Evaluation of total-LDH / heat resistant- LDH ratio in patients with acute myocardial infarction and unstable pectoral angina

چکیده: زمینه و هدف: اندازه گیری آنزیم های سرم به صورت معیار متداولی جهت تشخیص بیماران مشکوک به انفارکتوس میوکارد در آمده که از میان آنها می توان به لاکتات دهیدروژناز (LDH) و ایزوآنزیم های آن اشاره کرد. هدف این مطالعه مقایسه نسبت LDH تام به LDH مقاوم به حرارت، در بیماران مبتلا به انفارکتوس حاد میوکارد (MI) و آنژین صدری ناپایدار (UA) بود. روش بررسی: در این مطالعه توصیفی تحلیلی 110 بیمار با MI و 11 بیمار با UA، بستری در بخش CCU بیمارستان اکباتان همدان مورد مطامعه قرار گرفتند. تشخیص بیماری فرد بر اساس علایم بالینی، نوار قلب (ECG) و تغییرات آنزیمی بود. میزان LDH تام و LDH مقاوم به حرارت سرم 24 تا 48 ساعت بعد از بستری بر اساس مقدار مصرف نیکوتین آمید آدنین دینوکلئوتید فسفات (NADH) و تبدیل آن به نیکوتین آمید آدنین دینوکلئوتید (NAD) اندازه گیری شد. داده ها با استفاده از آزمون های آماری t و من ویتنی تجزیه و تحلیل گردیدند. یافته ها: نسبت LDH تام به LDH مقاوم به حرارت در بیماران مبتلا به MI 18/0±27/1 و در بیماران مبتلا به UA 39/1±51/2 بود (001/0

MAST CELLS IN BASAL CELL CARCINOMA

ABSTRACT Objective: Many researchers have been more interested in inflammatory changes in tumor stroma recently. Recent studies have shown that mast cells are significantly increased in human skin basal cell carcinoma (BCC) and are associated with tumor aggressiveness. In this study, we compared the number of mast cell population expressing c-kit in the BCC samples and normal skin. We also evaluated the number of this cell type in infliltrative and noninfiltrative subtypes of this tumor. Methodology: Tissue sections containing 30 cases of BCCs and 30 normal skins were prepared and after staining with c-kit were analyzed for the number of stromal mast cells. Results: Our results indicate that the number of c-kit positive mast cells was significantly higher in BCC when compared with normal skin (P <0.01), and number of mast cells in the stroma of infiltrative subtypes of this tumor is higher than noninfiltrative subtypes (p <0.04). In our study there wasn't any correlation between sex and age with mast cells count. Conclusion: Our results are in line with previous studies indicating that mast cell numbers are increased in BCC. In addition, the results suggest that mast cell populations may contribute to BCC progression. Besides, we demonstrated that this increase in mast cell density was independent of the patients' ages and sexes

Diagnostic value of P63 in differentiating normal gestation from molar pregnancy

Background: Considering the limitations of current pathologic methods in distinguishing two subtypes of hydatidiform mole and non-molar pregnancy, the utility of immunohistochemical markers in this regards and the importance of differentiating of mentioned pathologic patterns, in this study the expression of P63 in patients with complete hydatidiform mole (CHM), partial hydatidiform mole (PHM) and non-molar pregnancy was determined. Materials and Methods: In this study, formalin-fixed and paraffin-embedded tissues of 61 patients with definitive pathologic diagnosis of CHM, PHM and non-molar pregnancy retrieved. Diagnoses were based on the study of hematoxylin and eosin stained slides. Sections from all samples were stained for P63 marker using immunohistochemistry method. The nuclear immune reactivity of P63 marker in the three pathologic groups was determined by two pathologists. Results: P63 immune-staining was used to evaluate 20, 26 and 15 non-molar pregnancy, CHM and PHM cases, respectively. Mean ± SD of P63 nuclear immune-staining in molar pregnancy (CHM and PHM) and non-molar pregnancy were 32.4 ± 17.4 and 18.9 ± 17.2, respectively ( P = 0.006). The means were significantly different between non-molar pregnancy and PHM ( P < 0.000), CHM and PHM ( P = 0.02) and non-molar pregnancy and CHM ( P = 0.04). Conclusion: Considering the findings of the current study, though the nuclear immunoreactivity of P63 was higher in molar than non-molar pregnancy and in PHM than CHM, but using this marker alone is not suitable as a diagnostic test due to its low sensitivity and specificity. It could be used as adjuvant test in conflict cases. It is recommended to evaluate the role of other immunohistochemical markers like Ki-67 in this regard

