BACKGROUND:IDH1 (isocitrate dehydrogenase 1) mutation might be encounter in the low grade glioma and directs the progression of the tumor to a higher grade.OBJECTIVE:To assess the frequency of IDH1 mutations in gliomas and to correlate the IDH1 positivity with the type and grade of tumors, the age and sex of the patients.MATERIAL AND METHODS:A retro– and prospective case series study. One hundred and nine cases of intracranial gliomas were collected between 2008 and 2014 from Mosul Private Laboratories and Al-Jamboree Teaching Hospitals in Mosul. IDH1 mutations were assessed immunohistochemically using anti-IDH1 R132H mouse monoclonal antibody.RESULTS:IDH1 mutation was perceived in 34.86% of gliomas. In adult gliomas, the secondary glioblastoma and the low-grade astrocytoma had the greatest values of IDH1 positivity (88.88% and 62.5% respectively), followed by oligoastrocytoma/oligodendroglioma (50.0%), and anaplastic astrocytoma (47.36%). The primary glioblastomsa showed 17.64% IDH1 positivity. Males and females expressed the IDH1 equally. While, there was no role of IDH1 in pediatric gliomas.CONCLUSION:IDH1 mutation is commonly present in adult gliomas particularly in low-grade gliomas, and secondary glioblastoma, with equal sex distribution, but it has no role in pediatric gliomas.

Background: RIPASA scoring has been developed to replace the disappointingly low accuracy Alvarado score in Asian population for diagnosis of acute appendicitis. Objective of present study was to compare the RIPASA and Alvarado score in Arab population and determine their accuracy when applied to our patients in Egypt and Kingdom of Saudi Arabia (KSA).Methods: By applying the RIPASA and Alvarado scores to 100 patients from KSA, 100 patients from Egypt who presented to emergency with right iliac fossa pain. The decisions for appendicectomy were based on clinical judgment only. Histopathology as gold standard was correlated with both scores. ROC curve analysis, sensitivity, specificity, positive predictive value and negative predictive value, diagnostic accuracy for RIPASA and Alvarado system were calculated using SPSS version 20.Results: On comparing both the scoring system in patients of both hospital groups, we found that sensitivity of RIPASA scoring is greater than Alvarado scoring system 95.51% and 73.03% respectively in BTH group, and 97.56% and 79.27% respectively in KASH group, while the specificity of RIPASA scoring system is less than Alvarado scoring system 72.73% and 81.82% respectively in BTH group and 66.67% and 83.33% respectively in KASH group.Conclusions: In our Arab population the RIPASA score could be applied in diagnosis of acute appendicitis with higher sensitivity, NPV and diagnostic accuracy compared to the Alvarado score.

Objectives: 1-To determine the association between Hodgkin's lymphoma and Epstein-Barr virus. 2-To determine if it is related to certain age groups or specific histologic subtypes. 3-To compare the pattern with other developing or developed countries. Methods: Biopsies of seventy cases with Hodgkin's lymphoma were collected from the pathology laboratories. The clinical data, including the patient's age, sex, site of lymph node affected and the histological classification according to the REAL classification, were retrieved from the pathologic reports. Immunoperoxidase stains for LMP-1 were performed on 40 cases. Results: The mean age of all cases was 26.7 years, with a median of 25 years. There were 36 males and 34 females. The largest age group was seen in 15-40 years accounting for 68.5%. The third decade took the peak incidence (21/70, 30%). Nodular sclerosis Hodgkin's lymphoma was the most common subtype representing 58.5% of all the cases, followed by mixed cellularity (37.2% of cases). The lymphocyte depleted subtypes in 2.8%, whereas lymphocytic predominant seen in 1.4% of cases. Latent membrane protein-1 was observed in 37.5% of Hodgkin's lymphoma. The most frequent association was observed in lymphocytic depletion subtype (50%), followed by mixed cellularity subtype (45%). The least frequent association was in nodular sclerosis type (27.7%). The highest rate of EBV expression was seen in the pediatric age group (< 15 years; 66.6%) and the lowest rate was among young adults (15-40 years; 26.9%). Older age group (> 40 years) has a rate of EBV expression (50%) which is higher than the young adult patients, but lower than the pediatric age group. Epstein-Barr virus positive cases were mostly males (73.3%) compared to females (26.7%). Conclusion: Hodgkin's lymphoma in our locality, in comparison with earlier studies, shows changing pattern with a gradual trend to those of developed countries including peak age group and subtypes. Moreover, Epstein-Barr virus is seen in slightly more than one third of cases and mostly seen in childhood, mixed cellularity and lymphocytic depletion subtypes with a male predominance.

