Anatomic Pathology Laboratory Research Articles

P63 Expression in Ductal Carcinoma In Situ (DCIS) of the Breast and Its Correlation with Histopathological Grading and Morphological Variants

Background: Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer with varying potential for progression to invasive carcinoma. Myoepithelial cells (MECs) play a role in preventing this progression, and their absence is a hallmark of invasive disease. The p63 protein is a myoepithelial marker that can be assessed by immunohistochemistry (IHC). This study aimed to evaluate the relationship between p63 expression in MECs, the grade of DCIS, and the morphological subtype of DCIS. Methods: A cross-sectional study was conducted on 35 cases of DCIS diagnosed at the Anatomical Pathology Laboratory of Dr. M. Djamil General Hospital Padang. Paraffin blocks were collected, and Hematoxylin and Eosin (H&E) slides were reviewed to confirm the diagnosis and determine the histopathological grading (low, intermediate, and high) and morphological variants (comedo and non-comedo) of DCIS. Paraffin blocks were re-cut for p63 immunohistochemical staining. The extent of p63 expression was classified as complete or incomplete. Results: The majority of DCIS cases were high grade (54.3%) and of the non-comedo subtype (68.4%). All cases with complete p63 expression were of low histologic grade, while all cases with incomplete p63 expression were of high histologic grade. The results of the Chi-square test showed a statistically significant relationship between p63 expression and histopathological grading (p<0.001). There was no statistically significant relationship between p63 expression and morphological variant. Conclusion: The absence of p63 expression in DCIS is associated with high histologic grade. This finding suggests that p63 IHC may be a useful adjunct in evaluating DCIS.

Identifying and Addressing Errors in Anatomical Pathology: A Survey Analysis

Abstract Introduction/Objective To get an update on potential sources of pre-analytical, analytical, post-analytical and other sources of errors in anatomic pathology and strategies to mitigate such errors. Methods/Case Report The authors designed a 5-question survey in Google software and shared it widely on social media platforms. Results (if a Case Study enter NA) The survey, which garnered 43 responses from staff across various areas of the anatomic pathology laboratory, revealed significant insights. Labeling and fixation/preservation errors emerged as the most prevalent pre-analytical errors, while discrepancies between gross and microscopic examinations were common analytical errors. Specimen handling, inadequate clinical information, and transportation were the most frequently perceived other potential sources of errors. The implications of these findings are clear: robust protocols with multiple identifiers, staff training, and barcode labeling can significantly reduce patient identification errors. Similarly, standardized collection instructions, pre-labeled containers, and meticulous verification processes can effectively minimize such errors. Validated tests, standardized scoring systems, and proper investigation of quality control discrepancies are key to reducing analytical errors. Documented procedures, staff training, regular equipment calibration, and reagent testing are also crucial. Conclusion This study contributes to the literature on the current state of potential sources of errors in anatomic pathology. The study findings and recommendations on strategies to address such errors would improve the performance of the anatomic pathology laboratory and eventually improve patient care.

Prevalence of high-risk human papillomavirus genotypes and viral load correlated with squamous cell inflammation among women in Gabon

BackgroundHigh-risk genotypes of Human Papillomavirus are responsible for 90% of cases of cervical cancer worldwide. Inflammation of squamous cells is mainly linked to HPV. In Gabon, HPV is endemic and circulates among the female population. The study aimed to determine the prevalence of HR-HPV genotypes and to investigate the correlation between squamous cell inflammation and HPV viral load in infected women in Gabon.MethodsThe cross-sectional study was conducted at Libreville University Hospital Center (UHC) and National Public Health Laboratory from March to May 2024 among 399 women. Two cervical smears were taken. Genotype detection was carried out by multiplex fluorescence real-time PCR in the NPHL virology unit. Cytology was carried out in UHC’s anatomic-pathology laboratory. Data were analyzed by SPSS software. Graphs were plotted using Microsoft Excel 2016.ResultsThe prevalence of Human Papillomavirus was 26.1% (95% CI: 22-30.6). The prevalence of HR-HPV genotypes was 24.8%. The most common HR-HPV genotypes were HPV-16/52/18/35/56/58/53/68. The rate of multiple HPV infections was 29.8% and 95.2% for the HR-HPV infection rate. Viral load was significantly correlated with squamous cell inflammation (r = 0.977 and P = 0.001).ConclusionHR-HPV infection remains a concern in women, however early screening is necessary for optimal monitoring and management. HR-HPV viral load is a predictive marker of squamous cell inflammation.

