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 COMMENTARY 


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Published Date
October 26, 2017

Vol. 3, Issue 2

Pancreatic Adenocarcinoma: Role of the Site-Specific of Metastases

Vitorino Modesto dos Santos and Lister Arruda Modesto dos Santos

Corresponding author: Vitorino Modesto dos Santos, Department of Internal Medicine, Armed Forces Hospital, Catholic University, Estrada do Contorno do Bosque s/n, Cruzeiro Novo. CEP 70.658-900, Brasília-DF, Brazil

Pancreatic adenocarcinoma is a severe malignant condition with a median survival lower than one year, and a five-year survival rate of about 30%, including tumors resected at early stage. Recurrences within two years occur in up to 80% of the resected tumors. More than two thirds of advanced pancreatic adenocarcinomas have single site of metastases, mainly affecting the liver, lungs, bones and brain, by decreasing order of frequency.

Citation: dos Santos VM, dos Santos LAM (2017) Pancreatic Adenocarcinoma: Role of the Site-Specific of Metastases. Int J Pathol Clin Res 3:061. doi.org/10.23937/2469-5807/1510061



 Case Report 


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Published Date
October 25, 2017

Vol. 3, Issue 2

Empty Sella and Sagittal Sinus Thrombosis in a Woman with Subaortic Stenosise

Vitorino Modesto dos Santos, Rafaela Pinheiro Weiber, Rosana Aparecida Rodrigues Cardoso, Mariely Fernanda da Silva Helbingen and Bruno César Rodrigues do Amaral

Corresponding author: Vitorino Modesto dos Santos, PhD, Professor, Department of Internal Medicine, Catholic University of Brasília; Armed Forces Hospital, Estrada do Contorno do Bosque s/n, Cruzeiro Novo 70658-900, Brasília-DF, Brazil

Cerebral venous thrombosis is not a frequent condition and may follow unsuspected, with unspecific manifestations. Neuroimaging studies are mandatory in differential diagnosis, which includes arterial strokes and other benign and malignant causes of intracranial hypertension, headaches, seizures, and hemiparesis.

Citation: dos Santos VM, Weiber RP, Cardoso RAR, da Silva Helbingen MF, do Amaral BCR (2017) Empty Sella and Sagittal Sinus Thrombosis in a Woman with Subaortic Stenosis. Int J Pathol Clin Res 3:060. doi.org/10.23937/2469-5807/1510060



 Research Article 


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Published Date
October 13, 2017

Vol. 3, Issue 2

Decrease of Nitrergic Innervation in the Esophagus of Patients with Chagas Disease: Correlation with Loss of Interstitial Cells of Cajal

Rodolfo Duarte Nascimento, Patrícia Rocha Martins, Jacqueline Garcia Duarte and Débora d'Ávila Reis

Corresponding author: Débora d'Ávila Reis, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, CEP 31270-901, Minas Gerais, Brazil

The pathogenesis of megaesophagus in chronic Chagas disease, which is caused by infection with the parasite Trypanosoma cruzi is compelling. Individuals with megaesophagus often present achalasia and disturbances of peristalsis and neuronal loss.

Citation: Nascimento RD, Martins PR, Duarte JG, d'Ávila Reis D (2017) Decrease of Nitrergic Innervation in the Esophagus of Patients with Chagas Disease: Correlation with Loss of Interstitial Cells of Cajal. Int J Pathol Clin Res 3:059. doi.org/10.23937/2469-5807/1510059



 Case Report 


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Published Date
September 02, 2017

Vol. 3, Issue 2

Malignant Melanoma Arising in Association with Sinonasal Melanosis: A Case Report and Review of the Literature

Eric Ewing, Jeffrey B Jorgensen, Benjamin F Erhardt and Lester J Layfield

Corresponding author: Lester J Layfield, MD, Professor and Chair, Department of Pathology and Anatomical Sciences, University of Missouri, One Hospital Drive, M263 Medical Sciences Building, Columbia, MO 65212, USA

Malignant melanomas of the nasal mucosa represent approximately 1% of all melanomas and reported examples often arise in areas of pigmentation of the nasal mucosa. Melanin pigmentation has been reported to occur in the nasal glands and dendritic cells but melanomas arising from areas of pigmented (melanocyte containing) nasal glands have not been reported to our knowledge.

