Iranian Journal of Pathology最新文献

{"title":"Diagnostic Approach to Adult Erythroderma: A Rare Case of Sezary Syndrome.","authors":"Quri Meihaerani Savitri, Fitria Rettobyan, Linda Astari, Amira Suryani Rahmatika, Muhammad Noor Diansyah, Putu Niken Ayu Amrita, Pradana Zaky Romadhon, Sipirianus Ugroseno Yudho Bintoro, Ami Ashariati, Merlyna Savitri","doi":"10.30699/ijp.2024.2022723.3258","DOIUrl":"10.30699/ijp.2024.2022723.3258","url":null,"abstract":"<p><strong>Background & objective: </strong>Sezary Syndrome is an uncommon leukemic variant of Cutaneous T-cell Lymphoma (CTCL), comprising only 5% of all CTCL cases. The rarity of this syndrome emphasizes the critical need to comprehend its distinct clinical presentation, diagnosis, and treatment.</p><p><strong>Case presentation: </strong>A 51-year-old man was admitted with itchy, persistent, and extensive erythematous patches, ulcers, lumps, lymphadenopathy, alopecia, and nail dystrophy that had been present for eight months. Laboratory findings showed elevated LDH and 𝛽2-microglobulin. Peripheral blood smear analysis confirmed the presence of Sezary cells, while imaging revealed multiple lymph node enlargements. Skin biopsy and immunohistochemistry suggested cutaneous T-cell lymphoma (CTCL), while immunophenotyping verified a diagnosis of Sezary syndrome . The patient underwent fluid therapy, systemic antibiotics, topical antibiotics, phototherapy, and chemotherapy. Tenofovir was given due to the hepatitis B co-infection. Despite the improvement when discharged from the hospital, the patient's health eventually deteriorated, which led to death at home.</p><p><strong>Conclusion: </strong>This patient presented with Sezary Syndrome, exhibiting atypical dermatologic manifestations that must be differentiated from other causes of erythroderma. This case highlights the importance of a comprehensive diagnostic approach, including clinical evaluation, laboratory tests, imaging, and biopsies. Sezary Syndrome is an inherently aggressive malignancy, characterized by a poor response to treatment and a low 5-year survival rate.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 4","pages":"460-466"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Academy of Cytology Yokohama System for Reporting Breast Cytology and the ACR Breast Imaging Reporting and Data System (BIRADS): Are they Concordant?","authors":"Alka Yadav, Aparna Singh, Sonali Madaan, Mukta Pujani, Sujata Raychaudhuri, Charu Agarwal, Varsha Chauhan, Dipti Sidam, Jyoti Rajpoot, Garima Dhull, Cherry Bansal","doi":"10.30699/ijp.2024.2028955.3300","DOIUrl":"10.30699/ijp.2024.2028955.3300","url":null,"abstract":"<p><strong>Background & objective: </strong>Breast cancer is the leading cause of cancer deaths among women worldwide. Fine needle aspiration cytology (FNAC) and breast sonography have played a pivotal role in the characterization of a breast lump. The main objective of this study was to analyze the correlation between the International Academy of Cytology (IAC) Yokohama for Reporting Breast Fine Needle Aspiration Biopsies (FNAB) and breast imaging reporting and data system (BIRADS) for sonography along with histopathological correlation.</p><p><strong>Methods: </strong>A total of 135 FNAC specimens were categorized according to the IAC Yokohama system and BIRADS reporting system and their correlation with histopathology wherever possible to calculate the risk of malignancy (ROM).</p><p><strong>Results: </strong>According to IAC Yokohama categorization, the cases in categories I, II, III, IV, and V were 1,78,8,6 and 42, respectively. Akin to cytology, most of the cases were assigned BIRADS score two followed by score 6, with the Pearson's correlation coefficient between the IAC Yokohama system for reporting breast cytology and BIRADS scoring system of 1.957 with a P-value < 0.001 (strong correlation). The sensitivity, specificity, PPV, NPV, and DA of FNAC with category III assumed as malignant were 98.9%, 85%, 76.1%, 99.3%, and 89.5%, respectively. Histopathological correlation was available for 90 cases. The ROM for categories II, III, IV, and V was 5.6%,37.5%,100%, and 100%, respectively.</p><p><strong>Conclusion: </strong>IAC Yokohama system of reporting breast cytopathology and BIRADS serves as a common language of communication between pathologists and clinicians and aid in better stratification of the lesions. Both FNAC (minimally invasive) and ultrasound (non-invasive imaging technique) are diagnostic tools that complement each other for patient diagnosis and management.