Anatomic Pathology Research Articles

Scientific heritage of Ippolit Vasilievich Davydovsky: issues of gerontology in the light of general pathology

Ippolit Vasilyevich Davydovsky is an outstanding pathologist, academician of the USSR Academy of Medical Sciences, professor, who made a tremendous contribution to the creation of the basic postulates of modern pathological anatomy. He chose the study of gerontology as one of the areas of his scientific interests. This topic is quite relevant today since gerontology is beginning to become a separate medical specialtyin domestic medicine. The authors analyze the aspects disclosed in the monograph “Gerontology”, as well as the ideas presented in other works on the issues described above. An overview of the main theories and provisions that were proposed by I.V. Davydovsky during the development of his scientific career is provided. The importance of a comprehensive study of gerontology, which is inextricably linked with other branches of medicine, is emphasized. The natural philosophical understanding of the aging process is considered. The problem of atherosclerosis in geriatrics is described separately. In addition to gerontology, the article provides examples of other fundamental works by I.V. Davydovsky: a textbook on general human pathology, which focuses on the inseparability of pathomorphology and pathophysiology as components of one discipline; a monograph dedicated to organopathology, which provides a generalized understanding of the pathogenesis of diseases of the human body. Thus, the scientist sought to dialogue with clinicians in his published works, thereby promoting the clinical-anatomical direction. The view of the community of pathologists on the scientific activity of I.V. Davydovsky, one of the brightest representatives of his specialty, is interesting.

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.

CORRELATION OF T-CELL LYMPHOMA SUBTYPES WITH ANEMIA AT DR MOHAMMAD HOESIN HOSPITAL PALEMBANG 2018-2022

Lymphoma is divided into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Among NHL T-cell lymphoma is a rare malignancy of T cells, accounts for 12% of all NHL cases, it is further classified into 53 subtypes by WHO. T-cell lymphoma generally have worse prognosis than those B cells. In 2020 there were 16.125 new cases in Indonesia with 9.024 deaths for all ages and genders. Anemia occurs in some cases of lymphoma, which will make the prognosis of lymphoma worse. This study aims to determine the relationship between T-cell lymphoma subtype and anemia. This observational analytic study utilized a cross-sectional design conducted at the Department of Anatomic Pathology Faculty of Medicine Sriwiaya University/Dr. Mohammad Hoesin Palembang Hospital (RSMH) and the central laboratory of RSMH. The samples from this study were all patients who were diagnosed histopathologically and immunohistochemically as T cell lymphoma at RSMH Palembang from 2018 to 2022. Among 38 samples, T-cell lymphoma predominated in the age group <55 years (73,7%), male gender (73,7%), extranodal location (73,7%), and ENKTCL, nasal subtype (55,3%). Anemia occurred in 60,5% cases and most often it is mild anemia (60,9%). There was no significant correlation between T-cell lymphoma subtype and anemia status (*p = 0.178) and T-cell lymphoma subtype and anemia degree (*p = 0.342). It can be concluded that there is no significant correlation between the T-cell lymphoma subtype and anemia.

Comparative Analysis of Impacted Mandibular Third Molar Root Proximity to the Mandibular Canal using Orthopantomography and Cone-beam Computed Tomography Imaging Modalities: A Pilot Study