Clinicopathological Characteristics of Colorectal Cancer in the Anatomical Pathology Laboratory of Dr. M. Djamil Padang 2017-2020

Colorectal cancer is a malignant epithelial tumor originating from colorectal mucosa. Clinicopathology factors including age, gender, location, histopathological type, differentiation, depth of invasion, lymph node metastasis, and lymphovascular invasion are known affect the prognosis. This study aims to determine the clinicopathological characteristics of colorectal cancer at Anatomical Pathology Laboratory RSUP. Dr. M. Djamil Padang in 2017-2020 This study was descriptive observational with total sampling technique from medical records. Samples included all colorectal cancer patients in 2017-2020 who were fulfilled inclusion criteria, with total 251 samples. The results showed that the most patiens were female (52.2%), the age group were > 50 years (66.1%), mostly located in the rectosigmoid (71.7%). Most of the histopathological types were adenocarcinoma (79.7%), with low grade differentiation (88.8%). More than a half of tumor invasion was at T3 (58.2%). Mainly metastatic status to lymph nodes was Nx (54.2%) and lymphovascular invasion were positive in 60% samples that included the lymphovascular invasion examination. The conclusion of this study is most of colorectal cancer in Anatomical Pathology Laboratory RSUP. Dr. M. Djamil Padang in 2017-2020 are in advanced stage, Early detection needs to be done so that colorectal cancer can be diagnosed at an early stage.

Necrosis area, Tumor Size, and Lymph Node of Breast Cancer

Background: Breast cancer is the leading cause of cancer deaths in women worldwide in 2020. The high mortality rate is often influenced by various reasons, one of which is patients's prognosis. One of the prognostic factors is necrosis area, caused by hypoxic tumor tissue that can affect tumor growth and metastasis. Therefore, this study aims to determine the relationship between necrosis area with tumor size and lymph node metastasis in breast cancer patients. Methods: This study was an observational analytic with a cross-sectional approach. This research was conducted at the Anatomical Pathology Laboratory of Dr Soedarso Pontianak General Hospital and the Microscopy Laboratory of the Faculty of Medicine Tanjungpura University from September until November 2022. The study sample was 55 slides of Formalin-Fixed Paraffin-Embedded (FFPE). The study was conducted by observing the preparations under a microscope and then analyzed using ImageJ and SPSS software. The independent variable in this study was the necrosis area in the tumor microenvironment, and the dependent variables were tumor size and lymph node metastasis in breast tissue. Results: All study samples were female patients with invasive ductal carcinoma. Breast cancer tends to occur in patients aged 48-55 years. The highest percentage of necrosis area was 21% and the most diagnosed breast tumor size and lymph node metastasis were stage T4 and stage N2. Spearman's rho correlation test showed that there was no relationship between necrosis area and tumor size (p = 0.122; r = 0.16) and lymph node metastasis (p = 0.637; r = 0.18). Conclusions: There is no correlation between necrosis area with tumor size and lymph node metastasis of breast cancer patients in the Anatomical Pathology Laboratory at Dr Soedarso Pontianak General Hospital.

