.30[P<0.001]. The percentage of cells which demonstrated at least 3 AgNOR dots were 88.17% and 6.73% in small cell carcinoma and lymphocytes respectively [P<0.001]. The percentage of cells which exhibited at least 5 AgNOR dots were 55.67% and 0.6% respectively. AgNOR technique is a useful procedure for making differentiation between small cell carcinoma and lymphocytic infiltration in bronchial endoscopic biopsyies

[Evaluation of Ki- 67 experssion and AgNOR counts in mucoepidermoid carcinoma of salivary gland]

Introduction: mucoepidermoid carcinoma is the most common salivary gland malignancies, classified into three categories as low, intermediate and high. Because of its highly variable biologic potential, identification of patient's status histologically and proper classification is of high importance in treatment and finally prognosis

Materials and Methods: 20 samples with the diagnosis of MEC were selected from the archive of the oromaxillofacial pathology department of Mashhad dental school and Ghaem and Omid hospitals which included five samples of grade I, seven samples of grade II and 8 samples of grade III mucoepidermoid carcinoma. Three sections were taken from each specimen. The first section was stained with H and E, the second one by AgNOR technique and the last one with Ki-67 immunohistochemically. In each sample, the number of AgNOR dots in the nuclei of 100 cells and the number of brown nuclei which expressed Ki-67 in 100 cells were studied

Results: I. there was a significant correlation between salivary gland MEC histological grades and number of AgNOR dots. [rs=0.791, P value=0.00] 2. A significant correlation was detected between salivary gland MEC histological grades and ki-67 expression. [rs=0.893, P value=0.00] 3. The findings in our study [AgNOR dots and ki-67 expression] were slightly different between grades, I and II but the difference between the first two grades and the last grade was highly significant

Conclusion: use of any of the two proliferating markers mentioned above [AgNOR and Ki-67] is suitable in detection of histological grades of salivary gland MEC. Considering the highly significant difference between the last grade and the first two grades, MEC classification as low grade and high grade is suggested

presence of Estrogen and pregestrone receptors in intracranial vestibular schwanoma evaluated with immunohistochemical assay

The presence of estrogen and progesterone receptors evaluated in intra cranial vestibular schwanoma. Material and method: In this study 31 patients with acoustic neuroma operated between 1994 and 2001 in Ghaem Hospital were studied retrospectively. The paraffined biopsies were evaluated for presence of the estrogen and progesterone receptors by immunohistochemical assays. Medical records were reviewed for demographic characteristics of the patients, their clinical manifestations, location of tumors, surgical removal, and the size of tumors. there were 18 [58.1%] women and 13 [41.9%] men with average age 40.9 years. The most common clinical manifestation was hearing impairment [25 cases]. In eleven patients [35.5%] acoustic neuroma was in the right cerebellopontine angle [CPA], in 19 [61.3%] in left, and one patient with neurofibromatosis type II had bilateral vestibular schwanoma. Eighteen patients [58.1%] had progesterone receptors were detected. There was no relation between the patients characteristics [sex, age, and location of tumor] and the presence of the estrogen receptors of progesterone and estrogen receptors [p=0.524, p= 1.102, p= 0.526 respectively] and the progesterone receptors [p=0.739, p= 0.253, p= 0.466 respectively]. since the receptors of progesterone and estrogen were found in significant numbers in our patients, we suggest further studies on the role of these receptors in this tumor and their probable importance in treatment acoustic neuroma

Histiocyte-rich B-cell lymphoma: a case report of a rare variant of diffuse large B-cell lymphoma

The authors describe a case of histiocyte-rich B-cell lymphoma [HR-BCL], a variant of diffuse large B-cell lymphoma, in a 51-year-old man. The patient presented with large axillary lymphadenopathy. Histopathologic and immunohistochemical examination of lymph node biopsy revealed diffuse effacement of the lymph node architecture by reactive histiocytes and neoplastic CD20 positive B cells. Reactive histiocytes were negative for CD15 and CD30 immunostaining. The final diagnosis was histiocyte-rich B-cell lymphoma [HR-BCL] and the patient was referred to the oncology clinic for treatment