Diagnostic utility of PAX8 in differentiation of mullerian from non-mullerian tumors

Background: Considering the high prevalence of female genital tract neoplasms, non-specific nature of the initial symptoms, higher possibility of metastasis by the time of diagnosis, importance of differentiating metastatic Mullerian tumors or metastatic breast cancer in the female genital tract, especially in the ovary, and lack of diagnostic markers with high sensitivity and specificity, the purpose of the current study was to evaluate the utility of Paired box protein8 (PAX8) expression in Mullerian and non-Mullerian neoplasms. Materials and Methods: In this descriptive-analytic, cross-sectional study, paraffin-embedded tissues of patients with definitive pathologic diagnosis of Mullerian and non-Mullerian tumors were selected. PAX8 immunohistochemical (IHC) staining was performed for all selected blocks. Immunopositivity of the slides for PAX8 was reviewed. It was defined as the presence of nuclear staining in at least 10% of the tumor cell nuclei. Results: Thirty-seven Mullerian (including 18 ovarian epithelial tumors, 17 endometrial carcinoma and two endocervical adenocarcinoma) and 37 non-Mullerian tumors were studied for PAX8 expression. Twenty-nine of 37 (78.4%) and one of 37 (2.7%) of the Mullerian and non-Mullerian tumors were positive for PAX8, respectively. The sensitivity and specificity of PAX8 by IHC for differentiation of Mullerian from non-Mullerian tumors was 78.4% and 97.3%, respectively. Conclusion: Our findings indicated that PAX8 could be used as a useful IHC marker for diagnosing Mullerian tumors. It has moderate to high sensitivity, but high specificity, for diagnosing carcinomas of Mullerian origin

CD10 expression helps to differentiate basal cell carcinoma from trichoepithelioma*

Background: The distinction between basal cell carcinoma (BCC) and trichoepithelioma (TE) may be very difficult in some cases because of the close similarities of these two lesions clinically and histopathologically. The purpose of this study is to investigate the usefulness of CD10 in distinguishing BCC and TE. Methods: The immunohistochemical expression of CD10 was evaluated in an archived group of 30 BCCs and 12 TEs in a retrospective cross sectional study. The localization of anti-CD10 to the tumoral and/or stromal cells was determined in each case and was compared between these two tumors using Fisher′s Exact Test. Results: In BCC cases, the expression of CD10 was noted in tumoral cells in 26 cases (83.2%). Of these, 3 cases showed positivity of the stromal and basaloid cells, two cases demonstrated stromal expression alone and two BCCs were not immunoreactive. On the other hand, 10 out of 12 (83.3%) TEs showed positive stromal immunoreactivity. Of these, one case also showed positivity of the basaloid cells. One TE demonstrated epithelial expression alone and one TE was not immunoreactive. The pattern of staining of basaloid cells and stromal cells in BCC and trichoepithelioma was statistically different (p < 0.001). Conclusions: We conclude that CD10 is a useful marker in the differential diagnosis of BCC versus TE

Diagnostic value of claudin-4 marker in pleural and peritoneal effusion cytology: Does it differentiate between metastatic adenocarcinoma and reactive mesothelial cells?

Background: Several markers have been used to make a distinction between metastatic adenocarcinoma and reactive mesothelial cells in the body cavity effusions. This study aimed to evaluate the diagnostic value of claudin-4 marker in making such a distinction. Materials and Methods: In this cross-sectional study, a total of 92 pleural/peritoneol effusions have been studied, including 47 cases of definite metastatic carcinoma and 45 cases of reactive mesothelium, and definitely negative for malignancy. Specimens were collected from patients; cell block samples were derived and used for immunohistochemical staining. The antibody used for immunohistochemical labeling was monoclonal anti-claudin-4. In the evaluation, membrane-bound reactivity was considered as significant and positive cases were defined when at least more than 10% of tumor cells were distinctly labeled. Results: Claudin-4 protein was positive in 40 specimens of metastatic carcinoma, while none of the cases of reactive mesothelium stained with the marker. This was not detected in the mesothelial cells, though. Positive staining for claudin-4 was significantly more frequent in metastatic carcinoma than in the reactive mesothelium (P > 0.0001). The sensitivity and specificity of claudin-4 to distinguish reactive mesothelium from metastatic carcinoma were 85% (95% confidence interval [CI], 71.1-93.8%) and 100% (95% CI, 91.1-100%), respectively. Furthermore, negative likelihood ratio was 0.15 (95% CI, 0.08-0.29). Conclusion: The results of this study demonstrated that claudin-4 is less frequently expressed in reactive mesothelium. Thus, this claudin may be helpful in differentiating metastatic carcinoma from reactive mesothelial cells in pleural and peritoneal fluid cytology specimen

