Bilateral parotid gland tuberculosis

PubMedID: 16474972Tuberculosis is caused by a mycobacterium and is one of the most serious diseases in the world. Pulmonary involvement is the most common form of this condition. Primary tuberculosis of the parotid gland is rare. We report such a case in a 34-year-old man who presented with a painless preauricular mass on each side of his head. The clinical presentation, diagnosis, pathological findings and treatment are described. © Springer-Verlag 2006

Lumbosacral meningial hamartoma and hypertrichosis: A case report

Objective: Ectopic meningiomas are rare tumors. In this paper, we describe a patient with lumbosacral meningeal hamartoma and hypertrichosis. Methods: An 18-year-old female with a red-violet skin lesion on her lower back was determined spina bifida at L5-S1 by x-ray. Magnetic resonance imaging sequences showed a fibrous band arising from a posterior fusion defect at L5-S1. Light microscopy examination of the specimen were seen islets of meningothelial cells and calcified psammoma bodies spread among the vessels, neuronal structures, and dense collagenous tissue. Result:We present a case lumbosacral ectopic hamartoma with hypertrichosis and a review of the nomenclature, classification and pathogenesis of this disorder. Conclusion: Ectopic meningiomas are rare tumors in which etiopathogenesis is not clear. They are usually independent of intracranial meningiomas. These lesions characterize with clinical and pathological diagnostic difficulties. In the literature, these lesions have been given a lot of names like ectopic meningioma, meningial hamartoma, cu tenons meningioma. Because this lesion did not consist solelv of meningial elements, we suggested that the cases should be more accurately labeled as meningial hamartoma

PCNA and Ki-67 in central nervous system tumors: Correlation with the histological type and grade

PubMedID: 12125971Determination of proteins in the control of proliferation in normal cells helps a better understanding of cellular transformation and proliferation mechanisms. Measurement of proliferative activity is important in determining the tumor grade, recurrence span and malignancy. Proliferating cell nuclear antigen (PCNA) and Ki-67 are two of the nuclear markers used to demonstrate the proliferative phase of the cell cycle. In the present study, 63 central nervous system (CNS) tumors of various histologic types, diagnosed in Çukurova University Medical Faculty, Department of Pathology and graded according to WHO grading system were examined for PCNA and Ki-67 monoclonal antibodies using immunohistochemistry. Results were analyzed with statistical methods. Distribution of PCNA and Ki-67 LI (labeling index) values were determined for different tumor types. The highest PCNA and Ki-67 LI values were detected in medulloblastoma, malignant meningioma, primitive neuroectodermal tumor (PNET) and glioblastoma (GBM) groups, while pilocytic astrocytoma, meningioma, craniopharyngioma and oligodendroglioma showed the lowest values. In such tumors, the correlation between the increasing grade and PCNA and Ki-67 LI values were statistically significant. A correlation between the clinical outcome and Ki-67 and PCNA LI values was also detected. Conclusively, both markers can be used to evaluate the tumor grade and to assess the possibility of recurrence and malignancy in CNS tumors

Helicobacter Pylori CagA Status Predicts Severity of Bulbar Pathology but Not Severity of Gastritis in Turkish Patients

Background: The link between CagA+ Helicobacter pylori strains and more severe gastritis is not consistent throughout the world. Our aims were to study the features of infection with H. pylori CagA+ strains, and to assess how these strains relate to severity of gastric and duodenal pathology in a group of Turkish patients. Materials and Methods: Mucosal biopsies of the duodenal bulb and the gastric antrum, corpus, and cardia of 29 patients with positive H. pylori cultures were semiquantitatively assessed for inflammation, bacterial density, epithelial proliferation (Ki-67 expression), and p53 expression. CagA was tested with polymerase chain reaction. Results: The highest frequencies of H. pylori, inflammation, Ki-67, and p53 expression were observed in the antrum, followed by the cardia, fundus, and corpus, respectively. Density of H. pylori was positively correlated with the degree of inflammation and with p53 overexpression in all gastric regions. The frequency of CagA+ H. pylori status in patients with duodenal ulcers was 67%, whereas the figure in non-ulcer patients was 30% (p=0.07). Bulbar inflammation was significantly correlated with CagA status (r=0.48; p<0.01). There were no significant associations between CagA positivity and gastric inflammation, H. pylori density, or epithelial proliferation. Logistic regression analysis did not identify any histologic parameter or H. pylori strain as an independent predictor of duodenal ulcer. Conclusion: The density of H. pylori, regardless of CagA status, is the most important predictor of inflammatory and proliferative reaction to gastric mucosal infection. Ulcer development in the bulbus may be related to bulbar inflammation, which is enhanced by CagA+ strains which did not show significant effect on gastric pathology in Turkish patients

