Detection of Human Papillomavirus in Squamous Lesions of the Conjunctiva Using RNA and DNA In-Situ Hybridization.

In-situ hybridization provides a convenient and reliable method to detect human papillomavirus (HPV) infection in formalin-fixed paraffin-embedded tissue. Cases of conjunctival papillomas, conjunctival intraepithelial neoplasia (CIN), conjunctival carcinoma in situ (cCIS), and invasive squamous cell carcinoma (SCC), in which low-risk (LR) and/or high-risk (HR) HPV types were evaluated by RNA or DNA in-situ hybridization, were retrospectively identified. LR HPV types were frequently detected in conjunctival papillomas (25/30, 83%), including 17/18 (94%) with RNA probes, compared to 8/12 (75%) with DNA probes. None of the CIN/cCIS or SCC cases were positive for LR HPV by either method. HR HPV was detected by RNA in-situ hybridization in 1/16 (6%) of CIN/cCIS cases and 2/4 (50%) of SCC cases, while DNA in-situ hybridization failed to detect HPV infection in any of the CIN/cCIS lesions. Reactive atypia and dysplasia observed in papillomas was generally associated with the detection of LR HPV types. Collectively, our findings indicate RNA in-situ hybridization may provide a high-sensitivity approach for identifying HPV infection in squamous lesions of the conjunctiva and facilitate the distinction between reactive atypia and true dysplasia. There was no clear association between HPV infection and atopy in papillomas or dysplastic lesions.

Descemet membrane endothelial keratoplasty in eyes with COL8A2-associated corneal dystrophy.

Purpose: The p.(Leu450Trp) COL8A2 mutation, associated with an early-onset corneal endothelial dystrophy, can result in bullous keratopathy within the first few decades of life. People with this condition frequently experience anterior corneal changes in keratometry as the disease worsens, which may potentially affect refractive error after endothelial keratoplasty. We describe outcomes of the first cases of Descemet Membrane Endothelial Keratoplasty (DMEK) for patients with known mutations in this gene. Observations: Four eyes from two patients with COL8A2-associated corneal dystrophy underwent DMEK for this condition at a tertiary academic center. Preoperative and postoperative Scheimpflug imaging and manifest refraction was conducted. Mean central corneal thickness decreased from 713 µm preoperatively to 529 µm at one month. Despite long-standing corneal haze, all eyes reached between 20/20 and 20/30 best corrected visual acuity, and minimum postoperative central corneal thickness reached 482, 479, 479 and 533 µm. Refractive changes frequently occurred during the first postoperative year, with 3.6 D, 3.3 D, 3 D, and 0.8 D shifts in spherical equivalent taking place within this time period in the four eyes. Conclusions and Importance: In two patients with the p.(Leu450Trp) mutation in COL8A2 who underwent DMEK, resolution of corneal edema resulted in centrally thin corneas and refractive shifts postoperatively. Despite chronic edema, excellent visual acuity was achieved in all eyes.

Clinicopathological Features of 19 Eyelid Pilomatrixomas.

Introduction: Pilomatrixoma is a relatively rare, benign tumor arising from the hair root matrix. It is found frequently on the head and neck, with most involving the eyebrow in the periocular region. In contrast, eyelid pilomatrixoma is less common, and often clinically misdiagnosed. Here, we present clinical and histological data from 19 pilomatrixomas arising in the eyelid. Methods: The study represents a retrospective study of eyelid pilomatrixoma diagnosed at our institution since 1981. All slides were reviewed, and demographic as well as clinical data were obtained. Results: Patient ages ranged from 2 to 63 years (mean 24 years), including 12 (63%) females and 7 (37%) males. Eight (42%) and 4 (21%) cases arose in the first and second decades of life, respectively. Upper eyelid involvement was found in 14 (74%) of cases. Microscopically, the tumors were characterized by basaloid and shadow cells accompanied by calcification and foreign body giant cells. Conclusions: Eyelid pilomatrixoma is rarely suspected clinically, and can be mistaken for cyst, chalazion, sebaceous carcinoma, and other tumors. Physicians should consider the possibility of pilomatrixoma in the eyelid area, especially in children or young female patients. Complete excision is curative, and diagnosis can generally be established by histopathological examination.

