A Rare Malignant Tumor of Gall Bladder

A 35 yrs old lady presented with abdominal pain and loss of appetite. LFT, RFT and other Lab investigation were within normal limits.

Mdm2 and Egfr Expression and Prognosis in 16 Pulmonary Artery Sarcomas

There are few studies investigating the biomarker signatures and their relations with prognosis of pulmonary artery sarcoma patients. In the present study, we performed a cohort study on 16 cases of pulmonary artery sarcoma in an attempt to identify the potential diagnostic markers and molecular therapeutic targets of that vascular sarcoma. Patients who had undergone pulmonary artery sarcoma tumorectomy over 7 ½ years in our hospital were enrolled in this retrospective study. The resected tumors were analyzed by histopathology, the expression and mutation of Murine Double Minute 2 (MDM2), Epidermal Growth Factor Receptor (EGFR), and Platelet-Derived Growth Factor Alpha (PDGFRA) by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). The correlations between patients’ outcomes and tumor histological, IHC and FISH features were statistically analyzed. MDM2 immunostaining was seen mainly in intimal sarcoma. At univariate analysis, MDM2 expression had a positive correlation with shorter progression free survival (PFS). MDM2 and EGFR co-expression also had a positive correlation with shorter PFS and tumor metastasis. This study investigated MDM2, EGFR, and PDGFRA as potential biomarkers for diagnosis of pulmonary artery sarcoma and therapeutic targets.

Doppler Ultrasound in Prostate Cancer: It’s Utility for the Diagnosis of High-Grade Tumors

Purpose: The aim of the present study was to evaluate the association between prostate vascularization seen in Doppler ultrasound and histopathological grade (Gleason score) in patients with a diagnosis of prostate cancer. Methods: A Gleason score >7 was the dependent variable and Doppler ultrasound findings (vascular analysis, presence of nodule and prostate weight) were the independent variables. Univariate analysis was performed considering advanced tumors (Gleason >7) as the dependent variable and area of hypervascularization, age and PSA as the independent variables. Multivariate analysis was performed using a binary regression model with the occurrence of advanced tumors (Gleason >7) as the dependent variable. Results: In the univariate analysis, samples with Gleason ≤7 had a lower chance of being hypervascularized (OR: 0.44, 95% CI: 0.29-0.69), whereas those with Gleason scores >7 had a fourfold greater chance of being hypervascularized (OR: 4.136, 95% CI: 2.598-6.554, p<0.001). Moreover, hypervascularized tumors had a 7.4-fold greater chance of having a score >7. Conclusion: The present study reveals an association between tumor hypervascularization detected using Doppler ultrasound and higher Gleason scores (more aggressive tumors), enabling an indirect inference of a worse prognosis for hypervascularized prostatic tumors. These findings should be confirmed in longitudinal studies.

Rosai‐Dorfman‐Destombes Disease: A Clonal Histiocytic Neoplasm

Rosai‐Dorfman‐Destombes disease (RDD) has long been identified as a non-clonal histiocytic proliferation presenting with bulky lymphadenopathy. The recent decade has shown a significant paradigm shift in understanding the pathophysiology of histiocytic neoplasia. Mutations in genes causing constitutive activation of the MAPK/ERK pathway in nearly half of RDD cases have highlighted its clonal origin. Also, the knowledge of the pathway has led to the utilization of targeted therapy including MEK inhibitor cobimetinib in the management of refractory cases. We provide a brief review of the genetic analysis of sporadic RDD highlighting the utility of molecular analysis in clinical practice.

Gastrointestinal Stromal Tumors (GISTs) and Extragastrointestinal Stromal Tumors (E-GISTs) - A Review

GISTs (Gastrointestinal Stromal Tumors) are the most frequently encountered mesenchymal tumor of the gastrointestinal tract. Gastrointestinal stromal tumors have been recognized as a biologically distinctive tumor type, different from smooth muscle and neural tumors of the gastrointestinal tract (GIT). GISTs present 0.1%-3.0% of gastrointestinal malignant tumors. The goals in treating patients with GIST are to maximize the chance of cure, minimize recurrence. A multidisciplinary approach to patients with GISTs is necessary to optimize the timing of medical and surgical therapy as they have unpredictable behavior. Also long term follow up is essential for all patients, independent of their benign or malignant characteristics. This review highlight on clinical, diagnostic imaging, histopatholpgical, immunohistochemical ,new markers and management modalities for Gastrointestinal Stromal Tumors (GISTs) and Extragastrointestinal stromal tumors (E-GISTs).