Abstract Introduction: Fully detect risks of nerve damage, which can lead to temporary or permanent issues. Cone-beam computed tomography (CBCT) offers a three-dimensional (3D) view, providing more detailed visualisation of anatomical structures and their spatial relationships, which improves the accuracy of predicting nerve exposure. The study aims to evaluate and compare these imaging techniques’ effectiveness in categorising the relationship between third molars and the inferior alveolar canal, emphasising the importance of precise imaging for safer surgical outcomes. Materials and Methods: A pilot study involving 20 patients, representing 10% of the total sample size of 200, was conducted at Ahmedabad Dental College’s Department of Oral Medicine and Radiology. Investigators, trained to interpret radiological images from orthopantomography (OPG) and CBCT, compared their interpretations with those of two experts. A high inter-rater reliability was confirmed with a kappa statistic of 0.98. Following ethical approval, data were retrospectively collected from 20 cases, with digital OPG and CBCT images analysed and classified according to established criteria. Results: The results revealed a significant association between the results diagnosed through OPG and CBCT indicating similarity in their diagnosis. It was also seen that there was no bias towards the gender and the distribution was similar in case of diagnosis through OPG or CBCT. Conclusion: CBCT demands an in-depth understanding of anatomy and pathology, coupled with proficiency in operating imaging software and the ability to identify abnormalities in cross-sectional images. When executed and interpreted accurately, CBCT proves to be an exceptionally valuable tool in clinical dental practice. Its detailed 3D imaging capabilities enhance the assessment of complex cases, such as those involving intricate anatomical structures and pathologies. By providing comprehensive views that surpass traditional two-dimensional imaging, CBCT aids in precise diagnosis and treatment planning, making it an indispensable resource for addressing various dental conditions effectively.

Analysis of computed tomography venography for the diagnosis and endovascular treatment of iliac venous compression syndrome with venous leg ulcers: a retrospective study

Iliac vein compression syndrome (IVCS) is a clinical condition defined as obstruction of the iliac vein caused by chronic compression imposed by various causes. Currently, the clinical role of computed tomography venography (CTV) in the diagnosis of IVCS is unclear. Accurately diagnosing IVCS using CTV may enhance the understanding of the pathological anatomy of iliac veins, which may lead to better treatment outcomes, especially for recalcitrant venous leg ulcers (VLU). We aimed to investigate diagnostic criteria, contributing clinical factors, and stenting for IVCS with VLU in this study. CTV, digital subtraction angiography (DSV), and Doppler ultrasound (DUS) data were obtained from the medical and imaging records of 62 patients. Additionally, contributing factors and stenting for IVCS were analysed. Patients (100%) had clinical, aetiological, anatomic, or pathological C6 disease. CTV reduced the procedure time and contrast medium dose and provided more information than DSV. Risk factors for IVCS with VLU included female sex (P = 0.036) and advanced age (P = 0.014). The rate of ulcer healing was lower in the IVCS group without stent implantation (P = 0.020). Significant improvements were noted in venous clinical severity scores (P < 0.001) and chronic venous insufficiency questionnaire-20 scores (P < 0.001) after stenting for IVCS with C6 ulcers. CTV provides a more accurate diagnosis than DUS and DSV and allows detection of possible causes of IVCS. Female sex and advanced age were potential contributing factors for IVCS. Satisfactory outcomes were observed with stenting in the treatment of IVCS with C6 ulcers.

Head and neck sarcomas: Thirty years of experience in a tertiary referral center in Brazil.

This study analyzed the demographics, clinicopathological, treatment, and survival characteristics of head and neck sarcomas (HNS) diagnosed in a tertiary reference center in Brazil. HNS cases were retrospectively retrieved from the Department of Pathological Anatomy of the School of Medical Sciences of the State University of Campinas. The medical records were examined to extract demographic, clinicopathological, and follow-up information. The Pearson chi-square test, Kaplan-Meier curve, and Cox proportional hazards regression model were employed to identify survival and potential prognostic factors. A total of 47 patients were included in the study. The majority were men (61.7%) with a mean age of 38.9 years. The nasal cavity (34.0%) was the most common anatomical site. The lesions are usually presented as volume increases (78.7%). The most common histological subtypes were chondrosarcoma, osteosarcoma, and alveolar rhabdomyosarcoma. Surgical excision alone was the most common treatment modality. Local recurrence was observed in 10 cases, and metastases in 3 cases. During a mean follow-up period of 71.9 months, from diagnosis to the last follow-up, 31 patients (65.9%) were alive without the disease. A total of 10 patients (21.3%) died of the HNS for a mean follow-up period of 14.3 months. The time to presentation of more than 6 months (p = 0.0309) and the presence of metastases (p = 0.0315) were identified as prognostic factors for survival, while male sex was found to be an independent prognostic factor for recurrence. In conclusion, the results of this study indicate that the occurrence of a shorter lesion time to presentation and the presence of metastases were associated with a reduction in survival rates in patients with HNS.