Clinicopathologic analysis of conjunctivochalasis and paste-pinch-cut conjunctivoplasty for management.

OBJECTIVE: To correlate the histopathologic results of conjunctival specimens with clinical findings in patients with conjunctivochalasis and report the results of the paste-pinch-cut technique for management. DESIGN: Retrospective chart review. SETTING: Single tertiary ophthalmological centre (Ocular Surface Diseases and Dry Eye Clinic, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Md.). METHODS: Twenty-five patients (32 eyes) with clinically significant conjunctivochalasis. All patients were referred for clinically significant dry eye without previous diagnosis of chalasis. Sixteen patients had an underlying inflammatory systemic condition. Intervention or Observation Procedure(s): Patients underwent surgery with paste-pinch-cut technique. Subjective dry eye symptoms and ocular surface staining scores (corneal and conjunctival staining using fluorescein and lissamine green respectively) were assessed at every visit. MAIN OUTCOME MEASURES: Change in patient symptoms and ocular surface staining scores and histopathologic findings in conjunctival specimens. RESULTS: After surgery, significant improvement was achieved in dry-eye symptoms as well as both corneal and conjunctival staining scores in 29 eyes on reduced topical therapy. Only 3 eyes had persisting conjunctival lissamine staining. Light microscopic examination disclosed mild to moderate lymphoplasmocytic inflammation of the conjunctivae with areas of epithelial goblet cell loss, squamous metaplasia, stromal edema, and fibrosis. CONCLUSION: Conjunctivochalasis appears to be associated with significant inflammation in the setting of dry eye and underlying inflammatory systemic conditions. Although topical anti-inflammatory treatment could be attempted in the initial management, surgical excision should be considered in the absence of clinical response.

Peripheral retinal arteriolar leakage in giant cell arteritis: a case report.

A 76-year old African American female with a history of arteritic ischemic optic neuropathy (AION) secondary to biopsy-proven giant cell arteritis (GCA) presented with unilateral vision loss in her contralateral eye despite high-dose oral steroid treatment. Dilated fundus examination revealed three cotton wool spots. Fluorescein angiography showed slowed arteriolar filling with late staining of small peripheral arteries, consistent with small vessel arteritis. Laboratory tests for alternative vasculitides were negative. Review of her temporal artery biopsy specimen confirmed lymphoplasmacytic inflammation around small adventitial vessels with no destructive granulomatous or leukocytoclastic small vessel vasculitis, consistent with GCA. Our unique case demonstrates peripheral small vessel retinal arteriolar leakage in GCA, which is a rare finding. This association is of interest because GCA is commonly associated with medium to large vessel pathology without small vessel involvement.

Chocolate Cysts Associated With Porous Polyethylene Orbital Implants.

Late-onset orbital hemorrhage is a rare complication of alloplastic implant use in orbital wall reconstruction following trauma. The authors report 3 patients with chocolate cysts presenting 3 to 9 years after orbital fracture repair with porous polyethylene implants. All patients were managed by implant removal and evacuation of cyst contents. Complete excision of the cyst was performed in 1 patient, while partial excision of the capsule was performed in 2 patients. Improvement of symptoms associated with the mass effects of the cyst was noted after surgical intervention. The authors also report the first case of orbital volume expansion from a chocolate cyst associated with a nonbarriered porous polyethylene implant. Delayed hemorrhage with capsule formation, although extremely rare, is a possible complication following orbital fracture repair with porous polyethylene implants.

Tarsal Epithelial Cysts: Prevalence, Case Series, and Synthesis of Existing Literature.

