Anti-glomerular basement membrane antibody-mediated glomerulonephritis (anti-GBM Ab-mediated GN) is a rare autoimmune disease, characterized by crescentic glomeruli and linear GBM staining with immunoglobulin G (IgG). Exposure to viruses can trigger the formation of autoantibodies to the GBM. We report the first case of anti-GBM Ab-mediated GN associated with hepatitis A virus (HAV) infection. Although the pathogenesis of HAV-related anti-GBM Ab-mediated GN has not been documented, we suggest that the immune complexes produced by HAV infection might be deposited in the glomerular capillary walls and lead to immune complex-mediated glomerular damage, resulting in exposure of the sequestered GBM antigens and the formation of anti-GBM antibodies. Under immunosuppressive and intravenous cyclophosphamide therapy, his renal function has been improving without development of pulmonary symptoms.
Basic and Applied PathologyVolume 5, Issue 3 p. 81-82 FROM THE EDITOR What the literature says on bioelectricity? Jeong-Wook Seo MD , Jeong-Wook Seo MD Director, Seoul National University Medical Library, Editor-in-Chief, Basic and Applied Pathology, Professor, Department of Pathology, Seoul National University College of Medicine, Seoul, Korea Email: jwseo@snu.ac.krSearch for more papers by this author Jeong-Wook Seo MD , Jeong-Wook Seo MD Director, Seoul National University Medical Library, Editor-in-Chief, Basic and Applied Pathology, Professor, Department of Pathology, Seoul National University College of Medicine, Seoul, Korea Email: jwseo@snu.ac.krSearch for more papers by this author First published: 12 September 2012 https://doi.org/10.1111/j.1755-9294.2012.01134.xCitations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume5, Issue3September 2012Pages 81-82 RelatedInformation
ABSTRACT Background and aim: Breast lesions, though more common than most other organ lesions, still deserve a special place in every pathologists mind because of their diversity. Lesions in the breast vary from simple fibroadenoma to various commoner carcinomas like infiltrating ductal carcinomas, to rarer entities, such as angiosarcoma, hemangiopericytoma, nodular hidradenoma, pleomorphic variant of lobular carcinoma, medullary carcinomas and carcinoid tumors; which can be compared to “an oasis in the desert”. Methods: A 3‐year retrospective study was carried out to evaluate the incidence and pattern of rare breast lesions in an upcoming teaching hospital, along with clinicohistopathological correlation. Specimens were preserved in 10% formalin and processed in a routine manner. Hematoxylin–eosin sections were studied and a morphological diagnosis was reached. Results: Some rare entities, namely pleomorphic variant of lobular carcinoma, medullary carcinoma, mucinous carcinoma, tubular carcinoma, apocrine carcinoma, cribriform carcinoma, anaplastic carcinoma, occult breast carcinoma, hemangiopericytoma, angiosarcoma, carcinoid tumor and nodular hidradenoma, were diagnosed. A brief review of published work of the various rare entities encountered in the present study was also made. Conclusions: It is imperative to be vigilant during microscopic diagnosis so that rare tumors are not missed.
ABSTRACTA 50‐year‐old woman, who underwent left mastectomy 2 years ago for infiltrating ductal carcinoma, came for follow up. A routine ultrasound of the abdomen detected a lesion in the spleen, which was suspected to be an abscess/metastasis. There was no apparent involvement of other organs such as liver, bone, lungs etc. The patient underwent splenectomy and recovered without any complications. On histopathological examination, it was diagnosed to be splenic metastasis from breast carcinoma. We present this case because of the rarity of the lesion and also as a reminder to be cognizant of one of the less likely differential diagnosis of an intraparenchymal solid splenic mass.
