Histopathological Comparison Research Articles

Study of thyroid lesions based on cytological and histopathological comparison

Thyroid swelling is one of the most common indications for surgical excision. Since most of the swellings are benign and with euthyroid status, these patients do not require surgical excision. Fine needle aspiration cytology is a rapid, efficient, inexpensive and safe diagnostic method in these cases. FNAC has some limitations, particularly limited to representatives of samples and exact typing of benign and malignant neoplastic lesions. Thus, FNAC alone may not give a confirmative diagnosis regarding few thyroid lesions. Hence, histopathological study has been the standard technique for the diagnosis of thyroid lesions. To study the accuracy of fine needle aspiration cytology (FNAC) of thyroid swellings and to correlate with histopathology so as to avoid unnecessary surgeries for benign lesions.This was a prospective study done on 55 cases wherein Fine Needle Aspiration cytology was done followed by histopathology. The reports on both modalities were correlated and sensitivity, specificity and accuracy were calculated. In the present study, females (72.7%) outnumbered males (27.2%). Non neoplastic lesions constituted 83.3% in our study. Among Non-neoplastic lesions, Nodular goiter was most commonly reported and constituted 49% cases. The sensitivity and specificity for thyroid FNAC are reasonably good. FNAC is a minimally invasive, low cost testing modality. It accurately diagnoses malignant thyroid lesions. It has good specificity and accuracy but is less sensitive in diagnosing definitive etiology. However, it is an important diagnostic test to guide the management of thyroid lesions.

Comparison of Cytomorphology and Histopathology in Myelodysplastic Syndromes (MDS)

Introduction: Bone marrow cytomorphology, cytogenetics and molecular analyses are essential tools for diagnosing a myelodysplastic syndrome. MDS are characterized by dysplastic features of hematopoietic cells and may also show an increased blast cell count. Histopathology can provide additional information on bone marrow fibrosis and cellularity. We analysed correlations and differences between cytomorphological and histopathological findings at diagnosis. Patients and methods: In the Duesseldorf MDS registry, we identified 127 patients with detailed information available on bone marrow cytomorphology, blast count, blood cell counts and clinical features, who also had a bone marrow core biopsy taken at the time of diagnosis. From their formalin-fixed, paraffin-embedded histopathology specimens new sections and stains were made and evaluated by one reviewing pathologist (SB) who assessed a predefined set of features. The pathologist had no knowledge of the cytomorphological findings, except for the information that the specimen was from a "patient with myelodysplastic syndrome". Statistical analyses were performed by SPSS. Procedures were in accordance with the current version of the Helsinki Declaration. Informed consent was obtained from all patients included in the study. Results: The estimation of the percentage of CD34-positive cells by histopathology differed significantly from the cytomorphologically assessed medullary blast count, with a trend towards histopathological underestimation of blast cells (figure 1). Assessment of dysmegakaryopoiesis by histopathology identified 44 cases with dysplastic features, which were deemed inconspicious by cytomorphology. Histopathology yielded a significant positive correlation (p=0.002) between cellularity and degree of dysmegakaryopoiesis, and these two features were also correlated with higher-risk WHO subtypes. Fibrosis and dysmegakaryopoiesis were negatively correlated. Bone marrow cellularity seemed to be overestimated by cytomorphology compared with histopathology. The percentage of erythropoietic cells did not correlate well between cytomorphological and histopathological review. Neither WHO subtype nor medullary blast count showed an association with the proportion of erythropoiesis, regardless of the mode of evaluation. All patients with expanded erythropoiesis also showed signs of dysmegakaryopoiesis. There was no case of cytomorphologically diagnosed MDS that was not confirmed by histopathology, and 48% of MDS diagnoses were identical as to their WHO subtype. However, in 66 cases (52%), the WHO type diagnosed by histopathology differed from the WHO type diagnosed by cytomorphology. The discrepancy was mainly due to differing estimates of medullary blast counts. In our cohort, the degree of fibrosis positively correlated with bone marrow cellularity, a finding that appeared counterintuitive to clinical experience. Increased cellularity also correlated with higher-risk MDS subgroups. Prognosis in terms of overall survival was influenced by the following parameters: Cytomorphologically assessed medullary blast count, bone marrow cellularity, fibrosis, and percentage of erythropoiesis, the latter assessed by histopathology. Patients with of grade 2 or 3 fibrosis had an inferior outcome (figure 2). Conclusions: In our study, histopathology was fully congruent with bone marrow cytology as far as making a diagnosis of MDS is concerned. Histopathology, though, often underestimated the blast count and showed difficulty in identifying the correct MDS type according to the WHO classification. Histopathology is also at a disadvantage regarding evaluation of single cell morphology, with the exception of assessing certain aspects of dysmegakaryopoiesis. A clear advantage of histopathology is its exclusive capability of gauging bone marrow fibrosis and cellularity, both of which are relevant for the diagnosis and prognosis of MDS. We conclude that cytomorphology and histopathology should both be harnessed to optimize the characterization of a patient's myelodysplastic syndrome. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Endometriosis in Patients with Mayer-Rokitansky-Küster-Hauser-Syndrome—Histological Evaluation of Uterus Remnants and Peritoneal Lesions and Comparison to Samples from Endometriosis Patients without Mullerian Anomaly