Langerhans cell histiocytosis following Hodgkin lymphoma: a case report from Iran

The occurrence of Langerhans Cell Histiocytosis (LCH) in a patient with lymphoma is an indication of a probable relationship between them. The two conditions have similarities both clinically and histopathologically. Occurrence of these two conditions in the same patient, particularly not simultaneously, is rare. According to different management and treatment of these conditions, exact histopathologic evaluation and even using immunohistochemistery (IHC) can prevent misdiagnosis. In this report, a 10 year old boy presented who afflicted with LCH 3 years after diagnosis and treatment of mixed cellularity Hodgkin lymphoma

Idiopathic thrombocytopenic purpura in women with breast cancer

The association of solid tumors with idiopathic thrombocytopenic purpura (ITP) is rare. However, there have been some case reports indicating an association between breast cancer and ITP. In this article four patients with breast cancer and ITP are mentioned. The diagnosis of breast cancer was based on the results of biopsy or surgical sample. The ITP diagnosis criteria were 1) exclusion of drug induced thrombocytopenia, 2) platelet count less than 140 × 109 /l with normal or increased number of megakaryocytes on bone marrow samples, and 3) absence of splenomegaly. In this case report an association of breast cancer and ITP is shown

Mast cells in invasive ductal breast carcinoma

&lt;ul&gt; &lt;li&gt;&lt;strong&gt;BACKGROUND&lt;/strong&gt;: Inflammatory cells in the tumor stroma have gained increasing interests recently. We aimed to study the prognostic impact of the presence of stromal mast cells in invasive breast carcinomas.&lt;/li&gt; &lt;li&gt;&lt;strong&gt;METHODS&lt;/strong&gt;: Tissue sections of 108 cases with invasive breast cancers were prepared and stained with Giemsa. The presence of stromal mast cells were evaluated and its correlation with tumor&amp;rsquo;s grade, tumor size, positivity for estrogen and progesterone receptors (ER and PR, respectively), HER2/neu positivity and lymph node metastasis was analysed.&lt;/li&gt; &lt;li&gt;&lt;strong&gt;RESULTS&lt;/strong&gt;: The median age was 52.3 years (range 28-85 years). Grading was done according to the Nottingham Modification of the Bloom-Richardson system. Fifty-four (50%) women had grade 1, 16 (14.8%) had grade 2 and 38 (35.2%) had grade 3 tumor. The presence of stromal mast cells correlated significantly to low grade tumors (p = 0.004) and ER Positivity (p = 0.04). There was no correlation between the presence of stromal mast cells and the PR positivity, HER2/neu positivity, tumor size and lymph node metastasis (p &gt; 0.05).&lt;/li&gt; &lt;li&gt;&lt;strong&gt;CONCLUSIONS&lt;/strong&gt;: Our results indicated that the presence of mast cells in breast cancer is correlated with a much lower grade of this tumor. Also in our study, there was a positive correlation between ER receptor positivity and the presence of mast cells in the stroma of breast cancer.&lt;/li&gt; &lt;li&gt;&lt;strong&gt;KEY WORDS&lt;/strong&gt;: Invasive ductal carcinoma, mast cell, prognosis.&lt;/li&gt; &lt;/ul&gt

Pericardial effusion in celiac disease

Celiac disease is an autoimmune disorder that affected 1% of all population in United State. Classic manifestations of disease consist of early childhood diarrhea, malabsorption, steatorrhea and growth retardation but disease can affects adult at any age. In adult anemia is a more frequent finding. This patient was a 40-year-old lady with progressive fatigue and lower extremities pitting edema. Iron deficiency anemia and celiac disease were diagnosed on the basis of low serum ferritin, elevated serum level of IgA endomysial and tissue transglutaminase anti-bodies and histologic findings in small bowel biopsies. Pericardial effusion in her evaluation was detected incidentally. Asymptomatic pericardial effusion in this patient was only detectable with imaging. After starting of gluten free diet and iron supplement fatigue, peripheral edema and pericardial effusion on echocardiography decreased. It should be noted that asymptomatic pericardial effusion may be seen in adults with celiac disease