PURPOSE: Tarsal epithelial cysts (TECs) are squamous epithelial-lined lesions of the eyelid that are often mistaken for chalazia or epidermal inclusion cysts. They remain poorly described in the literature. This study is designed to characterize the prevalence and clinical features of TEC. METHODS: We conducted a single-center retrospective review of adult patients with a diagnosis of eyelid neoplasm, eyelid cyst, hordeolum, stye, or chalazion between January 1, 2011 and July 1, 2017. Among this cohort, we identified patients with a histopathologic diagnosis of TEC. We also conducted a PubMed literature review and synthesis of existing clinical data of patients reported to have TEC, noting common clinical and histopathological features. RESULTS: Of 7,516 patients, we identified 6 patients with a histopathological diagnosis of TEC, amounting to a prevalence of 0.08% amongst patients with eyelid lesions. Average age was 49.7 years (range 18-76 years), with a 1:1 male to female ratio. The most common presenting symptom was a painless eyelid mass, and the majority (66.6%) had a preoperative diagnosis of chalazion. All but 1 patient had surgical excision from the posterior approach and there was 1 recurrence in the follow-up period. On review of the literature, we identified 68 prior cases of TEC from 18 clinical studies, with clinical features mirroring our case series. CONCLUSIONS: TEC has stereotypical clinical and histologic features that distinguish it from other tarsal lesions. Our review identified TEC as a relatively rare cause of eyelid lesions.

Fecal calprotectin Level in patients with IBD and noninflammatory disease of colon: a study in Babol, Northern, Iran.

BACKGROUND: Inflammatory bowel disease (IBD) is a chronic disease with a relapsing course of inflammation in the digestive system. Endoscopy and histopathology are the golden standard methods for detection and assessment of IBD. A distinct increase of fecal calprotectin level can be a useful marker for the diagnosis of IBD. The aim of this study was to evaluate the fecal calprotectin level in patients with IBD and without inflammatory diseases of the colon. METHODS: Calprotectin levels of patients referred to the Ayatollah Rouhani Hospital of Babol, northern Iran with clinical symptoms of colon disease were evaluated. After a week, colonoscopy and biopsy were performed on all patients and they were divided into two groups. The first group included patients with confirmed IBD and the second group included patients with diseases other than IBD, patients with IBS and healthy persons. Then the measured fecal calprotectin level was compared between the two groups before colonoscopy. RESULTS: We observed correlation between calprotection in these two groups (p<0.0001). 38 (86.8%) patients in the case group and 5 (13.2%) patients in the control group had positive fecal calprotectin test and 12 (23.1%) patients in the case group and 40 (76.9%) patients in the control group had negative results. Basad on ROC curve, the cutoff point of calprotectin was 127.65 with 73% sensitivity and 89% specificity. The area under the curve was 0.83 with 95% confidence interval, 0.74-0.91 (p<0.0001). CONCLUSIONS: The results pointed to this fact that fecal calprotectin can be a noninvasive marker in differentiating IBD from IBS.

The diagnostic value of fine needle aspiration in comparison with frozen section in thyroid nodules: A 20-year study.

BACKGROUND: Fine needle aspiration (FNA) is the most important method in the diagnosis of thyroid nodules before surgery. Recently, the efficiency of FNA in thyroid nodule management has been debatable. On the other hand, intraoperative frozen section (FS) has been used to confirm the diagnosis of FNA and select the proper surgical approach. In this regard, the present study aimed to assess the diagnostic value of FNA as compared to FS in the diagnosis of thyroid nodules. METHODS: This retrospective study was performed on 69 patients with FNA and FS and histopathological examination from 1993 to 2014 in Babol, northern Iran. FNA was classified into 5 groups: benign (colloid goiter), lymphocytic thyroiditis, follicular lesions, suspicious and malignant, and FS was classified as after benign or malignant. The results of both methods were compared with each other. RESULTS: This retrospective study was performed on 69 patients with FNA and FS and histopathological examination from 1993 to 2014 in Babol, northern Iran. FNA was classified into 5 groups: benign (colloid goiter), lymphocytic thyroiditis, follicular lesions, suspicious and malignant, and FS was classified as after benign or malignant. The results of both methods were compared with each other. CONCLUSION: FNA was considered as a simple, less invasive and cost effective method with fewer side effects for evaluation of thyroid nodules. Particulary it had a high sensitivity and specificity in experienced and skilled hands.

