Histopathological Examination Of Tissue Biopsy Research Articles

Agreement Between Clinical and Histopathological Diagnoses of Oral and Maxillofacial Lesions and Influencing Factors: A Five-Year Retrospective Study.

Diagnosing oral and maxillofacial lesions is a multi-step, multidisciplinary process. If a clinical diagnosis is achievable, then a histopathological diagnosis is indicated to support and confirm the diagnosis. Histopathological examination of tissue biopsies is therefore an essential part of the diagnosis and/or treatment plan. The purpose of this study was to investigate the agreement between the clinical and histopathological diagnoses of oral and maxillofacial lesions and the patient, lesion, and healthcare provider factors that may affect this agreement. This was an observational, cross-sectional study of all patients who had been referred to the Oral Pathology Central Laboratory at the Faculty of Dentistry and University Dental Hospital at King Abdulaziz University in Jeddah, Saudi Arabia, between 2018 and 2022 for diagnosis of oral and maxillofacial lesions. Data extracted included information about the referring dental provider such as their clinical experience (number of years), specialty, certification, and education. Agreement between the clinical and histopathological diagnoses was evaluated, and logistic regression was used to assess provider characteristics associated with the accuracy of diagnosis. The clinical and pathological diagnoses were concordant in 44.1% (n=378) of cases, and concordance was highest for odontogenic tumors (72.7%, n=24), significantly higher than for inflammatory lesions (37.3%, n=111). The anatomical locations with the highest diagnostic accuracy were the ventral surface of the tongue (71.4%, n=5), followed by the lips (52.6%, n=20). Patient age and sex and the dentist's years of experience were not associated with diagnostic agreement (p=0.2, p=0.9, and p=0.08, respectively). However, concordant diagnoses were significantly associated with the dentist's rank (p=0.02) and specialty (p=0.01). Clinical diagnoses made by oral surgeons at the time of biopsy were 1.6-times more likely (p=0.01) to agree with the pathological diagnosis compared with those made by other specialties when controlling for education, certification, and years of experience. These data are a reminder that a clinical diagnosis alone is not sufficient to secure the final diagnosis and to plan treatment. Histopathological examination remains essential for most oral and maxillofacial lesions.

Jaw Cysts: A Retrospective Study in a Turkish Subpopulation

Objectives: Cysts seen in the jaws may be odontogenic or non-odontogenic, depending on the tissue of origin. Although there are different methods to diagnose these lesions, histopathological examination of tissue biopsy of the lesion is accepted as the 'gold standard' in cases where the diagnosis is insufficient. Although there are different methods to diagnose these lesions, histopathological examination of tissue biopsy of the lesion is accepted as the 'gold standard' in cases where the diagnosis is insufficient.
 Materials and Methods: Pathology results of 436 patients who applied to Zonguldak Bülent Ecevit University Faculty of Dentistry, Oral and Maxillofacial Radiology Clinic between 2016-2021 for any reason and underwent biopsy were retrospectively scanned using digital archives. While classifying the cyst, the criteria published by the World Health Organization (WHO) in 2017 were taken into account. Obtained results were recorded for statistical analysis. SPSS 22.0 Software Package Program (SPSS 22.0 Software Package Program, Inc. Chicago, IL, USA) was used as statistical software in the study.
 Results: Of the 436 patients included in the study, 250 (57.3%) were male and 186 (42.7%) were female. The ages of the patients ranged between 7 and 82 years, and the mean age of the patients was 35.5±15.8. As a result of the findings, it was determined that the most common cysts were radicular cysts (53.7%). Radicular cysts were most commonly located in the posterior mandible and anterior maxilla anatomically.
 Conclusions: In addition to clinical and radiological examination, histopathological examination of biopsy samples taken from tissues is of great importance in the correct diagnosis and treatment planning of jaw cysts.

Invasive Fungal Infections Complicating COVID-19: A Narrative Review.

