Scoring System and Diagnosis of Papillary Thyroid Carcinoma Using Human Bone Marrow Endothelium Marker-1, Cytokeratin 19, and Galectin-3.

Background: The increasing incidence of papillary thyroid carcinoma (PTC) and the inadequacy of routine histologic examination in its diagnosis necessitate the application of ancillary studies like immunohistochemistry. This research aimed to investigate the scoring system and diagnosis of PTC with cytokeratin 19 (CK19), human bone marrow endothelium marker-1 (HBME-1), and galectin-3. Methods: This experimental laboratory study was performed at Babol University of Medical Sciences, Mazandaran, Iran from April 2017 to March 2019. Neoplastic and nonneoplastic tissue samples of 100 cases with a diagnosis of PTC were selected by convenience sampling. CK19, HBME-1, and galectin-3 immunohistochemistry markers were used on tissue samples. Analysis was performed using the t test and the chi-square test, as well as the receiver operator characteristic (ROC) curve (significance level P < 0.05). Results: The CK19 staining was observed in all 100 (100%) non-neoplastic tissues, but HBME-1 and galectin-3 were positive in 36 (36%) and 14 (14%) of non-neoplastic tissues, respectively. The intensity scores of all the markers and their total had significantly different means in PTC and non-neoplastic tissues (P < 0.001). A significant difference was observed between the total score of each marker and the total score of their combination (P < 0.001). The combination of all 3 markers with an 11.5 0 cut-off for the total score showed the most sensitive (0.99) and specific (1.00) results. Conclusion: Interpreting CK19, HBME-1, and galectin-3 with the aid of the proposed scoring system was fruitful. HBME-1 and galectin-3 can be used individually or in combination for the diagnosis of PTC.

Quantitative analysis of Merkel cell polyomavirus (MCPyV) genome in non-melanoma skin cancer and normal tumor margins.

Merkel cell polyomavirus (MCPyV) is the cause of approximately 80% of Merkel cell carcinomas (MCC). The common types of non-melanoma skin cancer (NMSC) including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are histologically similar to MCC. In the present study, 58 NMSC formalin-fixed paraffin-embedded tissue (FFPE) samples including 12 SCC, 46 BCC, and 58 FFPE samples of adjacent non-tumoral margins as the control were included. Determination of large tumor antigens (LTAg) copy number was performed by qReal-Time PCR as a viral copy number per cell to elucidate MCPyV carcinogenic role in non-melanoma skin cancer. Out of 58 samples, 36 (62%) cancerous and 22 (37.9%) normal tumor margins were positive for MCPyV LTAg. Median copy numbers of MCPyV LTAg among all NMSC samples and non-tumoral margins were 0.308×10-2 and 0.269×10-3 copies per cell respectively (P=0.001). In addition, although the viral load in the majority of samples was detected to be lower than one copy per cell, in 4 BCC samples, a viral load higher than one LTAg copy per cell was detected. The present study revealed that the detection of higher levels of MCPyV LTAg viral load in some BCC and SCC samples may be correlated with the role of MCPyV in some cases of BCC and SCC skin cancer.

Drug-induced hepatitis after Sinopharm COVID-19 vaccination: A case study of a 62-year-old patient.

Introduction: COVID-19 virus pandemic has begun since 2020 and became one of the most important causes of mortalities. Accordingly, vaccination has found a vital role in control of COVID-19 virus. Despite many advantages of vaccines in controlling the virus spread and reducing the mortal rate, these benefits came at the expense of side effects which have not been fully explored nor should be ignored. One of the most serious side effects of vaccination, which has been reported recently, is liver injury. Case presentation: This study presents a case of hepatitis initiated by Sinopharm vaccine for COVID-19. A 62-year-old man presented with jaundice, weight loss and elevated liver enzymes three days after getting the second dose of COVID-19 vaccine. Microscopic sections showed hepatitis pattern of injury with both portal and lobular inflammation and marked eosinophils infiltration. Discussion: Several cases of hepatitis have been reported after COVID-19 vaccines, but almost all of them were diagnosed as autoimmune hepatitis, triggered by COVID-19 mRNA or viral vector vaccines but the present case is one of the first reported cases of hepatitis after Sinopharm vaccine, an inactivated virus COVID-19 vaccine. Spontaneous decrease in liver enzyme levels, without corticosteroids therapy, is against to the diagnosis of autoimmune hepatitis in other reported cases. Conclusion: Considering the microscopic findings, along with the negative serologic studies for viral and autoimmune hepatitis, and by ruling out of other causes of hepatitis like COVID-19 or other viral infections, a probable relation between liver injury and Sinopharm vaccine may be interpreted.

D2-40 A Helpful Marker in Assessment of Lymphatic Vessel Invasion in Carcinoma of Breast.