Congenital Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a Mullerian-duct anomaly that is characterized by agenesis of the uterus and upper part of the vagina. Uterus remnants of varying sizes can often be found. Although a functional uterus is missing, the existence of endometriosis in this patient group has been described in the literature; however, a histopathological comparison of the characteristics of the endometrium within the uterus remnants versus endometriotic peritoneal lesions in the same patient is lacking. Moreover, the characteristics of endometriotic tissue in patients with MRKH syndrome have not been correlated with those of patients with endometriosis without Mullerian anomaly. Patients who underwent laparoscopic neovagina creation with the removal of uterus remnants and possible resection of endometriotic lesions between 2010 and 2022 at the Department of Women's health of the University of Tuebingen were included in our study. Uterine remnants and endometriotic tissue were evaluated via histopathology and immunohistochemistry and were compared to endometriotic samples from patients without Mullerian anomaly. Endometriosis was detected in nine MRKH patients; in four patients, endometrial remnants could be sufficiently compared to endometriotic lesions. All samples exhibited increased expression of hormonal receptors. In two patients, Ki67 proliferation index was significantly increased in peritoneal endometriotic lesions compared with the endometrium of the remnants. In contrast, endometrium and endometriotic lesions of endometriosis patients did not exhibit any differences in the Ki67 proliferation index. Our results demonstrate distinctive immunohistochemical variability between uterine remnants and endometriotic lesions in patients with MRKH syndrome compared with patients with endometriosis, indicating a possible explanation model of the yet-unknown etiology of endometriosis. For confirmation, investigation of a broader patient collective is necessary.

Comparison of renal histopathology in three patients with gross hematuria after SARS-CoV-2 vaccination.

We present three cases of IgA nephropathy with gross hematuria following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccination. Case 1 was a 60-year-old woman who has previously experienced transient proteinuria. Case 2 was a 22-year-old woman with no history of urinary abnormality. Finally, case 3 was a 66-year-old woman who has had microscopic hematuria since she was in her 50s. They were all diagnosed as IgA nephropathy with little histological active lesion. Their renal function and proteinuria improved without the use of corticosteroids. There were differences in the findings of vascular endothelial damage based on the time between the appearance of gross hematuria and renal biopsy. Glomerular endocapillary damage could be a part of the mechanism triggered by mRNA vaccination. When a patient presents with gross hematuria following vaccination, a comprehensive approach including renal biopsy should be considered.

