Zeitschrift für Zytologie und Histologie

Basosquamous carcinoma is a rare type. It considered as an aggressive type of basal cell carcinoma (BCC) this type of BCC has an increased risk of recurrence and metastasesorm. We present the case of a patient of 52 years with an ulcerative lesion of 10 cm in the right buttock treated with radical surgical and adjuvant radiation. This case needs critically to differentiate BSCC from the close terminology of Basaloid squamous cell carcinoma, which is an aggressive variant of squamous cell carcinoma occurring in the upper aero digestive tract. Paucity of literature about BCC compelled us to illustrate this case for study.

Objective: To determine the prevalence of underlying significant cervical lesions and factors associated with such lesions in women with atypical squamous cells of undetermined significance (ASC-US) cytology.

Materials and methods: Women with ASC-US cytology undergoing colposcopy and directed biopsy at the Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital between January 2007 and December 2012 were reviewed. Patients’ characteristics including histopathology were collected and analyzed. Significant cervical lesions were defined as cervical intraepithelial neoplasia grade 2 (CIN2), CIN3, adenocarcinoma in situ (AIS), and invasive cervical carcinoma.

Results: During the study period 154,638 Pap smears were carried out, of which 2,136 (1.38%) were ASC-US cytology. The ratio of ASC cytology/squamous intraepithelial lesions (SIL) cytology was 1.8:1. Among 2,136 women with ASC-US cytology, 627 underwent colposcopic examination and 540 had cervical biopsy. Significant cervical lesions were noted in 46 (8.6%) women. Invasive cervical carcinoma was detected in 5 (1%) women including 3 squamous cell carcinoma and 2 adenocarcinoma.

Conclusions: The underlying significant cervical lesions in women with ASC-US cytology was 8.6% and approximately 1% had invasive cervical cancer. Diagnostic work-up with colposcopy is recommended. No significant factor predicting high-grade cervical lesions was noted in women with ASC-US cytology.

The biocidal efficacy of ozone has been investigated in cryostats at -20°C and +30°C and 30-120 min exposure time. Stainless steel coupons were inoculated with 50 μl bacterial or viral test suspension. The tests were performed using Staphylococcus aureus and Mycobacterium terrae as test bacteria and Polyoma virus (Simian virus 40, SV 40). The inoculated coupons were exposed to a combination of ozone and UV generated by UV lamps in the cryostats. To measure the level of disinfection achieved, the number of surviving bacteria recovered from the coupons and, respectively, the virus infectivity titer was determined. Reduction factors were calculated by dividing the initial titer by the titer of recovered viable bacteria or virus.

Bactericidal efficacy at -20°C was demonstrated by inactivation of S. aureus by at least 5 log10 units in an automatic defrost/60 min ozone cycle in all test positions, which allowed to remove the +30°C/120 min test from the testing panel. In a 30 min treatment, a disinfection rate of 5 log10 units was achieved in some, but not all test positions. Mycobacterium terrae, the substitute for the pathogenic M. tuberculosis, was inactivated by >5.3 log10 units in all tested locations using a 120-minute ozone cycle at +30°C. The infective virus titer was reduced by at least 5 log10 units in the same ozone cycle on the pressure plate and chuck positions. Apart from this, significant reductions in viable cell and virus numbers have been shown for all disinfection protocols and test positions, thus demonstrating the principle efficacy of a combination of gaseous ozone and UV as a disinfectant in cryostats.

Rosai-Dorfman disease (RDD) is a rare and self-limiting non-Langherhans histiocytosis with lymph node and cutaneous manifestations. This sinus histiocytosis is very extremely usual in children that progress to massive lymphadenopathy. Emperipolesis is a common Histopathological findings and protein S-100 is positive in most cases of RDD. Here, report a case of a 48-year-old with adult with RDD that exhibited cervical lymphadenopathy without fever or Osteolyticlesions. Histopathological and immunohistochemistry studies of lymph node showed emperipolesis, S-100 protein, CD68 positive and macrophages negative for CD1a. After that the diagnosis of RDD was done. However, cervical lymphadenopathy was not solved spontaneously, and the treatment with corticosteroid therapy was initiated and the follow-up showed a clinical improvement condition of the patient.

