Efficiency of Silver Staining in Differential Diagnosis of Adenoid Cystic Carcinoma from Polymorphous Low-Grade Adenocarcinoma

Objectives The aim of this study is find a practical and easy way to histologically differentiate between two malignant tumors namely Adenoid Cystic Carcinoma (ACC) and Polymorphous Low-grade Adeno Carcinoma (PLGA) silver nitrate staining.Methods In this cross-sectional study, 30 parrafin-embedded blocks of ACC and nine paraffin-embedded blocks of PLGA with the most acceptable standards were selected and stained with silver nitrate. Then the number and quality (size and pattern) of the stained spots in five random microscopic fields at 100× magnification (at least 100 cells) were evaluated. T-test was used to compare the number of dots between the two tumors while the quality of dots was compared with the Mann-Whitney U test.Results The mean silver stainable nucleolus organizer region (AgNOR) count was 3/45 for ACC and 2/45 for PLGA. Significant differences were observed in the number of dots between ACC and PLGA (p=0.004), but there was no statistically significant difference between the two tumors in terms of quality of dots.Conclusion AgNOR count can be useful as an available method in confirm the diagnosis of ACC and differentiate it from PLGA

Proliferative activity in oral pyogenic granuloma: A comparative immunohistochemical study

<b>Context:</b> Pyogenic granuloma (PG) is one of the most common reactive vascular lesions in the oral mucosa, which has been divided into the lobular capillary hemangioma (LCH) and the non lobular type (non-LCH) as two distinct entities, on the basis of some investigations. <b>Aims:</b> This study aims to compare the proliferative and angiogenic activity of two histological types of PG to determine whether they have two distinct types of biological behavior. <b>Settings and Design:</b> In this retrospective cross-sectional study, immunostaining was performed on 10 cases of each type of PG. <b>Materials and Methods:</b> About 4&#956;m sections were cut from formalin-fixed paraffin-embedded blocks and each specimen was stained with both anti-CD31 and anti-Ki-67 antibodies simultaneously. Labeling index (LI) was determined for both types by counting Ki-67 and CD31 positive cells separately and simultaneously in 1000 stromal and luminal cells. Micro vessel count (MVC), the mean number of micro vessels in five areas at &#935;200 magnification, was also determined for both groups. <b>Statistical Analysis:</b> The results were statistically compared using the Mann-Whitney U-test. <b>Results:</b> Ki-67 LI in LCH (5.4 &#177; 2.4) was higher than non-LCH (3.9 &#177; 3.9). The percentage of CD31 positive cells in LCH (28.5 &#177; 22) was lower than non-LCH (37.1 &#177; 20.8) and simultaneously immunostaining for both markers in LCH type (2.4 &#177; 2.1) was higher than non-LCH (1.2 &#177; 1). The MVC was approximately 77.35 &#177; 34.6 and 82.6 &#177; 42.7 in the lobular areas of LCH and central areas of non-LCH PG, respectively. These differences were not statistically significant. <b>Conclusions:</b> These results demonstrate a higher proliferation activity in endothelial cells of LCH PG than in non-LCH

Reliability of Fine Needle Aspiration Cytology for Salivary Gland Lesions

Background and Aim: Fine needle aspiration (FNA) cytology is a safe, reliable, mini-mally invasive and cost-effective technique for the diagnosis of salivary gland lesions. This study aimed to assess the accuracy, reliability and diagnostic value of FNA cytology in Iran. Materials and Methods: A total of 200 records of patients with a history of biopsy or surgical excision of salivary gland lesions along with their histological and cytological examination results were retrieved and evaluated in the Pathology Department of Amir Alam Hospital during 2007-2013. The results of cytological diagnosis were divided into 4 groups of unfavorable, benign, suspicious and malignant. The cytological results were compared with the histological data. The accuracy, sensitivity, specificity, positive predic-tive value (PPV) and negative predictive value (NPV) of FNA cytology were calculated using SPSS version 16.00. Results: Of the specimens chosen for the study, 173 were from the parotid, 22 from the submandibular and 5 from the minor salivary glands. FNA cytological diagnosis was be-nign in 161 cases, suspicious for malignancy in 4 cases, and malignancy in 35 cases. Of 161 cases diagnosed as benign by FNA cytology, 25 were malignant and the frequency of false positive results was 15.5%. The accuracy, sensitivity, specificity, PPV and NPV of the FNA test were 82, 53, 93, 72 and 84%, respectively. Conclusion: A good agreement exists between the FNA results and final histopathological diagnosis of salivary gland tumors. Also, this study showed that FNA cytology has mod-erate accuracy and relative diagnostic value for diagnosis of salivary gland lesions

