Histopathological Evidence Research Articles

Histopathological evidence of cellular alterations in the dentate gyrus is associated with aberrant RB1CC1-ATG16L1 expression in the hippocampus among older adults with chronic schizophrenia: A pilot post-mortem study

BackgroundRecent evidence brings autophagy, and specifically the RB1CC1 gene into sharp focus as aetiologically relevant to Schizophrenia. Our understanding of whether and how these genetic signatures translate to cellular functions remains limited. Material and methodsPost-mortem study of 10 individuals with Schizophrenia and 18 individuals without any neurological/psychiatric disorder, matched for age, sex, post-mortem-interval, pH and BRAAK score. Formalin-fixed, paraffin-embedded, 6 μm sections cut through segments of the anterior, middle and posterior left or right hippocampus were examined for histopathological differences and immunohistochemical expression of RB1CC1 and ATG16L1 proteins. ResultsDentate gyrus (DG) granule cells area (p = 0.005) and circularity (p = 0.012) were significantly lower among Schizophrenia vs. controls. Antipsychotics were associated with lower circularity (p = 0.007). RB1CC1 and ATG16L1 immunoexpression were positively correlated (p < 0.001) and significantly lower in the CA1 (p = 0.047, p = 0.005, respectively). RB1CC1 immunoexpression was significantly higher in the DG among Schizophrenia vs. controls (p = 0.047,). The latter was more pronounced among donors treated with antipsychotics. Lower ATG16L1 CA1 immunoreactivity was correlated with lower granule cell area (p < 0.001). ConclusionsFor the first time, we present histopathological evidence of morphological alterations in the DG of the human brain in Schizophrenia. We propose that these changes indicate DG developmental arrest, which is associated with diminished RB1CC1-ATG16L1-mediated autophagy initiation in the CA1. We suggest that this is a pathological process, whereas RB1CC1-ATG16L1 upregulation in the DG, and possibly in the CA4, may represent a compensatory/restorative mechanism. Antipsychotics may upregulate RB1CC1-ATG16L1 autophagy initiation. Larger studies are required to validate these findings and explore clinical correlations.

Antibiotic and Surgical Treatment of Diabetic Foot Osteomyelitis: The Histopathological Evidence

Background: Osteomyelitis is one of the most frequent infections of the diabetic foot, accounting for 20–70% of foot infections. The treatment of osteomyelitis continues to be debated, and the possibility of performing conservative surgery associated with targeted antibiotic treatment allows for reductions in the amount of bone removed, the resolution of osteomyelitis, and a reduction in the changes in the biomechanics of the foot. The objective of this study was to evaluate the outcomes of osteomyelitis treatment with a combination of antibiotic and surgical procedures based on a histopathological analysis of the infected bone and margins. Materials and Methods: We analyzed 25 diabetic patients with osteomyelitis. We treated each patient with empiric antibiotic treatment, surgical removal of the infected bone, and targeted antibiotic treatment. During the surgical procedure, we collected infected bone samples and margins for microbiological and histopathological analyses. Results: All the patients had type 2 diabetes, with a mean age of 71 ± 10 years. Antibiotic therapy was administered orally for an average duration of 21 ± 9 days, aimed at improving the microbiological outcome. Histological examinations of the resected infected bone revealed the presence of osteomyelitis in 23 (92%) patients. The healthy margin sample, surgically assessed as non-infected, was confirmed negative in 80% of cases. At a follow-up of 18 ± 7 months, we achieved complete healing in twenty patients (80%), with an average healing time of 70 ± 41 days. No recurrence of osteomyelitis was observed. Conclusions: The data from this study demonstrate that the combination of targeted antibiotic therapy and conservative surgical treatment is effective in resolving osteomyelitis without recurrence with a very long follow-up. Histological analyses allowed us to confirm the actual presence of osteomyelitis and demonstrate that clinical differentiation during surgery is effective in identifying a healthy margin.

Suspected corneal metastasis in a case of nasopharyngeal carcinoma

A 13-year-old girl child undergoing chemotherapy for the terminal stage of undifferentiated metastatic nasopharyngeal carcinoma presented to us with a complaint of poor vision in the left eye (LE). There were no complaints of pain, photophobia, or watering. On examination, there was asymmetric optic disc pallor in both eyes with a patch of corneal infiltration in the LE that was difficult to attribute to any obvious common pathology. The richly vascular posterior segment is a well-known target of ocular metastasis for several malignancies. Corneal involvement, if it occurs, is through local spread. However in this case, in the absence of any other factors to account for this corneal infiltration along with presence of adjacent corneal neovascularization, corneal metastasis is highly suspected. Unfortunately, histopathological evidence could not be collected due to the poor general health of the patient, who did not turn up for a follow-up.