Evaluation of the Effects of Ethanolic Extract of Sesamum Indicum Seeds on Sperm Morphology and Viability in KetoconazoleInduced Testicular Damage in Male Wistar Rats

Aim: The study was aimed at evaluating the effects of ethanolic extract of Sesamum indicum seeds on sperm morphology and viability in ketoconazole induced testicular damage in Wistar rats. Methods: Forty eight adult male Wistar rats were divided into eight Groups of six rats each. Groups 1,2,3,4,5,6,7 and 8 were administered 1ml of normal saline, 100 mg /kg body weight (bwt) of Ketoconazole only, 500 mg/kg bwt of ethanolic extract of sesamum indicum (EESI) seeds then100 mg/kg bwt of Ketoconazole, 100 mg/kg bwt of Ketoconazole then 250 mg /kg body weight of EESI seeds,100 mg/kg bwt of Ketoconazole then 500 mg/kg bwt of EESI, 100 mg/kg body weight of Ketoconazole then 0.36 mg/kg body weight of Mesterolone, 0.36 mg/kg body weight of Mesterolone, 500 mg/kg body weight of EESI respectively. All administrations were carried out orally once per day. The sperm smears were collected for semen analyses. Result: A significant increase in the abnormalities of sperm morphology and viability respectively were noted in the group administered ketoconazole alone (Group 2) compared with other experimental Groups (P ≤ 0.05). Conclusions: The administration of ethanolic extract of Sesamum indicum appeared to have minimized the damages and sperm deaths caused by ketoconazole which may be due to its androgenic properties.

COVID -19 Infection and the Steps to be Taken in a Medical Laboratory

COVID-19 is a contagious disease. This virus mainly infects throat and lungs. This disease spreads through the infected person’s cough, sneeze, respiratory droplets or contact of the person. If infected by this virus the symptoms which will be seen in the infected person are given

An Act of Futility, or Pascal’s Wager?

Futility is defined as something unimportant, useless, ineffective, without value or purpose, frivolousness, unable to solve problems. The definition of futility is clear and simple; the difficultly is its clinical application in the management of complex cases. The implications are different when dealing with medical or surgical patients. It is radically different when the decision of not doing any other efforts for the treatment of intractable heart failure or disseminated carcinomatosis or when we are dealing with surgical patients whose diseases carry very low opportunity of survival or of improvement in his general wellbeing. It is in the medical cases that the strategy of hanging the Crepe is used when trying to communicate to the relatives the gravity of their beloved ones illness. At times the physicians exaggerate the seriousness of the disease to lessen the suffering if eventually the patient dies. Crepe is a black piece of cloth forming a bow that used to be placed in the front door of the house to indicate the death and mourning of the relatives. This custom has been abandoned in almost all countries. Physicians undertake the utmost efforts in trying to preserve the life of their patients as well as to provide quality of life no matter the economic circumstances. In recent years I had two patients who were so sick that their condition gave the impression that their lives were close to an end. Nevertheless, after an operation deemed by some other physicians as futile, both patients recovered and are leading a normal lives for the past six and five years respectively.

Ameloblastic Fibrosarcoma an Uncommon Odontogenic Tumor of Right Maxilla

Ameloblastic Fibrosarcoma (AFS) is an uncommon mixed odontogenic tumor composed of a benign epithelial and a malignant ectomesenchymal component. We report a case of a 15 year old female presented with a history of painful swelling over right maxilla of 6 months duration. On examination showed an irregular greyish white solid mass measuring 4.5 x 3.4 cm. On radiograph CT Neck (plain and contrast) showed mass lesion in right maxillary sinus with erosion of its floor and extending into right gingivo-buccal space. Features suggestive of neoplastic pathology. The right subtotal maxillary resection was done. On histopathological evaluation showed an irregular greyish white solid mass measuring 4.1 x 3.4 x 3.3 cm. On cut section showed grey white fleshy tumor. On histopathology reported as ameloblastic fibrosarcoma. We are presenting this extremely rare case for its clinical, radiological and histopathological features.

TERT Promoter Mutation is a Diagnostic and Differential Diagnostic Marker for Tumors with Urothelial Origin

Telomerase reverse transcriptase (TERT) promoter mutations have been found in approximately 60–80% of bladder urothelial cancers and its variants of all grades anywhere in the urinary tract. The TERT promoter mutations occur early in urothelial neoplasia and are biomarkers for neoplasm development, recurrence, diagnosis, differential diagnosis, and potentially a therapeutic target. This review highlighted the role of TERT promoter mutations in urothelial tumorigenesis, and the potential clinical implications.