Matrix Metalloproteinases 9 Expresion of Thyroid Follicular Neoplasm FNAB and Its Relationship with Thyroid Malignancy Histopathology

Background Fine-Needle Aspiration Biopsy (FNAB) thyroid nodules is not easy to distinguish betwen follicular malignancy and follicular benign lession. Malignancy diagnosis can only be made from histopathology examination by examing tumor invation to capsule and vaskular. Matrix Metalloproteinase 9 (MMP-9) examination can be added to help making initial diagnois. MMP-9 is a proteolytic enzyme that plays important role in cancer progressivity, especially in thyroid. High MMP-9 expression will lead to earlier degradation of thyroid and its will make the cell metastasist easier. This study is to examine MMP-9 expression of thyroid follicular neoplasm related tomalignancy through histopathology examination and the diagnostic test of FNAB MMP-9 expression and histophatologic examination. Methods We used 42 sample FNAB follicular thyroid in Anatomic Pathology laboratories RSUP M Djamil Padang and histopathologic examination was performed. Immunohistochemical was staining with primary antibody MMP-9 then its expression were assessed in stroma and cytoplasmic cell tumour. Results MMP-9 expression was found positive in malignancy histopathologic (80.9%). Expression of MMP-9 at FNAB folikullar neoplasm thyroid is significant in malignant histopathologic thyroid (p=0.017). MMP-9 Sensitivity in thyroid follicular noduleFNAB is quite good (88.575) and its specificity is 51.14%. Conclusion Increased MMP-9 expression of FNAB follicular thyroid neoplasm is associated with histopathologic malignancy.

Cardiac Histopathology Alterations Induced by Subchronic Mangosteen Rind Extract in Wistar Rats

Mangosteen (Garcinia mangostana L.) is renowned for its potent antioxidant characteristics, including free radical scavenging, and its antibacterial, antifungal, anti-inflammatory, and antidiabetic properties. This study aims to assess the subchronic toxicity effects of ethanol extract from mangosteen rind on the cardiac histopathology of male and female Wistar rats. This research was a posttest-only control group design. Forty biological specimens from 40 Wistar rats were divided into four groups, a control group, and three treatment groups, which were given ethanol extract of mangosteen rind with doses of 250 mg/kg, 500 mg/kg, and 1,000 mg/kg for 28 days. Cardiac specimens were prepared and examined using hematoxylin-eosin (HE) staining at the Anatomical Pathology Laboratory of Universitas Jenderal Achmad Yani in December 2021. The findings indicated that prolonged ingestion of large amounts of ethanol extract from mangosteen rind can cause toxic effects characterized by an inflammatory response in cardiac tissue. No fibrosis or hypertrophy was detected; however, inflammatory changes such as the presence of inflammatory cells, vacuolar changes, and neovascularization were observed. The inflammation observed might be due to excessive antioxidant administration leading to oxidative stress. Inflammatory cells may trigger fibrotic remodeling in the heart. The difference in the quantity of inflammatory cells between male and female rats suggests that gender influences the inflammatory response. Overall, administration of ethanol extract from mangosteen rind at doses of 250 mg/kg, 500 mg/kg, and 1,000 mg/kg cause subchronic toxicity effects on the heart histopathology of Wistar rats, marked by inflammation.

The Prognostic Role of Fibulin-2 and Ki-67 Index in Patients with Meningioma: A Study among Minangkabau Ethnicity.

To analyze the association between fibulin-2 and Ki-67 index with histopathological grade and other clinicopathological factors in patients with meningioma among the Minangkabau ethnic group. This cross-sectional observational study uses 50 specimens comprising 25 low-risk meningioma cases and 25 high-risk meningioma cases obtained at three anatomical pathology laboratories in Padang, West Sumatra, Indonesia, between 2019 and 2022. All samples were stained using an immunohistochemistry procedure with Ki-67 and fibulin-2. The chi-square test was used to assess IBM SPSS statistics version 26 for Windows was used to assess the association of Ki-67 and fibulin-2 with the histopathological grade. The p-value of <0.05 was considered significant. We found a significant association between Ki-67 (p = 0.013) or fibulin-2 (p = 0.001) expression with histopathological grade of meningioma. High histopathological grade has high expression of Ki-67 and fibulin-2, with Odds ratio (OR) of 13.500 (1.556-117.137) and 10.028 (2,738-36,722), respectively. Fibulin-2 expression was also associated with the age of patients (p = 0.020). The low age group (<50) has high expression of fibulin-2 (OR 0.196 (0.056-0.691). Conclusion: Ki-67 and fibulin-2 were associated with the histopathological grade of meningioma, while fibulin-2 is also associated with age in the Minangkabau ethnic group.

