Iranian Journal of Pathology最新文献

Background & objective: CD24 is a small, highly glycosylated membrane protein whose expression is associated with tumorigenesis and the progression of several types of cancer. Prostate adenocarcinoma is one of the most common cancers in men, and microscopic Gleason grading is an important factor affecting prognosis. This study aims to investigate the relationship between immunohistochemical expression of CD24 and its relationship with benign prostatic hyperplasia (BPH) and Gleason grade in prostate adenocarcinoma.

Methods: This cross-sectional study was conducted on 163 patients, with an average age of 70.63±9.05 years, including 78 (47.9%) patients with prostate adenocarcinoma and 85 (52.1%) patients with benign prostatic hyperplasia., referred to Mostafa Khomeini Hospital in Tehran between 2018 and 2021, who underwent open prostatectomy or Trans Urethral Resection of Prostate (TURP). Immunohistochemical staining was used to evaluate CD24 expression, and Gleason grade was determined in the case of prostate adenocarcinoma. Data were analyzed with SPSS 22 and a P-value<0.05 was considered statistically significant.

Results: The percentage and intensity of CD24 staining in prostate adenocarcinoma patients was significantly higher than in BPH patients (P<0.05). Gleason score strongly correlated with the percentage and intensity of CD24 staining (P<0.05). The immunoreactive score, obtained by multiplying the CD24 expression percentage with staining intensity, was also significantly related to the Gleason score (P<0.05).

Conclusion: CD24 expression can be considered as a factor in differentiating cases of prostate adenocarcinoma from benign prostatic hyperplasia. Also, a high level of this marker can indicate the progress of prostate cancer.

We report a 4.5-year-old girl with recurrent episodes of bilateral lower limb weakness following periods of upper respiratory tract infection since the age of 1.5 years. Nerve conduction velocity and electromyography studies suggested distal motor neuropathy. The whole exome sequencing analysis revealed a homozygous variant, c.955G>A (p.Gly319Ser), of the mitochondrial trifunctional protein α-subunit (HADHA) gene. This variant has already been reported as pathogenic in an Iranian consanguineous family with a probable diagnosis of Charcot-Marie-Tooth disease. In addition, this variant, in compound heterozygosity with another likely pathogenic variant, has been known to be linked with mitochondrial trifunctional protein deficiency.

Wolffian adnexal tumors (FATWOs) originate from the mesonephric duct remnants. FATWOs are extremely rare and 100 incidental FATWOs have been reported in the English literature as of now. Most FATWOs have low potential for malignancy but aggressive behavior including recurrence and metastasis have been described in few cases; There is no standard protocol for optimal treatment of FATWOs. The case described here is a 35-year-old female who presented with a right-side ovarian mass via abdominal ultrasound. She had a history of left salpingo-oophorectomy due to an abdominal mass, which both histopathologic and immunohistochemical study's findings were consistent with Wolffian tumor. Later, she underwent total abdominal hysterectomy with tumor debulking because of the probable malignant behavior of the tumor. FATWO has a heterogeneous histologic pattern which may make its diagnosis challenging. No specific immunohistochemical markers have yet been recognized for FATWO and pathogenesis or molecular alterations are not definitive. Therefore, there is no comprehensive recommendation for optimal clinical management of FATWO or its recurrence.

Background & objective: Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide, which can lead to virus-related cancers. This study aimed to investigate the frequency of HPV genotypes in women with genital warts referred to available laboratories in Tehran by molecular hybridization method.

Methods: This cross-sectional descriptive study was conducted on the genital warts of 67 women aged 20-50, who were referred to the clinics of Afshar, Namad, Mani, and Al-Mohammed in Tehran province. Viral DNA was extracted using Add prep genomic DNA extraction kit, and genotyping was studied using HPV Direct Flow CHIP Kit. Data were analyzed by GraphPad Prism software.

Results: HPV was reported to be positive in all cases. The most common low-risk genotype involved was type 6, with 30 cases (44.77%), and the most common high-risk genotype involved was type 16, with 4 cases (5.97%) in the total population. Among the patients examined, there were 16 cases with multiple infections.

Conclusion: The results of this study showed that low-risk genotypes may be responsible for majority of the genital warts. High-risk genotypes and simultaneous infection with several genotypes could also be common in genital wart samples. Therefore, controlling HPV infection is important, especially in patients with high-risk genotypes. HPV genotyping should be considered in diagnosis and prevention of HPV-related cancers.

Background & objective: Thyroid lymphomas are predominantly secondary to lymphoma at other sites, and primary follicular lymphoma of the thyroid is a very rare entity.

Case presentation: Here, we report a case of a 62-year-old female who presented with swelling in the front of her neck for one month. The clinical diagnosis was a multinodular goiter. Fine needle aspiration cytology was done and reported as nodular colloid goiter with lymphocytic thyroiditis. The system examination was unremarkable. Histopathological assessments of the right hemithyroidectomy specimen revealed the effacement of thyroid architecture by abnormal and extensive lymphoid follicles. Immunohistochemistry revealed CD20, CD10, BCL2, and BCL6 positivity in the lymphoid follicles. FDG-PT CT scan demonstrated no evidence of lymphoma elsewhere. So, a e final diagnosis of follicular lymphoma of the thyroid was made.

Conclusion: Due to the rarity and low prevalence of primary follicular lymphoma of the thyroid and challenging in its differentiation from Hashimoto's thyroiditis with dense lymphoplasmacytic infiltration and formation of lymphoid follicles, histopathologic diagnosis should be confirmed by immunohistochemical studies.

