Clinicopathological Aspects Research Articles

Nutritional Wasting Disorders in Sheep.

Simple SummaryNutritional management is one of the most important factors to ensure adequate productivity and to prevent wasting in sheep flocks. Food needs to be offered in enough quantity and quality to avoid deficiency issues. Motility and metabolic disorders, such as subacute ruminal acidosis, may also lead to emaciation. A combination of a detailed flock history, clinico-pathologic findings, and ancillary tests is necessary to diagnose these conditions. Treatment approaches range from reinstating the levels of the depleted dietary compound to modifications in management practices.The different ovine production and breeding systems share the cornerstone of keeping a good body condition to ensure adequate productivity. Several infectious and parasitic disorders have detrimental effects on weight gains and may lead to emaciation. Flock health management procedures are aimed to prevent such conditions. Nutritional management is equally important to guarantee adequate body condition. Persistent bouts of low ruminal pH due to excess concentrate in the diet may lead to subacute ruminal acidosis. Pre-stomach motility disorders may also lead to ill-thrift and emaciation. An adequate mineral supplementation is key to prevent the effects of copper, selenium, and other micronutrients deprivation, which may include, among others, loss of condition. This review elaborates on the clinico-pathologic, diagnostic, and therapeutic aspects of some of these conditions, and highlights the necessity of considering them as contributors to states of wasting in sheep flocks.

Histology of variants of urothelial carcinoma of the bladder: a Moroccan series of 39 cases

BackgroundThe variant of urothelial carcinoma (UCV) is a rare and aggressive histological entity; its therapeutic management remains debated.MethodsBetween January 2017 and October 2019, 39 patients were diagnosed retrospectively with urothelial carcinoma with a histological variant. The aim of this study was to analyze the clinico-pathological and therapeutic aspects of these variants to better understand this invasive disease.ResultsIn 39 cases, 36 (92%) were men and 3 (8%) were women; the average age was 62 years; 54% of patients had a ≥ cT3 stage with clinical lymph node involvement in 28% and 23% had distant metastases, 36% of patients were treated with RC and 54% by other therapeutic and 10% refused RC. No patient received neoadjuvant chemotherapy. Lymph node involvement was 28.5%. The two predominant histological types were squamous and micropapillary differentiation between the operating piece and bladder biopsy 28.5%, 30% and 21.5% and 13%, respectively. The overall survival at 20 months was 70 and 40% for RC and the other therapeutic (TURB alone or a TURB with an adjuvant), respectively. There was no significant difference in survival between the two groups (p = 0.27).ConclusionUCVs are heterogeneous groups of tumors which are increasingly identified due to their distinct morphological characteristics with variable clinical prognosis. Therapeutic management is not in favor of cystectomy in our study. However, a prospective study using a larger cohort is still necessary to validate our results.

Salmonellosis in Calves by Serovar Dublin in Paraná State, Brazil - Clinicopathological Aspects