Epidemiological and Histopathology Study of Gastric Lesions in Ouest Africa

Gastric pathologies represent a global public health problem due to their frequency and severity. The objective of the study was to epidemiologically evaluate all gastric lesions diagnosed at the Pathological Anatomy Laboratory of Saint-Louis, Senegal over a period of 30 months. In addition to sociodemographic parameters, different histological types and molecular profiles were described. A total of 372 cases was identified, 96% were biopsies and 4% were partial gastrectomy surgical specimens. The sex ratio was 0.92 with 48% men (N=179) and 52% women (N=193). The mean age was 45.08 years. The lesions were distributed as follows: gastritis accounted for 86.02% (N=320) of which 70% were Hp gastritis (N=224) followed by gastric cancers with 10.76% (N=40) of which 95% (N=38) were adenocarcinoma (ADC). Male predominance was clear with a sex ratio of 2.1 (N=26 H/12 F) and the tubular subtype was the most common at 55.26% (N=21) for these ADCs. At the molecular level, 17.14% of cases were HER2+ cotation 3+. Other types of cancer were rare, including 1 case of GIST and 1 case of lymphoma (1 case). Polyps were rarely observed with a rate of 1.67% (N=6) and mostly hyperplastic and glandulocystic type.These epidemiological data described in our study can contribute to the development of strategies and preventive measures in the fight against these diseases in sub-Saharan Africa where studies are scarce.

Differences in merlin and p53 expression as a predisposing factor in orbital meningioma

Objectives: The behavior of orbital meningiomas is difficult to predict. The p53 tumor suppressor gene mutation and the neurofibromatosis 2 gene’s inactivation in the merlin formation are two of the several mechanisms that contribute to the development of tumors. This considers the comparison of merlin and p53 expression as an inclination to evaluate the orbital meningiomas. Materials and Methods: This investigation is an observational expository considered within the shape of cross-sectional (cross-sectional). The samples/objects of this study were 44 patients with orbital meningioma who had a clinical, radiological, and histopathological diagnosis at the anatomical pathology laboratory at Cicendo Eye Hospital and Hasan Sadikin Bandung in 2017–2020, then an immunohistochemical examination of merlin and p53 expression was performed. Results: The study indicated that there was no relationship between p53 expression and orbital meningioma grading, also there is no relationship between merlin expression and orbital meningioma grading. However, based on the analysis test results, grade 3 orbital meningiomas tended to have a positive p53 expression rather than a negative expression and tend to have a negative merlin expression instead of a positive. Conclusion: Meningiomas with negative merlin expression have a tendency to express positive p53. Likewise, the higher grade (grade 3) tends to express positive p53 and negative merlin, which may play a key role in tumorigenesis of orbital meningioma, hence, an added value for clinical information and behavioral descriptions of orbital meningioma itself.

Factors Affecting Extrapulmonary Tuberculosis Reinfection in Pulmonary Tuberculosis Patients in Gorontalo City