Study on ultrasound diagnosis and pathological anatomy of fetal complex congenital heart disease in the first trimester.

To assess the feasibility of using the stereo-microscope to identify the pathological anatomy of the congenital heart diseases in the first trimester. Fifteen fetuses of 8-12 weeks aborted due to prevent miscarriage failure and 42 fetuses of 11-14 weeks with congenital heart diseases were included in the study, we dissected their hearts through a stereo-microscope, then compared with the prenatal ultrasonographic diagnosis. Using stereomicroscopy, the positive view of the heart and the great arteries, the long axis view of the aortic arch, the inflow tract view of the bottom heart, the semilunar valve view of the bottom heart, and the transverse section of the ventricle were showed contented and obtained satisfactory images, but the structure of atrioventricular valve and venous system had a lower rate of display. The characteristic pathological changes of cardiac inflow and outflow tract can be obtained by dissecting the heart sequential under the stereo-microscopy. However it is often difficult to obtain satisfactory pathological sections for pulmonary venous abnormalities and Ebstein anomaly.

The Anatomic Pathology Hospitalist Model.

Challenges to staffing a high-quality frozen section service include consolidation of health systems and pathology practices, off-campus relocation of some pathology offices, growing numbers of stand-alone surgery centers, and subspecialization among pathologists and surgeons. To address these challenges, we developed a novel anatomic pathology hospitalist model with explicit emphasis in frozen section. To evaluate our anatomic pathology hospitalist program's impact on (1) frozen section staffing, (2) frozen-permanent diagnostic concordance, and (3) turnaround time. Frozen section staffing and performance data were collected for the 28-month period spanning July 1, 2021, to October 31, 2023. Outcomes were compared between hospitalists, nonhospitalists, and fellows. Hospitalists performed more frozen sections per month than nonhospitalists (median, 87 versus 17, respectively; P = .002). After implementation, nonhospitalists' average frozen section staffing obligation fell from 3.7 (30%) of 12.3 total service days per month to 2.8 (22%) of 12.6 total service days per month (P = .005), compared with hospitalists' average of 9.5 frozen section days (69%) of 13.7 total service days per month. Frozen-permanent concordance was marginally but significantly higher for hospitalists (4701 of 4744 blocks, 99.1%) than nonhospitalists (7259 of 7362 blocks, 98.6%; P = .02). Concordance did not correlate with pathologists' academic rank or subspecialization. Turnaround times were comparable for hospitalists, nonhospitalists, and fellows across multiple metrics. Our anatomic pathology hospitalists significantly reduced the frozen section obligations of nonhospitalist faculty, with a small but significant increase in frozen-permanent concordance and no substantial change in turnaround time.

Diagnostic Pathways of Leptospira spp. in Dogs with Kidney Injury.

Pathogenic Leptospira spp. causes leptospirosis in animals and humans globally, leading to systemic infections that can impact vital organs in affected animals. The purpose of this study was to evaluate kidney injury and to perform a retrospective analysis of leptospirosis infection in follow-up dog samples. The retrospective study collected epidemiological information obtained through paraclinical exams, immunohistochemistry (IHC), and molecular biology (qPCR) of cases from the Faculty of Veterinary Medicine from Timisoara between September 2016 and May 2023. No correlations were found between Leptospira infection and breed (p = 0.714), gender or castration status (p = 0.890), and anatomic pathology exam results (p = 0.608). Significant associations were found in cases with high levels of azotemia (p = 0.000) and immunological status (vaccinated vs. unvaccinated, p = 0.000), with the leptospirosis risk in unvaccinated animals calculated at OR = 85.500 (95%CI, 6.82-1071.26, p = 0.000). Retrospectively, leptospirosis was diagnosed in 27/65 cases (42%) using the IHC method, while the qPCR assay detected 29/65 cases (45%). This study demonstrates that qPCR is a robust and specific method for postmortem diagnosis of Leptospira spp. infection in dogs, offering higher specificity and reliability compared to traditional IHC methods, which showed 94.74% specificity in our study.

