A case of recurrent urinary tract infections with neurogenic bladder due to spinal tumors

Neuroblastic tumors are the most common extracranial solid tumors in children. They are manifested by different clinical presentations ranging from cord compression symptoms to asymptomatic cases. A 2.5-year girl with a history of vaginal delivery at 39 gestational weeks and low Apgar score presented by repeated episodes of urinary tract infections and progressive paraplegia started at the age of 8 months.Brain MRI and EEG were normal. Voiding cystourethrography revealed grade II vesicoureteral reflux in the left kidney. Lumbar MRI with and without contrast showed a dumbbell shape mass, the hyper signal in T2 -weighted image and low signal in T1 -weighted image, extramedullary, and intramural with mass effect on the cord.Microscopic examination of tissue obtained by surgery reported ganglioneuroma.Our case was interesting because of her presentation, neurogenic bladder associated with repeated episodes of urinary tract infections, and secondary paraplegia. Neurogenic bladder dysfunction is rarely reported in cases with ganglioneuroma

Lymphatic mapping and sentinel node biopsy in endometrial cancer — a feasibility study using cervical injection of radiotracer and blue dye

BACKGROUND: The aim of this study was to evaluate the feasibility and accuracy of sentinel lymph node (SLN) detection using preoperative lymphoscintigraphy and intra-operative gamma probe/blue dye for endometrial cancer patients. MATERIAL AND METHODS: Twenty four consecutive patients with endometrial cancer were recruited. All patients underwent lymphatic mapping and sentinel node biopsy using combined intracervical radiotracer and blue dye injections. Pelvic lymph node dissection was performed for all patients. Para-aortic lymphadenectomy was done in high risk patients. All SLNs were examined by frozen section and Hematoxylin and Eosin (H&E) permanent sections. RESULTS: Pre-operative lymphoscintigraphy showed at least one SLN in 21/24 patients. Intra-operatively, at least one SLN could be harvested by gamma probe and/or blue dye methods. A total of 95 SLNs were detected. Four SLNs were detected only by blue dye, 42 only by radiotracer, and 49 were hot/blue. Median number of SLN per patient was 3. Three patients had positive pelvic lymph nodes. All of them had positive SLN (no false negative case). Frozen section could identify SLN involvement in two of three patients with positive pathology. CONCLUSION: Lymphatic mapping and sentinel node biopsy is feasible and accurate in endometrial cancer patients using combined radiotracer and blue dye methods. Frozen section accuracy was lower and underscores the importance of expert pathologists for SLN mapping technique.

Age-related Variation in Expression of Breast Cancer Tumour Markers in Iranian Patients

Background: There are believed to be several risk factors affecting the prognosis of breast cancer through their effect on the growth rate of tumour. In the present study, we investigated estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), Ki-67, and tumor protein P53 (TP53) as well-known biomarkers, particularly in breast cancer prognosis, associated with age. Method: In a case-control study, 406 breast cancer patients were considered retrospectively. In order to extract the clinical and pathologic data, we employed the patients’ records. The extracted information was compared between two groups: for patients under 40 (group I) and above 40 years of age (group II). Herein, the researchers performed statistical analysis using SPSS Ver16. Results: The most prevalent type of cancer in both groups was found to be invasive ductal carcinoma. The major method of treatment was modified radical mastectomy. According to our observations, grade 3 breast cancer was more common in group I. Lymph node involvement significantly increased in group I, while oestrogen and progesterone receptor expressions were less in this group. HER2, TP53, and Ki-67 oncogenes were overexpressed in group I compared with group II. Conclusion: Expression of HER2, TP53, and Ki-67 biomarkers and a reduction in the number of hormonal receptors in younger patients (<40YO) indicated that breast cancer might be more invasive in younger women with breast cancer and therefore, they might have poorer prognosis and less favourable outcomes