Background: Calf diarrhea remains one of the main diseases affecting the cattle industry. Persistence of this significant problem is associated with the complexity of factors that may be involved (infectious, environmental). An accurate diagnosis is essential for confirming the cause and helping clinicians and cattle producers to apply appropriate strategies in a timely manner. This report describes the histological changes according to the degree of salmonellosis severity, which is a contagious infectious disease caused by Salmonella enterica subsp. enterica, a Gram-negative bacterium, in two beef calves in northern Paraná State, southern Brazil. Cases: Two 90-day-old crossbred Angus and Nellore calves from a beef farm in northern Paraná State were referred to a Veterinary Hospital. Animal 1- developed acute clinical signs (enteritis, ataxia, and muscle rigidity) and died the day after the signs began. Gross findings included heavy and non-collapsed lungs, pulmonary oedema, hepatomegaly, enteritis, and severe diffuse typhlitis. Microscopic analysis revealed severe diffuse necrotic enteritis, typhlitis, severe diffuse interstitial pneumonia, moderate centrilobular hepatic necrosis, mild multifocal nephritis, and severe spleen and lymph node necrosis. Paratyphoid nodules were evidenced on the liver, spleen, and mesenteric lymph nodes. Animal 2- presented apathy, green fibrinous diarrhea, and died three days after the onset of clinical signs. The macroscopic examination showed moderate diffuse enteritis and hepatosplenomegaly. At the microscopic examination, many paratyphoid nodules were observed on the liver, spleen, kidneys, and Peyer's patches, which were associated with intralesional and intravascular bacilli. Additional findings included severe diffuse fibrinous necrotic enteritis with intralesional bacilli, diffuse interstitial pneumonia, multifocal splenic necrosis, lymphoid depletion, and moderate multifocal to coalescent lymphocytic nephritis. Histological Gram staining was performed on selected samples, revealing intralesional Gram-negative bacilli in the liver and intestine. Thus, liver and intestine fragments were used for the microbiological examination. Microbiological culture, isolation and biochemical tests identified the genus Salmonella spp. Then, the colonies were subjected to serological tests for serovar identification, according to ISO/TR 6579-3, which determined the serovar Dublin. After identifying the disease etiological agent, the outbreak was controlled by appropriate antibiotic therapy combined with the correction of sanitary measures.Discussion: Enteritis is a frequent disease in calves, posing a diagnostic challenge in identifying the etiological agent. In the present case, the histological, microbiological, and serological results confirmed a disseminated Salmonella spp. infection. The microscopic findings, such as interstitial pneumonia, fibrinous necrotic enteritis markedly in ileum and paratyphoid nodules in various organs, are the most common aspects of the disease. However, fibrinous cholecystitis, which is considered pathognomonic for salmonellosis, was not observed in this study. Therefore, the absence of such a lesion should not exclude the disease in sick animals. A microscopic injury score was used to determine lesion severity by assigning values from 1 to 4, wherein: 1 = no apparent lesions, 2 = mild lesions, 3 = moderate lesions, and 4 = severe lesions. Both calves were scored as 4. Multiple predisposing factors for the condition were identified in this farm such as different age animals in the same paddock and no specific paddock for sick animals, given that the infectious agent remains in feces, saliva, and nasal discharge. The serovar Dublin induces several clinical signs such as septicemic, respiratory, and enteric manifestations, making a clinical diagnosis a challenge. Keywords: dysbiosis, calf diarrhea, infection, paratyphoid nodules, septicemia.Descritores: disbiose, diarreia neonatal, infecção, nódulos paratifoides, septicemia.Título: Salmonelose em bezerros pelo sorovar Dublin no estado do Paraná, Brasil - aspectos clínico-patológicos