Background & objective: Colorectal cancer is the second reason for cancer-associated death. The prognosis of the malignancy is defined by TNM scoring. However, tumor grading, lymphovascular invasion, perineural invasion, and tumor buddings may affect its prognosis. This study aimed to assess the prognostic and histologic impact of tumor budding in colorectal adenocarcinoma.

Methods: This study is a retrospective cohort of 192 patients with colorectal adenocarcinoma. All four stages of colorectal adenocarcinoma patients were included, but the patients in stages I and II were also analyzed separately. We used pathology reports to extract the histopathologic data. The prognostic values were extracted by calling the patients.

Results: Less than half of the patients were in stages I and II of the disease. According to our analysis, tumor extension and lymphovascular invasion were correlated with tumor budding count in patients in stages I and II, and lymphovascular invasion, tumor grade, tumor stage, lymph node involvement, tumor extension, tumor site, metastasis, and five-year survival were correlated with tumor budding within all stages.

Conclusion: It is recommended that tumor budding count should be assessed and reported in pathology reports of adenocarcinomas due to its high correlation with poor prognosis.

The effectiveness of immunotherapy for most cancer patients remains low, with approximately 10-30% of those treated surviving. Thus, much effort is being put into finding new ways to improve immune checkpoint therapy. Our review concludes that inhibition of proprotein convertase subtilisin/Kexin type 9 (PCSK9), which plays a critical role in regulating cholesterol metabolism, can cause movement of T cells toward tumors, with increased sensitivity to immune checkpoint therapies. We searched PubMed, NCBI, Scopus, and Google Scholar for the published articles without limitations on publication dates. We used the following terms: "PCSK9", "Cancer", "Immune Checkpoint", and "Cancer Prognosis" in the title and/or abstract. Our search initially revealed 600 records on the subject and stored them in the used databases under EndNote X8 management software. A total of 161 articles were selected and through a careful review, 76 were included in our research. We concluded that PCSK9 reduces the number of LDL receptors (LDL-R) on the cell surface, which is linked to its ability to regulate cholesterol levels in the body. Also, we discuss how suppressing PCSK9 leads to the MHC-1 accumulation on the surface of cancer cells, which results in T lymphocyte invasion. Finally, we believe that inhibiting PCSK9 may be an effective strategy for improving cancer immunotherapy.

Primary periocular histiocytoid carcinoma is a very rare malignant tumor. Until now, less than 50 cases have been reported in the English literature. It is characterized by resistant epiphora, limitation in extraocular motility, and ptosis. The definitive diagnosis of this lesion is made based on detecting histological histiocytoid features along with tracing positivity of specific biomarkers using immunohistochemistry. However, pathologists may be faced with two major obstacles in the diagnosis of this tumor including distinguishing it from metastatic histiocytoid lesions and also from benign mimics such as reactive inflammatory lesions. Here, we describe a case of primary periocular histiocytoid carcinoma located on the eyelid as well as review the literature to clarify the histopathological and diagnostic features of this tumor.

Background & objective: Breast cancer is thought to arise from non-invasive breast lesions, such as atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS). DCIS is considered a direct precursor of invasive carcinoma. The morphological features alone do not reflect the biological truth of this disease. Therefore, we investigated features of carcinoma in situ and the invasive components in women diagnosed with breast cancer.

Methods: This study was a cross-sectional study. The corresponding IHC slides were selected from the pathology archive and examined by the pathologist. Fifty-one samples which showed both in situ and invasive components confirmed immunohistochemically, were included in the study.

Results: In 70.6% of the cases a high grade of in situ and invasive carcinoma was observed. In 45.1% of the studied cases, a solid structure was observed in in-situ carcinoma, and no otherwise specified structure was observed in invasive carcinoma. In 74.5% of both in situ and invasive carcinoma types, ER.PR had a positive value. In 45.5% of the cases, both in situ and invasive carcinoma components show low Ki67. In 42.2%, both in situ and invasive carcinomas were Her2 negative. There was no significant difference between the grade (P=0.687), Her2 type (P=0.532), and structure (P=0.532). ER.PR (P=1.00) and Ki67 (P=0.180) of in situ and invasive carcinoma in this study.

Conclusion: Our study showed differences between in situ and invasive biomarker expression. According to our findings, owing to heterogeneity, in situ components can't be representative of invasive components for treatment choices.

Background & objective: Since early detection increases survival rates, colorectal carcinoma (CRC) is a major concern for researchers. CD10 is a cell membrane-bound metalloproteinase involved in carcinogenesis. Studies have associated it with the progression of CRC to advanced stages, metastasis, and venous invasions. We aimed to evaluate the immunohistochemical expression of CD10 in the tumor and stromal cells of colorectal adenoma and CRC and its correlation with the pathological prognostic factors.

Methods: This cross-sectional study was conducted on radical resection specimens of CRC and polypectomy specimens of the colorectal adenomas received for routine histopathological evaluation in the Department of Pathology, Ramaiah Medical College and Hospitals, Bengaluru, from March 2021 to October 2022. Tumor morphology was examined by light microscopy, and CD10 expression was evaluated by immunohistochemistry. Descriptive statistics in terms of percentage and Chi-square test/ Fisher exact tests were used for the statistical analysis.

Results: The study includes 46 cases of adenomas and CRCs each. Stromal CD10 expression was significantly higher in the carcinomas (63.4%) than in the adenomas (41.3%). Proliferative CRCs showed a significantly higher tumoral CD10 expression. The increase in the stromal CD10 expression in CRCs with increasing grades was found to be statistically significant. No significant association was seen between CD10 expression and other factors.

Conclusion: The results indicate a potential role of CD10 in the adenoma-carcinoma sequence. The significant increase in proliferating and high-grade CRCs suggests that CD10 could prove to be a potential biomarker for aggressiveness and also a therapeutic target in CRCs.