P63 and Ki-67 expression in trophoblastic disease and spontaneous abortion

&lt;!--[if gte mso 9]&gt;&lt;xml&gt; &lt;w:WordDocument&gt; &lt;w:View&gt;Normal&lt;/w:View&gt; &lt;w:Zoom&gt;0&lt;/w:Zoom&gt; &lt;w:PunctuationKerning /&gt; &lt;w:ValidateAgainstSchemas /&gt; &lt;w:SaveIfXMLInvalid&gt;false&lt;/w:SaveIfXMLInvalid&gt; &lt;w:IgnoreMixedContent&gt;false&lt;/w:IgnoreMixedContent&gt; &lt;w:AlwaysShowPlaceholderText&gt;false&lt;/w:AlwaysShowPlaceholderText&gt; &lt;w:Compatibility&gt; &lt;w:BreakWrappedTables /&gt; &lt;w:SnapToGridInCell /&gt; &lt;w:WrapTextWithPunct /&gt; &lt;w:UseAsianBreakRules /&gt; &lt;w:DontGrowAutofit /&gt; &lt;/w:Compatibility&gt; &lt;w:BrowserLevel&gt;MicrosoftInternetExplorer4&lt;/w:BrowserLevel&gt; &lt;/w:WordDocument&gt; &lt;/xml&gt;&lt;![endif]--&gt;&lt;!--[if gte mso 9]&gt;&lt;xml&gt; &lt;w:LatentStyles DefLockedState="false" LatentStyleCount="156"&gt; &lt;/w:LatentStyles&gt; &lt;/xml&gt;&lt;![endif]--&gt; &lt;ul&gt;&lt;li&gt;&lt;strong&gt;&lt;span style="font-size: 8pt;"&gt;BACKGROUND&lt;/span&gt;&lt;/strong&gt;&lt;strong&gt;&lt;span style="font-size: 8pt;"&gt;: &lt;/span&gt;&lt;/strong&gt;Despite well-described histopathologic criteria, the distinction of spontaneous abortion from hydatidiform mole and complete hydatidiform mole from partial hydatidiform mole remains a problem because of interobserver and intraobserver variability. The aim of this study was to evaluate the value of two immunohistochemical markers in the differential diagnosis of subgroups of lesions of villous trophoblasts and spontaneous abortions.&lt;/li&gt;&lt;li&gt;&lt;strong&gt;&lt;span style="font-size: 8pt;"&gt;METHODS&lt;/span&gt;&lt;/strong&gt;&lt;strong&gt;&lt;span style="font-size: 8pt;"&gt;:&lt;/span&gt; &lt;/strong&gt;Immunohistochemistry with the P63 and Ki-67 antibody was performed in formalin-fixed paraffin-embedded samples of non hydropic abortion (n = 14), partial hydatidiform mole (n = 12), complete hydatidiform mole (n = 12) and choriocarcinoma (n = 12). The Ki-67 and P63 labeling index (number of positive nuclei/total number of nuclei) for villous stromal cells, cytotrophoblasts and syncytiotrophoblasts were evaluated separately by counting 100 cells of each population. Statistical analysis was carried out by &amp;chi;2 analysis, and the Mann-Whitney U test. Statistical significance was determined at p &amp;lt; 0.05 on the basis of 2-tailed tests.&lt;/li&gt;&lt;li&gt;&lt;strong&gt;&lt;span style="font-size: 8pt;"&gt;RESULTS&lt;/span&gt;&lt;/strong&gt;&lt;strong&gt;&lt;span style="font-size: 8pt;"&gt;: &lt;/span&gt;&lt;/strong&gt;None of nonhydropic spontaneous abortions analyzed exhibited positive cytotrotrophoblastic and syncytiotrophoblastic cells for P63. The syncytiotrophoblastic cells were negative for p63 in all of choriocarcinomas. All of choriocarcinomas analyzed exhibited severe expression of Ki-67 in cytotrotrophoblastic cells. None of abortions and partial moles was diffusely labeled with Ki-67.&lt;/li&gt;&lt;li&gt;&lt;strong&gt;&lt;span style="font-size: 8pt;"&gt;CONCLUSIONS&lt;/span&gt;: &lt;/strong&gt;Ki-67 labeling index in cytotrophoblastic cells is the best index to differentiate between abortion and subgroups of lesions of villous trophoblasts as well as between different subgroups of lesions of villous trophoblasts. Ki-67 is a better marker than P63 to attain this goal.&lt;/li&gt;&lt;li&gt;&lt;strong&gt;&lt;span style="font-size: 8pt;"&gt;KEYWORDS&lt;/span&gt;&lt;/strong&gt;&lt;strong&gt;&lt;span style="font-size: 8pt;"&gt;:&lt;/span&gt; &lt;/strong&gt;Partial Hydatidiform Mole, Complete Hydatidiform Mole, Choriocarcinoma, Abortion, P63, Ki-67, Immunohistochemistry.&lt;/li&gt;&lt;/ul&gt

Brooke-Spiegler Syndrome

The Brooke-Spiegler syndrome (BSS) is an uncommon autosomal dominant disorder characterized by a high affinity to form multiple adnexal neoplasia (skin appendage tumors), especially trichoepitheliomas and cylindromas, and occasionally spiradenomas, which usually appear in the second or third decade of life. To date, only a few cases with this syndrome have been reported. This case report describes a 26-year-old woman who presented to the dermatology department of Qaem Hospital with tumoral lesions on her scalp, face, and forearm. Her father and younger brother were also affected. On examination, several round-to-oval skin-colored papules with a smooth pearly surface measuring 2 to 6 mm in diameter were seen on the mid-face, particularly in the nasolabial folds, the upper lip. Tumors and nodules seen on the scalp were pinkish red, dome-shaped, and to some extent, pedunculated with surface telangiectasia and induration. Histopathology of the facial papules showed trichoepithelioma while that of a scalp nodule showed cylindroma

Immunohistochemical Expression of Apoptosis Regulators in Squamous Cell Carcinoma of the Cervix and Their Association with Human Papillomavirus 16/18 Subtypes

Background: Human papillomavirus (HPV) infection is an important aetiological factor in squamous cell carcinoma (SCC) of the cervix. Limited studies have been focused on the differences between carcinogenesis of SCCs with and without HPV infection. Aims: The main goal of this study is to determine the expression of some of the apoptotic pathway regulators, including P53, Bax and Bcl2 in SCCs with and without high risk HPV 16/18 infection. Study Design: Cross sectional study. Methods: A total of 42 paraffin-embedded blocks with the histopathological diagnosis of invasive SCC with determined HPV 16/18 status were selected; half of them were HPV positive and the rest were negative. Afterwards, immunohistochemistry stained slides for p53, Bcl2 and Bax were evaluated with H-score, multiplicative and Additive Quick score by two pathologists; in cases of controversy about the results, the mean results were recorded. Results: Mean results and percentage of expression of our three markers were significantly higher in the HPV 16/18 infected group than in uninfected individuals: Respectively, the mean score for Bcl2, Bax and p53 staining according to H-scoring method was 68.5, 234, 106.4 in the HPV 16/18 infected group and 4.5, 218.8, 5.07 in the uninfected group; and the Multiplicative Quick score was 4, 14.6, 8.2 in the HPV 16/18 infected group and 3, 12.3, 3.5 in the uninfected group. Conclusion: High risk HPVs possibly act in favour of apoptotic pathway inactivation. The significant difference in apoptotic pathway between SCCs with and without high risk HPVs suggests a different early carcinogenesis pathway