Anatomical pathology features in day-old chicks with omphalitis

Anatomical pathology features in day-old chicks with omphalitis

Characteristics of primary tuberculous mastitis in tuberculosis endemic country: A case series

Tuberculous mastitis (TM) is a rare form of tuberculosis, occurring as a primary disease when there is no evidence of tuberculosis in other locations. There are no clear clinical features of TM, especially in the absence of a previous tuberculosis infection. Due to its unclear clinical picture, diagnosis is difficult, and it is often confused with breast carcinoma or pyogenic abscesses. The aim of this study was to report our experience and discuss the characteristics and diagnostic modalities in cases of primary TM in a tuberculosis-endemic area. Method A case series study was conducted at the Arifin Achmad Regional Hospital, reporting four cases of primary tuberculous mastitis in January 2024. The patients were women aged 24-41 years. Case presentation All patients presented with complaints of breast pain for the last 2 weeks to 2 months and complained of symptoms in the form of a lump in the breast that was reddish in colour and mastalgia. One patient was diagnosed during pregnancy, and one had a history of prior breastfeeding. One patient presented with FNAB results for breast carcinoma. The other patient complained of an ulcer on her breast. Physical examination revealed axillary lymphadenopathy in all patients. Histopathological examination revealed tuberculous mastitis in all patients and 1 with tuberculous mastitis, fibrocystic changes, and Atypical Ductal Hyperplasia (ADH). Conclusion Patients with tuberculous mastitis who visited our institution had symptoms similar to those of abscesses and breast cancer. The FNAC test is the most reliable, but false-negative results can occur. Diagnosis requires teamwork between the patient’s doctor, anatomical pathologist, and radiologist. This research requires a larger scale to describe actual conditions.

CLINICOHISTOPATHOLOGICAL STUDY OF TESTICULAR TUMOURS IN DR. HASAN SADIKIN GENERAL HOSPITAL BANDUNG

Objective: The purpose of this research was to describe the clinical and histopathological characteristics of testicular tumours at Hasan Sadikin General Hospital (RSHS) between 2017-2021. Material &amp; Methods: This research was a cross-sectional descriptive study examining the clinical and histopathological profiles of testicular tumours. The secondary data sources included medical records from the Department of Urology, Anatomic Pathology, Medical Records, and Hospital Information System (SIRS). The collected data covered age, ethnicity, clinical symptoms, site, stage, annual prevalence rate, and analyzed using Microsoft Excel. Results: There were 42 patients who had primary testicular tumour. The highest prevalence of testicular tumours at RSHS was in 2019 consist of 12(29%) patients and the lowest in 2020 were 6(14%) patients. Most patients were &gt;35 years old amounting 19(45%) patients, Sundanese ethnicity were 29(69%) patients, and testicular enlargement revealed in 27(64%) patients. Majority patients were in stage 0/IB 36(86%) patients and occurred in unilateral testis which 34(80%) patients, with 3(7%) patients metastasized. The most common histopathological type was seminoma 18(43%) cases followed by prepubertal-type yolk sac tumour 9(21%) patients. Seminomas, and the fibroma-thecoma group were mostly in patients over 35 years old, while prepubertal-type yolk sac tumour was more commonly in children under 15 years old. Conclusion: Prevalence of testicular tumours increased from 2017 to 2019, then started to decrease in 2020. Histopathologically, seminoma was the most common type. These tumours were most commonly found in older individuals (&gt;35 YO) and unilateral, diagnosed in stage 0/IB, and were mostly presented with enlargement of testis. Keywords: Testicular tumours, clinical features, histopathology

The Accuracy of FNAB as Diagnostic Tool For Thyroid Cancer Compared to Anatomical Pathology Results as Gold Standard at Sanjiwani Hospital, Gianyar