TOXICOLOGICAL EVALUATION OF NATURAL AND SYNTHETIC POLYMER BASED DISSOLVABLE MICRONEEDLE PATCHES HAVING VARIABLE RELEASE PROFILES

Acute toxicity studies of dissolvable microneedle (dMN) patches fabricated from a combination of polymers, i.e. thiolated chitosan (TCS), polyvinyl alcohol (PVA), and polyvinylpyrrolidone (PVP), were performed to determine the safety of polymers on white albino rabbits. The selected albino rabbits were categorized into four groups. Group I was a control group, whereas groups II, III and IV were administered different doses of polymeric dMN patches. The food and water uptake and the weight of the animals were observed before and after administration of the microneedle patch on days 1, 3, 5, 7 and 14. Hematological and serum biochemical changes were observed by taking blood samples of treated and control group rabbits on the 15th day of study. The weight of the main organs was determined and a histopathology study was also performed. Negligible alteration in body weight, meals and water uptake was observed. The control and treated animals displayed similar behavioral pattern. Moreover, the treated groups showed hematological and biochemical analysis results, which were comparable with the results of the control group animals. Animals from both control and treated groups did not present any significant difference in the results of relative organ body weight and urine analysis. A comparison of histopathology results for both treated and control animals’ vital organs confirmed the absence of lesions. The findings of antioxidant effect, dermal and cardiac toxicity studies of chitosan, thiolated chitosan and the TCS/PVA/PVP combination were compared to those of the analysis of circulating oxidative levels, demonstrating that the combination of TCS/PVA/PVP showed improved antioxidant effect, as compared to those of chitosan and thiolated chitosan alone, and showed no significant effect on skin and heart. Thus, the findings of the study established the fact that the fabricated polymeric dMNs are a safe carrier system for different drugs.

Artificial Intelligence for Contrast-Free MRI: Scar Assessment in Myocardial Infarction Using Deep Learning-Based Virtual Native Enhancement.

Myocardial scars are assessed noninvasively using cardiovascular magnetic resonance late gadolinium enhancement (LGE) as an imaging gold standard. A contrast-free approach would provide many advantages, including a faster and cheaper scan without contrast-associated problems. Virtual native enhancement (VNE) is a novel technology that can produce virtual LGE-like images without the need for contrast. VNE combines cine imaging and native T1 maps to produce LGE-like images using artificial intelligence. VNE was developed for patients with previous myocardial infarction from 4271 data sets (912 patients); each data set comprises slice position-matched cine, T1 maps, and LGE images. After quality control, 3002 data sets (775 patients) were used for development and 291 data sets (68 patients) for testing. The VNE generator was trained using generative adversarial networks, using 2 adversarial discriminators to improve the image quality. The left ventricle was contoured semiautomatically. Myocardial scar volume was quantified using the full width at half maximum method. Scar transmurality was measured using the centerline chord method and visualized on bull's-eye plots. Lesion quantification by VNE and LGE was compared using linear regression, Pearson correlation (R), and intraclass correlation coefficients. Proof-of-principle histopathologic comparison of VNE in a porcine model of myocardial infarction also was performed. VNE provided significantly better image quality than LGE on blinded analysis by 5 independent operators on 291 data sets (all P<0.001). VNE correlated strongly with LGE in quantifying scar size (R, 0.89; intraclass correlation coefficient, 0.94) and transmurality (R, 0.84; intraclass correlation coefficient, 0.90) in 66 patients (277 test data sets). Two cardiovascular magnetic resonance experts reviewed all test image slices and reported an overall accuracy of 84% for VNE in detecting scars when compared with LGE, with specificity of 100% and sensitivity of 77%. VNE also showed excellent visuospatial agreement with histopathology in 2 cases of a porcine model of myocardial infarction. VNE demonstrated high agreement with LGE cardiovascular magnetic resonance for myocardial scar assessment in patients with previous myocardial infarction in visuospatial distribution and lesion quantification with superior image quality. VNE is a potentially transformative artificial intelligence-based technology with promise in reducing scan times and costs, increasing clinical throughput, and improving the accessibility of cardiovascular magnetic resonance in the near future.

