Angiofibroma of the vulva.

BACKGROUND: Cellular angiofibroma is a benign and rare tumor. It usually arises in middle-aged women and involves the vulva. Complete local excision of the tumor is the best cure, and, usually, there is no recurrence after surgery. CASE REPORT: We describe a 20-year-old woman with a painless, growing vulvar mass who presented about 3 years ago. Her past medical history was negative for oral contraceptives, tobacco, and alcohol, and there were no similar lesions in her family history. A physical examination revealed two masses on the right and the left labia majora and similar lesions on the left axilla and both breasts. An uncomplicated simple resection of the vulvar masses was done in the operating room. There was no evidence of recurrence 12 months after surgery. Histopathologic examination revealed that the findings were consistent with the diagnosis of the cellular angiofibroma. Based on our knowledge, this patient is the youngest case of vulvar angiofibroma. The lesions were large and symmetrical (on both labia majora), although they differed in size. Extravulvar (breast and axilla) lesions were also noteworthy in this patient.

Gastrointestinal anthrax: clinical experience in 5 cases.

BACKGROUND: Bacillus anthracis may usually cause three forms of anthrax: inhalation, gastrointestinal and cutaneous. The gastrointestinal (GI) anthrax develops after eating contaminated meat. Thus, in this paper were report 5 cases of intestinal anthrax. CASE PRESENTATION: We report a case series of intestinal anthrax, with history of consumption of raw or poorly cooked liver of sheep. One patient was female and 4 were males with the age range between 17 and 26 years. All patients were admitted with abdominal pain, nausea, and vomiting. Examination revealed abdominal distention on the right lower quadrant or diffuse tenderness. Laboratory examination in all patients showed leukocytosis with polymorphonuclear of >80%. Because of the unclear and questionable diagnosis, exploratory laparotomy was performed on several patients, invariably showing an abundant yellowish and thick ascitic fluid, soft hypertrophied mesenteric lymph nodes (3-5 cm) mostly in the ileocecal region, and substantial edema involving one segment of small bowel, cecum or ascending colon. Anthrax was diagnosed on the epidemiologic basis (ingestion history of half cooked liver of sheep) or microbiologic (microscopy with bacterial culture) and pathologic testing (post surgery in four patients or autopsy in one patient). With appropriate treatment, 4 survived and one patient died. CONCLUSION: Gastrointestinal anthrax is characterized by rapid onset, fever, ascitis and septicemia. The symptoms can mimic those seen in an acute surgical abdomen. Rapid diagnosis and prompt initiation of antibiotic therapy and then exploratory laparotomy (right hemicolectomy) are keys to survival.

Expression of Bcl-2 and Bax in advanced or metastatic prostate carcinoma.

PURPOSE: To evaluate the correlation of Bcl-2 and Bax protein expressions with biochemical failure-free survival in patients with advanced or metastatic prostate carcinoma (PCa) undergoing androgen deprivation therapy. MATERIALS AND METHODS: This retrospective study was performed on patients with locally advanced (≥ T3) or metastatic PCa, who were referred to Omid Hospital between years 2003 and 2007. All subjects had undergone androgen deprivation therapy. Samples were analyzed immunohistochemically for Bax and Bcl-2 expression. The H-score was calculated for each sample based on intensity and percentage of stained cells. H-score > 50 was considered positive. RESULTS: Thirty-seven patients (13 metastatic and 24 locally advanced) were eligible for analysis. Thirty-six (97.3%) samples were positive for Bax and 26 (70.3%) for Bcl-2 expression. The median H-score for Bax and Bcl-2 was 200 (range, 40 to 300) and 85 (range, 0 to 220), respectively. While there was no correlation between Bax expression and Gleason score, high Bcl-2 expression (H-score > 85) was significantly associated with Gleason score > 7 (P = .004). The median time to progression in the advanced and metastatic groups was 22 (range, 10 to 37) months and 16 (range, 9 to 26) months, respectively. High Bcl-2 expression (P = .01) and prostate-specific antigen > 20 ng/mL (P = .01) were significant predictors of lower biochemical progression-free survival. CONCLUSION: High Bcl-2 expression was associated with higher Gleason scores and lower biochemical-free survival in patients with advanced PCa undergoing androgen deprivation therapy.

Peripheral bronchopathia osteochondroplastica.

Tracheobronchopathia osteochondroplastica refers to the abnormal presence of osseous and/or cartilaginous nodules in the submucosa of the trachea and/or bronchi. This disease presents with exophytic lesions that are covered by normal mucosa. In this study, we report the case of a 51-year-old man who complained of exertional dyspnea. Chest x-ray and computed tomography showed diffuse bilateral micronodular pulmonary infiltrate. Mucosal appearance during bronchoscopy was completely normal. Histologic examination of the biopsy taken by transbronchial lung biopsy showed discrete cartilaginous nodules in the walls of the bronchiole. According to our investigation, this presentation of peripheral bronchopathia osteochondroplastica has not been reported previously.

Oral submucous fibrosis in a young patient.

A seventeen-year-old male presented with a restriction in the oral cavity. The oral mucosa was white and he could not protrude his tongue. For 4 years he had habitually held a powdery material containing betel nut in the oral vestibule for several minutes a day. A biopsy of the labial mucosa was carried out and a diagnosis of oral submucous fibrosis was confirmed. This is a premalignant condition. Oral submucous fibrosis is very rare in young patients.

Immunohistochemical study association between human herpesvirus 8 and multiple myeloma.

Multiple myeloma (MM) is a plasma cell neoplasm characterized by a clonal proliferation of plasma cells that produce a monoclonal protein and involve the skeleton at multiple sites. Although human herpesvirus-8(HHV-8) has been implicated in pathogenesis of disease, but this role is not clear. The aim of this study was to show direct evidence of HHV-8 in bone marrow tissue of MM patients with use of immunohistochemical method. Standard immunohistochemstry was performed with HHV-8 marker on formalin fixed paraffin embedded bone marrow tissue in 30 MM cases and 30 subjects with normal bone marrow tissue. Slides were examined for nuclear immunoreactivity by two pathologists. The data were analyzed with 2 x 2 contingency tables and Fischer's exact test, also differences with P-value under 0.05 (P