Aim: The aim of this study was to assess the accuracy of fine needle aspiration biopsy (FNAB) as a diagnostic tool for thyroid cancer in Sanjiwani Hospital, Gianyar. Methods: This study used a diagnostic test method with a retrospective cross-sectional design. A total of 138 cases of thyroid nodules that received FNAB and anatomical pathology examinations were selected consecutively. The level of accuracy was determined from the number of sensitivity, specificity, positive predictive value and negative predictive value. Results: The results of this study showed a low sensitivity 11.53%, but high specificity 100%, positive predictive value 100%, and negative predictive value 82.96% of FNAB. The accuracy of FNAB as diagnostic tools of thyroid cancer was 83,3% compared with anatomical pathology results as gold standard. Conclusion: FNAB is less accurate to diagnose thyroid cancer, but FNAB examination is accurate in differentiate benign and cancer lesion in thyroid nodule.

Preoperative Cone Beam Computed Topography Assessment of Maxillary Sinus Variations in Dental Implant Patients.

The study included a cohort of 200 patients recommended for CBCT as part of their preoperative evaluation. The methodology involved detailed CBCT image analysis to identify and document various anatomical variations due to pneumatization, exostosis, hypoplasia, polyps, cysts, foreign bodies, and anthroliths within the maxillary sinus. Pneumatization was the most common variation, present in 77.5% of subjects. Polypoid lesions were found in 17.5% of patients, with a higher prevalence in younger age groups (57.1% in ages 20-35). Cysts and polyps affected 17.5% of subjects, predominantly males (65.7%). Anthroliths were observed in a minimal percentage (2%), and foreign bodies were found in 1.5% of the patients. Positive correlations were observed between the patient's age and both mucosal thickness and polypoid lesions and between the patient's gender and bone thickening (p-values < 0.05). The study concluded that CBCT is essential in the preoperative assessment of the maxillary sinus in dental implant candidates due to its superior imaging capabilities, allowing for the identification of critical anatomical variations and pathologies. This thorough evaluation is imperative to ensure the success of implant placement and to mitigate potential complications. However, further research with larger, more diverse populations is recommended to confirm these findings.

EGFR mutation based on lung laterality in adenocarcinoma type of non-small cell lung cancer

Targeted therapies have shown promise in improving survival rates for lung adenocarcinoma, a common and deadly malignancy. EGFR-targeting tyrosine kinase inhibitors (TKIs) are particularly effective among these therapies in cases with EGFR mutations. Detecting these mutations before TKI treatment is essential. Various radiological features have been linked to EGFR mutations. However, the relationship between tumor location and mutation types in Indonesian lung adenocarcinoma patients remains unexplored. This study aimed to identify the frequency of EGFR mutation in local lung adenocarcinoma cases based on the tumor location. Clinical data of lung adenocarcinoma patients (n = 272) diagnosed between 2018 and 2022 were retrospectively taken from the Department of Anatomical Pathology, Dr. Sardjito General Hospital, Yogyakarta. The qRT-PCR data of EGFR mutation status was obtained from the Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta. Descriptive analysis was performed using STATA version 14.0. EGFR mutations were found in 60.7% of patients, with 58.2% having exon 19 mutations and 21.2% exhibiting exon 21 L858R mutations. Mutation status was found to be significantly different based on the patient's gender (p = 0.022) and age (p = 0.029) but not with lung laterality (p = 0.093). The proportion of exon 19, exon 21 L858R, and uncommon mutations in the right and left lung adenocarcinoma was similar across all samples. This study found no difference between specific EGFR mutation types and tumor location in lung adenocarcinoma.

A rapid and reliable targeted LC-MS/MS method for quantitative analysis of the Tryptophan-NAD metabolic network disturbances in tissues and blood of sleep deprivation mice

