IRANIAN JOURNAL OF PATHOLOGY (IJP)
Year:2010 | Volume:5 | Issue:2|Papers Count:10

Background and Objectives: Giant cell Tumor of bone (GCT) is often regarded as a benign tumor, but its clinical course is unpredictable, has a high rate of recurrence, and even can metastases and transform to a malignant tumor. Histological features of the tumor often could not predict its future biologic behavior, so it is just called ''Giant cell tumor'' without indicating malignancy or benignicity. Several methods are suggested to predict the biologic behavior of this tumor. This study evaluated the relation between Bax & bcl-2 as proteins involved in cell proliferation and death (apoptosis) with histopathologic features and clinical course of GCT.Materials & Methods: Paraffin- embedded tissue specimens of 40 GCTs of conventional, aggressive, recurrent, malignant, & metastatic types were evaluated by immunohistochemistry for Bax & bcl-2 markers. Clinicopathologic features and immunohistochemical results were statistically analyzed and presented in tables & diagrams. Results: Age, sex, and pattern of skeletal involvement were the same as other worldwide reports. Expression of Bax & bcl-2 markers were significantly higher in malignant GCTs but no statistically significant difference was found in other subtypes for bcl-2 while there was statistically significant difference between subgroups for Bax. Conclusion: Considerable expression of Bax & bcl-2 markers in a GCT could signal its malignant course, but low expression is not valuable in predicting the clinical course. In addition, it seems that secondary tumor nodules in lung are just simple implantation not true malignant metastases.

Background and Objectives: Retinoblastoma is the most common intraocular pediatric malignancy. Angiogenic factor expression such as VEGF (vascular endothelial growth factor) in retinoblastoma can be confirmatory angiogenic potential of this tumor. This study was performed to determine the role of angiogenesis in local invasion of retinoblastoma and its correlation with patients’ survival.Materials and methods: This clinicopathological analysis was performed on 60 paraffinembedded eyes with adequate tumoral tissue, which were stained using a CD34 antibody. Microvessel count was carried out in three tumor areas with the richest vascularity (hot spots) at a high magnification (× 400). The obtained data were correlated with histopathological characteristics and 5-years survival. Statistical analysis of the data was performed using student t-test and ANOVA test (P<0.05).Results: Tumor with local invasion to choroids, optic nerve, sclera and cilliary body showed statistically significant higher mean vessel density (P=0.00, P=0.041, P= 0.008 and P= 0.002, respectively). In addition, a statistically significant correlation was detected between mean vascular density and 5-years survival (P=0.031).Conclusion: The results suggest that in retinoblastoma, mean vessel density has a significant role in local invasion of tumor growth and a significant correlation with patient survival. Therefore, in these patients an anti-angiogenic therapy and minute diagnostic and follow up programs should be considered to identify metastasis.

Background and Objectives: Breast cancer is the most common cancer amongst Iranian women and worldwide. Unfortunately, the current clinical and histological criteria can only help 60% of women with breast cancer in diagnosis and long-term treatment. Therefore, genetic markers can play an important role in improving the diagnosis and prognosis of breast cancer patients. The aim of this retrospective study was to investigate the role of chromosome 17 copy number assessed by Interphase Fluorescence in Situ Hybridization (FISH), as the genetic prognostic parameter.Materials and Methods: Thirty Iranian women, aged 31 to 65 years with sporadic primary breast carcinoma were studied. Chromosome copy number was evaluated in relation to established clinicopathological parameters, the immunohistochemical markers of ER, PR, P53, age and the duration and status of survival in the patients. FISH, using centromeric probe for chromosome 17 was applied to interphase cells prepared from paraffin embedded tumor sections. More than 3000 cells for chromosome 17 were assessed. Data were analyzed with programs in SPSS 11.5.Results: Aneusomy for chromosome 17 was present in all 30 patients to different levels. The total abnormality rate for chromosome 17 was 57.03%, in which hypodiploidy was more frequent than hyperdiploidy (2.5 folds). Significant correlation was observed between chromosome 17 aneusomy rate and the stage of breast cancer (P<0.05).Conclusion: Chromosome 17 hypodiploidy alongside other clinical and pathological parameters may be considered as useful prognostic markers in sporadic carcinoma of breast.

Background and Objectives: Nasal polyposis is a diseases resulting from complex pathogenetic mechanisms. Some studies showed that TGFb1 had significant role in this pathogenesis. In this study, we investigated the roe of cytokines and mediators in polyp development. Material and Methods: In this case- control study, healthy nasal mucosal samples were obtained from 24 people undergoing septoplasty or rhinoplasty and polyp samples were obtained from 15 patients with nasal and paranasal sinuses polyposis undergoing endoscopic sinus surgery. TGFb1 concentration was measured with ELISA in homogenized polyp and control samples. The difference of the mean concentrations was analyzed with Mann-Whitney test.Results: We detected TGFb1 in 11 patients’ samples and in 22 control samples. There was not significant differentiation between the mean of TGFb1 levels in two groups. Conclusion: Measuring level of TGFb1 with ELISA technique in homogenized polyp and control samples have not significant differentiation.

