Iranian Journal of Pathology最新文献

Background & objective: Acinetobacter baumannii is a globally recognized nosocomial pathogen capable of developing multidrug resistance. This study investigates antibiotic resistance patterns, evaluates common resistance genotypes, and explores the genetic relatedness of PDR A. baumannii clinical isolates from hospitals in the Middle Euphrates region of Iraq.

Methods: Fourteen PDR A. baumannii isolates were obtained and subjected to antimicrobial susceptibility testing using the Vitek-2 compact system. Resistance genes were identified via conventional PCR, and clonal relationships were analyzed using multilocus sequence typing (MLST).

Results: Among 175 A. baumannii isolates, 8% (14/175) were classified as PDR strains, exhibiting resistance to all tested antibiotics. TEM was the most prevalent resistance gene (50%), followed by CTX-M (43%). SHV, IMP, KPC, OXA-48, and Mcr-1 genes were absent in all PDR isolates. MLST analysis identified five sequence types (STs): ST2, ST218, ST138, ST123, and ST460, with ST2 being the most common (50%).

Conclusion: The high prevalence of PDR A. baumannii strains in Iraq highlights the need for enhanced antibiotic surveillance. A comprehensive molecular investigation is necessary to mitigate the spread of these resistant pathogens.

Cutaneous pseudolymphomas (PSLs) as lymphocytic infiltrates are benign lesions that clinically and histopathologically mimic lymphomas. Miliarial type lymphocytoma cutis is an uncommon type of pseudolymphoma that is characterized by multiple semi-translucent micropapules on the sun-exposed regions. We present a 61-year-old woman who was admitted to our clinic with diffuse, sand-like, and erythematous micropapules on her face. Microscopic findings revealed nodular lymphoid aggregation, with the germinal center formation consisting of polyclonal lymphoid infiltrate confirmed by Immunohistochemistry (IHC) studies. According to this clinicopathological correlation, the miliarial type pseudolymphoma was confirmed and she was treated with topical corticosteroid ointment with a good response.

Background & objective: The regulator of chromosome condensation 2 (RCC2) and RAS-related C3 botulinum toxin substrate 1 (Rac1) have been implicated in the promotion of breast cancer cell proliferation and migration. The signaling pathway involving p53/RCC2/Rac1 has been proposed to contribute to the regulation of colon cancer metastasis. However, until now, this pathway has not been thoroughly investigated in breast cancer. This study seeks to explore the influence of immunohistochemical expression and the correlation among RCC2, Rac1, and p53 in breast infiltrating ductal carcinoma (IDC).

Methods: Immunostaining was performed on 120 breast IDC specimens using RCC2, Rac1, and p53 antibodies. Statistical analyses were conducted to examine the correlations between these antibodies.

Results: A Positive expression of RCC2, Rac1, and p53 was observed in 116 (96.7%), 120 (100%), and 33 (27.5%) of the breast cancer cases, respectively. RCC2, Rac1, and p53 demonstrated association with poor prognostic parameters such as frequent mitoses, high Ki-67 status, positive lymphovascular invasion (LVI), and advanced tumor stage. A highly significant direct correlation was found between each immunohistochemical marker and the other two markers. Shorter overall survival was linked to multifocal tumors (P=0.017), advanced tumor stage (T3) (P=0.010), Luminal B subtype (P=0.015), progressive disease (P=0.003), positive Her2neu status (P=0.008), and metastasis to distant organs (P<0.001). However, RCC2, Rac1, and p53 did not exhibit a significant association with overall survival.

Conclusion: The high expression levels of RCC2, Rac1, and p53 in breast IDC suggest their potential role in tumor behavior. The association of RCC2 and Rac1 with poor prognostic parameters may serve as predictive indicators for aggressive tumors, thus implying that targeted therapy could be beneficial in the treatment of breast cancer.

Background & objective: Antigen Ki-67 (histone-based nuclear protein) is a static marker of tumor cell proliferation and growth and is commonly measured to indicate the effect of treatment in breast cancer patients. This single-arm trial study aimed to evaluate the effect of short-term endocrine therapy (letrozole) on Ki-67 levels in menopausal women with early hormone-positive breast cancer who were referred to two university hospitals.

Methods: Patients with a pre-treatment Ki67 of 5% or less were excluded from the study. Participants (n=25) received oral letrozole (2.5 mg daily) seven days before surgery. Ki-67% on both biopsies and the surgical specimens were measured and compared.

Results and conclusion: The mean age of patients was 62±9.4 (48-83 years). Our result indicated that pre-surgery consumption of letrozole for hormone-positive breast cancer can significantly decrease the of Ki-67 labeling index (23.24±9.74 vs. 16.92±9.55, P=0.001 by paired t-test), with no drug-related adverse events.

Background & objective: Penile squamous cell carcinoma (SCC) is an extremely rare malignancy. It is usually caused by chronic human papillomavirus (HPV) 16 and HPV 18 infections. This study was conducted to investigate the immunohistochemical overexpression of p16, a surrogate marker for HPV, and to evaluate its usefulness as a potential diagnostic biomarker.

Methods: In this cross-sectional prospective and retrospective cohort study, 56 penile squamous cell carcinoma (SCC) specimens and five penile premalignant specimens were evaluated in Kasturba Medical College, Mangalore, India, from January 2013- December 2018 in terms of clinical and histopathological features. Immunohistochemical expression for p16 in cases and controls was evaluated. Statistical comparison of p16 expression among clinical features, histological subtype, grade, and stages of tumor were done.

