en jalali 1390 7 5 gregorian 2011 9 27 online 1 fulltext

en Review Article Oral submucous fibrosis is chronic progressive condition of oral cavity. The condition is well recognized for its malignant potential. Usually the disease initiates with redness, blistering, and ulceration inside the mouth. It is characterized by progressive fibrosis of submucosal tissue. The pathogenesis of oral submucous fibrosis is not well understood. Betelquid chewing is the major etiological factor. In Pakistan, oral cancer is the second most common cancer in women and the third most common cancer in men. The incidence of oral cavity cancer in Karachi South district of Pakistan is the highest in the world. Head and neck cancer are major cancer burden in Pakistan. The incidence of oral submucous fibrosis is common in women as compared to men. While banning tobacco, betel nut, betel, Panmasala and Gutka is the key to prevention of the disease. No specific laboratory tests are available for oral submucous fibrosis. Comprehensive head and neck examinations should be part of all medical and dental examinations. The treatment of patient of oral submucous fibrosis depends on the degree of involvement. Commercially available of economical sachets of gutka, paan have strong association with this. Government should take some steps for the cessation of these products. 165 172 165 http://ijp.iranpath.org/IJPArticles/6_4/24-1.pdf 165 Farzeen Tanwir , Humera Akhlaq

en Original Article Background and Objectives: Significant progress has been made in treatment of hemophilia. Exvivo gene therapy is going popular due to the capability of this method in using isogenic cells for genetic manipulation and reintroducing them into same host after proliferation. Most gene therapy techniques use viral vectors, which usually harbor a strong and non-specific promoter (e.g. CMV early promoter) for driving the downstream gene. This may be a disadvantage due to uncontrollable nature of gene expression. In addition, considering the potentials of recently introduced stem cells as reservoirs and their potential to differentiate to other cell lines, uncontrolled expression may have unknown outcomes. To make gene therapy of hemophilia more resembling to the nature, we supposed f8 promoter might be a good candidate for driving downstream f8 coding sequence. Materials and Methods: To test our hypothesis, we designed and constructed a DNA construct by PCR, which harbors EGFP coding sequence downstream to mouse f8 promoter and transfected it to a mouse hepatoma cell line. Transfection was assayed qualitatively by fluorescent microscopy. Results: Fluorescence was detected in transfected cells a sign of presence of EGFP. Conclusion: f8 promoter can drive expression of downstream genes, a capability which and may have potential to be used in gene therapy of hemophilia. A conclusion that should be examined by further studies. 173 178 173 http://ijp.iranpath.org/IJPArticles/6_4/24-2.pdf 173 Pejman Fard-Esfahani , Mehdi Kadivar , Mojgan Allahyari , Fatemeh Mirkhani

en Original Article Background and Objectives: In spite of large number of studies conducted so far, sudden cardiac death remains an enigma and relative importance of acute coronary events as a trigger of sudden death is currently unclear. An autopsy study of heart was therefore planned to observe various histomorphological cardiac changes, and to determine the frequency association of acute coronary events and myocardial infarction with sudden death. Material and Methods: A prospective randomized study of two hundred autopsied hearts submitted for postmortem analysis was conducted in the Department of Pathology, PGIMS Rohtak over a period of two and a half years from June 2007 to December 2009. The hearts were examined grossly and microscopically to observe various histomorphological changes and findings were correlated clinically. Results: Out of 200 autopsied hearts, 142 (71%) revealed coronary artery atherosclerosis in one or more vessels. Maximum number of cases (32.5%) revealed three vessel diseases. Significant atherosclerosis (>50% reduction in diameter) was present in 125 (62.5%) cases, while 58 cases (29%) revealed no observable atherosclerotic change. One hundred twenty cases could be categorized under sudden cardiac death, 15.83% revealed changes of acute MI, 40% of healed MI and 44% revealed no change. Conclusion: The ischemic heart disease was found to be the leading cause of death with coronary atherosclerosis being the most significant pathogenetic mechanism and three vessel disease the most common pattern of involvement. Acute coronary events (occlusive or non-occlusive thrombus/ plaque rupture/ haemorrhage) were observed in only 16% of the cases of sudden coronary death. 179 186 179 http://ijp.iranpath.org/IJPArticles/6_4/24-3.pdf 179 Marwah Nisha, Sethi Bhawna, Gupta Sumiti, Duhan Amrita, Singh Sunita, Sen Rajeev