Tuberculosis is a disease caused by the bacteria Mycobacterium tuberculosis. Tuberculosis does not only occur in the lungs, which is called pulmonary tuberculosis but can occur outside the lung organs, which is called extrapulmonary tuberculosis. Reinfection from Pulmonary tuberculosis to Extrapulmonary tuberculosis can occur due to several factors. This study aims to determine the factors that can influence the occurrence of reinfection Extrapulmonary tuberculosis in pulmonary tuberculosis sufferers. Method Analytical research with a cross-sectional approach. The number of samples was 49 samples of Pulmonary tuberculosis sufferers who underwent initial diagnosis at the Anatomical Pathology Laboratory, Prof. Dr. Hi. Aloei Hospital. Saboe Gorontalo City. The results of the study showed that the variables Adherence to treatment (p: 0.047), and BCG Vaccine (p: 0.018) were &lt; α value: 0.05, while the significance value of comorbidity for EPTB Reinfection was (p: 0.991). The conclusion is that adherence to treatment and the BCG vaccine have a significant effect on the incidence of reinfection Extrapulmonary tuberculosis (EPTB) in patients with pulmonary tuberculosis (PTB), while comorbidities do not have a significant effect on the incidence of reinfection Extrapulmonary tuberculosis (EPTB) in patients with pulmonary tuberculosis (PTB).

Management of Cancer in the Digestive System

Cancer is a non-communicable disease characterized by the presence of abnormal cells/tissues that are malignant, grow quickly and uncontrollably and can spread to other places in the patient's body. Cancer cells are malignant and can invade and damage the function of the tissue. Digestive cancer, also called gastrointestinal cancer, attacks the organs of the digestive system. Digestive cancer also includes gastrointestinal cancer, liver cancer, stomach cancer, colorectal cancer, and pancreatic cancer. Risk factors for digestive cancers are varied because many different organs can be affected. Some factors that contribute to cancer throughout the digestive system include age, heavy drinking (alcohol), smoking, and diabetes sufferers. This type of liver cancer is cancer that grows in liver cells. Liver cancer is a type of cancer that ranks second as the cancer that causes the most deaths in the world. Gastric cancer is a group of malignant diseases that have multifactorial causes, namely genetic, lifestyle and environmental factors. The symptoms caused by stomach cancer are initially not as typical as the symptoms of general digestive complaints. The diagnosis of colorectal cancer can be carried out in stages, including through an appropriate history, physical examination, and supporting examinations in the form of laboratory examinations, both from clinical laboratories and anatomical pathology laboratories. The etiology of colorectal cancer is currently still unknown. Symptoms of colorectal cancer are varied and non-specific. The main complaints of patients with colorectal cancer relate to the size and location of the tumor. Tumors in the right colon, where the contents of the colon are fluid, tend to remain hidden until they are very advanced.

On Victory Day and the 80th Anniversary of the Lifting of the Siege of Leningrad. Review of the Archives of the Pathological Anatomy Laboratory of the Oncology Institute

On Victory Day and the 80th Anniversary of the Lifting of the Siege of Leningrad. Review of the Archives of the Pathological Anatomy Laboratory of the Oncology Institute

Frequency and Demographic Analysis of Odontogenic Tumors in Three Tertiary Institutions: An 11-Year Retrospective Study.

The study aims to evaluate the frequency, demographic features, treatment, and outcomes of OTs across three tertiary medical centers. OT cases were identified in King Abdulaziz Medical City (KAMC), King Fahad Medical City (KFMC), and Prince Sultan Military Medical City (PSMMC) from January 2010 to December 2021. Ninety-two OT cases were identified from the anatomical pathology laboratories of three tertiary hospitals. KFMC contributed the highest number of cases (43.5%), followed by KAMC (30.4%) and PSMMC (26.1%). The median age of OT patients was 29 years (range: 5-83), with males representing more than half of the patients (56.5%). The mandible was the most frequent site of OT occurrence (72.5%), with ameloblastoma being the predominant OT (63.0%), followed by odontoma (19.5%). Among the treatment modalities, bone resection was employed the most (51.0%), followed by enucleation (25.6%). Notably, 11.5% of OT cases with available follow-up data exhibited recurrence, with ameloblastoma accounting for eight recurrent cases. Although OTs are relatively common in the jaws, they are rare in anatomical pathology laboratories and the general population. This study contributes valuable insights into the epidemiology characteristics, treatment trends, and recurrence rates of OTs in Saudi Arabia.

