IRANIAN JOURNAL OF PATHOLOGY (IJP)
Year:2010 | Volume:5 | Issue:3|Papers Count:11

Background and Objective: Gliomas are the most common primary brain tumors. Despite therapeutic advances, the majority of gliomas do not respond to either chemo or radiotherapy. CD117, the gene product of c-kit has been expressed in cells of glial tumors. Because gastrointestinal stromal tumors (GISTs) that express CD117 respond dramatically to treatment with tyrosine kinase inhibitors, identification of glial tumors that express CD117 might open new therapeutic approaches for treatment of these tumors.Material and Methods: CD117 expression was investigated in 69 glial tumors of different types and grades. This protein was visualized by immunohistochemistry with commercially available antibody. The comparison of CD117 expression between high and low-grade tumors was evaluated with SPSS V16 soft ware and Chi square test.Results: Forty two percent of the tumors were positive for CD117 expression. There was a statistically significant difference in CD117 immunoreactivity between high grade and low-grade tumors (61.1% versus 21.2%, P=0.001). 96.6% of the positive cases had cell membranous and/ or cytoplasmic staining. All except two of the positive cases showed strong expression intensity. In 26.1% of cases, CD117 also expressed in endothelial cells of tumor vessels that 88.9% of them was in high-grade tamors. Glioblastoma, anaplastic oligodendroglioma and anaplastic ependymoma showed the highest staining grade.Conclusion: CD117 has an important role in growth of glial tumors, especially high grade ones and that patients with CD117 expressing glial tumors might benefit from tyrosine kinase inhibitors. This finding should be further studied.

Background and Objectives: Mutation directed inactivation of the tumor suppressor gene p53 have been found in countries with high frequency for hepatocellular carcinomas (HCCs). Our goal in the present study was screening of the p53 gene in tumor tissues from HCC affected individuals in southwest Iran for putative mutations in exons 7 and 8 that are known as hot spot regions. Materials & Methods: A total of 25 archival formalin fixed paraffin embedded samples prepared from 1997 to 2006 were collected from hospitals in southwest and northwest of Iran. We examined the codon 249 within the exon 7 using RFLP as well the full-length sequencing of exons 7 and 8. Results: The samples were diagnosed as HCC and classified in four groups, well differentiated (39%), moderately differentiated (54%), poorly differentiated (4.5%) and undifferentiated (2.5%). The hepatitis B virus (HBV) was detected in 16% (n=7) and 11% (n=5) of patient’s sera that were affected with liver cirrhosis. No patient was infected with hepatitis C virus. However, in one tumor sample a homozygote mutation was detected at codon 302.Conclusion: In contrast to the numerous reports, particularly from Asian countries, the selected HCC patients in this study show a very low mutation rate in the hot spot regions of the p53 gene. However, further mutation studies have to be conducted for the whole length of the p53 gene for more evaluation.

Background and Objectives: Primary amenorrhea is not a disease but a symptom that may result from several quite different causes. Common hormonal cause of primary amenorrhea includes constitutional delay, hypothalamic –pituitary dysfunction, chronic systemic disease and absent ovarian function. The aim of this study was to estimate the incidence of the chromosomal abnormality referred for karyotyping in patients with primary amenorrhea in southwest of Iran. Material and Methods: Chromosomal analysis was carried out in 220 such cases that were referred from different parts of the south of Iran. The standard protocol for peripheral blood lymphocyte culture was followed for metaphase chromosome preparation and conventional analysis of G-banded chromosome.Results: The frequency of abnormal karyotypes was 20% in primary amenorrhea. The chromosomal abnormalities can be classified into five main types with or without mosaicism. 1-The most frequent karyotype was X chromosome aneuploidies (10%, n=22) 2-Male karyotype 46, XY was present in 5.5 % (n=12). 3-Structural anomalies of the X chromosome were detected in 3.2% (n=7) . 4-Mosaicism of male chromosome constitution and X chromosome aneuploidy was present in two (0.9%) cases (45XO/46XY). 5-Mosaicism of X chromosome aneuploidy and structural anomalies of X chromosome was found in one (0.45%) case [45, X/46X, i (Xq)].Conclusion: The present study has emphasized that karyotyping is necessary in evaluation of primary amenorrhea. This study also revealed the incidence of chromosomal abnormalities in women with primary amenorrhea in southwest of Iran is similar to that reported in previous literatures.