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 4","pages":"400-407"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Mucosal Melanoma and Sinonasal Amelanotic Melanoma: A Summary of Two Unusual Cases.","authors":"Krishnendu Mondal, Rupali Mandal","doi":"10.30699/ijp.2024.2014328.3199","DOIUrl":"10.30699/ijp.2024.2014328.3199","url":null,"abstract":"","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 4","pages":"4474-4476"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Impact on Pathology Education Program in Iran.","authors":"Shabnam Mashhadi, Alireza Abdollahi, Fereshteh Ameli, Fatemeh Nili","doi":"10.30699/IJP.2024.2004823.3130","DOIUrl":"10.30699/IJP.2024.2004823.3130","url":null,"abstract":"<p><strong>Background & objective: </strong>The coronavirus disease brought worldwide uncertainty, and Iran was affected by it as well as many other countries in the world. Halting face-to-face education due to social distancing and resident re-employment in clinical wards leads to defective education. The aim of this survey was to evaluate the advantages and disadvantages of modifications made in pathology residency education in Iran.</p><p><strong>Methods: </strong>This online survey was conducted on all pathology residents in Iran. An online 30-item questionnaire was developed and used in this study.</p><p><strong>Results: </strong>Sixty residents (88.3% female) participated in this survey. The majority (70%) of the residents were over 30 years old. Fifty percent of the responders reported that their personal life was influenced by the pandemic. Skyroom and Adobe Connect were the most common platforms for online education with overall satisfaction of 65%. The webinars were considered suitable by 51.7% of the responders. Concerns at work were reported by 48.3% of the residents, while 78.3% reported being exposed to the disease and 55% reported being infected. Concerns about transmission of the disease to family members were reported by 90% of the responders.</p><p><strong>Conclusion: </strong>This study showed that the pathology residency modifications were successful in providing education. However, their social and educational life characteristics might affect their satisfaction with online education.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 3","pages":"272-276"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum C-reactive Protein Levels about Insulin Resistance and Beta Cell Function in Iranian Women with Subclinical Hypothyroidism.","authors":"Amirali Ayatollahi, Zohre Moosavi, Hossein Ayatollahi","doi":"10.30699/IJP.2024.2015823.3213","DOIUrl":"10.30699/IJP.2024.2015823.3213","url":null,"abstract":"<p><strong>Background & objective: </strong>Subclinical hypothyroidism (SCH), is defined as an asymptomatic state characterized by a normal serum concentration of free thyroxine and elevated serum concentration of TSH. This study aims to investigate the complex interplay between hyperinsulinism, insulin resistance, beta cell function, and low-grade chronic inflammation in Iranian women with SCH.</p><p><strong>Methods: </strong>Eighty women with SCH and 80 healthy women as controls matched to the patient group for sex, age, and body mass index (BMI), were enrolled in this prospective cross-sectional study. TSH, free T3, free T4, highly sensitive C-reactive protein (hs-CRP), fasting insulin, fasting glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, Triglyceride, HOMA-IR index, Beta cell function (HOMA-B index) and insulin sensitivity were determined.</p><p><strong>Results: </strong>Hs-CRP was not statistically different between the SCH patients and the control group (3.7±3.2 Vs 3.6±4.0, <i>P</i>>0.05). Total cholesterol and LDL-cholesterol were significantly higher; however, triglyceride and HDL-cholesterol were not statistically different in patients with SCH as compared with the control group. Fasting insulin levels and HOMA-IR and Beta cell function (HOMA-B) were significantly higher in SCH women compared to the control group. A positive correlation between HOMA-IR and HOMA-B with TSH levels was found (r=0.324, r=0.191, <i>P</i><0.05 respectively). A positive correlation between insulin levels and hs-CRP (r=0.22, <i>P</i><0.05), also between insulin levels and TSH (r=0.312, <i>P</i><0.05) and LDL- LDL-cholesterol was obtained (r=0.27, <i>P</i><0.05).</p><p><strong>Conclusion: </strong>Iranian women with SCH may exhibit elevated atherogenic parameters (hyperinsulinemia, LDL-cholesterol, and total cholesterol), HOMA-IR, and HOMA-B.