Adrenal incidentaloma is a mass lesion greater than 1 cm in diameter, serendipitously discovered by radiologic examination. The reported incidence of adrenal incidentalomas is between 4-6%. Majority of reported adrenal incidentalomas are adenomas (hormonally active/inactive), pheochromocytoma, adrenal carcinoma and metastatic carcinomas. We report three rare adrenal incidentalomas with brief review of literature. The three adrenal incidentalomas proved to be adrenal myelolipoma, adrenal pseudocyst and adrenal teratoma on histopathology. Preoperative hormonal assessment and postoperative histopathological examination is required in all cases of adrenal incidentalomas to rule out malignancy.

Recent studies in Sweden and Japan have reported that extensive gastric atrophy is associated with an increased risk for oesophageal squamous cell carcinoma. They also mentioned that this findings need to be confirmed in other ethnic groups due to the wide geographic variation of this cancer. Objectives: To determine the prevalence of extensive gastric atrophy in patients with squamous cell carcinoma of the oesophagus over a two year period. Method: Fifty nine patients with squamous cell carcinoma of the oesophagus referred to gastroenterology division for dilatation or stenting had four additional biopsies taken from the gastric antrum and corpus. This were then evaluated for the presence gastric atrophy and Helicobacter pylori by an experienced histopathologist. Results: Extensive gastric atrophy defined as atrophy of both the antrum and the corpus was found in 15(25%) of the fifty nine patients. Nine (60%) of these patients were also positive for Helicobacter pylori by methylene blue. Conclusion: The prevalence of extensive gastric atrophy in these patients with squamous cell carcinoma of the oesophagus is much lower than that found in Sweden and Japan, i.e. less than half of these two regions and the majority of them were found to be infected by h pylori. . This suggest that even though extensive gastric atrophy is an important factor in certain areas, it may be less important of a factor in South Africa and other geographic areas as shown in other studies. This still need to be investigated further in larger studies to fully understand the role of extensive gastric atrophy in these patients.

Background: The levels and function of circulating progenitor cells (CPCs) may be affected by chronic metabolic diseases. Aim: To investigate the levels and functions of CPCs in patients with non-alcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD). Methods: In this retrospective study, patients (n=82) undergoing elective coronary angiography for diagnosis of CAD were included. NAFLD was defined as presence of hepatic steatosis by ultrasound in the absence of other causes of liver disease and excessive alcohol use. After coronary angiography, patients were divided into NAFLD with CAD (n=24), NAFLD without CAD (n=13), only CAD (n=31) and Non-NAFLD and Non-CAD (n=14). CPCs were quantified by flow cytometry based on the expression of (CD34+, CD133+, CD34+CD133+) in presence or absence of the hematopoietic marker (CD45). We assessed serum levels of angiogenic growth factors (AGFs) (pg/ml) by Multiplex assay. Results: The levels of the CD45-CD34+ and CD45-CD133+ were higher in NAFLD patients with CAD (median, 15% and 2%, respectively) than NAFLD patients without CAD (median, 9% and 1%, respectively, all p ≤ 0.05). After age adjustment, only CD45-CD34+ circulating progenitor cells remain associated with increased risk of CAD in patients with NAFLD [OR: 8.71 (1.21-62.51)]. In contrast, the levels of the serum vascular endothelial growth factor-C (VEGF-C) was lower in NAFLD patients with CAD (median, 69 pg/ml) than NAFLD without CAD (median, 146 pg/ml) (p=0.01). Conclusions: Our results indicate that high levels of non-hematopoietic CPCs and low levels of AGFs may be associated with increased risk of CAD in NAFLD patients.

We report a case of an incidentally detected calcified liver lesion that was diagnosed as a hydatid cyst using fineneedle aspiration. The aspirated fluid from the thickened calcified cystic hepatic mass was clear. The cell block sections showed laminated membranes Echinococcus hooklets on the Hematoxylin and Eosin (H&E) stain as well as the AFB and GMS special stains. While needle aspiration may not indicated in cases of suspected hydatid disease, it may serve as a valuable diagnostic tool in cases of tumoral masses in which there is no clinical and radiological suspicion on this diagnosis. Awareness of the fact that the hooklets stain with AFB and GMS stains can facilitate the identification of the characteristic hooklets, which may be rare and can otherwise require painstaking search under lighting conditions that increase their refractivity. Similarly, awareness of the fact that PAS, AFB and GMS stains highlight the laminated membrane fragments, which may otherwise be missed or misinterpreted as mucus or artifacts, facilitates their recognition and orients the diagnosis towards the correct diagnosis.