Clinico-sero-pathological characteristics of anti-Ha antisynthetase syndrome.

To define the clinical, serological, and muscle histopathological characteristics, as well as treatment outcomes, of patients with anti-Ha antibody. We performed a retrospective analysis of clinical, serological, and pathological data and long-term treatment outcomes of anti-Ha patients between January 2005 and July 2023 at our center. Anti-Ha antibody was identified by immunoblot and reconfirmed by immunoprecipitation. Of the 570 patients with idiopathic inflammatory myopathies, 17 (3.0%) were found to be anti-Ha positive, of whom 5 (29.4%) were also positive for another myositis-specific antibody (MSA). All patients with anti-Ha antibody as the single MSA (12/17, 70.6%) had clinical and histopathological evidence of muscle damage. Skin lesions were identified in nine of them (75%), while both interstitial lung disease and Raynaud's phenomenon were only seen in four patients. A necrotizing myopathy without a perifascicular pattern was the most common pathological manifestation (50%). Perifascicular necrosis (PFN) and myofiber major histocompatibility complex class-II expression were observed only in one and four patients, respectively. Muscle weakness relapse was reported in five patients, and skin rashes worsening were observed in one patient. Most of the anti-Ha patients (66.7%) finally achieved a favorable outcome at last follow-up. Anti-Ha antibody might not be as rare as previously thought and may coexist with other MSAs. Muscle damage is the most common manifestation in anti-Ha patients, while extra-muscular symptoms except for the cutaneous manifestations are unusual. The histopathological features varied with a predominance of necrotizing myopathy without PFN. These patients often finally had favorable outcomes, although relapses often occur.

Retrospective study on clinical value and optimal use of [18F] FDG PET/CT for inflammation of unknown origin in Japanese patients

Despite advancements in medical technology, the challenges of diagnosing fever of unknown origin (FUO) and inflammation of unknown origin (IUO) persist. Positron emission tomography/computed tomography (PET/CT) has been used to assess these conditions; however, it is unclear which patients most benefit from this approach. This study aimed to assess the clinical value and optimal use of fluorine-18-labelled-fluorodeoxyglucose (18F-FDG)-PET/CT in patients with FUO/IUO. We reviewed FDG-PET/CT scans conducted at our department between January 2014 and December 2020 to further assess FUO/IUO. FUO was defined as a fever lasting over three weeks without a diagnosis based on conventional assessment. IUO was defined as prolonged inflammation with a body temperature below 38.3 ℃ and without a diagnosis after conventional diagnostic procedures. The efficacy of FDG-PET/CT was determined based on the diagnostic outcomes achieved by integrating imaging findings with histopathological or microbiological evidence, clinical criteria, or follow-up assessments. We conducted crude and age-sex adjusted logistic regression for potential risk factors to determine the degree of burden on demographic and clinical characteristics. Forty-five patients with FUO/IUO underwent FDG-PET/CT, and final diagnoses were made in 32 patients (71.1%). The percentages of diagnostic categories were 53.3%, 8.9%, and 6.7% for non-infectious inflammatory diseases, malignancy, and infection, respectively. In multivariable logistic regression analysis, IUO was the only independent predictor of the efficacy of FDG-PET/CT in the final diagnosis (odds ratio, 67.02; 95% confidence interval, 4.02–1119). Our results indicate that IUO was associated with a higher diagnostic yield compared to those with FUO.

NIMG-81. PREDICTING TUMOR PROGRESSION WITH FIBER DENSITY-WEIGHTED WHITE MATTER PATHLENGTH MAPS IN PATIENTS WITH GLIOBLASTOMA

