Myofibroblastoma of the Breast: A Morphologic and Immunohistochemical Study of Three Cases.

Myofibroblastoma (MFB) of the breast is an uncommon entity of benign spindle neoplasms of the breast. This tumour possesses a broad spectrum of histomorphological patterns. Distinguishing of myofibroblastoma variants from malignant mimics of this benign neoplasm is essential for pathologists to avoid further invasive surgical procedures. In this article, we report the clinical, morphological, and immunohistochemical features of three cases, including two females and one male patient with mammary myofibroblastoma with emphasis on the histomorphological findings. As there is not yet enough information about MFB, more reports of MFB are still required to more clarify the pathogenesis and potential predisposing factors of this rare type of breast tumours.

Evaluation of HER2/neu Expression in High-Grade Endometrial Carcinoma and Its Clinicopathological Correlation.

BACKGROUND & OBJECTIVE: Endometrial carcinoma (EC) has been traditionally classified into two distinct categories of low-grade and high-grade. Type I (low grade) EC, which constitutes the majority of cases, is linked to estrogen-related molecular pathways. But type II (high-grade) EC accounts for 10-20% of cases and behaves in an aggressive way. Pathologic and biological features of type II EC have not been fully elucidated yet. Several investigations have demonstrated HER2/neu expression and amplification in type II EC, especially papillary serous carcinoma (PSC). This study assessed HER2/neu expression in high-grade EC as well as its association with other clinical and histopathological prognostic factors. METHODS: In this cross-sectional study, we performed HER2/neu immunohistochemical (IHC) staining in 37 high-grade EC cases with histological diagnostic categories of PSC (n=23), clear cell carcinoma (CCC) (n=9), and carcinosarcoma with high-grade carcinomatous component (PSC, CCC, grade 3 endometrioid carcinoma, or unclassified high-grade adenocarcinoma) (n=5). All patients were followed for 2-9 years in order to evaluate their disease-free survival (DFS) and overall survival (OS) during study period (2005-2014). RESULTS: HER2/neu IHC staining was positive in 12 patients (32.4%) including 8/23 (34.8%) PSC, 2/9 (22.2%) CCC, and 2/5 (40%) carcinosarcoma cases. There was no statistically significant difference between HER2/neu expression and DFS or OS of the patients (P>0.05). CONCLUSION: We observed that HER2/neu is expressed in one-third of high-grade ECs. This ancillary test is supportive in follow-up of patients with high-grade ECs.

Multiple High Grade Rhabdoid Papillary Meningiomas Mimicking Choroid Plexus Carcinoma: A Case Report.

Rhabdoid papillary meningioma is an uncommon aggressive variant of meningioma which has the potential to metastasize and spread throughout the brain and even out of the cranium. Herein, we present recurrence of the brain tumor in a 26-year-old woman. The patient had history of the surgery for two lesions in the right temporal lobe and the left cerebellopontine angle. Imaging showed three lesions in the right temporal lobe, the right occipital horn wall, and the left cerebellopontine angle. These radiologic findings were mostly suggestive of atypical meningioma. In the surgical view, the mass was solid-cystic reddish Cauliflower-shaped in the right temporal lobe attaching to the temporal horn. The microscopic examination showed a cellular neoplasm with the sheet-like and papillary growth pattern. Individual cells had vesicular nuclei some with prominent nucleoli and eosinophilic cytoplasm. The areas of the tumor cells showed round eccentric nuclei and prominent nucleoli with eosinophilic cytoplasm. Immunohistochemistry studies showed diffuse positivity of tumor cells with Vimentin, EMA, and S100. The overall clinical, radiological and histopathological examinations were compatible with high grade rhabdoid-papillary meningiomas. In the present case study, we discuss imaging and histomorphological features of this rare entity of meningiomas.

Meningioangiomatosis in an otherwise healthy 13 year-old boy: A case report with emphasis on histopathological findings.

Meningioangiomatosis is regarded as a rare benign hamartomatous condition mostly involving the cerebral cortex and overlying leptomeninges. A strong association of MA with neurofibromatosis type 2 has been documented in published articles. Herein we report a case of an otherwise healthy 13-year-old boy with no family history or stigmata of neurofibromatosis who presented with intractable seizures. MRI revealed a 2x2 cm mass lesion in the frontal lobe. The patient underwent complete surgical resection of the lesion. Although the primary radiologic impression of the lesion was glioma, pathological evaluation of the resected specimen showed mainly proliferation of meningothelial cells and fibroblast-like cells with many thickened blood vessels, which are typical for diagnosis of meningioangiomatosis. After surgical removal of the lesion, the patient is free of seizures.