ABSTRACT Background and aim: Nasal polyposis is a relatively common condition found in 1–4% of the general population and in high percentages of some groups of patients. Nasal polyps diagnosed clinically are not always of inflammatory origin. A variety of non‐neoplastic and neoplastic conditions can present as nasal polyps. The aim of this study was to determine the various histopathological types, the predominant cells involved in the pathogenesis of inflammatory polyps with special reference to mast cells and to correlate them clinicopathologically. Methods: A total of 100 cases clinically diagnosed as nasal polyp, were studied over a period of 18 months. Results: Out of 100 cases studied, 91% of them were non‐neoplastic and 9% were neoplastic. Among the non‐neoplastic conditions, non‐allergic polyps accounted for 70% and allergic polyps accounted for 21% of cases. Among the neoplastic lesions, 6% were benign and 3% malignant. Squamous metaplasia was seen in 16.38% of cases. In stroma, mononuclear cells were predominant in 63.7% of inflammatory polyps, eosinophils in 19.11%, prominent edematous stroma in 26.39%, and vasculature > 2/high power field (hpf) in 20.39% of inflammatory polyps. 0–5 mast cells per 10 hpf were seen in 97.8% of inflammatory polyps in epithelium, whereas 11–20 mast cells in 26.4% of inflammatory polyps were seen in stroma. Conclusions: Nasal polyps diagnosed clinically are not always of inflammatory origin and therefore have to be subjected for histopathology.
ABSTRACT Background and aim: Microsatellite instability and fragile histidine triad (FHIT) loss have been seen to be involved in gallbladder carcinogenesis. We studied expression loss of mismatch repair (MMR) proteins and loss of FHIT expression in gallbladder cancer by immunohistochemistry using antibodies against MLH1, MSH2 and MSH6 proteins. Methods: One hundred and two consecutive cases of gallbladder cancer were retrospectively collected and expression of MLH1, MSH2 and MSH6 and FHIT protein was studied. The expression pattern was correlated with various clinicopathologic parameters and survival. Results: Expression loss of MMR proteins was found in 52.9% and loss of FHIT expression was found in 45% cases of gallbladder cancer. Loss of FHIT expression was seen in 12% of dysplasia associated with carcinoma. Expression loss of MMR proteins was found in 16% of dysplasia associated with chronic cholecystitis and 32.6% of dysplasia associated with carcinoma. Expression loss of MMR proteins had significant positive correlation with tumor stage and had worse survival compared with patients with intact expression. Loss of FHIT expression was significantly correlated with both tumor grade and stage. Conclusions: Frequency of expression loss of MMR proteins and loss of FHIT expression increased from dysplasia to carcinoma suggesting that both these abnormalities have a role in pathogenesis and occur at an early stage in carcinogenesis of gallbladder. Fifty three percent of gallbladder cancer with expression loss of MMR proteins also showed loss of FHIT expression and were frequent in advanced stage disease suggesting that reduced FHIT expression may be correlated with expression loss of MMR proteins on immunohistochemistry.
Basic and Applied PathologyVolume 5, Issue 3 p. 79-80 LETTER TO THE EDITOR Pathologic study on a new bioelectricity circulatory system Ran Tian, Ran Tian Researcher, Institute of Bioelectricity Technology, Laiwu Vocational and Technical College, Laiwu, China Email: rtian2@jhu.eduSearch for more papers by this authorYuling Wang, Yuling Wang Associate Professor, Peking University, Beijing, China, Professor, Laiwu Vocational and Technical, College, Laiwu, China Email: swdwang@163.comSearch for more papers by this author Ran Tian, Ran Tian Researcher, Institute of Bioelectricity Technology, Laiwu Vocational and Technical College, Laiwu, China Email: rtian2@jhu.eduSearch for more papers by this authorYuling Wang, Yuling Wang Associate Professor, Peking University, Beijing, China, Professor, Laiwu Vocational and Technical, College, Laiwu, China Email: swdwang@163.comSearch for more papers by this author First published: 12 September 2012 https://doi.org/10.1111/j.1755-9294.2012.01135.xCitations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume5, Issue3September 2012Pages 79-80 RelatedInformation
ABSTRACTWe report a case of stratified mucin producing intraepithelial lesion (SMILE), associated with adenocarcinoma and human papillomavirus (HPV) 18 infection. A 54‐year‐old lady presented with vaginal bleeding for 2 months. A punchy biopsy in private clinic showed papillary neoplasm composed of stratified columnar epithelium showing intracytoplasmic mucin vacuole. Microscopic examination for following cone biopsy demonstrated adenocarcinoma along with SMILE, and HPV 18 was detected by DNA chip examination. After several immunohistochemical stainings, SMILE showed predominant glandular differentiation.