Abstract PURPOSE Although histopathological evidence indicates that glioma cells preferentially migrate along large white-matter bundles, standard-of-care (SOC) radiation therapy (RT) planning remains an isotropic expansion of the anatomical lesion. We hypothesize that anisotropic expansion of RT target volumes along white-matter pathways using fiber density-weighted, white-matter pathlength maps (DW-WMPLMs) derived from diffusion tensor imaging (DTI) could improve the prediction of tumor cell migration beyond surgical margins by a deep learning model compared to SOC clinical target volumes (CTVs). METHODS DTI and anatomical MRI from 118 patients newly-diagnosed with glioblastoma were retrospectively analyzed with anatomical imaging from post-surgical resection and latest progression scan before intervention. Parallel-transport tractography seeded from the pre-surgery T2-lesion was used to estimate white-matter fiber propagation. Fibers that intersected with the resection cavity were weighted by their density to control the length of expansion and create a DW-WMPLM that was used together with T2-FLAIR and T1-post-contrast images as inputs to a novel 3D-Swin-UNetR network, trained to predict the recurrence region using 4-fold cross-validation and evaluated in a holdout test-set (95/23 CV/test). New weighted-overlap, coverage, and sparing indices were introduced to evaluate coverage of the progressed lesion and healthy brain excluded. RESULTS 52% of patients had progression outside the standard 2cm-isotropic CTV margin, motivating the need for anisotropic CTVs. Our novel DW-WMPLMs had 87±20% and 83±18% overlap with contrast-enhancing and T2-lesion progression, respectively. The deep-learning model trained with DW-WMPLMs and anatomical images achieved 19% and 56% higher Dice and weighted-overlap indices compared to the isotropic 2cm-CTV(p&amp;lt;0.02), with less normal brain included. CONCLUSION This study demonstrates the feasibility and benefit of incorporating a novel metric of white-matter track characterization into deep learning progression prediction models of glioblastoma for RT-planning. Current work is validating findings in a prospective cohort acquired immediately prior to RT and incorporating other imaging metrics.

Artemisinin emulgel ameliorates cartilage degradation in knee osteoarthritis: in vitro and in vivo studies.

Aim: Laboratory scale-up of artemisinin-loaded emulgel (ART-emulgel) was carried out and characterized for therapeutic performance in osteoarthritis (OA).Materials & methods: The solubility of ART in various oils, surfactants and co-surfactants were screened for construction of pseudo ternary phase diagram (TPD), followed by scale-up of artemisinin loaded nanoemulsion (ART-NE). ART-NE was amalgamated with Carbopol Ultrez 10-NF to prepare ART-emulgel that was later characterized invitro and invivo to analyze therapeutic efficacy in monosodium-iodoacetate (MIA) induced knee OA.Results: The droplet diameter of ART-NE was estimated to be 104.3±2.593nm with a polydispersity index of 0.245±0.019 in addition to ζ-potential of 0.434±0.028mV. Steady-state flux and permeability coefficient for ART-emulgel were estimated to be 0.651±0.031 µg.cm2/h and 0.245±0.011cm/h, respectively. ART-emulgel demonstrated 43.18% reduction in COX-2 level; 52.28% drop in IL-1β, and 88.78% alleviation of Tumor Necrosis Factor-α (TNF-α) level when compared with monosodium-iodoacetate induced OA rats. ART-emulgel and injectable ART (intra-articular; I.A) portrayed minor synovial erosion compared with blank and diclofenac emulgel. Histopathological evidences indicated restoration of cartilage integrity followed by reduction of OARSI scores in ART-emulgel when compared with disease control animals.Conclusion: ART-emulgel is a potential dosage form for translating into a clinically viable product for the management of OA.

Accuracy of Labial Salivary Gland Biopsy in Suspected Cases of Sjogren's Syndrome.

Sjögren's syndrome (SS) is a chronic autoimmune disorder primarily characterized by dysfunction of the exocrine glands, leading to dryness of the eyes and mouth (sicca symptoms). Labial salivary gland biopsy (LSGB) is a key diagnostic tool used to confirm SS through histopathological analysis. LSGB evaluates lymphocytic infiltration in the salivary glands, a hallmark of SS. Despite its utility, discrepancies between LSGB results and other diagnostic methods, like serology and clinical examination, persist. Given the potential for false negatives, especially in early-stage or mild diseases, LSGB is often used alongside other diagnostic tools. Assessing its diagnostic accuracy and correlation with clinical, demographic, and serological factors is critical for improving diagnostic precision in SS. This study aims to evaluate the diagnostic accuracy of LSGB in suspected SS cases, focusing on its correlation with clinical diagnoses, serological markers, and demographic factors. It also investigates whether LSGB can serve as a standalone diagnostic tool or should be integrated with other methods to enhance accuracy. This retrospective study evaluated 166 patients who underwent LSGB for suspected SS. Results were classified as "suggestive" or "not suggestive" of SS based on the histopathological evidence of lymphocytic infiltration. The relationship between LSGB outcomes and various demographics, serological markers, and the presence of other autoimmune diseases was examined. Statistical analyses assessed the significance of these associations. Categorical data were presented by frequency with percentage, and continuous data by mean with standard deviation (SD). Analyses were conducted using the Statistical Package for the Social Sciences (SPSS) version 27.0, with a P-value < 0.05 considered statistically significant. Among the 166 patients, 55 (33.1%) had LSGB results suggestive of SS, while 111 (66.9%) had non-suggestive findings. A significant association was found between antinuclear antibody (ANA) positivity and suggestive LSGB results (P = 0.003), indicating that ANA-positive patients were more likely to show histopathological evidence of SS. No significant associations were found with other serological markers, except for a near-significant trend with anti-Ro (anti-Ro/SSA antibodies) (P = 0.062). Age did not significantly influence biopsy outcomes (P = 0.580). The presence of other autoimmune diseases was significantly associated with suggestive LSGB findings (P = 0.034). LSGB remains a valuable diagnostic tool for SS, especially when serological and clinical findings are inconclusive. The study confirmed significant associations between ANA positivity and suggestive LSGB results, as well as the influence of other autoimmune diseases on histopathological outcomes. While Schirmer's test may detect ocular dryness, its correlation with LSGB findings was limited. LSGB should not be used as a standalone diagnostic measure but integrated with other tools, including serology and imaging, to improve accuracy. Future research should explore combining LSGB with salivary gland ultrasonography (SGUS) to enhance the detection of SS, particularly in early-stage or seronegative patients.