Invasive fungal infections (IFIs) can complicate the clinical course of COVID-19 and are associated with a significant increase in mortality, especially in critically ill patients admitted to an intensive care unit (ICU). This narrative review concerns 4099 cases of IFIs in 58,784 COVID-19 patients involved in 168 studies. COVID-19-associated invasive pulmonary aspergillosis (CAPA) is a diagnostic challenge because its non-specific clinical/imaging features and the fact that the proposed clinically diagnostic algorithms do not really apply to COVID-19 patients. Forty-seven observational studies and 41 case reports have described a total of 478 CAPA cases that were mainly diagnosed on the basis of cultured respiratory specimens and/or biomarkers/molecular biology, usually without histopathological confirmation. Candidemia is a widely described secondary infection in critically ill patients undergoing prolonged hospitalisation, and the case reports and observational studies of 401 cases indicate high crude mortality rates of 56.1% and 74.8%, respectively. COVID-19 patients are often characterised by the presence of known risk factors for candidemia such as in-dwelling vascular catheters, mechanical ventilation, and broad-spectrum antibiotics. We also describe 3185 cases of mucormycosis (including 1549 cases of rhino-orbital mucormycosis (48.6%)), for which the main risk factor is a history of poorly controlled diabetes mellitus (>76%). Its diagnosis involves a histopathological examination of tissue biopsies, and its treatment requires anti-fungal therapy combined with aggressive surgical resection/debridement, but crude mortality rates are again high: 50.8% in case reports and 16% in observational studies. The presence of other secondary IFIs usually diagnosed in severely immunocompromised patients show that SARS-CoV-2 is capable of stunning the host immune system: 20 cases of Pneumocystis jirovecii pneumonia, 5 cases of cryptococcosis, 4 cases of histoplasmosis, 1 case of coccidioides infection, 1 case of pulmonary infection due to Fusarium spp., and 1 case of pulmonary infection due to Scedosporium.

DNA integrity in diagnosis of premalignant lesions.

Background Carcinogenesis is a dynamic process which traditional biopsying can not keep up with. Saliva as fluid in the vicinity of the tumor can offer better insights to this process. This study aimed to identify the accuracy of salivary DNA integrity index in differentiating between oral premalignant lesions and oral cancer. Material and Methods This phase II diagnostic test accuracy study included 93 patients divided into three groups: 30 oral cancer patients, 33 patients with oral premalignant lesions divided into 21 oral lichen planus patients and 12 patients with leukoplakia and 30 normal individuals who acted as controls. Oral rinse was collected from all participants and they all underwent conventional visual and tactile examination, and patients with oral lesions had the diagnosis confirmed by histopathological examination of tissue biopsy. DNA integrity index was determined as the ratio between ALU247 and ALU115 measured by qPCR. Results There was no statistically significant difference regarding ALU115, ALU247 and DNA integrity index between the three study groups. The index was significantly higher in the oral cancer group than the oral lichen planus patients, while no significant difference was found between the oral cancer and the leukoplakia cases. The DNA integrity index sensitivity, specificity, positive and negative predictive values were 73%, 45%, 55% and 65% respectively. Conclusions Salivary DNA integrity index showed poor diagnostic abilities in differentiating between the oral cancer and premalignant lesions. Key words:DNA integrity index, oral lichen planus, leukoplakia, saliva, cell free DNA, oral cancer.

PREVALENCE AND HISTOPATHOLOGICAL EFFECTS OF SCHISTOSOMA HAEMATOBIUM ON THE FEMALE GENITAL TRACT IN SOHAG GOVERNORATE, UPPER EGYPT

Urinary schistosomiasis is a chronic granulomatous inflammation affects many body systems including female genital tract. The present study determined the prevalence and infection intensity of urogenital schistosomiasis and made a retrospective analysis of histopathological changes in female genital tract affected by S. haematobium among female patients attended Sohag University Hospitals, from October 2016 to September 2019. A total of 100 fallopian tube, 50 cervical and 50 vaginal specimens were collected from 200 female patients (126 rural & 74 urban) aged between 20-50 years; suffering from infertility, bleeding, pelvic discomfort and or dyspareunia. Histopathological examination of tissue biopsies was performed. Urine examination for all participants was done to detect S. haematobium eggs and infection intensity by using a standard urine filtration technique. Seven specimens (7%) were documented to have fallopian tube, five (10%) cervical and two (4%) vaginal schistosomiasis. Twelve out of 14 genital schistosomiasis cases were rural (85.7%) and two cases were urban (14.3%). Urine examination revealed 18 Schistosoma haematobium egg positive samples out of 200 participants (9%), {6 (33.3%) with light infection intensity and 12 (66.7%) with heavy infection intensity}. Nine out of 14 female genital schistosomiasis (FGS) cases (64.2%) were positive for Schistosoma haematobium eggs in urine, eight (88.8%) of them with heavy infection intensity.