Objective:To evaluate the overexpression of Her-2/neu in patients with breast cancer in Mosul (both invasive and intraductal) against other prognostic parameters of mammary carcinomas, such as histological type, grade, tumor size, patient age and number of lymph nodes involved. Methods: This is a retrospective study conducted in the Pathology laboratory of Al-Jamhoori Teaching Hospital and at private laboratories. A total of 36 breast cancer cases and 4 benign cases were diagnosed and collected in a period spanning from April 2006 to April 2007. We used Immunohistochemistry to evaluate the overexpression of Her-2/neu against the age, tumor size, type and grade and the axillary lymph node status. Results: The mean age of all cases was 47.5 years ranging from 28 to 72 years. Regarding the age, Her-2 positivity was shown in 2 peaks (4 th and 7 th decades), while Her-2 negativity was found in older age group (p=0.004). Overall Her-2 overexpression was in 37% of the cases; it was overexpressed in 34.5% of invasive ductal carcinoma, in 100% of medullary carcinoma and in 100% of ductal carcinoma in situ. Whereas no expression (0.0%) was seen in 3 cases of invasive lobular carcinoma and one case of colloid carcinoma. Her-2 positivity was associated with large size (T2 and T3) rather than small size tumors (p=0.015). There was a correlation between Her-2 positivity and high grade tumor [G3 in 69.2% of the positive cases (p=0.045)]. Her-2 positivity was associated with axillary lymph node metastasis in 84.6% of cases, but not reaching a statistical significance. The benign lesions included in this study (two fibroadenoma, one fibrocystic disease and one duct ectasia) all showed negativity for Her-2 stain. Conclusion: Her-2 overexpression was found in 37% of breast cancer in Mosul. Regarding age incidence Her-2 overexpression was noted at 2 peaks 3 rd and 6 th decades. Large size and high grade breast carcinomas were associated with high percentage of Her-2 positivity, and the majority of Her-2 positive cases had axillary lymph node metastases.

Objective: To evaluate the frequency, age distribution and document the histological pattern of various hematological disorders reported in bone marrow biopsy. Methods: A retro and prospective study carried out from 2000 to 2007 at pathology laboratory of Irbil Razkary Hospital. A total number of 117 cases were investigated. The biopsy was taken from posterior superior iliac spine by the clinician. A length of 0.5 to 2 cm of marrow element was obtained, put overnight in 10% formalin for fixation, followed by decalcification in 5% nitric acid. Then processed in usual manner. Sections were examined by 2 pathologists independently. Results: the mean age of patients was 46.16 years ranging from 2 years to 76 years. The male to female ratio was 1.49:1. The commonest presenting clinical features of patients underwent bone marrow biopsy were pallor (91.4%), followed by body weakness (59.0%). The most frequent histological diagnoses in order of frequency were unremarkable bone marrow (28.20%), lymphoma (11.1%), acute leukemia, chronic myeloproliferative disorders (9.40%), chronic leukemia, (5.12%), multiple myeloma (3.42%), metastatic tumor (2.56%), myelodysplastic syndrome and megaloblastic anemia equally reported (1.71%), pure red cell aplasia and granulomatous inflammation were present in (0.85%).Acute leukemia was encountered mostly in 1 st and 2 nd decades of life. Lymphoma, chronic leukemia, chronic myeloproliferative disorders occur in 4 th and 5 th decades. Myelodysplastic syndrome presented in older age group 5 th and 6 th decades. Multiple myeloma and metastases were seen in 6 th and 7 th decades of life. Other disorders were randomly distributed. Conclusion: Bone marrow trephine biopsy is an invasive procedure with few known complications, but is a valuable diagnostic tool in the diagnosis, staging, management and follow up of various conditions both neoplastic and non-neoplastic. High percentage of cases in our study showed normal marrow finding, this may reflect overindication of marrow biopsy, such finding urge for more clinicopathological coordination and data analysis.