IRANIAN JOURNAL OF PATHOLOGY (IJP)
Year:2015 | Volume:10 | Issue:3|Papers Count:11

Spindle cell neoplasms are defined as neoplasms that consist of spindle-shaped cells in the histopathology. Spindle cell neoplasms can affect the oral cavity. In the oral cavity, the origin of the spindle cell neoplasms may be traced to epithelial, mesenchymal and odontogenic components. This article aims to review the spindle cell neoplasms of the oral cavity with emphasis on histopathology.

Background and Objective: Clinical behavior of basal cell carcinoma (BCC) is known to be different according to histological growth pattern and basosquamous cell carcinomas (BSC) are known with their aggressive behavior and metastatic capacity. In this study, we evaluated bcl-2 and cyclin D1 expressions in BCC and BSC cases comparatively, to explore their predictive value on the aggressive behavior of these tumors.Methods: One hundred tumors belong to 92 patients diagnosed as basal cell carcinoma and basosquamous carcinoma were studied. Basal cell carcinomas were classified as aggressive and non-aggressive types according to growth pattern. Number of CyclinD1 and bcl-2 positive cells in immunohistochemically stained serial sections were scored as low (0-1 +) and high (2 and 3+) in all tumors.Results: A statistically significant difference was found between non-aggressive (nodular type) and aggressive types (micronodular, infiltrative typesand BSC) for these markers (P<0.005). Cyclin D1 was higher in the aggressive group, while bcl-2 was lower in the aggressive group compared to the non-aggressive group.Conclusion: HigherCyclin D1 and lower bcl-2 scoreswas correlated with aggressive tumor types and these results could be used as markers to predict aggressive behavior in BCC and BSCs.

Background &Objective: Breast cancer is the most common female malignancy. Detection of DNA of human papillomaviruses (HPVs) in breast carcinomas suggests that the virus may play a role in the pathogenesis of this disease. The aim of this study was to evaluate the frequency of HPVs genotypes 6, 11, 16, 18 and 31 in paraffin-embedded tissue samples of invasive breast carcinomas. Methods: Three hundred and twenty six paraffin-embedded tissue samples of breast cancer were studied. PCR was performed using specific primers for HPV genotypes.Results: Of total 206 (63.2%) samples positive for Beta-globin gene, 54 (26.2%) were HPV-positive and 152 (73.8%) were negative for HPV. Distribution of HPV genotypes were as follows: 19 (25.7%) were positive for genotype 11, 5 (6.8%) were positive for genotype 6; and 2 cases (2.7%) were positive for both genotypes 6 and 11. Samples were also screened for HPV genotypes 16, 18 and 31 but none was positive.Conclusion: The current study confirmed the association of HPV and breast cancer. However, all samples were negative for high-risk HPV types 16, 18 and 31.

Background and Objective: The production of carbapenemases especially Klebsiella pneumonia carbapenemase (KPC) is the most important mechanism of enzymatic resistance in isolated Enterobacteriaceae such as K. pneumoniae. The purpose of this study was detected of the carbapenemase producer K. pneumoniae strains with phenotypic and genotypicmethods.Method: Out of 800 strains, 270 K. pneumoniae strains (33.7%), were obtained. Antibiotic susceptibility test was performed by disk diffusion method in accordance with CLSI guidelines. Carbapenem resistant strains were identified by the Modified Hodge Test based on CLSI instruction and PCR for surveying the presence of bla-KPC gene.Results: A total 270 K. pneumoniae strains were collected. Antibiotic susceptibility test results showed the highest and lowest resistance was related to piperacillin (60.6%) and carbapenems (14.6%) respectively. 80.5% (33 of 41) isolates were positive by MHT, but all of them (100%) were negative for amplification of the bla-KPC gene in the PCR method.Conclusion: The MHT was an appropriate method for approving carbapenemase production. Moreover, a laboratory could accept the carbapenemase production with PCR method for the bla-KPCgene, which has the additional profit of validating which KPC is present.

Background and Objective: Smoking can be associated with the decreasing gingival blood flow and epithelial changes. The aim of this study was to evaluate the histopathological changes of gingival epithelium and connective tissue in smokers.Methods: The study was case-control. Sixty male patients (28 smokers and 32 nonsmokers) suffering chronic periodontitis were participated in the study. Periodontal parameters consisting the gingival (GI) and periodontal (PI) indexes were registered. Tissue samples were taken during flap surgery. The hemotoxylin and eosin stained slides were assessed for blood vessel density, inflammatory cells infiltration and epithelial changes. The histopathological findings were compared between smokers and nonsmokers. Data analyzed using t-test and chi-square tests.Results: Smokers had lower GI (1.35±0.48) and higher PI (2.87±0.68) than nonsmokers (2.72±0.31 and 1.87±0.25, respectively). The mean count of blood vessels with ≤ 0.5m diameter was 18.78±10.06 and 5.90±2.93 in smokers, nonsmokers, respectively. The mean inflammatory cells infiltration in smokers, and nonsmokers were 0.89±1.03 and 70±0.46 that showed significant difference between two groups (P= 0.001, SD=1.21). The difference of epithelial hyperkeratosis, atrophy and acanthosis was not different in smokers and nonsmokers. Loss of normal epithelium pattern comprising of bulbous rete ridges, loss of polarity and increased parabasal cells was seen in 23(82.14%) of smokers and 2(6.25%) of nonsmokers.Conclusion: Despite the normal appearance of gingiva in smokers, smoking increasing the epithelial changes resemble to early phases of dysplasia and decreasing inflammatory reaction.