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 3","pages":"326-331"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sclerosing Microcystic Adenocarcinoma of the Base of Tongue with Signet Ring-Like Cell Component: A Rare Case.","authors":"Parisa Mokhles, Alireza Sadeghipour, Maryam Kadivar, Nasrin Shayanfar, Zahra Keshtpour Amlashi, Pegah Alizade Pahlavan, Ashkan Shafiei","doi":"10.30699/IJP.2023.1989943.3068","DOIUrl":"10.30699/IJP.2023.1989943.3068","url":null,"abstract":"<p><p>Sclerosing microcystic adenocarcinoma (SMA) is an uncommon neoplasm of the oral cavity, with only 14 reported cases documented in the literature. We present a case of SMA in a 65-year-old woman with a history of high-grade lymphoma who developed clear cell changes in the deep muscular layer of the tongue. Currently, the diagnosis of SMA relies on careful morphological evaluation and the exclusion of other potential differential diagnoses.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 1","pages":"107-113"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Findings of Peripheral Blood Smear, Bone Marrow Aspiration and Biopsy, Iron Storage, and Immunophenotype in Patients with Chronic Lymphocytic Leukemia.","authors":"Shiva Didehban, Elham Jafari, Ali Hosseini, Parisa Khorasani","doi":"10.30699/IJP.2024.2011275.3170","DOIUrl":"10.30699/IJP.2024.2011275.3170","url":null,"abstract":"<p><strong>Background & objective: </strong>Chronic lymphocytic leukemia (CLL) is one of the most common types of leukemia in adults with various signs, symptoms, and types of progression. In this study, we have investigated the frequency and correlation of laboratory findings including peripheral blood smear, bone marrow aspiration and biopsy, and cellular immunophenotyping in CLL patients.</p><p><strong>Methods: </strong>In this cross-sectional and retrospective study, the laboratory information of all 161 patients with definite diagnoses of CLL was extracted, and the frequency and correlation between different laboratory data were analyzed by descriptive statistics methods and Jamovi software version 2022.</p><p><strong>Results: </strong>Demographic factors such as age and gender, and laboratory factors such as anemia, thrombocytopenia, white blood cell count, percentage of lymphocytes, and patterns of bone marrow involvement were evaluated for 161 patients. There was a significant relationship between the bone marrow iron storage and the percentage of FMC7 marker expression with the percentage of atypical lymphocytes in the peripheral blood.</p><p><strong>Conclusion: </strong>Chronic lymphocytic leukemia, a prevalent form of leukemia associated with substantial mortality and morbidity, can be detected through a range of diagnostic techniques. Analyzing the results of these diagnostic tests and examining the prevalence of these indicators in patients afflicted with the condition can prove highly beneficial for prompt disease diagnosis, and prognosis determination among affected individuals.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 2","pages":"152-159"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Significance of Atypical Squamous and Glandular Cell Lesions in Cervical Smear Screening Cytology: A Two-Year Follow-Up Study in an Iranian Population.","authors":"Narges Izadimood, Fatemeh Nili, Soheila Sarmadi, Houra Omdeh Ghiasi, Elham Mirzaeian","doi":"10.30699/IJP.2024.2020412.3242","DOIUrl":"10.30699/IJP.2024.2020412.3242","url":null,"abstract":"<p><strong>Background & objective: </strong>Atypical squamous cells (ASC) are the most common epithelial abnormalities found in cervical cytology reports. The clinical significance of ASC and atypical glandular cells (AGC) varies, making clinical management and follow-up challenges.</p><p><strong>Methods: </strong>All women diagnosed with ASC or AGC in the past 4 years and referred to a tertiary hospital were included. The study evaluated regression, persistence, or progression to significant abnormalities over a two-year follow-up period.