Association of gut microbiota with allograft injury in kidney transplant recipients: a comparative profiling through 16S metagenomics and quantitative PCR.

Introduction. The existence of a mutual relationship between gut microbiota and immune homeostasis highlights its importance in the context of kidney transplantation.Gap statement. The translational utility of gut microbiota as a biomarker for allograft injury has not been assessed before.Aim. In this study, we aimed to characterize the gut microbial diversity in kidney transplant recipients and investigate the alterations in the gut microbial composition in association with allograft injury such as histopathological graft rejection and calcineurin inhibitor toxicity. In addition, we compared the gut microbial quantitation using 16S metagenomics and quantitative PCR (qPCR) to assess its translational utility.Methodology. In this prospective longitudinal cohort study, we enrolled 38 kidney transplant recipients and collected serial faecal specimens (n=114), once before the induction therapy, and twice after transplant, during the first and third month. We characterized the gut microbial composition through 16S rRNA sequencing and qPCR from the DNA isolates of the samples. The recipients were clinically followed up for a median of 600 days post-transplant. Histopathological evidence of allograft rejection and calcineurin inhibitor toxicity were used for the correlational analysis with gut microbial diversity.Results. Significant differences in the gut microbial diversity were observed between the pre- and post-transplant samples. Pre-transplant gut microbiota revealed a higher relative abundance of phylum Bacteroidetes in the allograft rejection group, and a higher relative abundance of phylum Firmicutes was observed in the histopathological features of calcineurin inhibitor toxicity (hCNI toxicity) group. We found a high concordance between 16S metagenomics and qPCR outputs for assessing the gut microbial diversity. Furthermore, the receiver operating characteristic curve analysis has also proven that the pre-transplant levels of gut microbial dysbiosis, as a potential predictive biomarker for allograft injury.Conclusion. Our pilot study found a strong statistical association of gut microbial dysbiosis with kidney allograft injury, highlighting the potential of gut microbiota as a predictive biomarker and that qPCR serves as a more reliable and economic tool for assessing dysbiosis paving the way for its translational utility.

Persistent Chronic Active T-Cell-Mediated Rejection After Kidney Transplantation Is Associated With Poor Allograft Survival.

Histopathological findings of chronic active T-cell-mediated rejection (CA-TCMR) have been reported to potentially improve with treatment. However, whether this improvement is associated with a better renal prognosis remains unclear. This study was performed to analyze the impact of the histological response to therapy on kidney allograft survival in patients with CA-TCMR. The data of patients diagnosed with CA-TCMR between January 2018 and May 2023 were retrospectively reviewed. A composite graft endpoint was defined as a two-fold increase in the serum creatinine level or the development of end-stage kidney disease. Thirty-seven patients with CA-TCMR underwent 46 follow-up biopsies. Eleven patients who were diagnosed with CA-TCMR at the last biopsy were classified as the persistent group, while the remaining 26 patients were classified as the transient group. Both before and after treatment, there were no significant changes in serum creatinine, estimated glomerular filtration rate, or proteinuria in either group. However, the transient group showed a significant reduction in interstitial fibrosis and tubular atrophy without a specific etiology (IFTA). This improvement was attributed to better histopathological Banff scores after treatment. Patients with persistent CA-TCMR had significantly worse graft survival than those with transient CA-TCMR (p = 0.002), even after adjusting for significant clinical factors (hazard ratio: 11.4; 95% CI: 1.1-120.0; p = 0.043). Our findings suggest that the persistence of histopathologic evidence of CA-TCMR after treatment is a significant risk factor for allograft loss compared with transient CA-TCMR.

