Liver Abscess due to Fasciola hepatica: A Case Report of the North of Iran.

One of the rare manifestations of fascioliasis is liver abscess. In this paper, we report the case of a 38-year-old woman with a liver abscess caused by Fasciola hepatica (F. hepatica). The patient was referred to the clinic with recurrent fever, right upper quadrant (RUQ) pain, and a large abscess in her liver. Despite the consumption of an antibiotic drug, she still had symptoms. The symptoms began to disappear upon starting the consumption of triclabendazole (TCBZ). Fascioliasis can manifest itself with unusual symptoms that provide no specific clue for its diagnosis. Therefore, it is important to consider F. hepatica in the differential diagnosis of liver abscess, especially in endemic regions.

OLGA- and OLGIM-Based Staging in the Patients with Gastritis and Endoscopy Indications.

BACKGROUND: Gastric cancer is one of the most common cancers with high mortality. In Iran, the high-risk regions include Northern and Northwestern parts. The aim of this study was to assess the operative link on gastritis assessment- and operative link on gastric intestinal metaplasia-based staging in patients with upper gastrointestinal symptoms. METHODS: Totally, 345 patients underwent upper gastrointestinal endoscopy. Also, the status of Helicobacter pylori infection was evaluated using rapid urease test and histological method. Moreover, histological changes were assessed using the Update Sydney System. The operative link on gastritis assessment- and operative link on gastric intestinal metaplasia-based stages of 0-II were considered as low-risk stages and stages III and IV were considered as high-risk stages. RESULTS: Most of the patients were lower than 60 years (245 patients, 71%), and 71.9% of our patients had H. pylori infection. The frequency of atrophic gastritis and intestinal metaplasia was 44.9% and 25.2%, respectively (P < .001). Eleven patients (73.7%) with gastric adenocarcinoma had a low risk and 2 patients with low-grade dysplasia had a high risk of operative link on gastritis assessment and operative link on gastric intestinal metaplasia. Almost, 62.5% of gastric cancer patients with an intestinal type of gastric adenocarcinoma were at low-risk stages. CONCLUSIONS: Although high stages of operative link on gastritis assessment and operative link on gastric intestinal metaplasia need further follow-up, lower stages of atrophy or intestinal metaplasia also require follow-up. Furthermore, operative link on gastritis assessment method in detecting a greater number of patients who need follow-up is more successful and profitable.

Prevalence of pre-cancerous colon lesions in referred patients under patronage of a local relief foundation in Guilan province.

Colon cancer is the most commonly diagnosed gastrointestinal cancers in developed countries with varied incidence and the onset age of disease worldwide. Overall, 161 participants who were under patronage of a local relief foundation and referred to the endoscopy ward of Razi Hospital affiliated to the Guilan University of Medical Sciences. These patients have been aged more than 50 or more than 40 years with history of colorectal cancer in their first-degree family were enrolled from March 2016-March 2017. Demographic information were collected. Colonoscopy was performed and histopathological evaluation of observed lesions and polyps was done. Most of participants were female (113 individuals, 70.2%) and aged 50-60 years (83 individuals, 51.6%). Seventy-four (46%) had certain lesions. Most of colonoscopy findings were observed in the ascending colon in which depressed polyps and diverticulum were most frequent. However, rectum showed the most histological findings. All polyps of descending and ascending colons were neoplastic, while most of rectal polyps were non-neoplastic. Male patients, who were aged more than 60 years and smokers had significant higher percentage of both lesions and polyps in their colon (p<0.05). Moreover, significant positive association was detected between exposure to harmful industries and having polyps (p=0.01). We found male gender, higher age, smoking, and exposure to harmful industries as important risk factors for having colorectal lesions, which must be confirmed in further studies.

Intestinal tuberculosis in a 55-year-old woman with a 30-year history of rheumatoid arthritis.

INTRODUCTION: Tuberculosis (TB) is one of the endemic diseases with a challenging diagnosis in the absence of pulmonary disease. On the other hand, rheumatoid arthritis (RA) is a systemic autoimmune disease with extra-articular manifestations that occur at any age after onset, such as nodules, Sjögren's syndrome, anemia of chronic disease, and pulmonary manifestations, which are more frequently seen in patients with severe, active disease. Here we present a case of RA with intestinal TB. CASE REPORT: A 55-year-old woman with a 30-year history of RA using prednisolone and hydroxychloroquine presented with a nonpositional hypogastric pain and a weight loss of 20 kg over 7 months. No history of biological therapy was recorded. Colonoscopy revealed an ulcerated mass that was suspicious for malignancy. The pathobiological assessments confirmed ulceration and granulation tissue formation, foci of necrotizing granulomatous inflammation in lamina propria with adjacent mild crypt regenerative changes. Also, Ziehl-Neelsen staining for acid-fast bacilli in the granulomas was positive though the polymerase chain reaction assay did not detect the Mycobacterium tuberculosis. Anti-TB medication for 2 weeks eliminated the symptoms. CONCLUSIONS: Intestinal TB in patients with vague abdominal symptoms and relevant physical findings such as pain and palpable mass should be considered to prevent late or misdiagnosis.

Lymphangioma circumscriptum of glans penis: a report of two cases.

Lymphangioma circumscriptum is a developmental anomaly of lymphatic vessels, which appear as aggregates of clear or hemorrhagic vesicles on the skin or mouth. Glans penis involvement is very uncommon. Because of the sensitivity of the area, possible functional, cosmetic, or psychologic disturbances can result. Lymphangioma circumscriptum is rarely found on this location; hence, vigilance and awareness of this entity is necessary for a swift and proper diagnosis. Two cases are presented on the account of their rarity and unique representation.

Are mammaglobin and GCDFP-15 sensitive markers for diagnosis of metastatic basal-like triple negative breast carcinomas?

OBJECTIVE: There are small studies on expression of mammaglobin and GCDFP-15 for detection of basal-like triple negative breast cancer. This type of cancer has shorter survival and higher mortality rate. There must be reliable markers for detecting this type of tumor especially in metastatic cases with unknown origin. MATERIAL AND METHOD: In this study we assessed 66 paraffin blocks of breast cancers previously diagnosed as triple negative subtype in Mehr hospital (Tehran, Iran) by tissue microarray and immunohistochemistry technique for expression of mammaglobin and GCDFP-15. RESULTS: GCDFP-15 was positive in 12 cases (18.2%) and the other 54 (81.8%) cases remained negative. Mammaglobin was positive only in 6 cases (9.1%) and the remaining 60 (90.9%) cases were negative. CONCLUSION: According to recent studies and our findings, there is no useful immunohistochemical marker for detection of breast source in cases of metastatic triple negative breast cancer with unknown origin and we must try hard to discover more accurate immunohistochemical markers for these highly metastatic breast cancers.