Histomoniasis in Peacock (Pavo cristatus) in the Potiguar Semiarid

Background: Histomoniasis is a disease caused by Histomonas meleagridis, a flagellated protozoan that can cause severe necrotizing hepatitis and typhlitis in several bird species. The disease has a cosmopolitan distribution. In experimental infection, peacocks (Pavo spp.) showed susceptibility to histomoniasis, however there are few reports on natural histomoniasis in this species. In northeastern Brazil, reports about its occurrence in avian species are scarce and nonexistent in peacocks. Therefore, this report aims to describe the epidemiological and clinicopathological aspects of a histomoniasis case in a peacock (Pavo cristatus) in the Brazilian semiarid region.Case: A 3-month-old male peacock with a history of apathy and anorexia was attended in the Veterinary Hospital of the Universidade Federal Rural do Semi-Árido (UFERSA), Mossoró, RN, Brazil. The animal was raised extensively in a farm without basic sanitary measures, also with a history of living with animals of different species. After clinical examination, in which intense apathy and weight loss were confirmed, the bird was submitted to emergency therapeutic measures, however there was no clinical improvement and the bird died. At necropsy, intense diffuse bilateral necrotizing typhlitis and multifocal to coalescent necrotizing hepatitis were observed. Fragments of the organs were collected in 10% formaldehyde buffered with phosphate-saline buffer for histopathological analysis and cecal content were collected for microbiological analysis. Histopathology of the cecum revealed transmural necrotizing typhlitis associated with myriads of trophozoites morphologically compatible with Histomonas meleagridis. The same microorganisms observed in association with necrotizing hepatitis lesions, which allowed the diagnosis of histomoniasis. Also, the bacterium Pantoea agglomerans was isolated from the cecal content.Discussion: The macroscopic and microscopic findings allowed the diagnosis and the first recording of histomoniasis in peacock in the semi-arid region of Rio Grande do Norte. The bird was raised in an extensive breeding and without sanitary management, such as the use of anthelmintics, which may favor infection by the nematode Heterakis gallinarum, that’ transmits the protozoan Histomonas meleagridis. The contamination, which begins by the orofecal route, happens through the ingestion of eggs of the nematode contaminated with H. meleagridis that pass through the gastrointestinal tract, reaching the ceca and causing intense lesions in the organ, such as the bilateral transmural typhlitis that we observed in this case. From ceca, the protozoan has access to the bloodstream and reaches the liver, where it causes necrotic hepatitis, also present in the peacock. Both cecal and hepatic lesions were associated with myriads of microorganisms morphologically compatible with H. meleagridis, which allowed the diagnosis of the disease. The challenge in diagnosing this disease occurs mainly due to nonspecific clinical signs, such as apathy and weight loss, the only signs reported by the breeder and observed in this peacock. Confirmation of the occurrence of histomoniasis in any region is important to establish the disease among the differential diagnoses for the species, as in this case. Since this is the first report of peacock histomoniasis in the semi-arid region of Rio Grande do Norte, it is evident the need to consider the disease among possible diagnoses in cases of nonspecific symptoms and it also demonstrates the need to implement control and prophylaxis measures in peacock breeding aiming to avoid losses of birds and economic losses to the breeders and to promote quality of life to the animals.

Clinical Differential Diagnosis between Nonodontogenic and Endodontic Radiolucent Lesions in Periapical Location: A Critical Review.

In endodontics, accurate diagnoses are important for the selection of appropriate and successful therapy. Several nonendodontic entities in periapical location may resemble those of inflammatory endodontic origin and impact therapeutic approaches. The aim of this study was to review noninflammatory entities mimicking dentoalveolar abscesses or apical periodontitis and to discuss clinical and pathological features. In this review study, the authenticated search engine in PubMed (MEDLINE) database was used to find articles by using "Nonvital Pulp Dentoalveolar Abscess", "Nonvital Pulp And Apical Periodontitis", "Periapical Abscess", "Chronic Dentoalveolar Abscess", "Chronic Apical Periodontitis", "Periapical Granuloma", And "Radicular Cyst". Each of these predefined keywords were combined with the terms "Misdiagnosed", "Mimicking", "Masquerading", or "Simulating" to search for reported cases indexed from 1978 to 2020. All case reports fulfilling the selection criteria were reviewed to identify radiolucent nonendodontic periapical lesions focused on the questions: "Which pathological entities mimick radiolucent endodontic lesions in periapical location? Based on endodontic clinical parameters, what are the contrasting features?" Out of 426 articles, 111 were relevant to the subject, including a series of cases and case reports. Only well-documented English and recent papers were considered. A total of 30 noninflammatory entities appeared clinically as radiolucent endodontic lesion in periapical location. Lesions simulating chronic apical periodontitis represented 83.3% and dentoalveolar abscess 16.7%. Interestingly, primary malignancies and metastasis counted 43.3% and pain was a typical symptom. Swelling was a noncontributory clinical feature in distinguishing periapical lesions. Lack of pulp response was registered in 68.4% of nonedodontic lesions. A flowchart was generated to summarize clinicopathological aspects of radiolucent nonendodontic entities appearing as dentoalveolar abscesses or apical periodontitis In relation to clinical practice, it is very important for us to note that, a group of pathological entities may simulate radiolucencies of endodontic origin in periapical location, especially malignancies and non-inflammatory odontogenic lesions.