Noninvasive Assessment of Fat and Iron Deposition in the Liver by PDFF and T2* Measurement Using the 6-Point DIXON Method

Background: The gold standard procedure for the diagnosis of hepatic steatosis and iron deposition in the liver is histopathological examination of tissue biopsy, but the procedure is invasive and other non-invasive techniques are desirable. The aim of this study was to evaluate the diagnostic values of magnetic resonance imaging (MRI)-based proton density fat fraction (PDFF) and T2* value in the assessment of hepatic steatosis and iron deposition, respectively, in various chronic liver diseases. Methods: This was a cross-sectional study of 196 patients between October 2015 and October 2018. PDFF and T2* value were estimated by the 6-point DIXON method. Each patient underwent MRI and histopathological examination of liver biopsy. Brunt classification used in histopathological examination classified steatosis into four stages; from S0-3 while Berlin blue staining classified iron deposition into four grades. MRIs were processed for measurement of PDFF and T2* value. Finding: The amount of iron deposition had no effect on PDFF (1.9% for S0, 6.5% for S1, 13.9% for S2 and 22.3% for S3). However, T2* value decreased with increased severity of steatosis even in the absence of iron deposition. T2* values were 24.3 ms for grade 0, 17.6 ms for grade 1, 11.9 ms for grade 2 and 5.2 ms for grade 3 in cases with PDFF of <10.6%. Liver fibrosis had no effect on PDFF and T2* values. In cases with severe iron deposition, steatosis had little effect on the T2* value. Interpretation: MRI-based PDFF and T2* value correlated with histopathologically-determined steatosis and iron grades in various chronic liver diseases. In mild iron deposition, steatosis may influence the T2* value, and thus careful evaluation is required using the 6-point DIXON method. Funding: This research was completed without any government or non-government financial support. Declaration of Interest: Hiromitsu Kumada has received honoraria from MSD K.K., Bristol-Myers Squibb, Gilead Sciences, AbbVie Inc., and Dainippon Sumitomo Pharma. Kenji Ikeda received honorarium from Dainippon Sumitomo Pharma, Eisai Co., Ltd. Yoshiyuki Suzuki received honoraria from Bristol-Myers Squibb and Abb Vie Inc. Fumitaka Suzuki received honorarium from Bristol-Myers Squibb. Norio Akuta received honoraria from Bristol-Myers Squibb and Abb Vie Inc. All other authors declare no conflict of interest. Ethical Approval: The protocol was approved by the certified clinical research review board of Toranomon Hospital (approval number #641-H/B).

Recent Complications and Issues in Tuberculosis Treatment.

Tuberculosis is one of the major communicable diseases which can be prevented and cured. The prevalence of tuberculosis infection is more despite this disease causes major morbidity and mortality. To establish connection between tuberculosis (TB) related stigma and hindrance in search of a treatment after the inception of symptoms associated with tuberculosis. Physicians conducted the interviews using a structured questionnaire. Information from the medical reports available at health care centers (especial results of sputum microscopy, radiological and other investigations) was also distracted. Patients is said to be infected with TB having a minimum two initial +ve sputum smears or one +ve sputum smear and chest radiographic abnormalities along with active pulmonary TB as determined by clinician; one sputum +ve culture specimen +ve for Mycobacterium tuberculosis. High resolution computed tomography (HRCT), a new susceptible technique shows erratically disseminated military nodules. The organs associated and extents of lesions of miliary TB in the pulmonary tuberculosis are examined by ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI). Histopathological examination of tissue biopsy is a conservative and fast technique for the separation of mycobacterium tuberculosis and assessment of choroid tubercles in fundus. Even though numerous prognostic markers have been described which envisage mortality, yet untreated miliary TB has a serious outcome within one year. A high index of clinical research, early diagnosis and timely institution of anti-tuberculosis treatment can be life-saving. Response to first-line anti-tuberculosis drugs is good. Anti-tuberculosis drugs are patent.