Dermoscopy findings and histopathological comparison of cutaneous mast cell tumour in a dog

AbstractA 4‐year‐old intact, female, Boxer dog was presented for a 3‐month history of non‐pruritic nodule on the right hind limb. Dermoscopy with polarized light was made, and a non‐pigmented lesion with a reddish colour at the periphery, yellowish central area with chrysalis, thin telangiectasias in the reticular vascular pattern and polymorphic vessels surrounding the homogeneous area was observed. Later, cytological examination was performed, and a presumptive diagnosis of mast cell tumour was ascribed. An excisional biopsy of the nodule was taken, and histopathological examination confirmed the diagnosis of cutaneous mast cell tumour. To the best of the authors’ knowledge, this is the first report of dermoscopy of cutaneous mast cell tumour in dogs.

A comparative evaluation of the effects of pollution on selected organs of Oreochromis niloticus (Linnaeus, 1758) from two subtropical lakes with different pollution levels in Zimbabwe: Histopathological comparison

A comparative evaluation of the effects of pollution on selected organs of Oreochromis niloticus (Linnaeus, 1758) from two subtropical lakes with different pollution levels in Zimbabwe: Histopathological comparison

234.3: Establishing the Most Physiological Perfusion Milieu For Normothermic Ex Vivo Pancreas Perfusion in Porcine Models: How Far Have We Reached?

Introduction: The basic tenet of normothermic machine perfusion is to simulate the physiological milieu for perfusing the organ as close to the homeostasis as possible. Despite its success in lung and kidney transplant models, similar results could not be replicated in pancreas models owing to vulnerability of the organ to oedema and reperfusion injury. We, hereby summarise our experience so far in achieving the most conducive environment for the pancreas perfusion by altering composition of perfusing and dialysing fluids used in the machine to establish an “ideal” model of normothermic ex-vivo pancreas perfusion (NEVPP). Methods: The perfusate being used in NEVPP of porcine grafts (Yorkshire male pigs, 40-45 kgs) so far at our laboratory has been a modified version of our already established solution used in kidney perfusion models comprising of Steen’s solution (containing Dextran), leucocyte depleted porcine blood, electrolyte composition and trypsin inhibitor. In addition, a dialysing solution comprising of electrolytes and standard hemodialysis concentrate and sodium pyruvate is added to the circuit. By altering osmolality and sodium concentration of the perfusate (addition of hydroxyethyl starch and NaCl) and dialysate (addition of varying concentrations of NaCl), we assessed the physiological and biochemical parameters of the graft over 3 hrs of perfusion and compared with 3 best experiments from the previously established model (Standard NEVPP). Results: The average weight gain was found to be lower (25-33%) in grafts perfused with addition NaCl in the dialysate as opposed to the standard NEVPP model (45-50%). The best hemodynamic milieu (maximum arterial flow 200 ml/min at minimum pressure of 16 mm Hg) could be achieved by addition of 1gm/L of NaCl to dialysate along with increasing the CO2 concentration in the circuit to 9% as opposed to the standard 5%. The graft oedema as well as duodenal congestion was also minimum in this subset of the model (Figure 1). Addition of NaCl to the dialysate also resulted in achieving a more stable peak in the amylase levels (marker of graft injury) in the perfusate over 3 hrs compared to the standard NEVPP model (Figure 2). Similar trends were observed in this subset with lipase (average peak (3 hrs): 2885 U/L), LDH (average peak (3hrs): 576 U/L) and CPK (average peak (3hrs): 1120 U/L) levels. The oxygen extraction ratio remained in the range of 25-40 in this subset and was unaffected by altering the CO2 concentration to 9%. The histopathological comparison of tissue injury was also analysed. Conclusion: Owing to the precarious hemodynamics of pancreas, establishing optimal conditions for NEVPP is a formidable challenge. However, meticulous cold dissection, minimum handling of the organ while on the machine along with a relatively hyperosmolar composition of the dialysing solution has shown promising results so far.

