Background: Chronic gastritis (CG) is a very common disease. More than half of the worldwide population suffers from symptoms of CG. This disease has received great attention since the discovery of H. pylori as the most important cause of CG. Symptoms experienced by patients with CG are attributed to H. pylori-induced inflammatory reactions. Heparanase (HPSE) is a mammalian β-endoglucoronidase. In inflammation; HPSE degrades and remodels the extracellular matrix’s heparan sulfate polysaccharide chains liberating heparan sulfate-bound cytokines and chemokines, HPSE also facilitates movement of inflammatory cells. Aims: This study aimed to detect the function of HPSE in CG by correlating levels of HPSE expression with histopathological features of CG, including H. pylori infection, acute and chronic inflammatory cells, mucosal atrophic and/or metaplastic features. Methods: Ninety-five upper endoscopic-guided gastric punch biopsies were enrolled in this study. From each specimen, formalin-fixed and paraffin-embedded tissue blocks were prepared. Tissue sections were stained by Hematoxylin and eosin, Giemsa, and anti-heparanase antibody. Results: HPSE expression was statistically associated with H. pylori infection ( P-value < .000), and intensity of chronic lymphocytic inflammatory infiltrate in the gastric mucosal tissues ( P = .004). High levels of HPSE expression were also related to the presence of neutrophils in the gastric surface epithelium and lamina propria ( P-value < .009). Conclusions: HPSE expression was upregulated in H. pylori-associated chronic gastritis. Thus, future therapeutic agents that could specifically inhibit HPSE enzyme activity, may aid in the reduction of sequelae of H. pylori infection.
Background: Diagnosis of mycosis fungoides (MF) and its mimickers is a major diagnostic challenge in era of Dermatopathology. Objective: To draw a diagnostic stepwise approach to minimize this challenge focusing on the benign (unusual) mimickers of infectious etiology. Patients/methods: This retrospective study included 94 paraffin blocks of patients with clinical suspicious of MF or its mimickers, during the period from Jan 2019-July 2021. The hematoxylin and eosin (H&E) stained sections and their associated clinical presentations were reviewed. Ancillary studies were performed upon the preliminary clinical diagnosis of each case. Deeper serial sections with selected special stains were done for benign mimickers. Primary (CD3/CD4/CD7/CD68) and secondary (CD20/CD8/CD30) panels of immunohistochemistry (IHC) markers were performed for most of the cases. Results: A wide spectrum of MF mimickers was identified, our cases were categorized into 3 groups: the first is classic MF ( 24) and its variants (5), the second is benign mimickers [subgrouped into infectious (31) & non infectious (21)] and the third is heterogeneous group; (other lymphomas/parapsoriasis) (13). A suggested stepwise diagnostic approach with selected IHC panels characterizes each group. Conclusion:A constellation of diagnostic clinical data, diagnostic histopathological clues and the suggested stepwise approach minimize the misdiagnosis of classic MF and conclusively identify the infectious mimickers.
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