ABSTRACTBackground and aim: Using machine learning methods can be helpful in the clinical decision processes such as pathological diagnosis with the aid of microscopic feature datasets. In the present study using the Breast Cancer Wisconsin dataset, an optimal algorithm (classifiers) which can predict both diagnosis (benign vs malignant) and prognosis (recur vs non‐recur) was devised by comparing several classification algorithms. Methods: The performance of a two‐step algorithm, which sequentially decides diagnosis and prognosis, was compared with that of a multi‐class classifier, which divides classes simultaneously. Results: In the two‐step classifier, it was discovered that the functional trees (FT) algorithm is the best for the first step of classification, and Naïve Bayes is the best for the second step of classification. On the other hand, the one‐step classifier shows better accuracy and better prediction on benign and non‐recurring cases than the two‐step classifier, but it shows lower accuracy on predicting recurring cases, leading to lower sensitivity. Conclusions: We conclude that the two‐step classifier with FT and Naïve Bayes is better than the one‐step classifier. This work will be helpful in setting the automated screening system in real clinics and highlight clues to improve the accuracy by refining data and algorithm selection in data mining or machine learning processes.
Ameloblastic carcinoma, a rare aggressive odontogenic tumor occurs predominantly in the mandibular posterior region. Clinical symptoms are varied with possible metastasis to the regional lymph nodes or lung. Radiographically, it usually manifests as an ill-defined osteolytic radiolucency. Histologically, it resembles ameloblastoma that is mostly devoid of its familiar microscopic features in combination with prominent cytological atypia and mitotic activity. A rare and atypical presentation of ameloblastic carcinoma of the mandible with unconventional clinical and radiological features is documented in this case report.
Background and aim: Aurora kinase A (AURKA) is a member of the protein serine/threonine kinase family that plays critical roles in cell mitosis and in tumorigenesis. The aim of this study was to investigate the expression of AURKA in non-small cell lung cancer (NSCLC) and analyze the correlation between AURKA expression and clinicopathological factors. Methods: One hundred and twenty patients with NSCLC, including 56 with squamous cell carcinoma and 64 patients with adenocarcinoma who underwent operations, were analyzed. Immunostaining for AURKA was performed in a tissue microarray block. The clinicopathologic parameters of these patients were reviewed and analyzed for correlations with AURKA expression. Results: AURKA expression was positive in 66 patients (55.0%) and negative in 54 patients (45.0%). The correlation between AURKA expression and histologic grade was statistically significant ( P = 0.013). Subset analysis revealed that AURKA expression was significantly associated with histologic grade in squamous cell carcinoma ( P = 0.007), not in adenocarcinoma ( P = 0.499). No association was found between AURKA expression and other clinicopathological parameters. Analysis of survival failed to reveal statistically significant differences between positive and negative groups in both squamous cell carcinoma and adenocarcinoma of lung. Conclusions : AURKA expression was associated with the histologic grade of squamous cell carcinoma of lung, but no significant effect on overall survival.
ABSTRACTPrimary adrenal lymphoma is rare, but clinically important. We report a unique case of adrenal lymphoma which showed extensive cystic change mimicking a pseudocyst. Seventy‐three‐year‐old man visited our hospital for healthcare check‐up, and was found to have a large adrenal cystic mass. He was received adrenalectomy on the impression of an adrenal pseudocyst. On gross examination, the mass was a unilocular cyst with no solid mass formation. Microscopically, the cyst wall had no epithelial lining, but was infiltrated by some atypical large lymphoid tumor cells. The cystic space was filled with coagulative necrotic material with the tumor cell shadow. The most of the tumor cells expressed leukocyte common antigen, CD20, PAX5, Ki‐67, and Epstein‐Barr virus (EBV)‐encoded RNA, which was consistent with EBV‐positive diffuse large B‐cell lymphoma of the elderly. No extra‐adrenal involvement was observed in imaging studies. We concluded that primary adrenal lymphoma should be considered as a rare but important cause of adrenal cysts.