Retroperitoneal Soft-Tissue Sarcoma: Retrospective Study from a Cancer Hospital in Pakistan

Objectives: To determine the clinicopathological aspects and factors determining the recurrence and 5-year survival of patients diagnosed with retroperitoneal soft-tissue sarcoma in a Pakistani cohort of patients. Methods: This retrospective descriptive study was conducted at the Department of Surgical Oncology, Shaukat Khanum Memorial Hospital & Research Centre (SKMCH&RC), Lahore, Pakistan. Patients who underwent surgery for retroperitoneal sarcoma from January 2011 to December 2015 were included and followed for 5 years (December 2020). A total of 54 patients was included in this study. Results: Fifty-seven percent (n=31) cases were male with a median age at the time of presentation 43 (30-60) years. Well-differentiated liposarcoma was the most common variant. Non-compartmental resection was done in 40 (74%) of the cases. The overall 5-year survival was 74% with median Disease-Free Survival (DFS) of 14 (6-48) months. Recurrence was seen in 28 cases (52%). Conclusions: In the Pakistani cohort of patients. retroperitoneal soft-tissue sarcoma was more commonly seen in males at the median age of 43 years. The most common presentations were abdominal pain and mass. Well-differentiated liposarcoma was the most common histological variant. The overall 5-year survival was 74% that was affected by histological variant and grade. Recurrence was affected by histological variant and grade, margin positivity, and use of neoadjuvant therapy.

Clinico-Pathological Aspects of Spinal Nerve Root Entrapment

The patterns of the clinical presentation of spinal nerve root entrapment are subject of wide variability [1-3]. Although the sensory presentation patterns dominate different patterns of clinical presentation, other patterns namely; motor or sensorimotor patterns are also encountered

Clinicopathological profile of lung cancer in a teaching hospital in Eastern India

Background: There is a sharp rise in the occurrence of lung malignancy in recent years with considerable change in clinical and pathological course. Lung cancer is vigorous in nature with poor outcome. Objective: Our study intends to assess clinicopathological aspects of patients with lung malignancy in Eastern India. Methodology: We retrospectively assessed the inpatient documents of histopathologically proven cases of primary lung malignancy from July 2016 to June 2018. Results: We enrolled 63 patients of lung cancer. The disease showed 77.7% male predominance (M:F 3.5:1) and 73% occurrence in smokers. Majority of our patient (52.3%) aged greater than 60 years with an average age of 60.36 years. Productive cough in 95.2% and tumour mass in 85.7% was the common symptom and radiological presentation respectively. Histologically adenocarcinoma was seen in 66.67% of the patient and prevailed over 28.57% of squamous cell carcinoma. Conclusions: Adenocarcinoma of lung exceeds the decade old prevalent squamous cell carcinoma. Keywords: Lung cancer; Productive cough; Lung mass; Adenocarcinoma.

THE EXPRESSION OF HER-2 AND GALECTIN-3 IN COLORECTAL ADENOCARCINOMA AND THEIR RELATIONSHIP WITH CLINICOPATHOLOGICAL PARAMETERS