Histopathological Analysis and Comparison between Experimentally Fabricated Hydroxyapatite from Nile Tilapia Bone and Mineral Trioxide Aggregate as A Direct Pulp Capping Agents on Dog Pulp (In Vivo Study)

AIM: The aim of this study was to study response of exposed dental dog pulp to the HP from Nile Tilapia bone and MTA on induction of reparative dentin formation and to inflammatory response in pulp tissue. MATERIALS AND METHODS: Four male mongrel dogs 1 year old with total of 20 teeth from each dog were selected and divided into two groups that each group has 40 teeth according to the material used as pulp capping agents. The maxillary teeth and the mandibular teeth for each dog were capped by both materials alternatively; the cavities were then sealed by glass-ionomer cement. Each group divided in two groups according to 2-time intervals (4 weeks and 8 weeks). Animals were sacrificed and teeth were collected for histopathological analysis. RESULTS: Specimens capped by fish bone powder after 4 weeks, which showed non-significantly higher of inflammatory cell scores than that capped by MTA. It showed thin (score 1) to moderate (score 2) thickness of dentine bridge formation, mostly a-tubular dentin, in all specimens. After 8 weeks, significant decrease in inflammatory cell infiltration scores for both groups were found, but it was significant in case of fish bone powder. Furthermore, dentine bridge became more significant for both materials with slight histological change in the group capped by fish bone powder. CONCLUSIONS: HA from Nile Tilapia bone could be considered as a direct pulp capping material. Furthermore, more studies needed on the fabrication of this material to give better result in shape and the pattern of reparative dentine formed.

Frontal Fibrosing Alopecia: A Histopathological Comparison of the Frontal Hairline with Normal-Appearing Scalp.

Frontal fibrosing alopecia is characterized by the presence of a lymphocytic inflammatory infiltrate around the upper follicle and by perifollicular fibrosis, which results in the destruction of the hair follicle. Recent reports have also found the presence of those findings in clinically unaffected areas. The aim of this report is to perform a deeper analysis of the histopathological features of this apparently unaffected scalp. A cross-sectional study including 52 women with frontal fibrosing alopecia was performed. Two areas were biopsied: the frontal hairline and a normal-appearing scalp area. Sebaceous glands were reduced/absent in 80.8% of the frontal hairline samples compared to 42.3% of the “healthy scalp” samples (p = 0.001). Inflammatory infiltrate was observed in 92.3% of patients in the frontal hairline and in 86.5% of them in the “healthy scalp” area (p = 0.508), although the severity was higher in the former (p = 0.013). Follicular epithelium changes were seen in 70.6% of the frontal hairline biopsies compared to 48.1% of the “healthy scalp” biopsies (p = 0.012). Fibrous tissular changes were noted in 80.8% and 53.8% of the frontal hairline and “healthy scalp” biopsies, respectively (p = 0.003). In conclusion, the histopathological features of frontal fibrosing alopecia are shared by both affected and clinically unaffected areas.

Is there life on the airway tree? A pilot study of bronchial cell vitality and tissue morphology in the ex vivo lung perfusion (EVLP) era of lung transplantation.

Ex vivo lung perfusion (EVLP) is a relevant procedure to increase the lung donor pool but could potentially increase the airway tree ischemic injury risk. This study aimed to evaluate the direct effect of EVLP on the airway tree by evaluating bronchial cell vitality and tissue signs of injury on a series of 117 bronchial rings collected from 40 conventional and 19 EVLP-treated lung grafts. Bronchial rings and related scraped bronchial epithelial cells were collected before the EVLP procedure and surgical anastomosis. The preimplantation interval was significantly increased in the EVLP graft group (p < 0.01). Conventional grafts presented cell viability percentages of 47.07 ± 23.41 and 49.65 ± 21.25 in the first and second grafts which did not differ significantly from the EVLP group (first graft 50.54 ± 25.83 and second graft 50.22 ± 20.90 cell viability percentage). No significant differences in terms of histopathological features (edema, inflammatory infiltrate, and mucosa ulceration) were observed comparing conventional and EVLP samples. A comparison of bronchial cell viability and histopathology of EVLP samples retrieved at different time intervals revealed no significant differences. Accordingly, major bronchial complications after lung transplant were not observed in both groups. Based on these data, we observed that EVLP did not significantly impact bronchial cell vitality and airway tissue preservation nor interfere with bronchial anastomosis healing, further supporting it as a safe and useful procedure.