en Original Article Background and Objective: As one of the widely used drugs, aspirin (acetyl-salicylic acid, ASA) plays an important role in stroke treatment and prevention. In a previous study, we demonstrated ASA injection at 30 min after ischemia onset is neuroprotective. To determine whether the neurons protected by ASA had a normal ultrastructure, hippocampal CA1 pyramidal neurons were examined by Transmission Electron Microscope (TEM). Material and Methods: Adult male wistar rats were divided into three different groups (6 animals/ group): Sham-operated, control (48 MCAO+vehicle) and aspirin (48 MCAO + ASA). ASA (30 mg/kg) was injected 30 min after ischemia onset. The animals were killed 2 days after ischemia induction and their brain removed, processed, and examined under a TEM. Results: Apoptotic changes were observed in rats not treated with ASA. In contrast, pyramidal neuron ultrastructure appeared normal in rats that exhibited neuroprotection (defined at the light microscope level) by ASA when studied two days after ischemia. Conclusion: We conclude that administration of ASA after permanent focal cerebral ischemia remains a considerable therapeutic strategy 187 192 187 http://ijp.iranpath.org/IJPArticles/6_4/24-4.pdf 187 Majid Asadi-Shekaari , Hassan Eftekhar Vaghefi , Masoud Ezzat Abadi pour , Vahid Sheibani , Ali Shams Ara , Parisima Behbahani

en Original Article Background and Objectives: Classic Hodgkin lymphoma (CHL), anaplastic large cell lymphoma (ALCL) and some cases of diffuse large B cell lymphoma (DLBCL) have overlapping morphologic features. Since they all represent distinct clinico-pathologic entities, we explored the differential diagnostic impact of immunophenotyping to discriminate between them. Materials and Methods: We included 61 cases diagnosed as CHL, ALCL, and anaplastic variant of DLBCL. We reviewed morphologic microscopic findings by conventional staining and immunohistochemistry (IHC) with antibodies against PAX-5, CD30, CD15, CD45, EMA, ALK-1, and LMP-1. Results: Fifty cases corresponded to CHL (81.97%), 4 cases to ALCL (6.56%), and 4 cases to DLBCL (6.56%) excluding 3 cases, which remained unclassifiable (4.92%). PAX-5 was expressed in 94% of CHL and 100% of DLBCL cases. LMP-1 was expressed in 52% of CHL and 25% of DLBCL cases. EMA was invariably expressed in all 4 cases of ALK+ALCL. It was expressed in 4/50 cases (8%) of CHL and in 2/4 cases (50%) of DLBCL. CD45 was expressed in all cases of ALCL and DLBCL but also in 3/50 cases (6%) of CHL. Conclusion: The differentiation between ALCL and CHL based on EMA and CD45 is not reliable. Utilization of PAX-5 in combination with other markers such as CD15 and LMP-1 is recommended. CD20 and PAX-5 are not too helpful in the differentiation of CHL and DLBCL, while CD15 and CD79a were found to be quite useful discriminative markers for this purpose. 193 201 193 http://ijp.iranpath.org/IJPArticles/6_4/24-5.pdf 193 Hamid Tabrizchee , Armita Esmaili , Sergio Cogliatti

en Original Article Background and Objectives: Infection with parvovirus may induce spontaneous abortion, nonimmune hydrops fetalis, and intrauterine death in full term infants. The aim of this study was to determine the frequency of parvovirus B19 in paraffin-embedded formalin fixed placental tissues in lost fetuses by PCR method and comparison with its frequency in healthy full term neonates as controls. Materials and Methods: In a case control study, thirty-one formalin fixed paraffin embedded placental tissue from autopsies related to fetal losses and also the same number of control cases were collected and the PCR for internal control and target sequence were performed. Results: Thirty-one subjects and 31 controls were enrolled and three out of 31 cases were positive for parvovirus (9.7%) using PCR. Hydropic changes were noted in two of positive cases for parvovirus. Conclusion: Parvovirus B19 infection during pregnancy may cause red precursor cells damage resulting in anemia and congestive heart failure. We suggest that studies with greater sample sizes are carried out to determine the frequency and management of parvovirus B19 infection because of timely diagnosis and transfusion of severe hydropic fetuses can reduce the risk of fetal death. 202 207 202 http://ijp.iranpath.org/IJPArticles/6_4/24-6.pdf 202 Reza Shahsiah , Maryam Monajemzadeh , Hasan Hoseinzadeh , Mohammad Taghi Haghi ashtiani , Sedigheh Hantooshzadeh , Alireza Alaei Alamooti , Fatemeh Mahjoub