Colorectal carcinoma (CRC) is the third most common cancer among worldwide. Data from WHO GLOBOCAN in 2018 show there were 1.8 million cases of CRC in the world, with mortality rates 861,000. Histopathology of tumor show 90% of CRC is adenocarcinoma and predominantly in men. Some proteins that are thought to play a role in tumor development are HER2 and Galectin-3. Correlation between expression of Human Epidermal Growth Factor Receptor 2 (HER2) and Galectin-3 with clinicopathology aspect are expected to help determine treatment options. The aim of this study was to investigate the correlation between expression levels of HER-2 and Galectin-3 in vary clinicopathological aspect of colorectal adenocarcinoma. Cross sectional study was conducted in 40 samples of colorectal adenocarcinoma in dr. Kariadi Central General Hospital from 1st January 2018 until 31st December 2018. Samples were analyzed regarding the expression of HER2 and Galectin-3 by immunohistochemical staining of paraffin-embedded material. Coexpression of HER-2, Galectin-3 and the clinicopathological parameters (gender, age, location, depth of invasion, lymph nodes metastase, distant metastase and stage) were analyzed using Chi square test and Spearmans correlation test. Positive HER-2 expression was found on 5% of samples, while strong expresion of Galectin-3 was found on 12.5% of samples. There was no significant correlation between HER-2 and Galectin-3 expression and clinicopathology aspect.

Clinicopathological study of gall bladder carcinoma with special reference to its management in a tertiary care hospital

Background: Incidence of gallbladder carcinoma is increasing progressively among Indians and is regarded as a major cause of mortality and morbidity. In spite of this, limited studies have been conducted so far. Objective of the study was to know the prevalence, clinicopathological aspects, and prevalent treatment protocol of gall bladder cancer in a tertiary care hospital in Eastern India.Methods: 64 cases of histologically proven gallbladder cancer patients were studied. Patient characteristics were recorded using pretested proforma along with relevant investigations, and histopathology and treatment provided were recorded.Results: Our study reveals that gallbladder cancer has a prominent peak in the 7th decade of life with male: female ratio of 1:2.2. Most of the patients were having body mass index between 20.0 and 24.99, which is in sharp contrast to the available literatures. Pain is the most common symptom followed by constitutional symptoms. Majority of cases presented at advanced stage (64.1%) with significantly elevated CA19.9 level, and were managed with palliative chemotherapy.35.9% of our cases were respectable at the time of diagnosis, and extended cholecystectomy could be performed in 31.3%. Log rank test showed pattern of survival of the patients who were resected was significantly better than those of who were not resected.Conclusions: We know gallbladder cancer is a disease with very few patients amenable to surgery at the time of presentation. Thus, instead of retrospectively analyzing individual institutional data, high volume institutions with the necessary expertise for treating gallbladder cancer should collaborate with a view of generating strong evidence-based surgical guidelines.

Symptomatic Cerebral Ependymal Cyst : A Case Report

Cerebral ependymal cyst is a rare benign neuroepithelial cyst. We report a case of cerebral ependymal cyst in a 62-year-old lady who presented with status epilepticus. She gave history of progressive right occipital headache over a year. Magnetic Resonance Imaging of the brain showed a large occipital cyst. She underwent a right craniotomy, deroofing of the cyst and insertion of Ommaya catheter. The clinicopathological aspects of the cyst are discussed.

Carcinoma of the Rectum: A Clinicopathological Evaluation of Patients in Tertiary Care Hospitals

Background: Colorectal carcinoma is the fourth most commonly diagnosed cancer and the third leading cause of cancer deaths worldwide. The rectum is the most frequent site involved. The disease is no less common in our country in comparison to western world. The aim of this study was to determine the incidence and to review the clinicopathological aspects of carcinoma rectum in different ages in our country.
 Methods: This is a prospective observational study which includes 50 cases of carcinoma rectum which were admitted under different surgical units of Dhaka Medical College Hospital and Bangabandhu Sheikh Mujib Medical University during the period of November 2007 to December 2008.
 Results: The present study showed maximum incidence of carcinoma rectum in the age group 21-30 years. Next common age group was 31-40 years. Incidence declined after 60 years. Majority of victims were male giving a male to female ratio of 1.17:1. As regards the mode of clinical presentation, most patients presented with bleeding per rectum. Majority of patients in this study was moderately anaemic. Curative resection was possible in 54% cases, palliative resection in 38% and palliative end colostomy was done in 4% cases. Only 2% mortality was reported in this study. Histopathological grading showed that poorly differentiated adenocarcinoma of rectum was more common in younger age group.
 Conclusion: Younger patients with carcinoma rectum have several distinct clinicopathological features. Since early diagnosis is essential to improve the cure rate for carcinoma rectum, all known procedure tools must be used to detect carcinoma of the rectum in an early stage, in addition to periodic selective investigations of high-risk group.
 Journal of Surgical Sciences (2020) Vol. 24 (1) : 15-20