ABSTRACTDiffuse pulmonary lymphangiomatosis (DPL) is a rare disorder involving the intrathoracic lymphatic system from the mediastinum to the pleura. Although DPL is a lymphatic developmental abnormality and is pathologically benign, it has various clinical presentations and a progressive course. We recently studied a case of DPL in a 35‐year‐old man presenting with cough and hemoptysis with unilateral chylothorax. A chest computed tomography scan showed diffuse interstitial thickening along the peribronchovascular bundles and intralobular septae with pleural and pericardial effusion. Wedge resection of the left lower lung was performed to make a diagnosis. Microscopically, the lesion was characterized by variably sized and increased lymphatic channels of the interlobular septa and subpleural area. The cells lining the lymphatics were immunohistochemically positive for D2–40 and CD34. This patient is still alive without recurrent symptoms 13 months after beginning a low‐fat medium‐chain triglyceride diet and chemical pleurodesis.
ABSTRACT Background and aim: Death of non‐human primates due to enteritis is common. The present study examined 27 carcasses of non‐human primates and documented two enteritis cases in rhesus macaques ( Macaca mulatta ) of Assam State Zoo. Methods: For histopathological examination, fragments of small intestine and colon were collected from necropsied animals, fixed in 10% buffered formaldehyde solution, and processed by routine paraffin embedding techniques and stained with hematoxylin and eosin. We cultured contents of intestinal tracts and selected tissues for their microflora. Results: At post mortem examination, grossly hemorrhages and ulceration in the intestines were noticed. Microscopical examination revealed degenerative changes of the epithelial cells of the villi and capillary congestion in the lamina propria and in the submucosa. Cultural examination showed the presence of Eschericia coli in the intestine. Conclusions: The study recommended that under certain environmental conditions, pathogenic E. coli were able to multiply and cause death of animals.
ABSTRACTBackground and aimZinc deficiency due to low intake or unavailability by bioactive compounds may lead to morphological changes in the intestines resulting in disruptions in gut function. This study aims to assess effects of phytic acid on gut morphology of rats.MethodsDiets supplemented with sweet potato phytate extract were fed to Wistar rats in zinc‐deficient and zinc‐sufficient states for 4 weeks. Similar test animals also had diets supplemented with the commercially available sodium phytate salt (IP6) for comparison. At the end of the feeding period, body weights, feed intake and markers of intestinal function were assessed.ResultsAcute zinc deficiency adversely affected the glycocalyx, goblet and Paneth cells within the small intestine. This may eventually lead to compromisation of the gut's immune system and further reductions in its metabolic and absorptive capacity. This was further aggravated by sweet potato phytate extract consumption. IP6 supplementation on the other hand, increased surface amplification in the jejunum resulting in increased gut transit time and more efficient absorption of nutrients.ConclusionsTo minimize compromisation of the gut's immune, absorptive and metabolic functions, adequate zinc supplementation is necessary especially if foods rich in phytates are included in the diet. Supplementation of the diet with IP6 seems to offset some of these effects with maximum benefits observed if the diet is properly supplemented with essential minerals.
ABSTRACT Primary localized amyloidosis of the urinary tract is a rare disease, usually mimicking a malignancy or inflammation in its clinical presentation and in diagnostic imaging studies. We present a case of localized amyloidosis arising in the left upper ureter in a 77‐year‐old man. The patient visited the hospital complaining of painless gross hematuria and dysuria for 1 month. Laboratory examination revealed hematuria only. Urine cytology was unremarkable. Abdominal computed tomography revealed an obstructing mass with calcification in the ureter. The clinical impression was of a ureteral stone or malignancy. A nephroureterectomy was performed. The ureter showed segmental fibrotic thickening with luminal obstruction. Microscopic examination revealed deposition of pale‐eosinophilic amorphous material with calcification and ossification. Congo‐red staining showed amyloid deposits with positive polarizing microscopic findings. Although its incidence is rare, localized amyloidosis should be considered in the differential diagnosis of ureteral tumorous lesions to avoid unnecessary surgery.