Histopathological Comparison between Punch and Full Thickness Rectal Biopsy in Diagnosis of Hirschsprung’s Disease

Background: The diagnosis of Hirschsprung’s disease (HD) is dependent on the histological study of rectal ganglion cells. Open rectal biopsy is the mainstay that requires general anesthesia (GA) and carries risk of many complications. Rectal punch biopsy has gained wide acceptance and has become the choice as it is simple, safe, having no need of anesthesia, done bedside with a simple biopsy forcep with high degree of accuracy and virtual absence of any complications. Objective: To find out the efficacy of rectal punch biopsy in the diagnosis of Hirschsprung’s disease. Materials and Methods: A cross sectional descriptive observational study was carried out with the histological findings of 60 rectal punch biopsies with corresponding 60 full thickness rectal biopsies from 60 suspected HD patients from March 2018 to February 2020. Sections made from the paraffin blocks were stained with H&amp;E and were examined for the presence or absence of ganglion cells and hypertrophic nerve fibers in the submucosa. Then the relations were studied. These findings were compared with full thickness rectal biopsy. Result: There were 40(66.7%) cases of male and 20(33.3%) cases of female including 26 (43.3%) cases of infants. Out of 60 cases, 10 cases (seven inadequate and three suspicious) of punch biopsy were not compared with full thickness rectal biopsy. Out of 50 cases, 38(63.3%) cases were HD in punch biopsy; among these 36(92.3%) cases were HD and 2(18.2%) cases were Non-HD in full thickness rectal tissue biopsy. The accuracy of punch biopsy was measured by sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and efficiency of the test which were 92.3%, 81.8%, 94.7%, 75.0% and 90.0% respectively. Conclusion: The rectal punch biopsy is simple, safe, no need of anesthesia and can be done with a simple biopsy forcep with high degree of accuracy. KYAMC Journal Vol. 13, No. 01, April 2022: 37-40

Role of ultrasound in evaluation of ovarian lesions and its correlation with histopathological findings

Introduction: Ovarian lesions are the most common pathology in gynaecology. They present with pelvic pain, menstrual abnormalities. Sonography is non-invasive, radiation-free, cost effective and widely available. The characterization of ovarian masses and distinguishing between benign and malignant pathology is of utmost importance to enable decisions regarding optimal treatment. Material And Methods: A prospective study was done in a sample of 100 patients suspected of having ovarian lesions on the basis of history and clinical examination. All the patients were subjected to transabdominal sonography with full bladder technique using 3.5 - 5.5 MHz curvilinear transducer and 10 MHz linear transducer. TVS was performed whenever required to obtain additional findings. Histopathological findings were correlated with the findings on sonography. Results: A total of 100 patients with clinically suspected ovarian pathology were examined by ultrasound and histopathological comparison was done.Out of 70 patients with benign lesions, 66 patients were correctly diagnosed on ultrasonography (94%). Out of total 30 patients with malignant tumours, 26 (87%) patients were correctly diagnosed on ultrasonography. Conclusion: The present study evaluates ovarian mass by USG considering histopathological examination of post operative specimen as gold standard.

Protocol for a Sepsis Model Utilizing Fecal Suspension in Mice: Fecal Suspension Intraperitoneal Injection Model.