Overexpression of Mammaglobin-A in Primary Breast Tissue Tumor and High Concentration of mRNA Mammaglobin-A in Peripheral Blood as Risk Factors for Metastatic Breast Cancer

Objective: There is still limited evidence for the use of biomarkers in breast cancer. However, mammaglobin-A in tissue and blood has recently been found as a promising biomarker for detecting metastases. Therefore, this study will examine the overexpression of mammaglobin-A in primary breast tissue tumors and the elevated concentration of mammaglobin-A messenger RNA (mRNA0 in peripheral blood as potential risk factors for breast cancer metastasis. Methods: The study was conducted at Sanglah General Hospital in Bali, Indonesia, from July 2017 to March 2018. It employed a hybrid research design, combining both cross-sectional (n = 70) and case-control (metastasis = 20 and non-metastasis = 20) approaches. Peripheral blood samples were collected using specialized L6 tubes and were analyzed for the expression of mammaglobin-A mRNA using quantitative real-time PCR. The diagnosis of breast cancer was established through open biopsy, considered the gold standard. Biopsy specimens underwent histopathological examination and standard immunohistochemistry (IHC) analysis to assess ER, PR, HER2, and Ki67 markers. The evaluation of mammaglobin-A protein expression was conducted via IHC at the Anatomical Pathology Laboratory of Prima Medika Hospital. Result: The mean mammaglobin-A mRNA level in the metastatic group was 11.59±1.37, while in the non-metastatic group was 8.17±1.27-fold change relative to the housekeeping gene beta microglobulin. The mean mammaglobin-A mRNA levels in the two groups were significantly different (p&lt;0.05). Overexpression of mammaglobin-A in cancer tissue was 7.36 times more likely for metastasis compared to non-metastatic (OR = 7.36; 95% CI = 1.34-40.55; p = 0.013). Additionally, mammaglobin-A mRNA concentration was found to be nine times higher for breast cancer metastasis compared to the non-metastatic group (OR = 9.00; 95% CI = 2.15-37.66; p = 0.002). Conclusion: The mean mammaglobin-A level in the metastatic group significantly differs from that in the non-metastatic group. Overexpression of mammaglobin-A and a high concentration of Mammaglobin-A mRNA are influential risk factors for metastatic breast cancer.

COLIBACILLOSIS IN PIGLETS AT TARO VILLAGE, GIANYAR, BALI

Colibacillosis is a disease caused by Escherichia coli bacteria, which attacks piglets and can result in weight loss, stunted growth and, if not treated immediately, will cause death. The aim of this case report is to establish a diagnosis of the death of a 35 day old pig using anamnesis, epidemiological procedures, clinical symptoms, anatomical pathology examination and laboratory examination. The laboratory examinations in question are histopathology, bacteriology and parasitology. The animal case obtained was a young pig suspected of being infected with E. coli, which came from a farm in Taro Village, Tegallalang, Gianyar, Bali. The case pig is a Landrace type, 35 days old weighing ± 7 kg, male. Symptoms observed in the cases were that the piglets looked thin, weak, anorexic, and had yellowish diarrhea. The pig population is 100, during one maintenance period there were approximately 7 pigs who were sick and 2 pigs who died. Based on anamnesis, clinical symptoms, epidemiology, changes in anatomical pathology and histopathological lesions, isolation and identification of colonies on NA media, EMBA, gram staining, primary test, secondary test (biochemical test), and sugar test, E. Coli bacteria were successfully isolated. So a diagnosis was obtained that the pig case was infected with colibacillosis. The results of a stool examination in the parasitology laboratory did not reveal any infection with worm eggs or protozoa. Based on anamnesis, clinical symptoms, epidemiology, anatomical pathological changes, histopathological lesions, and bacterial tests. Conclusion in pig cases diagnosed with colibacillosis by Escherichia coli. It is necessary to carry out good sanitation and management to prevent the occurrence of colibacillosis.