Meningioma: A Review of Clinicopathological and Molecular Aspects.

Meningiomas are the most the common primary brain tumors in adults, representing approximately a third of all intracranial neoplasms. They classically are found to be more common in females, with the exception of higher grades that have a predilection for males, and patients of older age. Meningiomas can also be seen as a spectrum of inherited syndromes such as neurofibromatosis 2 as well as ionizing radiation. In general, the 5-year survival for a WHO grade I meningioma exceeds 80%; however, survival is greatly reduced in anaplastic meningiomas. The standard of care for meningiomas in a surgically-accessible location is gross total resection. Radiation therapy is generally saved for atypical, anaplastic, recurrent, and surgically inaccessible benign meningiomas with a total dose of ~60 Gy. However, the method of radiation, regimen and timing is still evolving and is an area of active research with ongoing clinical trials. While there are currently no good adjuvant chemotherapeutic agents available, recent advances in the genomic and epigenomic landscape of meningiomas are being explored for potential targeted therapy.

Specific miRNA and Gene Deregulation Characterize the Increased Angiogenic Remodeling of Thoracic Aneurysmatic Aortopathy in Marfan Syndrome.

Marfan syndrome (MFS) is a connective tissue disease caused by mutations in the FBN1 gene, leading to alterations in the extracellular matrix microfibril assembly and the early formation of thoracic aorta aneurysms (TAAs). Non-genetic TAAs share many clinico-pathological aspects with MFS and deregulation of some microRNAs (miRNAs) has been demonstrated to be involved in the progression of TAA. In this study, 40 patients undergoing elective ascending aorta surgery were enrolled to compare TAA histomorphological features, miRNA profile and related target genes in order to find specific alterations that may explain the earlier and more severe clinical outcomes in MFS patients. Histomorphological, ultrastructural and in vitro studies were performed in order to compare aortic wall features of MFS and non-MFS TAA. MFS displayed greater glycosaminoglycan accumulation and loss/fragmentation of elastic fibers compared to non-MFS TAA. Immunohistochemistry revealed increased CD133+ angiogenic remodeling, greater MMP-2 expression, inflammation and smooth muscle cell (SMC) turnover in MFS TAA. Cultured SMCs from MFS confirmed higher turnover and α-smooth muscle actin expression compared with non-MFS TAA. Moreover, twenty-five miRNAs, including miR-26a, miR-29, miR-143 and miR-145, were found to be downregulated and only miR-632 was upregulated in MFS TAA in vivo. Bioinformatics analysis revealed that some deregulated miRNAs in MFS TAA are implicated in cell proliferation, extracellular matrix structure/function and TGFβ signaling. Finally, gene analysis showed 28 upregulated and seven downregulated genes in MFS TAA, some of them belonging to the CDH1/APC and CCNA2/TP53 signaling pathways. Specific miRNA and gene deregulation characterized the aortopathy of MFS and this was associated with increased angiogenic remodeling, likely favoring the early and more severe clinical outcomes, compared to non-MFS TAA. Our findings provide new insights concerning the pathogenetic mechanisms of MFS TAA; further investigation is needed to confirm if these newly identified specific deregulated miRNAs may represent potential therapeutic targets to counteract the rapid progression of MFS aortopathy.