Disseminated sarcoidosis: pulmonary, endobronchial and gastric

Sarcoidosis is a chronic granulomatous idiopathic systemic disease. Although the pulmonary involvement is the most common form of the disease, sarcoidosis can affect the airways, determining mucosal nodularity and even bronchostenosis. Gastrointestinal involvement is very rare and it is primarily manifested as gastric sarcoidosis. The diagnosis is based on symptoms, radiological findings and histopathological examination of tissue biopsies. In this work, we describe a case of pulmonary, endobronchial and gastric sarcoidosis in the same patient and discuss the approach to this rare presentation of the disease

A Rare Extra-Pulmonary Presentation Of Tuberculosis As Gum Tuberculosis

Tuberculosis (TB) is a chronic granulamatous disorder presenting mostly (80%) as a pulmonary disease, the extra-pulmonary presentation being relatively uncommon. The oral cavity can sometimes be a site for extra-pulmonary tuberculosis with a highly variable clinical presentation including ulceration, diffuse infl ammatory lesions, granulomas and fi ssures. Oral lesions usually appear secondary to a primary tubercular infection elsewhere, although primary infection of the oral mucosa by Mycobacterium tuberculosis has been described. We report here a rare case of primary tuberculosis of the hard palate extending to gingiva, manifesting as gingival enlargement with ulceration. Diagnosis was established by histopathological examination of tissue biopsy and by chest radiography. The patient was put on anti-tubercular therapy for nine months to which a prompt response was obtained. This emphasizes the need to consider tuberculosis in the differential diagnosis of non-healing mucosal lesions of oral cavity for early diagnosis and prompt treatment. SAARC Journal of Tuberculosis, Lung Diseases &amp; HIV/AIDS; 2013; X(1); 37-39 DOI: http://dx.doi.org/10.3126/saarctb.v10i1.8675

Biopsieindikationen

The role of a standardized histopathological examination of tissue biopsies and of different tissue compartments (synovia, vascular tissue, bone) is discussed in order to stratify the therapy of different forms of arthritis and other rheumatological diseases. Furthermore the diagnostic steps for the histopathological diagnosis of metabolic osteopathic diseases are highlighted. The synovitis-score is described as a diagnostic device leading to the diagnosis of a low-grade synovitis, which is associated with degenerative and posttraumatic arthropathies, or of a high-grade synovitis which is associated with rheumatic diseases.

Successful treatment of multifocal cutaneous leishmaniasis with miltefosine

We report a 48-year-old immunocompetent male, resident of Central India, who presented with slowly progressive asymptomatic multiple red lesions on different parts of body. On enquiry, the patient gave history of travel to Middle East 6 months back. Examination showed 10 crusted erythematous indurated plaques and nodules over forearms, left leg, right index finger, left wrist and dorsa of both feet. Histopathological examination of tissue biopsy showed multiple intracellular as well as extracellular leishmania donovan bodies. Keeping in mind the higher rate of side effects to pentavalent antimony, we treated this patient with oral miltefosine 50 mg bid and the lesions showed complete resolution over 4 months of therapy.

Clinical and histological healing pattern of peri‐implantitis lesions following non‐surgical treatment with an Er:YAG laser

The aim of the present study was to assess clinical and histo-pathological healing pattern of peri-implantitis lesions following non-surgical treatment with an Er:YAG laser (ERL). Twelve patients suffering from peri-implantitis (n = 12 implants) received a single episode of non-surgical instrumentation using ERL (12.7 J/cm2). Assessment of clinical parameters (plaque index (PI), bleeding on probing (BOP), probing pocket depth, gingival recession (GR), and clinical attachment level (CAL)), surgical defect examination, and histo-pathological examination of peri-implant tissue biopsies was performed after 1, 3, 6, 9, 12, and 24 months. All patients exhibited improvements of all clinical parameters investigated. However, histo-pathological examination of tissue biopsies revealed a mixed chronic inflammatory cell infiltrate (macrophages, lymphocytes, and plasma cells) which seemed to be encapsulated by deposition of irregular bundles of fibrous connective tissue showing increased proliferation of vascular structures. It was concluded that a single course of non-surgical treatment of peri-implantitis using ERL may not be sufficient for the maintenance of failing implants.