Estimating postoperative survival rate of gastric cancer patients and its effective factors in Babol, northern Iran: 2006-2011.

BACKGROUND: The importance of gastric cancer, considering its progressive course and high mortality is one of the reasons we pay attention to patients' survival and the significance of this study was to estimate survival and determine the effective factors on patients with gastric cancer. METHODS: In this cross-sectional study, all patients with gastric cancer who underwent surgery in Shahid Beheshti Hospital, Babol, northern Iran during 2006-2011 were enrolled. To get information, a checklist was prepared consisting gender, age, and other factors related to survival from the start of diagnosis to the end of study. Statistical analysis was performed using SPSS Version 20, t-test, chi-square test and Cox regression and Kaplan-Meier. RESULTS: One hundred seventy-five patients consisting 132(75.4%) males and 43(24.6%) females entered the study. Among the 146 patients who were followed up for 50 months, 25 (14.28%) cases survived and 121 (69.15%) cases died. Survival did not have a significant association with gender, age, family history, smoking, location and type of tumor, metastasis, involved lymph nodes and treatment. Tumor stage and type of surgery had a significant association with survival in Cox regression. CONCLUSION: Diagnosis of cancer at the early stage and type of surgery increased survival rate.

Assessment of oral cytological features in smokers and nonsmokers after application of toluidine blue.

INTRODUCTION: Smoking is the most important etiologic factor of oral cancer. Exfoliative cytology is the best method for early detection of oral cancer. Toluidine blue staining is used for detection of oral premalignant and malignant lesions. The aim of this study was to enhance the accuracy of oral exfoliative cytology in evaluating dysplastic features using toluidine blue staining. METHODS AND MATERIALS: This clinical trials study was performed on 60 male smokers and nonsmokers without clinically oral lesion. Oral exfoliative cytological smears were prepared before and after application of toluidine blue and stained with Papanicolaou and evaluated under light microscope. Cytological features such as cellular clumping nuclear-to-cytoplasmic ratio, cellular and nuclear pleomorphism, micronuclei, binucleation, presence of bacterial colonies, and keratin flakes were assessed and compared before and after application of toluidine blue. RESULTS: Results showed that cellular clumping and micronuclei were significantly decreased after application of toluidine blue and conversely cellular and nuclear pleomorphisms were significantly increased. Frequency of micronuclei and binucleation were greater in smokers than nonsmokers which were insignificant. Cellular and nuclear pleomorphisms were significantly higher in smokers than nonsmokers after application of toluidine blue. CONCLUSION: Toluidine blue improved cellular, nuclear, and structural features of oral cytological smears and filtered false-positive or false-negative results. Thus, application of toluidine blue in combination with oral exfoliative cytology for early detection of oral cancer is recommended. Diagn. Cytopathol. 2017;45:513-519. © 2017 Wiley Periodicals, Inc.

Testicular Biopsy in Males With Infertility: A Longitudinal Study.