Left atrial volumetric-mechanical coupling index as a marker of subclinical primary heart involvement in systemic sclerosis

Abstract Background Primary heart involvement in systemic sclerosis (SSc) is a common yet often clinically silent marker of poor prognosis. Up to 80% of patients have histopathological evidence of heart involvement, highlighting the need for better screening and diagnostic methods. N-terminal pro-brain natriuretic peptide (NTproBNP), a well-established cardiac biomarker, is often increased in patients with SSc, but with a not fully understood mechanism. Meanwhile, left atrial volumetric-mechanical coupling index (LACI), a new echocardiographic parameter, has been shown to predict cardiovascular outcomes in heart failure patients and the general population, but it has not been studied in SSc. Purpose To identify new echocardiographic parameters, particularly related to left atrial volume and function, as markers of increased NTproBNP in SSc patients without overt heart involvement. Methods Consecutive SSc patients without overt heart disease referred for routine cardiac screening underwent 2D and 3D transthoracic echocardiography, including atrial and ventricular strain analysis. LACI was calculated by both 2D and 3D echocardiography as the ratio between the left atrial volume index and the tissue-Doppler-imaging septal a’ velocity. Patients with significant structural and functional changes suggestive of systolic or diastolic dysfunction or pulmonary hypertension, and those with impaired global left ventricular strain were excluded. Logistic regression, Pearson correlation coefficients, and area under the receiver-operating characteristic curve (AUC) are used to analyze the association and predictive power of LACI for elevated NTproBNP. Results A total of 36 SSc patients (55±10 years old; 34 (94%) women; mean disease duration 14±11 years) were included. Sixteen (44.4%) had diffuse cutaneous involvement (dcSSc). Seventeen (47%) patients had increased NTproBNP levels (i.e. &amp;gt;125 pg/mL). Among all tested variables, 3D LACI had the best correlation with NTproBNP values (r = 0.63, p&amp;lt;0.001). A 3D LACI of &amp;gt;2 associated with NTproBNP of &amp;gt;125 pg/mL (odds ratio 7.33 [95%CI 1.38-38.8]; p=0.01) and predicted these increased values with a sensitivity of 76.9% and a specificity of 81.2% (AUC 0.78). NTproBNP was also correlated with 2D LACI (r=0.55, p&amp;lt;0.001), peak left atrial longitudinal strain (r=-0.42, p=0.01), and left atrial contraction strain (r=0.48, p=0.005). Compared to patients with limited cutaneous involvement, those with dcSSc had higher NTproBNP values (250±139.6 vs 107.2±110.9 pg/mL, p=0.001), higher 3D LACI values (2.6±0.9 vs 1.9±0.5, p=0.02), with similar left atrial and ventricular strain parameters. Conclusion Left atrial volumetric-mechanical coupling index assessed by 3D echocardiography is significantly associated with and predictive of elevated NTproBNP levels in SSc patients without overt heart disease and may be a potentially useful non-invasive marker for screening for early subclinical heart involvement in SSc patients.

Histopathological Features of Chronic Gastritis and its Association with Helicobacter pylori Infection.

A Helicobacter pylori (H. pylori) infection is the most common cause of chronic gastritis (CG), with approximately 50% of the world's population infected. Long-term infection increases the risk of progression to gastric cancer. This study evaluated the histopathological changes in CG using the Updated Sydney System (USS) to estimate the prevalence and correlation of H. pylori gastritis with other histological variables. This research was a prospective observational study conducted in the Department of Pathology of a tertiary care teaching hospital in Central India. The study was conducted between Feb 2017 to April 2018. Two antral biopsies were taken per patient, one for a Rapid Urease Test and the second for routine histopathology. All samples were analyzed according to the USS. CG was found in 83.84% of total dyspeptic patients. The most common age group was 31-40 years, with a male preponderance. Of 109 gastric antral biopsies with histopathological evidence of chronic gastritis, neutrophilic activity, intestinal metaplasia, atrophy, and lymphoid aggregates were present in 50 (45.87%), 10 (9.2%), 23 (21.10%), and 11(10.09%) cases, respectively. The prevalence of H. pylori was 46.78%, and its association with the degree of chronic inflammation and intestinal metaplasia was statistically significant. H. pylori was significantly associated with the degree of chronic inflammation and intestinal metaplasia. Hence, this study suggests a vigorous search for H. pylori should be initiated if chronic inflammation and intestinal metaplasia are seen in antral gastric biopsies.