Specificity of MOC-31 and HBME-1 immunohistochemistry in the differential diagnosis of adenocarcinoma and malignant mesothelioma: A study on environmental malignant mesothelioma cases from Turkish villages

PubMedID: 12515999Histological diagnosis of malignant mesothelioma (MM) and differentiation from adenocarcinoma is often difficult. A number of clinical, radiologic, histologic and histochemical criteria have been used as diagnostic aids, but most cases cannot be readily classified on the basis of these characteristics. In recent years, a panel of immunohistochemical antibodies have been increasingly applied for the differential diagnosis of these two tumors. MOC-31 has been recently used as specific for adenocarcinomas while reacting with a minimal number of benign and malignant mesothelial proliferations, and HBME-1 has also been presented as a mesothelial cell marker. In this study, we aimed to show the importance of these two antibodies among the environmental MM cases from Southeastern Turkey. Fifty five cases of MM and twenty adenocarcinomas were included in this study. Histochemical (PAS, PAS-D, mucicarmine) and immunohistochemical (Keratin, EMA, CEA, MOC-31, HBME-1) stains have been performed on each case. Keratin was positive in all cases. EMA stained 50 of 55 MM and all the adenocarcinoma cases. According to our results, dPAS, mucicarmen, CEA and MOC-31 positivity was statistically significant in the diagnosis of adenocarcinoma whereas HBME-1 was demonstrable in most MM cases (52/55) and 11 adenocarcinoma cases. - This study confirmed that in the diagnostic distinction between MM and adenocarcinoma, immunohistochemistry is an important diagnostic tool, however, a panel of antibodies must be used rather than any single antibody. HBME-1 should be included in this panel; MOC-31 can be used where CEA is not available or to doublecheck the reactivity of this antibody

The expression of survivin and Ki-67 in meningiomas: Correlation with grade and clinical outcome

PubMedID: 15072469Identification of proteins involving in the control of proliferation in normal cells may lead to a better understanding of cellular transformation and proliferation mechanisms. Measurement of proliferative activity may help determine the tumor grade, recurrence and malignancy. Forty meningiomas of various histological grade, diagnosed in Baskent University and Çukurova University Medical Faculty, Departments of Pathology, were graded according to WHO grading system and survivin and Ki-67 monoclonal antibodies were administered by immunohistochemical method. Findings were analyzed with statistical methods; distribution of survivin expression and Ki-67 LI values were determined for different grade meningiomas. The correlation between increasing grades of meningiomas, particularly between grades I and III, survivin and Ki-67 LI values was statistically significant. In addition, we have found a positive correlation between clinical outcome, survivin and Ki-67 LI. For over expression of survivin in some of the grade I meningiomas and no or mild expression in some of the grades II and III meningiomas, however, it has been suggested that apoptosis inhibited by survivin is not the only factor responsible for progression of meningiomas. © 2004 Kluwer Academic Publishers

New automated image analysis method for the assessment of Ki-67 labeling index in meningiomas.

Many studies have emphasised the importance of Ki-67 labeling index (LI) as the proliferation marker in meningiomas. Several authors confirmed, that Ki-67 LI has prognostic significance and correlates with likelihood of tumour recurrences. These observations were widely accepted by pathologists, but up till now no standard method for Ki-67 LI assessment was developed and introduced for the diagnostic pathology. In this paper we present a new computerised system for automated Ki-67 LI estimation in meningiomas as an aid for histological grading of meningiomas and potential standard method of Ki-67 LI assessment. We also discuss the concordance of Ki-67 LI results obtained by presented computerized system and expert pathologist, as well as possible pitfalls and mistakes in automated counting of immunopositive or negative cells. For the quantitative evaluation of digital images of meningiomas the designed software uses an algorithm based on mathematical description of cell morphology. This solution acts together with the Support Vector Machine (SVM) used in the classification mode for the recognition of immunoreactivity of cells. The applied sequential thresholding simulated well the human process of cell recognition. The same digital images of randomly selected tumour areas were parallelly analysed by computer and blindly by two expert pathologists. Ki-67 labeling indices were estimated and the results compared. The mean relative discrepancy between the levels of Ki-67 LI by our system and by the human expert did not exceed 14% in all investigated cases. These preliminary results suggest that the designed software could be an useful tool supporting the diagnostic digital pathology. However, more extended studies are needed for approval of this suggestion