BACKGROUND & OBJECTIVE: Regarding the importance of histologic examination of testicular biopsy for clinical planning of infertility, the current study was conducted to compare 2 separate histologic examination of testicular biopsy. Also, some cases with known fertility outcome were followed and their histological patterns were also compared with those of the outcome. METHODS: The current study was conducted on testicular biopsies of 924 males evaluated for infertility from 1990 to 2013, retrieved from the archive of pathology department of Shahid Beheshti Hospital, Babol, Northern Iran. All slides were reviewed by a pathologist unaware of the original results. Data including age, histological pattern of spermatogenesis (pure and mixed), smoking, and the history of ejaculatory duct obstruction were retrieved from the pathology archive. In some cases, the outcome was also compared with that of the histological pattern. All analyses were executed using SPSS version 22 statistical software. To analyze the data, t test, Chi-square test, one-way ANOVA, and the least significant difference (LSD) test were used. RESULTS AND CONCLUSION: Out of the 924 testicular biopsies, 34 (3.7%) cases had different reports from original reading. LSD analysis indicated Sertoli cell only syndrome (SCO) as the most common histological pattern. There was a significant difference between the mean age of cases with SCO and that of the ones with hypospermatogenesis (HYPO) (P =0.03). Obstruction was higher in pure pattern (P=0.04). The pregnancy rate was higher in the wives of males with obstructive infertility than the ones with non-obstructive infertility. SCO was the most common histological pattern of testicular biopsy during 23 years. Pure patterns were more than mixed patterns, and the mean age was lower in mixed patterns. Also, pure patterns were the most common findings in the cases with obstructive infertility.

Detection of Toxoplasma gondii DNA in Malignant Breast Tissues in Breast Cancer Patients.

Breast cancer is the most prevalent malignancy in women throughout the world. Similar to other cancers, a strong relationship between breast cancer and environmental factors such as infectious agents has been reported. Toxoplasma gondii is a protozoan parasite which may play a role in cancer induction. The present study aimed to investigate a possible association between a history of T. gondii infection and breast cancer by detecting T. gondii DNA in malignant and non-malignant breast and lymph nodes tissues from breast cancer patients with latent toxoplasmosis. Formalin-fixed, paraffin-embedded (FFPE) tissue blocks from malignant/non-malignant breast and lymph nodes were obtained from twenty-nine breast cancer patients who were positive for anti-Toxoplasma antibodies (IgG). FFPE tissue blocks were deparaffinized using hot water method, and DNA was extracted. A conventional PCR analysis was performed to amplify partial regions of T. gondii B1 and REP-529 genes. Ninety-three samples from 29 patients were examined. All patients were negative for anti-T. gondii antibodies (IgM). T. gondii DNA was detected in 3 (10.3%) patients by PCR analysis of either B1 or REP-529 genes. These include two malignant breast and one normal lymph node samples. Sequence analysis of these genes showed a good similarity with previously published B1 and REP-529 sequences of T. gondii in NCBI GenBank. This study did not find any association between T. gondii infection and breast cancer. Furthermore, it is the first molecular identification of T. gondii in FFPE tissue samples obtained from breast cancer patients.

Expression of estrogen and progesterone receptors in papillary thyroid carcinoma.

BACKGROUND: Papillary thyroid carcinoma (PTC), occurs mostly in women and sex hormones may play a role in the pathogenesis and clinical course. The objective of this study was to determine the status and prevalence of estrogen and progesterone receptors in PTC with regard to age, gender, tumor size and lymph node involvement. METHODS: Immunohistochemical stains were performed on 92 tissue blocks of PTC for estrogen receptor (ER) and progesterone receptor (PR) expression in tumor cells. Chi-square test and Mann-Whitney U test were used to determine statistical difference using statistical software SPSS. RESULTS: The mean age of patients was 39.32±1.7 years (range 13-80) with 79(85.9%) women and 13 (14.1%) men. Lymph node involvement was seen in 76.1% of patients. The average tumor size was 3.6±2.21 cm. The rate of ER and PR expression were 46.75% and 5.6%, respectively. ER expression for females was higher than males (P=0.014), but no relation was found between males and females in PR expression (P=0.7). Also there was no statistical difference between ER and PR expression with respect to age, lymph node involvement and tumor size. CONCLUSION: Our study showed higher ER expression in females than males with PTC. No relation was found between the expression of these receptors and age of presentation, lymph node involvement and tumor size. Further investigation is required to determine the prognostic importance of ER and PR in PTC.