Dysbiosis index and fecal concentrations of sterols, long-chain fatty acids and unconjugated bile acids in dogs with inflammatory protein-losing enteropathy.

Canine protein-losing enteropathy (PLE) is a syndrome characterized by gastrointestinal loss of proteins. While fecal microbiome and metabolome perturbations have been reported in dogs with chronic enteropathy, they have not been widely studied in dogs with PLE. Therefore, the study aims were to investigate gut microbiome and targeted fecal metabolites in dogs with inflammatory PLE (iPLE) and evaluate whether treatment affects these changes at short-term follow-up. Thirty-eight dogs with PLE and histopathological evidence of gastrointestinal inflammation and 47 healthy dogs were enrolled. Fecal samples were collected before endoscopy (T0) and after one month of therapy (T1). Microbiome and metabolome alterations were investigated using qPCR assays (dysbiosis index, DI) and gas chromatography/mass spectrometry (long-chain fatty acids, sterols, unconjugated bile acids), respectively. Median (min-max) DI of iPLE dogs was 0.4 (-5.9 to 7.7) and was significantly higher (p < 0.0001) than median DI in healthy dogs [-2.0 (-6.0 to 5.3)]. No significant associations were found between DI and selected clinicopathological variables. DI did not significantly differ between T0 and T1. In iPLE dogs, at T0, myristic, palmitic, linoleic, oleic, cis-vaccenic, stearic, arachidonic, gondoic, docosanoic, erucic, and nervonic acids were significantly higher (p < 0.0001) than healthy dogs. In iPLE dogs, oleic acid (p = 0.044), stearic acid (p = 0.013), erucic acid (p = 0.018) and nervonic acid (p = 0.002) were significantly decreased at T1. At T0, cholesterol and lathosterol (p < 0.0001) were significantly higher in iPLE dogs compared to healthy dogs, while total measured phytosterols were significantly lower (p = 0.001). No significant differences in total sterols, total phytosterols and total zoosterols content were found at T1, compared to T0. At T0, total primary bile acids and total secondary bile acids did not significantly differ between healthy control dogs and iPLE dogs. No significant differences in fecal bile acid content were found at T1. Dysbiosis and lipid metabolism perturbations were observed in dogs with iPLE. Different therapeutic protocols lead to an improvement of some but not all metabolome perturbations at short-term follow-up.

Clinically Suspicious Cases of Hansen's Disease at a Tertiary Care Hospital in South India: A Clinicopathological Study.

Background and objective Hansen's disease, also known as leprosy, is a chronic granulomatous condition caused by Mycobacterium leprae, primarily affecting the skin and peripheral nerves. The disease has a wide spectrum of clinical and histopathological manifestations, often mimicking other inflammatory and infectious conditions. This variability poses significant challenges in its early diagnosis and management. Aligning clinical suspicion with histopathological evidence is critical for effective treatment and control of transmission. This study was designed to explore the concordance between clinical impressions and histopathological diagnoses and to understand the diagnostic utility of various histopathological techniques. We aimed to establish and correlate the histopathological types of leprosy with clinical presentations. We also sought to determine the extent to which different histopathological techniques, including special stains, can corroborate with clinical types, thereby enhancing diagnostic precision. Materials and methods This was a hospital-based, retrospective study of clinically suspicious cases of leprosy at a tertiary care hospital in South India. A total of 100 cases of various age groups were identified and included in the study. All cases underwent skin biopsy with samples subjected to routine hematoxylin and eosin (H&E) staining and acid-fast bacilli (AFB) staining for the detection oflepra bacilli. Results Among the 100 clinically suspicious cases of leprosy, 50were histopathologically confirmed as leprosy and 50were categorized as non-specific dermatitis. Among the 50 histologically confirmed cases of leprosy, the most common type was lepromatous leprosy (LL) (38%) followed by borderline tuberculoid (BT) (30%) leprosy.Modified AFBstain was positive in 21 cases and was instrumental in confirming the suspected cases of leprosy. The overall correlation between the clinical and histopathological diagnosis was significant, with the highest correlation noted in LL cases. Conclusions Our findings underscorethe complexity of diagnosing leprosy due to its varied clinical and pathological presentations. Despite a high overall concordance rate, the discrepancies between clinical impressions and histopathological findings observed highlight the need for a multidimensional diagnostic approach. Incorporating a combination of clinical assessment, routine histology, and special staining can enhance diagnostic accuracy, leading to better patient management and outcomes.