ANGIOLYMPHOID HYPERPLASIA WITH EOSINOPHILIA: A CASE REPORT OF A RARE BENIGN VASCULAR TUMOR

Oral vascular lesions present a variety of clinicopathologic aspects and often lead to diagnostic difficulties. We describe the case of a 27-year-old male patient referred to our service for evaluation of an asymptomatic lesion in the oral cavity. Intraoral examination revealed a sessile, red nodule of soft consistency in lateral border of tongue, measuring approximately 0.5 cm in diameter. Based on clinical diagnosis of inflammatory fibrous hyperplasia, an excisional biopsy was performed. Histopathologic analysis revealed a benign vascular lesion characterized by proliferation of epithelioid endothelial cells, mostly constituting small-caliber tortuous blood vessels. Mononuclear inflammatory infiltrate with remarkable presence of eosinophils was also evident. Proliferating cells demonstrated diffuse immunopositivity for CD31, CD34, and S100. These findings led to the histopathologic diagnosis of angiolymphoid hyperplasia with eosinophilia. This report emphasizes the importance of knowledge regarding clinicopathologic features of oral vascular lesions for a correct diagnosis and management of the patient.

Increased IL-33 and IL-17 in Colorectal Carcinoma Patients with Severe Disease

Abstract Colorectal cancer (CRC) represents one of the most common cancers. It is frequently diagnosed at advanced stages, indicating on need for new diagnostic markers. The aim of this study was to determine systemic and fecal values of IL-17 and IL-33 in patients with CRC and the relationship with clinicopathological aspects of disease. The blood samples and feces liquid fraction of 50 patients with CRC were analyzed. Serum and fecal levels of IL-33 and IL-17 were measured using sensitive enzyme-linked immunosorbent assay (ELISA) kits. Fecal levels of Il-33 and IL-17 were increased in CRC patients with poor tumor tissue differentiation. Serum IL-33 and fecal IL-17 were increased in patients with presence of lung/liver metastasis or peritoneal carcinomatosis, respectively, while enhanced fecal IL-33 was detected only in patients with peritoneal carcinomatosis. Positive correlation between IL-33 and IL-17 values in sera and feces, respectively was also observed. We believe that increased local values of IL-33 and IL-17, reflected trough higher fecal concentration, in CRC patients with poor tumor tissue differentiation and with presence of lung/liver metastasis or peritoneal carcinomatosis may be considered as a sign of the tumor’s malignant progression and, consequently, of a poor prognosis for patients.

GLANDULAR ODONTOGENIC CYST: CLINICOPATHOLOGIC PROFILE OF 4 CASES

Glandular odontogenic cyst (GOC) is a rare aggressive developmental cyst with epithelial features that simulate glandular differentiation. It has a tendency for erosion of cortical bone and propensity for recurrence. GOC occurs mainly in the anterior mandible with a painless swelling. It is characterized by variable thickness of the epithelium cyst, epithelial spheres, luminal layer of cuboidal to low columnar cells, apocrine metaplasia of the luminal cells, cilia, papillary projections, intraepithelial microcysts, clear cells, mucous cells, and multiple cystic compartments. We report 4 cases of GOC and highlight their main clinicopathologic aspects. Two females and two males, 33, 46, 49, 62 years old, respectively, presented with swellings in the anterior mandible. The lesions were multilocular or unilocular. The diagnostic hypotheses were a dentigerous cyst and ameloblastoma. Microscopically, the cysts exhibited at least 7 criteria necessary for the diagnosis of GOC. The patients remain free of any recurrence 3 years after surgery. Glandular odontogenic cyst (GOC) is a rare aggressive developmental cyst with epithelial features that simulate glandular differentiation. It has a tendency for erosion of cortical bone and propensity for recurrence. GOC occurs mainly in the anterior mandible with a painless swelling. It is characterized by variable thickness of the epithelium cyst, epithelial spheres, luminal layer of cuboidal to low columnar cells, apocrine metaplasia of the luminal cells, cilia, papillary projections, intraepithelial microcysts, clear cells, mucous cells, and multiple cystic compartments. We report 4 cases of GOC and highlight their main clinicopathologic aspects. Two females and two males, 33, 46, 49, 62 years old, respectively, presented with swellings in the anterior mandible. The lesions were multilocular or unilocular. The diagnostic hypotheses were a dentigerous cyst and ameloblastoma. Microscopically, the cysts exhibited at least 7 criteria necessary for the diagnosis of GOC. The patients remain free of any recurrence 3 years after surgery.