ABSTRACTBackground and aim: A study was carried out to analyze the presentation, to identify the causes and to find out the bone marrow morphology in cases of pancytopenia. Pancytopenia was an indication for bone marrow examination in 48 out of a total of 100 cases (48%) for which a bone marrow examination was requested. Methods: The data regarding the various signs and symptoms, the causes and the bone marrow findings were obtained and analyzed using simple statistical methods. All age groups were included for the study. Results: Generalized weakness (70.83%) was the commonest symptom and pallor (45.83%) was the predominant sign. Anisocytosis (79.1%) was the most important peripheral blood finding in pancytopenic patients followed by microcytosis (52.08%). The commonest cause of pancytopenia in the present study was hypoplastic marrow (33.33%), followed by normoblastic erythroid hyperplasia (27.08%), megaloblastic marrow (18.75%), and myelodysplastic syndrome (8.33%). Normal bone marrow and dry tap accounted for three cases each (6.25%). Of the various cases of myelodysplastic syndrome, one was refractory anemia; two were refractory cytopenia with multilineage dysplasia and one myelodysplastic syndrome unclassified. Dry tap was seen in three cases of pancytopenia. Bone marrow biopsy was done in one, which showed features of myelofibrosis. Conclusions: A thorough evaluation of the pancytopenic patients is necessary as it has varied causes.
ABSTRACTBackground and aim: Occurrence of nephritis in non‐human primates is not common. The present study examined 27 carcasses of non‐human primates of Assam State Zoo and Department of Forest and Environment, Government of Assam, during the period from December 2007 to November 2009. Methods: Tissue samples were collected in 10% formol saline solution to be processed, sectioned and stained by routine histopathological procedures. Whenever warranted, special staining such as Brown and Brenn, Zeihl‐Neelsen's and modified Periodic Acid‐Schiff stains were used as per standard techniques. Results: Out of 27 non‐human primates, two rhesus macaque (Macaca mulatta) and one slow loris (Nycticebus coucang) died due to nephritis. At postmortem examination, grossly the kidneys were enlarged and pale in colour and the microscopic picture revealed acute glomerulonephritis characterized by increased cellularity of glomeruli. The swollen glomerular tufts with leucocytic infiltration completely occupied the Bowman's capsular space. Conclusions: Death due to nephritis was 11.11% in non‐human primates of Assam State Zoo and Department of Forest and Environment, Government of Assam.
ABSTRACT Background and aim: Extracts of elm tree ( Ulmus davidiana japonica ) have long been used for the treatment of inflammatory diseases in traditional medicine. Several in vitro studies have indicated that some components of the elm tree have anti‐inflammatory and/or anti‐oxidative effects. We investigated the chemopreventive effects of bark extract of elm tree (BEE) on a chronic inflammation‐associated mouse gastric cancer model. Methods: Gastric cancer was generated by the combination treatment of N ‐methyl‐ N ‐nitrosourea and Helicobacter pylori to C57BL/6 mice. Various concentrations of BEE (0, 125, 250, 500, and 1,000 ppm) was fed to the mice for 38 weeks. Results: The incidence of gastric tumors at 50 weeks were significantly lower in the highest dose BEE‐fed mice (26.67%) than control mice (85.71%) ( P < 0.01). The multiplicity and size of tumors were also significantly lowered by BEE feeding in a dose‐dependent manner ( P < 0.01). In addition, BEE decreased the nuclear β‐catenin localization and nuclear cyclin‐D1 expression in adenocarcinomas. Furthermore, BEE suppressed H. pylori ‐associated chronic inflammation determined by histologic gradings of H. pylori density, chronic gastritis, glandular atrophy and intestinal metaplasia in non‐tumorous gastric mucosae. Conclusions: These findings suggest that BEE inhibits the development of gastric tumorigenesis via suppression of H. pylori infection‐associated chronic inflammation.
Russell body gastritis (RBG) is a rare gastric mucosal lesion comprising numerous Russell body-containing plasma cells (Mott cells). Early gastric cancer was discovered during a routine health checkup of a 55-year-old man treated with esophagogastroduodenoscopy. Endoscopic submucosal dissection and a histological examination revealed well-differentiated tubular adenocarcinoma and RBG. The two lesions were contiguous but not intermingled. Helicobacter pylori infection was also identified. Immunohistochemically, Mott cells of RBG manifested λ-light chain restriction. However, polymerase chain reaction analysis did not reveal IgH gene rearrangement. Epstein–Barr virus encoded RNA in situ hybridization showed no Epstein–Barr virus infection in cancer or Mott cells. Thus, two distinct RBG features are demonstrated: coexistence with early gastric cancer and λ-light chain restriction. The proliferation of Mott cells with light chain restriction may be due to a chronic hyperinflammatory response caused by H. pylori infection. However, it is unclear whether RBG is associated with gastric carcinoma.