Background and Objectives: Breast cancer is the most common malignancy among women in the world. The aim of this study was to assess estrogen receptor (ER), progesterone receptor (PR) and HER-2/neu of infiltrating ductal carcinoma (IDC) with tumor size, histologic grade, lymph node metastasis and age.Methods: This study was carried out on 300 tissue blocks ofpatients with IDC who underwent mastectomyfrom 2007 to 2011 in ShahidBeheshti Hospital, affiliated to Babol University of Medical Sciences, Babol, Iran. Data including age, tumor size, and histologic grade and lymph node status retrieved from pathology department.Result: Themean age of the patients was 40.2±2.3 (ranged 19-82 years). ER and PR were positively correlated with each other (P=0.001) and they inversely correlated with HER-2/neu (P=0.001). We observed correlation between ER and PR expression and low histologic grade (P=0.001) and HER-2/neu expression and high histologic grade (P=0.003). There was correlation between HER-2/neu expression and lymph node involvement (P=0.03). None of these makers showed correlation with age and tumor size (P>0.05).Conclusion: Our findings indicate the importance of ER, PR and HER-2/neu expression asprognostic factors for therapeutic decision.

Neuroblastoma is the most common extracranial solid tumor in childhood. In different classification of neuroblastomas, a subset of undifferentiated or poorly differentiated tumors with bizarre histological features has been mentioned. A 3-year-old girl presented with abdominal pain. Her haematological and biochemical parameters were normal except her urinary vanelylmandelic acid level was elevated five times the normal value (64.4 IU/ml). On computed tomographyscan, a retroperitoneal contrast-enhancing mass was visible around D12-D13 region (60×52×47mm). Sections of CT guided trucut biopsy revealed large cells with pleomorphic nuclei, abundant cytoplasm and occasional multinucleated giant cells. Immunohistochemistry showed the cells reactive for neuron specific enolase, chromogranin-A, synaptophysin, non-reactive for cytokeratin, desmin and glial fibrillary acid protein and Alk-1. A diagnosis of anaplastic neuroblastoma was made. The child is currently under chemotherapy and doing well.

Mucinous carcinoma of the breast is a well-differentiated type of adenocarcinoma accounting for 2-5% of all breast cancers. Pure mucinous carcinoma of the breast has a favorable prognosis, usually seen in post-menopausal women. Neuroendocrine differentiation has been described in both in-situ and infiltrating breast cancers. Mucinous carcinomas of the breast appear to have the greatest association with neuroendocrine differentiation. Chromogranin A and synaptophysin are specific immunohisto chemical markers of neuroendocrine differentiation. Wereporta case of mucinous carcinoma of the breast with neuroendocrine differentiation in a 67-year-old female who was treated surgically in a classical manner.

Ollier’s syndrome, a variant of multiple enchondromatosis, is a rare disease with an estimated prevalence of 1/100,000, characterized by multiple enchondromas, asymmetrically involving small bones of the hands and feet, especially the proximal phalanges. Intracranial enchondromas, such as those arising from the skull base are extremely rare. Herein, we report a 25-year-old female, known case of Ollier’s disease, presenting with right eyelid ptosis and visual disturbance. Brain MRI revealed a skull base tumour suspicious to enchondroma followed by trans-sphenoidal resection. Histologic examination of the excisional biopsy sample confirmed the diagnosis of enchondroma.

Leiomyomas are benign tumors that originate from smooth muscle cells. Leiomyomas are well known to be the commonest neoplasm arising from the uterus but leiomyomas originating from the scrotum is a rare entity. They originate from the subcutaneous tissue or tunica dartos and can be solitary or multiple. We present a case of solitary scrotal leiomyoma in a 75 years old male who presented with a slowly growing, painless, firm, mobile 4cm lump in right side of scrotum. Clinically, it was provisionally diagnosed as sebaceous cyst and was excised. Histopathology and Immunohistochemistry (IHC) showed findings consistent with Leiomyoma. There was no cytological atypia or mitosis. The final diagnosis of scrotal leiomyoma was given.

Blue nevi are uncommon, asymptomatic lesions of the uterine cervix. These lesions are not often detected clinically or on colposcopy. Careful histopathological examination is required. The nevus cells are said to originate from the immature melanoblasts of the neural crest. These lesions need to be differentiated from malignant melanoma and melanosis of the cervix. We present here a case report of incidentally detected cervical blue nevus in a 52 year old lady.