Results: Analysis of the pattern of p16 staining showed diffuse and strong nuclear and cytoplasmic expression in 32.8% of the cases. There was a highly significant association (P<0.001) of pattern of p16 expression among the HPV and non-HPV subtypes of penile carcinoma. p16 expression was not significantly associated with other prognostic parameters like site of the lesion, lymphovascular invasion, perineural invasion, histologic grade, and pathologic stage.

Conclusion: Expression of p16 would be a useful tool in differentiation between the HPV-associated and non-HPV-associated subtypes of penile SCC that may be helpful in prediction of aggressiveness and invasive potential of the respective histologic subtypes.

The occurrence of rectosigmoid junction inflammatory myofibroblastic tumor (IMT) is uncommon in children. This is a rare form of mesenchymal tumor, belonging to the category of soft tissue tumors, and can be found at any anatomical site from the central nervous system to the gastrointestinal tract. Our patient was a 10-year-old male subject complaining of lack of defecation and constipation. The patient had decreased the frequency of defecation and constipation about two weeks before his referral and had not improved despite the use of laxatives. The abdomen was completely distended and there was no tenderness or guarding in the examination. Several airfluid levels are shown on the abdominal X-ray. In the ultrasound, free fluid was reported in the interlobular and pelvic spaces. The patient was transferred into the operating room. A tumor of the rectosigmoid junction was detected. Histopathologic studies showed evidence of IMT. IMT is a rare neoplasm of unknown origin, which may occur in various sites of the body. Complete surgical removal is usually curative, but early detection of recurrence is required. Treatment options include chemotherapy, radiation therapy, and immunotherapy. Further investigations are needed to improve the understanding and management of this rare tumor.

Background & objective: COVID-19 is a global pandemic that has caused an increase in hospitalization rates and high mortality. Secondary bacterial infections in hospitalized patients are one of the common complications of this viral disease. Due to the increased prevalence of antibiotic resistance, treating these patients is challenging. Therefore, this study aimed to evaluate the secondary bacterial infection and antimicrobial sensitivity test in hospitalized patients with COVID-19 in a tertiary hospital.

Methods: In this retrospective descriptive study, all patients with COVID-19 who were admitted to Shahid Modares Hospital (Tehran-Iran) from October 2020 to March 2021 with positive culture results for bacterial infections, were assessed. The significance level was lower than 0.05.

Results: Ninety-seven patients with a mean age of 65.23 ± 16.72 years were assessed. The male patients accounted for 58.8% of the patients, while 41.2% were female. The ICU admitted patients with critical COVID-19 severity accounted for 59.8%, while 40.2% were hospitalized in the ward with a severe form of the disease. Age, length of hospitalization, and mortality rate were significantly higher in patients with ICU admission (all P-values<0.05). The most antibiotic-resistant bacteria were Klebsiella pneumoniae (32.98%). ICU admission showed a significantly higher rate in patients who were resistant to Cefotaxime, Ceftriaxone, Gentamicin, and Co-trimoxazole compared to the patients who were hospitalized in the ward (all P-values<0.05).

Conclusion: Secondary bacterial infection in hospitalized patients with COVID-19 may lead to high mortality.

Lung cancer is the leading cause of cancer-related death around the globe. It is generally divided into small-cell and non-small-cell lung carcinomas. Small-cell lung cancer (SCLC) is a malignant tumor characterized by rapid growth, high metastatic potential, and a frequent rate of relapse after chemotherapy. All the features may worse aggressiveness of this cancer and increase the possibility of unsuccessful therapeutic attempts. Notch1 signaling is a crucial molecular pathway in the regulation of many cellular functions, including cell-cell communication and gene regulation. Moreover, it was proposed previously that Notch1 might be oncogenic in various types of cancer, but the question arises as to why many SCLC cell lines do not express this pathway. This review aims to explore the role of this complex pathway in SCLC in both vitro and vivo studies and whether it has a tumor-promoting or suppressive effect. After an extensive literature review, it was found that the expression of Notch1 signaling in SCLC reduces its proliferative ability while promoting increased cell apoptosis. Furthermore, it reduces cell motility, invasion, and metastatic ability and enhances cell-cell adhesion by inhibiting epithelial-mesenchymal transition (EMT). Furthermore, it contributes to cell chemo-resistance by altering multidrug resistance-associated protein-1 (MRP-1), demonstrating an overall tumor-suppressive effect. Given these findings, induction of Notch1 using histone deacetylase inhibitor (HDACi) may be a potential future therapeutic strategy for SCLC management. Nevertheless, the effect of such a sophisticated signaling pathway in tumor carcinogenesis can't be generalized to all human cancers, and further studies are needed to better tailor therapeutic plans based on the specific cellular context.

Background & objective: Placenta provides nutrition and protection from various infections and toxins to the baby while they are in the mother's womb. The present study was done to see the effects of coronavirus infection on the placenta of infected mothers and the final pregnancy outcome.

Methods: A total of 50 antenatal women (25 infected with coronavirus and 25 uninfected women) were enrolled and their placentae were examined for any significant histopathological changes. These changes were then correlated with the final pregnancy outcome.

Results: A significant number of placentae from infected mothers demonstrated features of maternal (54%) and fetal malperfusion (76%). However, no significant adverse pregnancy outcome was noted.

Conclusion: Increased rates of maternal malperfusion, and fetal malperfusion may be seen in placentae from infected women. However, these changes may not progress to any adverse fetal outcomes.