Risk Factors for Portal Vein Thrombosis in Patients With Cirrhosis Awaiting Liver Transplantation in Shiraz, Iran.

BACKGROUND: Portal vein thrombosis is a fairly common and potentially life-threatening complication in patients with liver cirrhosis. The risk factors for portal vein thrombosis in these patients are still not fully understood. OBJECTIVES: This study aimed to investigate the associations between various risk factors in cirrhotic patients and the development of portal vein thrombosis. PATIENTS AND METHODS: In this case-control study performed at the Shiraz organ transplantation center, Iran, we studied 219 patients (> 18 years old) with liver cirrhosis, who were awaiting liver transplants in our unit, from November 2010 to May 2011. The patients were evaluated by history, physical examination, and laboratory tests, including factor V Leiden, prothrombin gene mutation, Janus Kinase 2 (JAK2) mutation, and serum levels of protein C, protein S, antithrombin III, homocysteine, factor VIII, and anticardiolipin antibodies. RESULTS: There was no statistically significant difference in the assessed hypercoagulable states between patients with or without portal vein thrombosis. A history of previous variceal bleeding with subsequent endoscopic treatment in patients with portal vein thrombosis was significantly higher than in those without it (P = 0.013, OR: 2.526, 95% CI: 1.200 - 5.317). CONCLUSIONS: In our population of cirrhotic patients, treatment of variceal bleeding predisposed the patients to portal vein thrombosis, but hypercoagulable disorders by themselves were not associated with portal vein thrombosis.

Histopathology of post-transplant liver biopsies, the first report from iran.

BACKGROUND: Evaluation of a transplanted liver by Imaging techniques and enzyme changes is sensitive to hepatocellular or biliary problems, but in most instances liver allograft biopsies are performed in order to find out the final reason for these changes. OBJECTIVES: It's been about 17 years (with more than 1326 cases) since the first liver transplantation in the Namazi Hospital of Shiraz University of Medical Sciences while during the last five years the number of post liver transplant biopsies have increased. Until now there has been no report of the pathological results of post liver transplant needle biopsies from Iran. MATERIALS AND METHODS: During the last 5 years, there have been 382 post liver transplant biopsies. We studied the clinical charts and pathological results of all needle biopsies. RESULTS: A total of 382 needle biopsies were performed on 287 patients aged between 1 and 64 years old. The earliest specimen was obtained within the first few hours following transplantation, and the last was gathered 3209 days (261 ± 523) post-transplantation. Acute rejection was the most common diagnosis, which occurred in 180 (47%) of specimens. Among other complications were vascular problems (8.6%), preservation/reperfusion (I/R) injury (7%), chronic rejection (5.2%), biliary injury/obstruction (3.4%), recurrence of primary disease (2.6%), drug-induced hepatic injury (1.8%), cirrhosis (1.6%), sepsis (1.4%), cytomegalovirus hepatitis (1.4%), post-transplantation lymphoproliferative disease (1%) and Venous outflow obstruction (0.5%). CONCLUSIONS: The most common pathological diagnosis of post-transplant liver needle biopsies has been acute rejection, followed by ischemia due to hepatic artery thrombosis, preservation/reperfusion injury, and chronic rejection.

A young woman with multiple cutaneous epithelioid angiomatous nodules (CEAN) on her forearm: a case report and follow-up of therapeutic intervention.

Cutaneous epithelioid angiomatous nodule (CEAN) is regarded as a very rare entity of benign vascular hyperplasia that clinically manifests as mainly single, small, rapidly-growing reddish to bluish nodules or papules, mainly on the head and neck of adults. Most patients present with solitary lesions. We present a 39-year-old female with multiple, rapidly-growing, erythematous nodules on her left forearm during a one-year period. The overall histologic picture suggested Cutaneous Epithelioid Angiomatous Nodule (CEAN). In this case we tried different treatments and compared the results.

Unknown: A middle-aged woman with a solitary targetoid lesion on her shin.

We report a 42-year-old woman with an asymptomatic solitary targetoid patch on her shin of 1 month duration. Histopathologic evaluation revealed intact epidermis with vascular proliferation in the papillary dermis. Vascular channels were irregular, thin walled, and dilated. They were lined by prominent endothelial cells having plumped protruding nuclei and scanty cytoplasm. There was a mild extravasation of red blood cells and mild lymphocytic infiltration around blood vessels in the upper and mid dermis.