Background and Objectives: Gliomas are the most prevalent primary brain tumors. The purpose of this retrospective cohort study was evaluation of clinical trend and prognosis of patients with brain glioma and effective factors in prognosis.Materials and Methods: Hundred and forty-five patients with supratentorial brain glioma, treated in Shahid Mostafa Khomeini & Hazrat-e-Rasool hospitals in Tehran, Iran from March 1999 to August 2005, were studied. Clinical, therapeutic and malignancy grade data were collected. The WHO classification was used for reporting malignancy grade. All patients were pursued until August 2005. Mann-Whitney, Kaplan-Meier, Cox Regression, and Chi-Square test were used for analysis. Results: Median survival was 39.7 weeks for malignancy grade IV. One-year survival rates in malignancy grades of II, III, IV and all patients were 86%, 83%, 40% and 47%, respectively. In multivariate analysis, effective factors in prognosis of all patients above 60 were radiotherapy and malignancy grade IV; and in patients with malignant glioma were age of above 60 and radiotherapy; and in patients with low-grade glioma were motor deficits.Conclusions: Survival rate decreases from malignancy grade II to IV and this reduction is evident in malignancy grade IV. Role of radiotherapy as an effective factor in prognosis in all patients and in malignant glioma is important.

Background: and Objectives: The aim of this study was to detect the antibacterial properties of 0.01, 0.5 and 1% nano-TiO2 and -CdO against E. coli. Materials and Methods: E. coli was cultured in liquid and agar nutrient medium to evaluate the antibacterial effects of 0.01, 0.05 and 1% of both nano-TiO2 and -CdO via the optical density (OD) and log CFU/ml measurements.Results: Non-significant effect was seen for 0.01% of both nano-specimens. While, 0.05 and 1% of both nanoparticles showed considerably decreased bacterial number. A 4.5 and 1.9 times decrease in the OD value was found in the presence of 1 and 0.5% nano-TiO2, respectively (P< 0.001). 1.5 and 3.3 times decreased OD was seen in the presence of 0.5 and 1% nano-CdO, respectively, as compared to control (P<0.001). In the second study, 6.3 log CFU/ml of E. coli were present in the cultures treated with 1% nano-TiO2 and CdO at 4°C in water. Control E. coli cells survived for 12 days while complete cell death was seen when 1% nano-TiO2 was applied for 13 hours as compared to 1% nano-CdO, which showed complete cell death after 15 hours. In the third study, E. coli was grown in the agar medium with and without both nanoparticles and suppressed growth (4.5 and 5.6 times; P<0.001) was seen in the presence of 1% nano-CdO and -TiO2, respectively.Conclusion: In spite of the fact that both nanoparticles showed bactericidal activity, nano-TiO2 has proven to be more efficient antibacterial agent as compared to nano-CdO.

Background and Objectives: Non-fementer gram-negative bacilli (NFGB) are ubiquitous pathogen that has emerged as a major cause of health care associated infections. The aim of this study was to determine the prevalence and antimicrobial susceptibility of NFGB in an Iranian hospital.Materials and Methods: From July 2005 to November 2006 a total of 257 strains of NFGB including 109 (42.41%) strains of Pseudomonas aeruoginosa, 88 (34.24%) strains of Acinetobacter baumannii, 48 (18.67%) stains of Stenotrophomonas maltophilia and 12 (4.66%) strains of Burkholderia cepacia were isolated from clinical specimens taken from patients hospitalized in Milad Hospitsl, Tehran, Iran. Conventional bacteriological methods were used for identification and susceptibility testing of NFGB. Susceptibility testing was performed by method as recommended by Clinical Laboratory Standard Institute (CLSI). Data were analyzed using SPSS 11.5 for Windows (SPSS Inc., Chicago, IL).Results: A total of 257 non-duplicating of NFGB strains were isolated from 234 hospitalized patients. The most effective antibiotic against P. aeruginosa and A. baumannii was imipenem followed by tobramycin. Fluoroquinolones had moderate activity against P. aerugunosa. Most isolates of A.baumannii were multi-drug resistant. Susceptibility of S. maltophila to ticarcillinclavuanic, ofloxacin and ceftazidim was 96%, 94% and 81%, respectively. Thirty three percent of this bacterium isolates were resistant to co-trimoxazole.Conclusion: In our study, imipenem was the most effective antibiotic against P. aeruginosa and A. baummannii isolates. Previous history use of antibiotics, longer duration of hospital stay and mechanical ventilation were the major risk factors for resistance acquisition in NFGB especially in P. aeruginosa and A. baumannii.

Ancient schwannomas rarely found in the central nervous system and ancient change in an intracranial schwannoma (intracranial portion of the trigeminal nerve) is extremely rare. A seventyyear man presented with headache of 3 months duration and one episode of generalized tonic-clonic seizures. Imaging findings were suggestive of left temporal high grade lesion. During surgery there was well capsulated extra-axial lesion. Histology was suggestive of ancient schwannoma. Based on the literature it is suggested when the intraoperative appearance of a cerebello-pontine lesion is consistent with a schwannoma and the frozen section is suggestive of a malignant lesion, a complete excision of the lesion can be carried out.

Mesenchymal chondrosarcoma (MC) is an uncommon tumor with an aggressive behaviour. We present two cases of MC. The first one is a unique case of MC of the maxilla metastasized from the clavicle. The second describes MC in the mandible with extensive involvement of the condyle. A 31-year-old male and a 22-year-old male presented to Saveetha Dental College, with a 2-month history of progressive mass in left posterior maxilla and a firm swelling in the right mandibular region, respectively. Incisional biopsy of both the cases revealed characteristic bimorphic pattern composed of sheets of undifferentiated round and spindle cells along with areas of chondroid matrix of variable cellularity. Histopathological features were suggestive of MC. These type of neoplasm show local aggressive behaviour with high metastatic and recurrence potential due to which the prognosis of MC is poor.

Placental site trophoblastic tumor (PSTT) is the rare variant of gestational trophoblastic diseases (GTD), which differs histologically and immunologically from GTD. Diagnosis of PSTT is often difficult and delayed. In most cases, diagnosis is not possible until the surgery is performed. The most therapeutic choice is hysterectomy and it is usually successful. Here we report two cases of PSTT.