en Case Report Extra-skeletal Ewing’s sarcoma is a rare soft tissue malignant neoplasm, morphologically indistinguishable from skeletal Ewing’s sarcoma. The usual sites of involvement are the soft tissues of para-vertebral region, chest wall, and lower extremity. Extra-skeletal Ewing’s sarcoma is rare in the head and neck region and very few cases are reported in the parotid gland. The cytological features of a case of extra-skeletal Ewing’s sarcoma involving the parotid gland, an extremely uncommon site for occurrence of this tumor, are reported here. The significance of the fine needle aspiration cytology lies in the early diagnosis and hence better prognosis of this lesion. 208 211 208 http://ijp.iranpath.org/IJPArticles/6_4/24-7.pdf 208 Divya Kota Nagappa, Jayashree Krishnamurthy

en Case Report Bronchiolo-alveolar carcinoma with subcutaneous chest wall metastasis is a very rare presentation. A case of 36- year-old male with metastatic subcutaneous chest nodule of bronchiolo-alveolar carcinoma, diagnosed by fine needle aspiration cytology, is reported here. Cutaneous metastases are of diagnostic importance because they may be the first manifestation of an undiscovered internal malignancy and indicates a poor prognostic sign. Fine needle aspiration cytology plays an important role in the early diagnosis of subcutaneous metastasis and helps to differentiate from other subcutaneous nodules like skin adnexal lesions, soft tissue tumors and inflammatory lesions. 212 215 212 http://ijp.iranpath.org/IJPArticles/6_4/24-8.pdf 212 Krishnamurthy Jayashree, Divya Kota Nagappa

en Case Report Tubal pregnancies are common but presence of hydatidiform mole in tube is a rare entity. A woman of 53years presented with acute abdomen, preoperative pregnancy test was positive and ultrasonography suspected the case as hydatidiform mole in right tube. The patient was treated with total abdominal hysterectomy with bilateral salpingo-oophorectomy as her family was completed. Subsequent histopathological examination showed ruptured complete hydatidiform mole in right tube. Postoperative period was uneventful with normalization of β-HCG titer within two weeks. 216 218 216 http://ijp.iranpath.org/IJPArticles/6_4/24-9.pdf 216 Mimi Gangopadhyay , Arghya Bandyopadhyay , Sailes Ray , Pranati Bera , Biswajit Dey

en Case Report Hydatid disease is endemic in some parts of the world. This disease can occur in any organ. We present a 22-year-old farmer who was suffering from hydatidosis for 4 years. He was admitted to the hospital because of fever, cough, and chest pain in 2004. A chest radiograph revealed multiple nodules in both of lungs. A transthoracic echocardiogram showed cystic lesion in the apex of right ventricle. IgG Ab ELISA for hydatid cyst was positive and albendazole was administrated. One year later, he was admitted to the hospital because of hemoptysis, a transthoracic lung biopsy was performed. Pathologic examination revealed laminated membrane of hydatid cyst in associated with fibrinoleukocytic exudates. Three years after the second admission, he was admitted to the hospital because of dyspnea. Iranian people especially who live in village need more information about the routes of prevention because therapy is difficult in some cases. 219 223 219 http://ijp.iranpath.org/IJPArticles/6_4/24-10.pdf 219 Mahshid Talebi –Taher , Seied Ali Javad –Moosavi , Alireza Sadeghi-pour , Shokofeh Hadj-sadeghi

en Case Report Chloroma or gr anulocytic sarcoma (GS) is a malignant neoplasm of myeloid lineage that occur in a variety of anatomic sites other than the bone marrow including soft tissue, bone, lymph node, nasal fossa, skin and sometime in the orbit. In the subconjunctiva it is rarely reported. A 4-year-old girl with a history of treated acute myelogenous leukemia was referred to Farabi Eye Hospital, Tehran, Iran for the evaluation of subconjunctival mass that was appeared since one month ago. Cell blood count (CBC) of the patient was normal except for Hb=7gm/dl. General physical examination was normal except for the signs of anemia. Histopathological evaluation of subconjunctival mass showed a malignant large round cell neoplasm. Immunohistochemical studies confirmed granulocytic sarcoma. Wh en confronting a large cell or undifferentiated round cell neoplasm, the possibility of myeloid sarcoma should be investigated. Myeloperoxidase (MPO), cluster designation (CD) molecules such as CD34, CD45, CD15, CD68 and lysozyme positivity or Leder staining are useful in this regard. 224 228 224 http://ijp.iranpath.org/IJPArticles/6_4/24-11.pdf 224 Fahimeh Asadi Amoli , Masoumeh Mohebbi , Amir Hossein Sina

en Letters to Editors 229 230 229 http://ijp.iranpath.org/IJPArticles/6_4/24-12.pdf 229 Viroj Wiwanitkit