Background and Objective: Garlic has been known worldwide as a dietary constituent with many pharmacological effects. The present in vitro study was designed to investigate the putative anticancer effect of garlic extract on cancer cells, and if this effect was through apoptosis induction. Material and Methods: Human colon adenocarcinoma cells HT29 were treated with different doses (1, 5 and 10 mg/ml) of fresh garlic extract in cell culture at 24, 48 and 72 h. Cell death was assessed by viability test, and its apoptotic nature was determined by terminal deoxynucleotidyltransferase mediated dUTP nick end labeling (TUNEL) assay. All experiments were statistically analyzed using SPSS 11.5 software.Results: Garlic extract induced a dose-dependent cell death with the highest values at 72 hours. The apoptosis analyses by TUNEL assay demonstrated that in each dose/time group the apoptotic values are much less prominent than the related cell death percentage found in viability test. In every dose, the sum of apoptotic cells in all three-time points was nearly equal to the percentage of cell death at 72 hours.Conclusion: Fresh garlic extract can induce a dose-dependent apoptotic cell death in cultured HT29 cell line.

Background and Objective: Ovarian tumors are among the most frequent pathologic conditions in gynecologic practice and a frequent cause of hospitalization and surgery. The aim of this study was to determine histologic distribution of benign operated masses especially functional ovarian cysts. Material and Methods: Benign ovarian files of operated patients (2961 cases) in 20 tertiary and secondary hospitals were reviewed regarding age and histopathology from 1998- 2005. Analysis was done by SPSS software (version 13).Results: The most common benign histologies in order of frequency were functional cyst (57%), serous cystadenoma (13%), dermoid cyst (10%), mucinous cystadenoma (7%) and endometrioma (6%).Conclusion: Functional cysts were the most common benign ovarian cyst. Nearly high distribution of functional cysts in the present study may be an index of need to management improvement and less surgical decisions in ovarian tumors.

Background and Objective: Organisms producing CTX-M b-lactamases are emerging as a source of resistance to oxyiminocephalosporins such as ceftriaxone and ceftazidime. However, the laboratory detection of these strains is not well defined. In this study, phenotypic assay for screening of extended-spectrum b-lactamases producing strains and molecular assay for the identification of CTX-M b-lactamases genes was developed and used to investigate the prevalence of these enzymes among clinical isolates of Klebsiella pneumoniae in three general hospitals of Tehran, Iran. Materials and Methods: Phenotypic detection was used for screening of isolates by agar dilution method. A decrease of ³3 doubling dilution in an MIC for either ceftriaxone or ceftazidime tested in combination with 4 mg/l clavulanic acid (prepared from Glasco Smith company) versus its MIC when tested alone, confirmed an ESBL-producing organism. The PCR assay consisted of four primer sets. Results: In initial screening test, 117 (69%) from 168 clinical isolates were positive and 51 isolates (31%) were negative. From the positive isolates, 96 isolates were positive in phenotypic confirmatory test. Using molecular assay, 117 strains potentially producing extended-spectrum-b-lactamases were examined for the presence of CTX-M enzymes. 88 strains (75.2%) were positive for blactx-m group I genes, 1 strain (0.85%) was positive for blactx-m group III greens, and 2 strains (1.7%) were positive for blactx-m group IV.Conclusion: The prevalence of extended-spectrum b-lactamases (ESBLs) are increasing significantly in hospitals of Tehran. In other side, we found that the CTX-M I group had the most prevalence than other CTX-M groups.