A study on direct metastasis to levels III, IV in oral tongue squamous cell carcinoma

ObjectiveThis study aimed to determine the frequency and specific metastatic patterns of direct metastasis to levels III and IV in oral tongue squamous cell carcinoma (OTSCC) among Japanese individuals. MethodsWe conducted neck dissections on 319 patients at our department from January 2001 to December 2020. Of these, 220 patients with histopathological evidence of lymph node metastasis were included in the study. Lymph node metastases were categorized by level to elucidate the metastatic patterns. Additionally, metastatic sites within level III were identified as either anterior or posterior to the internal jugular vein, and these findings were compared between the direct metastatic group and the non-direct metastatic group. ResultsAmong the patients, 13 experienced direct metastases to level III or IV. Specifically, 12 patients had metastases at level III, and one patient had metastases at both levels III and IV, constituting 5.9 % (13/220) of those with cervical lymph node metastasis in OTSCC. No patients exhibited direct metastases solely to level IV. Within level III, the direct metastasis group showed a significantly higher incidence of metastasis anterior to the internal jugular vein (p = 0.03). ConclusionsDirect metastasis to levels III and/or IV occurred in 5.9 % of the cases. Although elective neck dissection up to level III is generally sufficient, metastasis to level IV, while infrequent, can occur. Therefore, vigilant follow-up with attention to the lower neck regions is crucial.

Fucoidan Ameliorates Testosterone-Induced Benign Prostatic Hyperplasia (BPH) in Rats.

Benign prostatic hyperplasia (BPH) is a major urological health issue for men globally. Fucoidan, a sulfated polysaccharide, displays diverse bioactivities such as anti-inflammatory, anti-tumor, antioxidant, and immunoregulatory effects. This 28-day study examined the effects of Undaria pinnatifida fucoidan on testosterone-induced BPH in rats. Forty-eight Sprague Dawley (SD) rats were randomly divided into six groups; G1- vehicle control, G2- testosterone alone BPH control group (3 mg/kg), G3- finasteride (10 mg/kg) + testosterone, G4- fucoidan (40 mg/kg) + testosterone, G5- fucoidan (400 mg/kg) + testosterone, and G6- fucoidan alone (400 mg/kg). The animals were observed for clinical signs, body weight, feed consumption, prostate weight, prostate index, and biochemical markers such as tumor necrosis factor-alpha (TNF-α), interleukin- 1β (IL-1β), prostate-specific antigen (PSA) and messenger ribonucleic acid (mRNA) expression of BCL-2-associated X protein (BAX) and B-cell lymphoma-2 (BCL-2) in serum. Testosterone and dihydrotestosterone (DHT) levels were evaluated in both serum and prostate. Fucoidan significantly prevented an increase in prostate weight and prostate index induced by testosterone. DHT levels in the prostate of the intervention groups were significantly lower than in the BPH control group (p <0.05); however, no significant difference was observed in serum levels. Similarly, a significant reduction was observed in serum and prostate testosterone levels in the intervention groups compared to the BPH control group (p <0.05). Biochemical analyses showed PSA levels were significantly lower in the fucoidan groups compared to the BPH control group (p<0.05). Although not statistically significant, fucoidan groups showed a trend of reducing IL-1β and TNF-α levels. Fucoidan demonstrated pro-apoptotic potential in its ability to decrease BCL-2 and increase BAX. Histopathological evidence revealed fewer microscopic lesions in the fucoidan groups compared to the BPH control group. The results suggest Undaria pinnatifida fucoidan can reduce testosterone-induced BPH symptoms in SD rats.

Microbiologic and Histopathologic Features of Pedal Osteomyelitis.

The value of microbiology and histopathology in the diagnosis of neuropathic foot osteomyelitis remains poorly understood. In this retrospective cohort study, we evaluated the concordance of microbiology and histopathology results from bone resections and found similar proportions of bacterial growth in samples with and without histopathologic evidence of osteomyelitis.