BackgroundVarious animal models of sepsis have been developed to optimize sepsis treatment. However, therapeutic agents that were successful in animal models were rarely effective in human clinical trials. The cecal ligation and puncture (CLP) model is currently the gold standard for sepsis studies. However, its limitations include the high variability among researchers and the difficulty in comparing animals with different cecum shapes and sizes. In this study, we established a protocol for the creation of a simple and accessible sepsis rodent model using fecal suspensions that minimized differences in technical effects among researchers and individual differences in animals.MethodsA mouse model of sepsis using fecal suspension intraperitoneal injection (FSI) was created using fresh stool excreted within 24 h. The collected fresh stool was dissolved in saline solution and filtered. The obtained fecal suspension was injected intraperitoneally into the mice. Moreover, fecal suspensions with different concentrations were prepared, and the survival rates were compared among the fecal suspensions for each concentration. To assess the validity of the FSI as a sepsis model, CLP and FSI with similar mortality rates were compared pathologically, physiologically, immunologically, and bacteriologically. Histopathological comparison was evaluated by hematoxylin-eosin and Gram staining of the parenchymal organs. Physiological evaluation was performed by comparing the respiratory rate, body temperature, and blood gas analysis results. Immunological assessment was performed using multiplex analysis. Bacteriological comparisons were performed by culturing ascites fluid.ResultsThe FSI model increased mortality in proportion to the fecal suspension concentration. The mortality rate was reduced with antibiotic administration. In various comparative experiments conducted using the FSI and CLP models, both models showed findings consistent with sepsis. Furthermore, the FSI model showed less variability among the individuals in each test.ConclusionThis is the first detailed and accurate report of a protocol for creating a sepsis model using fecal suspension. The FSI model is a minimally invasive and accessible sepsis rodent model. Its clinical validity as a sepsis model was proven via histological, physiological, microbiological, and immunological evaluation methods. The FSI model minimizes individual differences between mice and helps to conduct accurate studies after the onset of sepsis.

Transabdominal Ultrasonographic Evaluation of Enlarged Prostate with Histopathological Comparison

Introduction: The prostate is an accessory gland of the male reproductive system. It can be involved by a number of diseases ranging from inflammation to malignant diseases. Most common causes of prostatomegaly are benign prostatic hyperplasia, prostatitis, intraprostatic and periprostatic cyst, prostatic adenocarcinoma. Objectives: To evaluate the diagnostic usefulness of Transabdominal ultrasonography in enlarged prostate and compare the USG findings with the histopathological findings. Method: This cross sectional study was carried out in Radiology and Imaging Department of Sir Salimullah medical college and Mitford hospital, Dhaka, from January 2014 to December 2015 with clinically suspected enlarged prostate by department of Urology and referred to the Radiology and Imaging Department for proper evaluation whether benign or malignant by Trans-abdominal ultrasonography before treatment planning and further management. Results: In this study, mean age was 65. 8 years with standard deviation of mean ± 9. 7 years and the age ranged from 50 to 89 years. The most common symptoms associated with enlarged prostate were incomplete emptying 90%, frequency 84%, intermittency 80% urgency, 76%, weak stream, 70% straining 66%, nocturia 60%. Out of 50 patients, histopathological diagnosis of 44 (88%) was nodular hyperplasia, 2 (4%) was nodular hyperplasia with chronic prostatitis and rest of 4(8%) was adenocarcinoma of prostate. Conclusion: Ultrasonography is a non-invasive, available, radiation free procedure, which is used as a first line preliminary diagnostic procedure.

Establishing Patient-Derived Cancer Cell Cultures and Xenografts in Biliary Tract Cancer.