Objective: To determine the O-acetyl sialomucin content in different type of adenocarcinomas in gastric biopsies. Study design: Descriptive, Cross sectional study. Place and duration of study: Histopathology department, Sheikh Zaid hospital, Lahore, Pakistan from January 2012 to July 2014. Materials and methods: Total sixty cases of gastric adenocarcinoma diagnosed on H&E were included in this study. Patient’s gender and age were noted. Periodate borohydrate PAS saponification technique to detect sialomucin was applied and the results were recorded. The data was analyzed by using computer software program SPSS version 20. Results: Out of 60 patients of gastric adenocarcinoma, the male to female ratio was 2:1. The age of the patients ranged between 30 to 80 years with an average age of 51.4 ± 11.4. Out of the 60 cases, 31 were of intestinal type adenocarcinomas, rest 29 cases were diagnosed as diffuse type adenocarcinomas according to Laurén classification. On histochemical examination, 13 out of 31 cases were O acetyl sialomucin positive in intestinal adenocarcinoma group where as only 3 cases were positive in diffuse type adenocarcinoma by combined Periodate borohydride PAS saponification technique. Conclusion: The clinicopathological and histochemical results in our study not only ascertain prognosis at the time of initial diagnosis but also incorporate sialomucin as therapeutic target in advanced cases of gastric adenocarcinoma.

Background: Cervical lymphadenopathy is a common clinical finding in all age-groups that ranges in etiology from inflammation to malignancy. Fine needle aspiration cytology (FNAC) is a standard first-line investigation in the evaluation of cervical lymphadenopathy.

Objective: The study aimed to analyze the clinical profile and causes of cervical lymphadenopathy in different age-groups and the diagnostic utility of FNAC in our setup.

Methods: This retrospective study included all the patients of cervical lymphadenopathy of more than 2-3 weeks duration, who underwent FNAC in our tertiary care institution in Kashmir valley, India during the two-year study period (January 2009-December 2011) in whom the aspirated material was adequate and satisfactory for evaluation.

Results: A total of 790 patients were selected. Upper deep cervical lymph nodes were involved most frequently (38.9%); reactive lymphadenitis (39.4%) followed by metastasis (38.2%) were the commonest causes, in general. In addition, reactive lymphadenitis was the most common cause of lymphadenopathy in all age groups less than 40 years and at all topographic sites of cervical lymph node. However, in more than 40 years age-groups and at supraclavicular region, metastasis was the commonest cause of enlargement. Squamous cell carcinoma (36.4%) followed by adenocarcinoma, (25.8%) were the most common metastatic tumors.

Conclusion: Enlargement of cervical lymph nodes, particularly in elderly patients involving supraclavicular nodes, should raise a suspicion of malignancy; and cervical lymphadenopathy can be effectively evaluated by FNAC without the need for surgical biopsy.

The present studies included evaluation of pathogenic parasitic protozoans, bacteria, fungi and algae collected from drinking water of three sources; wells, tap and three re-purifying water-private companies; from Rafha City, Northern Borders, Saudi Arabia, to count and identify these contaminants. The results revealed three species of parasitic protozoans (Giardia lamblia, Cryptosporidium parvum and Cyclospora cayetanensis), Four species of Coliform bacteria (Proteus mirabilis, Escherichia coli, Enterobacter cloacae and E. aerogenes) beside seven bacterial genera (Bacillus, Brevibacillus, Staphylococcus, Streptococcus, Aeromonas, Acinetobacter and Pseudomonas), five genera of fungi (Aspergillus, Chrysoporium, Alternaria, Acremonium and Exophiala) as well as three genera of algae in tap and the present three re-purifying water-private companies (Anabaena, Microcystis and Oscillatoria). The present results indicated that the three water sources of Rafha city are important contributor to transmission of contaminants to consumers. The present work recommends future field-application of selected specialized antiparasites and anti-bacterial compounds to control, or at least reduce the present resulting contaminators to gain safe levels of drinking water, according to WHO (World Health Organisation -, or at least SASO (Saudi Standards, Metrology and Quality Organization) - levels, to reduce the risk of propagation of the present microorganisms