CHONDROBLASTIC OSTEOSARCOMA IN THE MANDIBLE: A CASE REPORT

Osteosarcoma of the jaws is uncommon and mainly occurs as a fast-growing painful swelling in the posterior mandible. The knowledge of clinicopathologic aspects of osteosarcoma is essential for early diagnosis and adequate treatment. The aim of this study is to report a clinical case of chondroblastic osteosarcoma in the posterior left mandible in a 53-year-old male patient with complaint of paresthesia in the left lower lip and a fast-growing swelling in the gingival mucosa. Radiographically, the classical sunray appearance can be observed. Microscopically, we identified atypical polygonal cells with large and hyperchromatic nuclei associated with osteoid material and chondroblastic differentiation. The diagnosis of chondroblastic osteosarcoma was made. The patient was referred to an oncologist for treatment with surgery and chemotherapy.

Analysis of the clinicopathological characteristics and prognosis of adenoid cystic carcinoma of the intraoral minor salivary glands: a retrospective study of 40 cases

The clinicopathological aspects and prognostic factors of 40 patients with adenoid cystic carcinoma (ACC) of the intraoral minor salivary glands, treated between 2007 and 2017 at a single institution, were evaluated retrospectively. Twenty-six were female and 14 were male, and they ranged in age from 26 to 81 years (median 55 years). ACC occurred mainly in the palate, with 54.8% of cases presenting T3–T4 lesions. Curative surgery was performed in all patients, and 62.5% of patients were treated with postoperative adjuvant radiotherapy. In the final analysis, positive surgical margins were noted in 57.5% of cases and perineural invasion in 70%. Follow-up was at least 13 months (range 13–141 months, median 59 months). Nineteen patients (47.5%) developed recurrent disease after initial surgery and nine patients had died at the end of follow-up. The 5- and 10-year overall survival rates were 88.3% and 25.6%, respectively. The 5- and 10-year disease-free survival rates were 75.6% and 34.0%, respectively. Patients with a tumour size >4cm and those with positive surgical margins showed a significantly higher risk of local recurrence. Elective neck dissection is suggested for patients with clinically positive lymph nodes or a locally advanced tumour, especially those undergoing microvascular reconstruction. The survival analysis results are similar to those reported previously in the literature.

Role of Omentin-1 in the Diagnosis and Prognosis of Breast Cancer in Egyptian Females.

Background: The most common malignancy of females of Egypt is breast cancer. It accounts for 32 per cent of women's cancer. Clarifying and assessing prognostic factors associated with breast cancer is essential as they are the corner stone to identify the high-risk groups that can benefit from adjuvant therapy and improve their prognosis for the disease. Study Objective: The aim of this study was to assess the role of serum omentin-1 levels in the Egyptian female population as prognostic markers for breast cancer. Patients and methods: Study subjects are 120 BC patients and 30 age and BMI matching health controls, serum omentin-1 levels have been investigated and correlated with the clinicopathological aspects of the BC patients Results : Our study revealed a significant difference in omentin-1 between healthy controls and BC patients, and a gradual increase in severity of the disease. Conclusion: our findings suggested that omentin-1 could be a diagnostic marker for early detection of cases and associated with the prognosis of breast cancer, supporting its role as biomarkers of the prognosis.