Epidemiological Aspects of Hepatitis B and C and Human Immunodeficiency Viruses Among Hemodialysis Patients in Mazandaran Province, Iran.

BACKGROUND: Hemodialysis patients are potentially susceptible to infection with blood-borne viral agents, especially hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). OBJECTIVES: The aim of this study was to evaluate the prevalence and incidence of HBV, HCV, and HIV infections in hemodialysis patients. PATIENTS AND METHODS: This study was carried out in 482 hemodialysis patients who had been referred to eight dialysis centers in the Mazandaran province in Iran from 2012 - 2014. HBs Ag, HCV Ab, HBs Ab and HIV Ab were assessed every three months for two years. The patients' demographic characteristics, including age, gender, area of residence, and duration of dialysis, were noted. The prevalence of each virus was also determined. RESULTS: From a total of 482 patients, 253 (52.5%) males and 229 (47.5%) females were evaluated. The mean age of all patients was 54.96 ± 16.1 years, and all participants were HIV negative. One subject had both HBV and HCV infections. HBs Ag and anti-HCV were detected in 10 (2.1%) and 40 (8.27%) patients, respectively. The mean age of HCV-positive patients was 55.4 ± 16.4, while HCV-negative patients were an average of 51.6 ± 10.7 years old (P = 0.002). The incidence of HCV was higher in people from 40-59 years of age (P < 0.001). No patients had HBV, and incidence of HCV was 0.5% in the first year and 0.75 in the second year. No cases of HIV were identified. CONCLUSIONS: The results show that the prevalence rates of HBV and HCV in hemodialysis patients were moderate to low in the Mazandaran province. Based upon the obtained levels of these viruses, these incidence rates are therefore reasonable.

Detection of Merkel Cell Polyomavirus and Human Papillomavirus in Esophageal Squamous Cell Carcinomas and Non-Cancerous Esophageal Samples in Northern Iran.

Human papillomavirus (HPV) infection is one of the hypothesized causes of esophageal squamous cell carcinoma (ESCC), but the etiological association remains uncertain. It was postulated that other infectious agents together with HPV may increase the risk of ESCC. The current investigation aimed to explore the presence of a new human tumor virus, Merkel cell polyomavirus (MCPyV), together with HPV in ESCC tumors and non-cancerous esophageal samples in northern Iran. In total, 96 esophageal samples (51 with ESCC, and 45 without esophageal malignancy) were examined. HPV DNA was detected in esophageal specimens of 16 out of the 51 ESCC cases (31.4 %) and 20 out of the 45 non-cancerous samples (44.4 %). Untypable HPV genotypes were recognized in high rates in cancerous (75.0 %) and non-cancerous (55.0 %) esophageal specimens. MCPyV DNA was detected in esophageal specimens of 23 out of the 51 ESCC cases (45.1 %) and 16 out of the 45 non-cancerous samples (35.6 %). The mean MCPyV DNA copy number was 1.0 × 10(-5) ± 2.4 × 10(-5) and 6.0 × 10(-6) ± 1.3 × 10(-5) per cell in ESCC cases and non-cancerous samples, respectively. There was no statistically significant difference between cancerous and non-cancerous samples regarding mean MCPyV DNA load (P = 0.353). A bayesian logistic regression model adjusted to the location of esophageal specimen and MCPyV infection, revealed a significant association between HPV and odds of ESCC (OR, 2.45; 95 % CI: 1.01-6.16). This study provides the evidence of the detection of the MCPyV DNA at a low viral copy number in cancerous and non- cancerous esophageal samples.

Cytokeratin7 expression in gastric and colorectal adenocarcinoma: Correlation with prognostic factors.