Clinicopathological characteristics and tumor infiltrating immune cells associations of PD-L1 tumor expression in non-small cell lung cancer patients.

Our study aimed to perform on Moroccan patients' non-small cell lung carcinoma (NSCLC) concerning the relationship between PD-L1 tumor expression, clinicopathological features and tumor infiltrating immune cells (ICs). This is a retrospective study (2019 to 2021) conducted on samples from Moroccan patients with NSCLC at the Pathological Anatomy Laboratory of Ibn Rochd University Hospital in Casablanca. Eligible participants for our study had to meet the following predefined criteria: age ≥18 years, histologically confirmed NSCLC, no prior therapeutic interventions, availability of clinical and pathological data, and a usable tumor sample for determining PD-L1 status. Exclusion criteria applied to patients with other types of lung cancer and unusable tumor samples. The evaluation of tumor and immune expression of PD-L1 was performed using immunohistochemistry (IHC), with the 22C3 clone on the Dako Autostainer Link 48 platform. Tumor PD-L1 expression was categorized into 3 levels: TPS <1% (negative expression), TPS 1-49% (low expression), and TPS ≥50% (high expression). ICs infiltrating the tumor expressing PD-L1 were considered positive when more than 1% of positive ICs were present. Among the 316 analyzed samples, 56.6% showed a negative expression of PD-L1, 16.8% displayed a low expression of PD-L1, and 26.6% exhibited a strong expression. Regarding the histological type, among patients with TPS ≥ 50%, 25.8% had adenocarcinoma. Among patients with TPS ≥ 50%, 24.81% were smokers. PD-L1 was also strongly expressed in the lung (28.2%) and bronchi (26.5%). PD-L1 expression (TPS ≥ 50%) was observed in 35.29% of early-stage patients. Concerning tumor cells (TCs), 27.5% of tumors infiltrated by ICs had TPS ≥ 50%. Furthermore, coexpression of PD-L1 on both TCs and ICs infiltrating the tumor was found in 27.8% of tumors. Statistical analysis demonstrated a significant association between tumor PD-L1 expression and smoking status (P=0.019). However, no significant difference was observed between PD-L1 expression and the presence of ICs infiltrating the tumor (P=0.652), as well as the IHC expression of PD-L1 on ICs (P=0.259). Our results demonstrate a significant association between PD-L1 expression and smoking status. However, no significant association was observed between PD-L1 expression and the presence of infiltrating ICs, nor with the IHC expression of PD-L1 on ICs. Our data underscore the importance of participating in the study of specific factors influencing PD-L1 expression in patients with NSCLC.

Strategy to evaluate the impact of formaldehyde in anatomical pathology laboratory part II

Formaldehyde (FA) is a hazardous chemical, highly used in the anatomical pathology laboratories. The adverse health effects related to FA occupational exposure are generally related to long-term exposure, however the short-term exposure to peak concentrations are equally of high concern. The occupational monitoring commonly uses the 8h-Time Weight Average (TWA) metric to assess the exposure, but for those chemicals with acute effects, also the15min short-term exposure is strongly recommended. In this study, the occupational monitoring was carried out in an anatomical pathology laboratory with an in-continuous, instantaneous, and direct reading instrument for 65 work shifts (WS). In none of these, the FA European Union (EU) TWA occupational limit (620 g/m3) was exceeded. Differently, in 40 WS the EU Short Term Exposure Limit (STEL) (740 g/m3) was exceeded, even several times a WS. In sight of this, the 8h-TWA metric only could give poor information of the exposure scenario, involving peak emissions, then a 15min peak exposure assessment, via in continuous monitoring, could help managing the risk. In addition, using the inference equation, an Action Value (AV) of the 8h-TWA above which the 15min measurements are strongly recommended, equal to 23.1 g/m3, is suggested for FA.

