Cutaneous mast cell tumours (MCTs) are the most common skin tumours in dogs. Due to the prevalence of canine MCTs and the variable biologic behavior of this disease, accurate prognostication and a thorough understanding of MCT biology are critical for the treatment of this disease. A cytologic diagnosis of mast cell tumor with evidence of prior hemorrhage was made, and the masses were surgically removed. Cytological evaluation of fine-needle aspirates from the cutaneous mass from the axillary comprised many well-differentiated, highly granulated mast cells with moderate numbers of eosinophils. Nuclei were varied in size and shape with high nuclear’to’cytoplasmic ratio, prominent nucleoli, marked atypical and mitotic figures. Microscopically, mass consisted of sheets of neoplastic round cells that formed nonencapsulated nodules in the dermis and infiltrated into the adjacent dermal collagen, and also there was diffuse subcutis invasion of round to pleomorphic tumor cells. Tumor cells had moderate to abundant cytoplasm, round to ovoid nuclei with scattered chromatin, and mitotic figures. In this tumor, cytoplasmic granules showed atypical metachromasia. In addition, eosinophils were scattered among the mast cells at the periphery of the nodules. The presence of eosinophils and the observation, at high magnification, of cells with cytoplasmic metachromatic granules. Invasion of the deep subcutaneous fat or cutaneous muscles were a common feature of grade III tumour. Finally, a diagnosis of grade III cutaneous mast cell tumor was made.Virtual slidesThe virtual slide(s) of this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4755249151157024.
BackgroundAtherosclerosis accounts for a large proportion of cardiovascular system associated morbidity and mortality. We studied the possible association between the histopathological changes of the coronary atherosclerotic lesions and the risk of sudden cardiac death (SCD) using autopsy cases.MethodsWe performed an autopsy analysis (n = 13, 4 women, 9 men mean age 67.5 years; age range 56–93 years) of SCD which occurred in patients aged over 50 years during March 2010 to December 2013. The following variables were considered: sex, age, medical history, autopsy findings to macroscopic and histological evaluation of the heart. The autopsies were performed according to standard techniques. In all subjects, the heart was dissected following standard autopsy protocol and a 5 cm section of the right coronary artery (RCA) in the atrio-ventricular groove from its origin, a 5 cm segment of the left anterior descending artery (LADA) distal to the origin of the circumflex artery, but including the region of origin of the circumflex branch and left coronary artery (LCA) from its origin till the circumflex branch were excised, dissected out, fixed in 10 % formalin, marked for identification and sent for histopathological analysis.ResultsAtherosclerotic plaques were identified in 6.5 % of specimens, 69.34 % of males and 30.66 % of female. Such plaques were typically concentric and more represented with necrosis, calcification, cholesterol crystals, and giant cells, as well as had a higher inflammatory cell count. Furthermore, intima and media thickness of coronary arteries were significantly higher in studied specimens with visualize the connective tissue layers of the adventitia and the fatty acid containing adipose cells in the periadventitial tissue. Furthermore, the degree of microscopic lesion of atherosclerosis increased proportionally with the increase in the intensity of lipid deposition and with the percentage of collagen in the atherosclerotic plaques.ConclusionIn this study, age estimate to be a risk factor for coronary atherosclerosis in individuals more than 50 years old and may be used to predict SCD. Altogether, an enhanced understanding of the pathobiologic processes responsible for atherosclerotic changes might allow for early identification of a high-risk coronary plaque and thereby provide a rationale for innovative diagnostic and/or therapeutic strategies for the management of coronary patients and prevention of acute coronary syndromes.
The early diagnosis of hepatocellular carcinoma is challenging because it requires specific biomarkers. It has been determined that deregulation or dysfunction of microRNAs (miRNAs) could contribute to development of cancer. The aim of this research was to evaluate the main role of tissue miRNAs as prognostic biomarkers for early diagnosis of hepatocellular carcinoma. We used quantitative real-time PCR to evaluate the level of miR-148b and miR-25 expressions in hepatocellular carcinoma (HCC) patients and normal tissues and their relationship with clinicopathological features and survival in HCC patients. Quantitative real-time PCR was observed that median relative expression of miR-148b decreased in tumors tissue compared with normal tissues (P<0.05), while overexpression of miR-25 was observed in HCC tissues in comparison with normal tissues (P<0.003). The results suggested that the low level of miR-148b expression was remarkably related to tumor-node-metastasis (TNM) stage (stages III and IV; P=0.024) and vein invasion (P=0.032). Nevertheless, there was no significantly relationship of miR-148b expression with other clinical factors including sex (P = 0.612), age (P=0.536), size of tumor (P=0.513), and hepatic cirrhosis (P = 0.417). Moreover, increased level of miR-25 expression was remarkably associated with TNM stage (P=0.013). Kaplan-Meier survival and log-rank test confirm that shorter overall survival was strongly linked to decreased expression of miR-148b (P=0.004), while high expression of miR-25 was associated with shorter time survival than that patient with low level of miR-25 expression (P = 0.027). The result of multivariate Cox proportional hazards model suggested that low miR-148b expression, high miR-25 expression TNM stage, and vein invasion were independently related to poor survival of HCC patients in terms of miR-148b and miR-25 (Tables 3 and 4). Our results indicated that downregulation of miR-148b could play a role as an independent prognostic factor in patients with HCC. Furthermore, miR-25 can be as a prognostic marker and high expression of miR-25 has predictive value for poor prognosis in HCC patients.
BackgroundGout is a metabolic disorder that results in hyperuricemia and the deposition of positively birefringent monosodium urate crystals in various parts of the body. The purpose of this study was to characterize the incidence and diagnostic features of visceral gout found at necropsy in two patients.Case presentationThe authors present an unusual report of untreated gout leading to major structure destructions in visceral organs. Gross post-mortem examination revealed a white powdery substance and display needle-like crystalline symmetry under the macroscopic on the visceral surfaces. Microscopically, the presence of crystalline deposits (urate tophi) were detected in visceral organs, such as; kidney, liver, lung and mesentery. Irrespective of its location, gout was observed, by H&E, as intracellular and extracellular eosinophilic deposits that compressed surrounding tissues. Moreover, numerous necrotizing granulomas of multifarious sizes were observed that were compounded by large aggregations of eosinophilic material (gout), surrounded by epithelioid macrophages, lymphoplasmacytic cells, foreign body multinucleated giant cells, fibrosis, fibroplasia and few edema. On the other hand, our results revealed that granulomatous nodules in the mesentery and kidney contained large numbers of gout foci compared with lung and liver. Furthermore, the immediate cause of death in these cases were not identified, but appeared to result from multiple factors, including the visceral gout due to unsuitable environmental conditions.ConclusionIn summary, we have identified a valid histopathologic damage index for use in laboratory studies of visceral gout. This system provides a feasible method of representing visceral damage in gout, and may allow for better understanding of the natural history, pathophysiology and the management of acute attacks of gouty visceral in this disease. Finally, to the best of our knowledge, understanding of the distribution of monosodium urate crystals within the body can aid clinical diagnosis and further understanding of the resulting pathology.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1293547351151638.
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