BACKGROUND: Gastric and colorectal adenocarcinoma are the second and the fifth most common cancers in Iran, respectively. Expression of cytokeratin 7 (CK7) is established in most malignancies including gastric and colorectal adenocarcinoma. Demonstration of Ck7 could be related to prognostic factors and help to the better management of the patients. The objective of our study was to evaluate the CK7 expression in gastric and colorectal adenocarcinoma and its correlation with other prognostic factors. METHODS: This cross-sectional study was performed on 99 tissue blocks from patients with gastric or colorectal adenocarcinoma undergoing surgery. Tumor grade, tumor size, depth of invasion and metastasis to lymph nodes were determined. Then, the expression of CK7 was studied using immunohistochemistry staining. RESULTS: Expression of CK7 was 50% and 33.8% in gastric and colorectal adenocarcinoma, respectively. There was not only a significant correlation between CK7 expression and tumor size (r=0.267, P=0.009) but also histologic grade (r=0.222, P=0.028). CONCLUSION: CK7 could be more expressed with the increase in tumor size and was associated with poorly differentiated gastric and colorectal adenocarcinoma. However, with these results gathered, it is highly recommended that further studies will be conducted to reveal the exact prognostic role of this factor.

The Value of Bronchoalveolar Lavage in the Diagnosis of Sputum Smear-NegativePulmonary Tuberculosis.

BACKGROUND AND OBJECTIVES: Sputum smear staining for acid-fast bacilli is initial approach to the diagnosis of pulmonary tuberculosis (PTB) but more than 50% of cases are sputum smear-negative. This study was aimed to investigate the diagnostic value of fiberoptic bronchoscopy (FOB) guided bronchoalveolar lavage (BAL) in patients suspected to have tuberculosis. METHODS: This prospective cross-sectional study was carried out on 290 sputum smear-negative patients who were clinically suspicious for PTB in 2006-12. All patients were subjected to FOB andBAL, then BAL specimens stained and cultured. RESULTS: Of the 290 patients, 173 cases (59.7%) were men and 117 cases (40.3%) were women with the age of 52.6±19.1 years (ranged 20-76 years). Of the total 290 BAL specimens, 110 specimens (38%) were positive for acid-fast bacilli. Sensitivity, specificity, PPV and NPV was 60%, 91%, 89% and 64%, respectively. Also, LR (+) and LR (-) was 64.6% and 0.44%, respectively. CONCLUSION: FOB guided BAL is a reliable, rapid and useful method for establishing the diagnosis of smear negative PTB with minimal complications.

Correlation of ER, PR and HER-2/Neu with other Prognostic Factors in Infiltrating Ductal Carcinoma of Breast.

BACKGROUND AND OBJECTIVES: Breast cancer is the most common malignancy among women in the world. The aim of this study was to assess estrogen receptor (ER), progesterone receptor (PR) and HER-2/neu of infiltrating ductal carcinoma (IDC) with tumor size, histologic grade, lymph node metastasis and age. METHODS: This study was carried out on 300 tissue blocks of patients with IDC who underwent mastectomy from 2007 to 2011 in Shahid Beheshti Hospital, affiliated to Babol University of Medical Sciences, Babol, Iran. Data including age, tumor size, and histologic grade and lymph node status retrieved from pathology department. RESULT: The mean age of the patients was 40.2±2.3 (ranged 19-82 years). ER and PR were positively correlated with each other ( P = 0.001) and they inversely correlated with HER-2/neu ( P =0.001). We observed correlation between ER and PR expression and low histologic grade ( P = 0.001) and HER-2/neu expression and high histologic grade ( P = 0.003). There was correlation between HER-2/neu expression and lymph node involvement ( P =0.03). None of these makers showed correlation with age and tumor size ( P > 0.05). CONCLUSION: Our findings indicate the importance of ER, PR and HER-2/neu expression as prognostic factors for therapeutic decision.