Dermoscopic Features and Algorithm- A Guide to Detecting Pre-Malignant Facial Pigmented Skin Lesions in Ethnic Skin

Introduction: Detection of pre malignant facial pigmented lesions on a photo damaged ethnic skin has been crucial for dermatologists in preventing malignant transformation. Facial Pigmented Skin Lesions (FPSLs) that render a diagnostic challenge include, Pigmented Actinic Keratosis (PAK), early Seborrheic Keratosis (SK), Solar Lentigo (SL) and Lentigo Maligna (LM). Dermatoscopy or epiluminescence microscopy, is skin surface microscopy that has demonstrated to be a non-invasive, in vivo, high yield technique to evaluate a pigmented macule for an atypical evolution. Objective: To establish dermatoscopic findings of clinically challenging FPSLs conforming PAK, SK, SL and LM and derive an Algorithm with diagnostic features for detecting Premalignant Facial Pigmented Skin Lesions. Subjects and Methods: We here in conducted a largest case study a cross-sectional analysis of clinically challenging 182 flat FPSLs, evaluated dermoscopic images consistent to pigmented AK, early SK, SL and LM and subsequently biopsied for histopathological evidence. Four major dermoscopic features were appraised: pigment pattern, sharp demarcation, vascular criteria and follicular/epidermal pattern. Study Design: Cross sectional validation-study Setting: Department of Dermatology Unit II, King Edward Medical University, Mayo Hospital Lahore. Study was conducted for a period of six months. Result: We derived an “Algorithm” elucidating diagnostic findings of FPSLs. Pigmented AK on dermoscopy has strawberry pattern in 42% of lesions (pink to red pseudo-network with erythematous background, prominent follicular ostia fenced by a white targetoid halo), while Sharp demarcation (57.15%) and follicular/epidermal pattern (cerebriform pattern 100% of lesions, milia-like cysts, 50%, and comedo-like openings 38.57%) are distinctively observed SK. In SL, homogenous structureless pigmentation is significant entirely (100%). However, in LM predominates pseudonetwork (89.47%), homogenous structureless pigmentation (78%) and vascular patterns while strawberry pattern is observed in (26.31%) of lesions. Conclusion Our “Dermoscopic Algorithm” constitutes diagnostic characteristics of “Facial Pigmented Skin Lesions,” that would not only aid in early corrective detection of clinically similar lesions with different biologic behavior, but serve the the purpose to prevent vigorous malignant transformation in photo damaged ethnic skin, particularly Lentigo Maligna turning into a potential Melanoma, Hence, Sharp demarcation with cribriform pattern is specific of Sebhorric Keratosis (SK), while homogenous structureless pigmentation without prominent vascular pattern is distinctive of Solar Lentigo (SL). Pigmented Actinic Keratosis (AK) is described by prominent strawberry pattern. Nonetheless, homogenous structureless pigmentation and vascular pattern with pseudonetwork are featured in Lentigo Maligna (LM), lacking of prominent strawberry pattern. Conflict of Interest: The Authors have no conflict of interest to disclose.

Biochemical and Histopathological Evidence on Beneficial Effects of Standardized Extract from Tragopogon graminifolius as a Dietary Supplement in Fatty Liver: Role of Oxidative Stress

Biochemical and Histopathological Evidence on Beneficial Effects of Standardized Extract from Tragopogon graminifolius as a Dietary Supplement in Fatty Liver: Role of Oxidative Stress

Comparative Histopathologic Analysis of Inner Ear Damage in Meningitis: Otogenic Versus Meningogenic Routes.

To distinguish the patterns of inner ear changes between meningogenic and otogenic routes in meningitis cases. Our hypothesis is that pinpointing distinct patterns linked to each route could aid in the development of diagnostic strategies and targeted therapies. Temporal bones (TBs) from patients with a history of meningitis and histopathological evidence of labyrinthitis were divided into two groups (otogenic and meningogenic). Inner ear histopathological examination was performed to identify qualitative and semi-quantitative changes. This assessment encompassed inflammation patterns, indications of early ossification, hair cell loss, and alterations in the lateral wall, round window membrane, cochlear aqueduct and vestibular aqueduct. Thirty-six TBs were included in the study (otogenic, 21; meningogenic, 15). Generalized labyrinthitis was more common in otogenic cases (100% vs. 53%, p < 0.001). Early signs of cochlear ossification were exclusively observed in otogenic cases (9 TBs). The spiral ligament of otogenic cases has shown a uniform loss of fibrocytes across all cochlear turns, while meningogenic cases showed more severe loss in the apical turn. Otogenic cases exhibited a higher prevalence of severe inflammation of the cochlear aqueduct and endolymphatic sac. Meningogenic cases showed more severe loss of vestibular hair cells in the otolithic organs. Otogenic cases displayed a higher prevalence of changes in the spiral ligament and signs of early ossification, whereas meningogenic cases were associated with a higher degree of vestibular damage. Our findings emphasize the importance of considering the infection route and its implications for timely diagnosis and development of pathology-oriented treatment strategies. NA Laryngoscope, 2024.