</p><p><strong>Results: </strong>Out of 22,386 cervical cytology smears, 208 (4.8%) patients were diagnosed with ASC (ASC-US: 3%, ASC-H: 1.8%) or AGC (0.25%). Among ASC-US patients with documented follow-up, 11 (46%) showed significant abnormalities, while 13 (54%) showed insignificant abnormalities. In the ASC-H group, with available follow-up, 20 (72%) showed significant abnormalities, and 8 (28%) showed insignificant abnormalities. When considering ASC-US and cervical intraepithelial neoplasia 1 (CIN 1) as low-grade lesions, 19 (31%) patients with ASC-H had low-grade, and 13 (69%) had high-grade abnormalities. In the ASC-US group, 10 (99%) patients had low-grade lesions, while only 1 (1%) had high-grade lesions. Among AGC, not otherwise specified (NOS) patients with follow-up, 17 (65%) had significant lesions, and 9 (35%) had insignificant lesions. All 13 patients with AGC, favor neoplastic (FN)/adenocarcinoma in situ (AIS), showed significant lesions.</p><p><strong>Conclusion: </strong>While patients diagnosed with ASC-H and AGC are at a higher risk for significant lesions, ASC-US patients may also develop significant lesions. Thus, ASC-US is clinically significant, and these patients should be closely monitored.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 4","pages":"376-383"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Ki-67 Labeling Index Quantification by Eye-rolling, Manual Count, and Digital Image Analysis; An Approach with Caution.","authors":"Aminder Singh, Vikram Narang, Ankita Soni, Kajal Angural, Saveena Jindal, Bhavna Garg, Harpreet Kaur","doi":"10.30699/IJP.2024.2008346.3150","DOIUrl":"10.30699/IJP.2024.2008346.3150","url":null,"abstract":"<p><strong>Background and objective: </strong>An accurate Ki-67 labeling index assessment is critical for managing a few tumors, like breast carcinomas and neuroendocrine tumors. We aimed to determine the degree of agreement between digital image analysis (DIA) and eye-rolling assessment (EE) and DIA and manual count (MC) for Ki-67 LI scoring.</p><p><strong>Methods: </strong>A total of 120 cases (both tru-cut biopsies and resected specimens) were selected during the study period from the institutional database, wherein the Ki-67 labeling index was performed. The selected cases were divided into two groups, i.e., breast neoplasms and other neoplasms. The correlation between DIA and EE and DIA and MC for Ki-67 LI scoring was calculated in both groups.</p><p><strong>Results: </strong>A total of 113 cases were analyzed for Ki-67 LI by three different methods (EE, MC, and DIA); 7 cases were rejected due to poor image quality. Ki-67 LI scoring by DIA and EE was highly correlated in both study groups with a Spearman's rank correlation coefficient of 0.809 (<i>P</i>=0.01) and 0.904 (<i>P</i>=0.01), respectively. Correlation between DIA and MC methods was also found to be almost perfect in both study groups with a Spearman's rank correlation coefficient of 0.974 (<i>P</i>=0.01) and 0.955 (<i>P</i>=0.01), respectively.</p><p><strong>Conclusion: </strong>ImmunoRatio is a free web-based digital image analysis application that can be used for Ki-67 LI assessment with considerable reliability and reproducibility. Yet, it carries a few limitations and demands a careful approach and final confirmation by an expert.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 1","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Malignant Melanoma of the Small Intestine Presenting with Peritonitis: A Case Report.","authors":"Alireza Khooei, Sahar Seifnia, Amin Dalili, Hossein Bavandi, Saeid Dehghan Nezhad, Motahare Ebrahimnejad","doi":"10.30699/IJP.2023.1996329.3100","DOIUrl":"10.30699/IJP.2023.1996329.3100","url":null,"abstract":"<p><p>Malignant melanoma of the small intestine is mostly a metastatic tumor of other primary lesions, especially of skin origin. Primary malignant melanoma of the small intestine is very uncommon. The clinical presentation is usually nonspecific, thus leading to late diagnosis. We report a 42-year-old man who presented to the emergency department of Imam-Reza Hospital with symptoms and signs of peritonitis and was a candidate for emergency laparotomy and enterectomy. The medical and family history were unremarkable. A bulky mass was seen 190 cm away from the Treitz band, and a diagnosis of malignant melanoma was confirmed by histologic and immunohistochemical study. Further clinical examination revealed no primary tumor elsewhere, so the diagnosis of primary small intestinal melanoma was concluded. Although metastatic malignant melanoma in the GI tract is common, the primary one is a very rare entity. The diagnosis could be challenging because a thorough investigation is needed to rule out the possible initial origin.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 1","pages":"114-117"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}