BackgroundTRY-NAD metabolic network includes TRY (tryptophan), 5-HT (5-hydroxytryptamine), KYN (kynurenine), and NAD (nicotinamide adenine dinucleotide) pathway, which plays a significant role in neurological diseases and ageing. It is important to monitor these metabolites for studying the pathological anatomy of disease and treatment of responses evaluation. Although previous studies have reported quantitative methods for several metabolites in the network, the bottlenecks of simultaneously quantifying the whole metabolic network are their similar structures, diverse physico-chemical properties, and instability. Standardized protocols for the whole metabolic network are still missing, which hinders the in-depth study of TRY-NAD metabolic network in laboratory research and clinical screening. ResultsWe developed a LC-MS/MS method for quantifying 28 metabolites in the TRY-NAD network simultaneously. Optimization was done for the mass spectral parameters, chromatographic conditions and sample pretreatment process. The developed method was fully validated in terms of standard curves, sensitivity, carryover, recovery, matrix effect, accuracy, precision, and stability. The pretreatment of 30 samples only takes 90 min, and the LC-MS/MS running time of one sample is only 13 min. With this method, we bring to light the chaos of global TRY-NAD metabolic network in sleep deprivation mice for the first time, including serum, clotted blood cells, hippocampus, cerebral cortex, and liver. NAD pathway levels in brain and blood decreased, whereas the opposite happened in the liver. The 5-HT pathway decreased and the concentration of KYN increased significantly in the brain. The concentration of many metabolites in KYN pathway (NAD+ de novo synthesis pathway) increased in the liver. SignificanceThis method is the first time to determine the metabolites of KYN, 5-HT and NAD pathway at the same time, and it is found that TRY-NAD metabolic network will be disordered after sleep deprivation. This work clarifies the importance of the pH of the extraction solution, the time and temperature control in pretreatment in standardized protocols building, and overcoming the problems of inconsistent sample pretreatment, separation, matrix effect interference and potential metabolite degradation. This method exhibits great prospects in providing more information on metabolic disturbances caused by sleep deprivation as well as neurological diseases and ageing.

Premalignant and Malignant Ocular Surface Squamous Cell Neoplasia: A Retrospective Hospital-Based Study Spanning 18 Years

Abstract Ocular surface squamous cell neoplasia can arise from a premalignant lesion (conjunctival intraepithelial neoplasia or ocular surface squamous cell intraepithelial neoplasia). Their respective magnitudes will provide an indication of early treatment or progression of the disease. This study, therefore, aims to determine the frequency of premalignant and malignant ocular surface squamous neoplasia. This is a retrospective study of all cases of premalignant and malignant ocular surface squamous neoplastic lesions histologically diagnosed over an 18-year period at the Department of Anatomic Pathology, University of Benin Teaching Hospital. The results showed that there were more malignant ocular surface squamous neoplastic lesions relative to ocular surface squamous cell intraepithelial neoplastic lesions. Also, the latter occurs at a relatively lower median age in comparison to the former. In conclusion, our findings suggest that late presentation of symptoms may account for higher frequency of malignant ocular surface squamous neoplastic lesions.

Method Validation: Evaluation of the Analytical Performance of Standard Hematoxylin-Eosin Staining

Introduction The optimization of diagnostic quality is a major issue in Pathological Anatomy and Cytology (ACP) to secure analytical circuits and protect the operational flow of histological analyses and molecular biology examinations. The objective of this work is to validate the analytical performance of standard hematoxylin-eosin (H.E) staining according to the evaluation criteria of slides in the laboratory.  Materials and Methods Method validation involves numerous steps requiring close collaboration between pathologists and technicians. For our study, the validation covered performances such as inter-technician variability, inter- pathologist variability, and inter-block contamination. The study included 4 paraffin-embedded blocks from 2 surgical specimens, each block being sectioned by 4 different technicians on 4 different microtomes. The 16 obtained sections were stained and read by 2 expert pathologists.  Results Across the 7 evaluation criteria, a preliminary concordance of 98 % was generally found, with no differences impacting the diagnosis.  Conclusion The process of qualitative method validation in ACP is complex due to the multiplicity of stakeholders, the presence of several sub-processes, the difficulty in managing interfaces, and the desire to align with current regulations as a reference site (ISO 20166-4/2021 standard).4. Nevertheless, it is necessary within a quality assurance approach.

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.

Divergences in neuroendocrine prostate cancer frequency as recognized by anatomic pathologists, clinicians, and basic scientists.

Divergences in neuroendocrine prostate cancer frequency as recognized by anatomic pathologists, clinicians, and basic scientists.