Diagnostic significance of CD10 marker to differentiate colorectal adenocarcinoma from adenomatous polyp: A pathological correlation.

Background: Colorectal cancer could be developed from adenomatous polyp. The study aimed to evaluate the diagnostic significance of stromal and epithelial CD10 (Neprilysin) expression in patients with colorectal adenocarcinoma and adenomatous polyps. Methods: This cross-sectional study was conducted on 141 patients with colorectal adenocarcinoma and adenomatous polyps referred to Ayatollah Rouhani Hospital from March 2020 to March 2021. Differential diagnoses of colorectal adenocarcinoma and adenomatous polyps were made colonoscopically, and then samples were taken from the lesions. The pathologists confirmed the final diagnosis as colorectal adenocarcinoma, high-grade or low-grade adenomatous polyps. The stromal and epithelial CD10 expression was evaluated by immunohistochemistry. The data was analyzed by SPSS 22 software (p<0.05). Results: Sixty-five (46.1%) of the cases were low-grade polyps that were included positive (4 cases; 6.20%) and negative (61 cases; 93.80%) CD10 expression (P=0.001), also 76 (53.9%) of them were either high-grade polyps (21 cases) or adenocarcinomas (21 cases). Also, epithelial CD10 expression was significantly higher in the well-differentiated adenocarcinoma (38 cases) group than moderate (13 cases) and poor (4 cases) groups (P =0.001). Moreover, the CD10 expression level in the adenomatous polyps (10 positive cases and 76 negative cases) was correlated with the degree of dysplasia (P = 0.001) and the presence of tumor invasion (8 positive cases and 133 negative cases) (P = 0.001). Conclusion: The CD10 expression is associated with an increased degree of dysplasia and the presence of tumor invasion in patients with pre-neoplastic lesions and colorectal adenocarcinoma.

Primary retroperitoneal mucinous cystadenoma in a female patient: A case report.

INTRODUCTION: Primary retroperitoneal mucinous cystadenoma is an extremely uncommon tumor occurring mostly in females. The histogenesis of PRMC remains unclear and Open surgery is the most impressive treatment. CASE PRESENTATION: We present a 20-year-old Iranian woman with history of intermittent abdominal pain. In physical examination, her abdomen had a mildly asymmetrical distention and a round shape mass was palpated in right abdomen also she had a mild tenderness in right abdomen. Radiologic assessment revealed a right retroperitoneal smooth cystic mass (20 × 15 cm) without invasive features. The patient underwent complete surgical excision of the tumor by a laparotomic approach because of its size. The lesion was gently dissected from the contiguous organs and removed completely without spillage of its content. In microscopic investigations, sections showed a unilocular cyst with fibrous wall lined via monolayered bland looking columnar mucinous epithelium and no atypia or stromal invasion was presented. Diagnosis of a PRMC was made. The patient has discharged without any complications in 2 days' postoperative course. DISCUSSION: Generally, cysts are asymptomatic and are found fortuitously after a routine checkup assessment. Symptoms and signs related to this cyst are mainly because of their huge size and compression effect. Radiological assessments are effective in specifying the lesion preoperatively; although, the final diagnosis always needs histopathological verification. CONCLUSION: When the tumor is diagnosed, full resection should be considered because of the infectious or malignant potential of the tumor.

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.

Occult nodal metastasis in head and neck carcinoma patients treated with chemoradiotherapy.

BACKGROUND AND AIM: Neck lymph node metastasis plays an important role in the prognosis of patients with squamous cell carcinoma of the head and neck. The aim of this study was to evaluate the occult nodal metastasis in patients with head and neck squamous cell carcinoma (HNSCC) treated with chemo radiotherapy. METHODS: In this 5-year prospective study, patients with recurrent head and neck squamous cell carcinomas (HN-SCC) after primary treatment with chemoradiotherapy or radiotherapy that candidate for surgery were enrolled. In total, 50 patients with squamous cell carcinomas of the head and neck with N0 neck were included in the study. Age, initial location of recurrent tumor, T staging in primary and recurrent tumors, neck condition (N0 or N+), and pathology report for neck metastasis, number of affected lymph nodes and duration of tumor recurrence were examined. RESULTS: Out of 50 patients with mean age of 57.04 ± 14.4 years, 13 were female (26%) and 37 (74%) were male. In terms of primary tumor size, 52% (26 patients) were in T2 stage. The primary and recurrent tumor was located in the oral cavity in 33 patients (66%). Nine 0f 50 patients (18%) had occult metastases. CONCLUSION: It seems that END surgery is necessary for treatment the occult lymph node neck metastasis of recurrent head and neck cancers with N0 neck. Therefore, it is possible that END surgery has reduced cervical recurrence in these patients.