BACKGROUND & OBJECTIVE: Breast cancer is the most common malignancy among Iranian women and worldwide. Lymphatic vessel invasion (LVI) was found to be an independent prognostic factor in many carcinomas, including invasive carcinoma of the breast. The aim of this study was to compare the hematoxylin and eosin (H&E) staining method and use of the immunohistochemical (IHC) marker ofD2-40, for evaluation of LVI in breast carcinoma specimens. METHODS: The study was conducted on 50 patients undergone surgery between the years 2010 and 2015 in Rohani Hospital, Babol, Iran with invasive carcinoma of the breast with Census sampling method. LVI was assessed by two surgical pathologists, using H&E- stained sections and two IHC markers, i.e., D2-40 and CD31. RESULTS: LVI was detected in 25 (50%) patients by H&E and in 14 (28%) patients by D2-40. Twelve out of 25 patients with positive LVI in H&E were confirmed by D2-40 and 2 out of 25 patients with negative lymphatic vessel in H&E. Only one case showed weak staining of CD31 proving LVI. These results showed a significant difference between the H&E staining and D2-40 IHC study for LVI detection (P=0.004). CONCLUSION: The D2-40 IHC marker is helpful in the diagnosis and confirmation of LVI in invasive carcinoma of the breast. CD31 is not suitable for the evaluation of lymphatic vessels.

Two Rare Cases of Uterine Leiomyosarcomas Originating from Submucosal Leiomyomas Proved by Their Immunohistochemistry Profiles.

The most common mesenchymal tumours of the uterine corpus originate from smooth muscle cells. Leiomyomas are commonly found in women of child bearing age; however, leiomyosarcomas occur later in life (50-55 years of age). Most uterine leiomyosarcomas occur de novo, but rare cases of leiomyosarcomas that arise from leiomyomas have been reported. We present two cases of fertile women with submucosal leiomyomas that became malignant and discuss their pathologic features and immunohistochemistry studies for P16, P53 and Ki67.

The negative association between inflammatory bowel disease and Helicobacter pylori seropositivity.

BACKGROUND: The role of Helicobacter pylori (H. pylori) in inflammatory bowel disease is a controversial argument. The initial theory of this study was that Helicobacter is a risk factor for inflammatory bowel disease. In this study, we investigated the coincidence of H. pylori exposure and IBDs. METHODS: This case-control study has been done in Babol, teaching Hospitals; 60 newly diagnosed IBD cases without any Helicobacter eradicating treatment and 120 control patients without inflammatory bowel disease evidence in biopsy, investigated for H. pylori exposure by IgA and IgG ELISA tests. Clinical information, demographics and ELISA test results have been analyzed using SPSS.Version.18 (level of significance was less than 0.05). RESULTS: Mean age of case group was 42.27±13.64 years; in control group it was 45.52±13.83 years. There was a significant difference between the case and control groups in IgG study of the following subgroups: age under 30, females, males, urban, higher education level and BMI between 18.5 and 24.9 (p-value was respectively; 0.004, 0.014, 0.047, 0.002, 0.013, 0.003). On the basis of logistic regression; IBD was less common in females, patients with lower education and patients with positive result of IgG (p-value was respectively 0.002, 0.013, 0.010). CONCLUSION: As a result of this study, Helicobacter pylori exposure, may could play a protective role against inflammatory bowel disease.

Association of Helicobacter pylori Infection With Colon Cancer and Adenomatous Polyps.

BACKGROUND AND OBJECTIVE: Helicobacter pylori infection is one of the most common chronic bacterial infections in the world, especially in the developing countries. This bacterium is the cause of many diseases such as lymphoma, gastritis, peptic ulcers, and stomach cancer. According to recent reports, H. pylori infection can potentially increase the risk of colon cancer. The current study aimed at investigating the association of H. pylori infection and the risk of colorectal cancer and adenomatous polyps. METHODS: The current study was conducted on 50 patients with colon cancer and adenomatous polyps as the case group and 100 subjects with no specific pathologies (i e, polyps, neoplasms, or inflammatory diseases) as the control group. Blood samples were collected from the patients in order to assess the presence of anti-Helicobacter pylori infection antibodies, and the serum titer levels of anti-Helicobacter pylori IgG and IgA antibodies were measured using indirect enzyme-linked immunosorbent assay (ELISA) and a kit procured by Pishtaz Teb Company (Iran). RESULTS: A total of 33 patients in the current study had adenomatous polyps and 17 had colon cancer. H. pylori infection (IgA >20 U/mL and IgG >10 U/mL) was significantly more prevalent in the patients with colon cancer and adenomatous polyps compared with the healthy controls (P= 0.003, P= 0.039, respectively). CONCLUSION: The obtained results suggested that H. pylori infection can be considered as a risk factor for colon cancer and adenomatous polyps.