(PM-02) GENITOURINARY TUBERCULOSIS IN MALE PATIENTS: A CASE SERIES FROM A FEDERAL UNIVERSITY HOSPITAL

Abstract Introduction Tuberculosis is a significant global public health threat, causing 1.2 million deaths in 2019. In Brazil, the incidence of the disease in the same year was 46 new cases per 100,000 inhabitants. Genitourinary tuberculosis is the third most common form of extrapulmonary tuberculosis, resulting from the spread of mycobacteria through hematogenous dissemination from a latent chronic pulmonary infection or by local spread. Objective This study aims to present a case series of genitourinary tuberculosis in male patients from a tertiary university hospital. Method The study conducted a descriptive analysis of a case series using data from the Unit of Pathological Anatomy Laboratory and the Center for Infectious Diseases between 1999 and 2020. Results Four male patients, with a mean age of 32 years (ranging from 23 to 46), were evaluated. Key symptoms reported during medical consultations at the Urology outpatient service included scrotal nodules, increased testicular volume, and orchialgia, with an average symptom duration of six months. Physical examinations revealed a hard nodular mass in the epididymis or upper testicular pole, mostly on the right side (in half of the cases) or the left side (in the other half). Histological examination of biopsies indicated chronic granulomatous inflammation consistent with tuberculoid in all cases, with negative tumor markers. Notably, none of the patients reported contact with tuberculosis or leprosy patients, and only one patient had a positive PPD test (&amp;gt;24mm). Conclusion Genitourinary tuberculosis is a treatable and preventable disease. Understanding its clinical aspects, forms of presentation, dissemination, diagnosis, and treatment is crucial. Drug therapy, including rifampicin, isoniazid, pyrazinamide, and ethambutol, was effective in resolving symptoms in all patients. Surgical intervention in the form of orchidectomy was required for some cases, resulting in positive outcomes. Financing No conflict.

The association between p53 and FGFR3 expression with the aggressiveness of bladder invasive urothelial carcinoma cases in Prof. dr. IGNG Ngoerah Hospital, Bali, Indonesia

Background: Bladder urothelial carcinoma (BUC) shows varying histological features, behavior, and prognosis. The two most common genes altered in BUC were TP53 and FGFR3. The FGFR3 alteration related to lesser aggressiveness than TP53 and anti-FGFR3 targeted therapy is being investigated. This study determined p53 and FGFR3 expression in BUC cases treated at Prof. dr. IGNG Ngoerah Hospital. Methods: A cross-sectional observational analytic study was conducted in 2023 in the Anatomical Pathology Laboratory at Prof. dr. IGNG Ngoerah Hospital. The subjects were forty-three BUC patients from 2018-2022 who met the eligibility criteria obtained by consecutive sampling. Tumor aggressiveness, represented by the degree of differentiation and depth of invasion, was assessed from HE slides, resulting in low and high-grade muscle-invasive (MI) and non-muscle-invasive (NMI) cases. The p53 and FGFR3 expression were assessed with immunostaining and categorized as low and high expression with 50% and 70% cut-off of positive cells, respectively. The association between variables was statistically analyzed with the Fisher Exact test. Results: Most patients were male (82.44%), aged &gt;50 years (92.37%), invasive type (62.60%), high grade (80.12%), and MI (52.67%). Immunostaining showed a predominance of high p53 expression (60.5%) and low FGFR3 expression (62.8%). Some cases showed concomitant p53 and FGFR3 expression. Statistical analysis revealed no association between p53 expression and the degree of differentiation and depth of invasion (p=0.625; 0.388, respectively). There was a significant association between FGFR3 expression and the degree of differentiation (p=0.003) but not with the depth of invasion (p=0.110). Conclusion: In conclusion, p53 expression was not associated with BUC aggressiveness, whereas FGFR3 expression was significantly associated with the degree of differentiation but not with the depth of invasion. Concomitant p53 and FGFR3 expression may reflect the complexity of BUC carcinogenesis. Further studies are needed for a better understanding of TP53 and FGFR3's involvement in BUC carcinogenesis and therapy.