Retrospective Evaluation of Endodontic Procedural Errors by Under-and Post-Graduate Dental Students Using Two Radiographic Systems

Background and Aim: Recognition of factors that cause procedural errors in dental prac-tice and their prevention increase the success rate of endodontic treatment. This study aimed to evaluate the rate of procedural errors in a clinical training setting using conventional and digital radiography systems. Materials and Methods: In this study, digital and conventional radiographs available in the archives of the Department of Endodontics, Shahed School of Dentistry were used, including 684 conventional radiographs of 171 patients (treated by the 5th and 6th year un der-graduate dental students and the 1st and 2nd year post-graduate students) and 852 digi tal radiographs of 213 patients (treated by the 5th and 6th year under-graduate dental stu dents and the 1st, 2nd, and 3rd year post-graduate students). The errors investigated in this tudy included missing a canal, canal transportation, ledge formation, apical perforation, furcal perforation, strip perforation, overfilling, under-filling, poor obturation and broken instrument. Radiographs were examined by 3 observers in terms of type of error during endodontic treat ment. Once examined, cases that were agreed upon by at least two observers were accept-ed. Results: In the under-graduate student group, the most frequent errors found in conven tional radiographs were poor obturation and under-filling with 8.13% prevalence rate. The most frequent error in post-graduate student group was poor obturation as well with 10.58% frequency. In digital radiographs, in both under-graduate and post-graduate groups, the most frequent error was poor obturation, as well (11.86% in undergraduate and 9.47% in post-graduate groups). The number of error-free anterior teeth (82.05%) was significantly more than that of posterior teeth (65.29%)(p<0.05). Also, 11,96% of anterior teeth had problems in terms of length and quality of filling, while in these respects, 23.5% of posterior teeth were unacceptable, and there was a significant difference in the frequen cy of these procedural errors between the anterior and posterior teeth (p<0.05). Conclusion: It appears that the educational system in the Department of Endodontics at Shahed School of Dentistry must place a stronger emphasis on the internal anatomy and principles of root canal treatment of the posterior teeth, as well as on the final stage of en-dodontic treatment (canal filling) for all teeth. It should be noted that an inappropriate canal filling might be secondary to improper canal preparation. Key Words: Procedural Errors , Conventional Radiography , Digital Radiograph

Tissue expression, serum and salivary levels of vascular endothelial growth factor in patients with HNSCC

Introduction: Vascular endothelial growth factor is thought to be an important angiogenic factor involved in tumor growth, progression, and metastasis. Objective: The present study evaluated the relation between tissue expression, serum and salivary levels of vascular endothelial growth factor in head and neck squamous cell carcinomas, and their correlation with clinicopathologic features. Methods: Samples were collected from 30 patients with head and neck squamous cell carcinomas and 24 healthy volunteers. Immunohistochemical analysis was used for tissue expression and enzyme-linked immunosorbent assay was employed to measure serum and salivary levels. Results: No vascular endothelial growth factor staining was observed in normal tissues, whereas vascular endothelial growth factor expression was seen in 6 patients (20%). Mean serum level of VEGF was 83.7 ± 104.47 in patients and 50.04 ± 32.94 in controls. Mean salivary level of vascular endothelial growth factor was 174.41 ± 115.07 in patients and 149.58 ± 101.88 in controls. No significant difference was found by Mann-Whitney test between controls and patients (p = 0.411, p = 0.944, respectively). No correlation was found between vascular endothelial growth factor tissue expression and its serum and salivary level. Conclusion: Overexpression of vascular endothelial growth factor was found in head and neck squamous cell carcinoma patients, suggesting its role in the pathogenesis of head and neck squamous cell carcinoma, but no relation was found between tissue expression, serum levels, and salivary levels of this marker