Biliary tract cancers (BTCs) are rare and show a dismal prognosis with limited treatment options. To improve our understanding of these heterogeneous tumors and develop effective therapeutic agents, suitable preclinical models reflecting diverse tumor characteristics are needed. We established and characterized new patient-derived cancer cell cultures and patient-derived xenograft (PDX) models using malignant ascites from five patients with BTC. Five patient-derived cancer cell cultures and three PDX models derived from malignant ascites of five patients with BTC, AMCBTC-01, -02, -03, -04, and -05, were established. To characterize the models histogenetically and confirm whether characteristics of the primary tumor were maintained, targeted sequencing and histopathological comparison between primary tissue and xenograft tumors were performed. From malignant ascites of five BTC patients, five patient-derived cancer cell cultures (100% success rate), and three PDXs (60% success rate) were established. The morphological characteristics of three primary xenograft tumors were compared with those of matched primary tumors, and they displayed a similar morphology. The mutated genes in samples (models, primary tumor tissue, or both) from more than one patient were TP53 (n=2), KRAS (n=2), and STK11 (n=2). Overall, the pattern of commonly mutated genes in BTC cell cultures was different from that in commercially available BTC cell lines. We successfully established the patient-derived cancer cell cultures and xenograft models derived from malignant ascites in BTC patients. These models accompanied by different genetic characteristics from commercially available models will help better understand BTC biology.

Comparison of Prevalence, Histopathology, and Genetic Relationship of Pneumocystis spp. in Eleven Mammal Families

Comparison of Prevalence, Histopathology, and Genetic Relationship of Pneumocystis spp. in Eleven Mammal Families

Microvascular Rarefaction and Myocardial Fibrosis in Hypertrophic Obstructive Cardiomyopathy: A Histopathological Comparison of Pediatric and Adult Patients.

Hypertrophic obstructive cardiomyopathy (HOCM) is a genetic cardiomyopathy characterized by microvascular ischemia and myocardial fibrosis. Microvessels play an important role in myocardial fibrosis in HOCM. However, the changes of myocardial microvessels and myocardial fibrosis in pediatric and adult patients with HOCM remain unclear. This study was to investigate the changes in myocardial microvessel density (MVD) and myocardial fibrosis in pediatric and adult patients with HOCM. We analyzed the changes in MVD and myocardial fibrosis in myectomy left ventricular (LV) septal wall specimens in 12 adult patients and five pediatric patients with HOCM. Control myocardium from the LV septal wall was collected at autopsy of 5 adults and 4 pediatric individuals, who died of non-cardiac causes. There was no significant difference in MVD between pediatric HOCM patients and control subjects (706.4±187.5 vs. 940.2±491.1, P > 0.05), but the myocardial fibrosis area ratio was significantly increased in HOCM than in control subjects (10.6±3.5 vs. 4.9±1.2, P < 0.01). MVD was significantly reduced, and myocardial fibrosis area ratio was significantly higher in adult HOCM patients than in control subjects (i.e. 523.3± 209.4 vs. 845.7±260.7, P < 0.05; 12.8±5.1 vs. 4.4±1.3, P < 0.05). There was no significant difference in MVD and myocardial fibrosis between pediatric and adult HOCM patients (706.4±187.5 vs. 523.3±209.4, P > 0.05; 10.6±3.5 vs. 12.8±5.1, P > 0.05). Conclusions: Pediatric and adult patients with HOCM have high myocardial fibrosis. The present findings suggest that myocardial microvascular density lesions contribute to myocardial fibrosis during childhood.

Comparison of transepithelial cytology and histopathology in the diagnosis of potentially malignant and malignant lesions of the oral mucosa

Background/Aim: The objective of the study was to compare cytological diagnoses using transepithelial cytology (oral brush biopsy) with histopathological diagnoses obtained by incisional biopsy in patients with benign lesions, oral potentially malignant disorders and oral squamous cell carcinoma. Material and Methods: The study included 57 patients. Brush biopsy was performed after local anaesthesia administration using the cervical brush. It was immediately followed by an incisional biopsy. Modified Bethesda System was used for cytological analysis and correlated with histopathological diagnoses according to intraepithelial neoplasia. Results: Good agreement was shown between cytological and histopathological diagnosis (kappa = 0.791). The sensitivity of the study was 92.85%, specificity 100%, positive predictive value (PPV) was 100% and negative predictive value (NPV) 93.54%. Conclusions: Oral brush biopsy, which allows the collection of epithelial cells of all layers can provide fast, precise and efficient cytological results which are in good agreement with the 'gold standard' - incisional biopsy followed by histopathology.