Background and Objectives: Blood stream infections cause significant morbidity and mortality in the world. In this study, we aimed at describing the organisms responsible for septicemia in 20062007- and their antimicrobial susceptibility that might lead to proper selection of antimicrobial agents in hospitalized patients with suspected sepsis. Materials and Methods: Microbiology reports of 1753 blood specimens collected from inpatients of a referral hospital in Iran were retrospectively reviewed. Specimen culture, bacterial identification, and disk diffusion susceptibility testing were performed according to The Clinical and Laboratory Standards Institute guidelines. Data were analyzed by SPSS, X² Test and the fisher exact Test.Results: Coagulase-negative Staphylococci accounted for most isolated bacteria (24.61%), in both genders. The second and third most frequent isolated bacteria in adults were staphylococcus aureus and Stenotrophomonas maltophilia, and in children were Klebsiella pneumoniae and S. aureus. Among the all Gram – positive cocci, vancomycin was the most effective agent. The most effective antibiotic varied among the Gram-Negative isolates, for example 95.65% of S. maltophilia were susceptible to co-Trimoxazole, and amikacin were suitable antibiotic in 85.29% of E. coli. Conclusion: As the degree of antibiotic resistance rate for blood stream pathogens is alarming, it is mandatory to monitor the susceptibility of these isolates in order to avoid inappropriate use of antibiotics in hospital wards.

Adenosquamous carcinomas of stomach are rare entities comprising 0.5% of stomach carcinomas. Here, we report a case of a 50-year-old female, who presented with weakness, pallor, and symptoms of gastric outlet obstruction. A partial gastrectomy was done and histology showed evidence of adenosquamous carcinoma of the antrum with metastasis to the perigastric lymph nodes. The patient condition improved at 6-month follow-up.

Primary sarcomas of the kidney are exceptional. Among renal sarcomas, leiomyosarcoma is the most common histologic subtype amounting to 50-60% of all cases. The tumor usually arises from either the renal capsule or smooth muscle tissue in the renal pelvic wall. In this paper, we report a patient with leiomyosarcoma of the kidney presented with non-specific abdominal pain and a palpable mass. Histologic examination revealed a mesenchymal tumor composed of pleomorphic spindle cells arranged in interlacing pattern with high mitotic activity. Immunohistochemical study was positive for Demin, smooth muscle Actin (SMA), and muscle specific antigen (MSA).The rarity of this disease and very little information about it, its severity, and poor prognosis, uncommon form of presentation, large size of the mass, and difficulty in management are highlighted and reported.

Gardner’s syndrome is an autosomal dominant inherited disorder. Familial polyposis of the colon, osteomas, hypertrophy of the retinal-pigmented layer and a multitude of soft tissue tumors are characteristic features. The syndrome may be presented with colonic or extracolonic symptoms. A 75-year-old male patient presented to Al-zahra Clinic with diffuse abdominal pain. An abdominal surgery was performed on him due to invasive abdominal mass. The surgical specimen was examined by H&E and immunohistochemical staining. The final diagnosis was fibromatosis. There was a history of gardner’s syndrome in his family. Colonoscopy was done to confirm the diagnosis of gardner’s syndrome. The diagnosis of gardner’s syndrome was made according to following findings: abdominal fibromatosis, multiple jaw osteomas and polyposis coli. The patient with gardner’s syndrome can present with abdominal fibromatosis even in an old age. In IHC staining CD117 was seen with coarse granular cytoplasmic pattern in fibromatosis, and so, this pattern of CD117 staining can be a clue to the diagnosis of fibromatosis.

The new paradigm in laboratory medicine is decentralization. The concept of bench top analyzer is introduced. After the first appearance of the bench top analyzer in 1970’s, continuous improvement of the technology can be observed (1). At present, there are some available bench top clinical chemistry analyzers. Here, the author performs a study to assess the fundamental performance between two bench top clinical chemistry analyzers. The studied model is the SPOTCHEM D-concept (2) versus Reflotron (3). The two studied bench top analyzers are the two widely used clinical chemistry analyzers in Thailand. The SPOTCHEM D-concept and Reflotron are based on solid phase based technology. The scenario of Thailand is used for modeling. The details of the product property were collected and given by a main point of care testing company in Thailand, Connect Diagnostics….