[Evaluation of diagnostic value of fine needle aspiration in thyroid nodules]

Thyroid diseases particularly nodular lesions are among the most common diseases of human. Approximately 5% of the populations have palpable thyroid nodules which are detected in the routine Autopsy. Nearly 95% of thyroid nodules are benign wherease malignant nodules include 5% of them. Fine needle aspiration [FNA] has been recognized as a simple, inexpensive and available procedure for rapid diagnosis. The objective of this study was to determine the value of FNA in thyroid diagnosis. In this retrospective research, 536 patients with thyroid nodules reffered for FNA or hospitalized for thyroid surgery in Imam Reza Hospital from March 2002 until March 2005 were studied. Individual and laboratory data were gathered in a questionnaire and analyzed by descriptive statistics. This study included 107 men and 429 women and the average age of patients was 40 years. Out of 536 patients 12.7% had malignant, 70.3% benign and 8.6% yield suspicious results and 2.4% of FNAs were insufficient. Comparing the results of FNA and biopsy, FNA had the specificity of 89.5%, sensitivity of 91.5%, and accuracy of 93.7%; negative and positive predictive values were 80.9% and 95.5% respectively. These results reemphasized that, FNA is a simple and non invasive procedure and if performed carefully and evaluated by an expert pathologist is of high sensitivity and specificity

Immunohistochemical expression of P53 protein in histologically favorable Wilms tumor and its relationship to tumor stage at presentation

Wilms tumor, as the most common renal tumor of children, has been associated with chromosomal abnormalities. Although a correlation between anaplasia and mutations of P53 tumor suppresser gene has been found in Wilms tumor, significance of these mutations in different clinical stages of favorable- Wilms tumor, remains largely unresolved. The goal of this study was to determine the frequency of P53 expression in histologically favorable Wilms tumors and its correlation to tumor-stage at presentation. In this retrospective study, 48 cases of confirmed Wilms tumor with favorable-histology were retrieved from the files of departments of pathology in three hospitals in Mashhad University of Medical Sciences between 1990 and 2004. Histological characteristics and clinicopathological staging were in accordance with National Wilms Tumor Study guidelines. P53 expression was determined by the immunohistochemical method. For each section, the proportion of neoplastic cells exhibiting nuclear positivity was broadly quantified and their intensity of staining was charted, based on visual impression by two pathologists. A total of 48 cases of histologically favorable Wilms tumor were assessed. Eleven cases [23%] showed positivity for P53 which were 3 [27.3%] with stage II, 3 [27.3%] with stage IV, 2 [18.2%] with stage I, 2 [18.2%] with stage III and 1 case [9.1%] with stage V. The P53 immunopositivity was seen in 1-25% of tumor cells in 9 cases [18.8%], in 26 to 50% of tumor cells in 1 case [2.1%] and in >75% of tumor cells in the other one case [2.1%]. The intensity of staining was moderate in 6 cases [12.5%], weak in 4 [6.3%] and strong only in one case 4.2%]. The most common component with P53 immunoreactivity was blastemal in 11 cases [100%]. In 4 cases [36.4%] there was also positivity in epithelial and in 2 cases [18.2%] in mesenchymal components. We found no correlation of P53 immunoreactivity and its intensity to tumor stage at presentation in individuals with histologyically favorable Wilms tumors [p=0.66, p=0.52 respectively]

[Small round cell tumours with unknown origin in pathology specimens of iman reza hospital from 1362-1382]

The term" small round cell tumour"describes a group of highly aggressive tumours composed of relatively small and monotonous undifferentiated cells with high nuclear to cytoplasmic ratio. This group includes: Ewing sarcoma [EWS], Peripheral neuroepithelioma [PN], Primitive neuroectodermal tumour [PNET], Neuroblastoma, Rhabdomyosarcoma [RMS], Desmoplastic small round cell tumour [DSRCT], Lymphoma, Leukemia, Small cell osteosarcoma Small cell carcinoma, Olfactory neuroblastoma, Merkel cell carcinoma, Small cell melanoma, and Mesenchymal chondrosarcoma. Their clinical presentation often overlap, thus making a definitive diagnosis problematic in some cases. Yet, a clear undrestanding of their clinicopathologic features usually allows for a confident diagnosis, especially if immunohistochemistry is used. This is an immunohistochemistry study of small round cell tumours with unknown origin that were diagnosed in pathology service of Imam Reza Hospital from 1362-1382. In this period, we found 24 cases which were reported SRCT without definitive diagnosis the immunohistochemistry kits are from DAKO Company and applied as directed by manufacturers. The SRCT is most frequent in the first decade of life [45%], 13 cases were male and 11 cases were female. IHC influence on diagnosis in 11 cases [46%] confirm the first ordered diagnosis and diagnosis made in another 9 [33%] of SRCTs,and in 2cases[8%]the first diagnosis was changed. Overally in review, 35 cases from 48 SRCTs with unknown origin [%75] were diagnosed by routine stainings by light microscopy without immunohistochemistry