Citation: Ewing E, Jorgensen JB, Erhardt BF, Layfield LJ (2017) Malignant Melanoma Arising in Association with Sinonasal Melanosis: A Case Report and Review of the Literature. Int J Pathol Clin Res 3:058. doi.org/10.23937/2469-5807/1510058



 Review Article 


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Published Date
June 05, 2017

Vol. 3, Issue 1

The "Second Opinion Medical Network"

Palmieri B, Laurino C and Vadala Maria

Corresponding author: Vadalà Maria, Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Modena, Italy

The "Second Opinion Medical Network" is a consultation referral web and Medical Office System involving a wide panel of specialists to which patients affected by different diseases not adequately satisfied in terms of diagnosis and treatment can submit records and data for a clinical update.

Citation: Palmieri B, Laurino C, Vadala M (2017) The "Second Opinion Medical Network". Int J Pathol Clin Res 3:056. doi.org/10.23937/2469-5807/1510056



 Research Article 


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Published Date
May 29, 2017

Vol. 3, Issue 1

Aliskiren and Losartan Study in Non Diabetic CKD- A 3 Year Second Phase Follow up Study on Proteinuria

Keng-Thye Woo, Choong-Meng Chan, Stephanie Fook-Chong, Cynthia Lim, Jason Choo, Hui-Lin Choong, Suhail Mohamad, Han-Kim Tan, Kok-Seng Wong and Marjorie Foo

Corresponding author: Keng-Thye Woo, Department of Renal Medicine, Singapore General Hospital, Outram Road 169608, Singapore

This is a 6 year retrospective analysis of the therapeutic efficacy and safety of Combined Aliskiren (150 mg a day) and Losartan (100 mg a day) in non Diabetic Chronic Kidney Disease (CKD) patients. The objective of this Second (2nd) Phase study was to ascertain the proportion of patients who would remain in remission for the next 3 years and for those who had a relapse of proteinuria after stopping treatment in order to decide when would be an optimum time to stop therapy as well as to ascertain the effects of stopping therapy.

Citation: Woo KT, Chan CM, Fook-Chong S, Lim C, Choo J, et al. (2017) Aliskiren and Losartan Study in Non Diabetic CKD- A 3 Year Second Phase Follow up Study on Proteinuria. Int J Pathol Clin Res 3:055. doi.org/10.23937/2469-5807/1510055



 Review Article 


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Published Date
May 22, 2017

Vol. 3, Issue 1

Exosomes in the Pathogenic Protozoan Trypanosoma Cruzi

Wanderley de Souza and Emile Barrias

Corresponding author: Wanderley de Souza, Instituto de Biofísica Carlos Chagas Filho and Núcleo de Biologia Estrutural e Bioimagens-CENABIO, Instituto Nacional de Ciencia e Tecnologia em Biologia Estrutural e Bioimagens, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

Significant advances have recently occurred in the identification and characterization of different types of microvesicles released by eukaryotic cells into the extracellular space. Exosomes are one such type of these vesicles they originate from multivesicular bodies and have received much attention.

Citation: de Souza W, Barrias E (2017) Exosomes in the Pathogenic Protozoan Trypanosoma Cruzi. Int J Pathol Clin Res 3:054. doi.org/10.23937/2469-5807/1510054



 Case Report 


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Published Date
May 12, 2017

Vol. 3, Issue 1

Cystic Lymphangioma: an Uncommon Cause of Pediatric Abdominal Pain

Ivan Fernandez-Vega

Corresponding author: Dr. Ivan Fernandez-Vega, PhD, MD, Service of Anatomic Pathology, Hospital Universitario Central de Asturias, Avenida de Roma s/n, E-33011, Oviedo, Asturias, Spain

Lymphangiomas are benign congenital malformations characterized by an abnormal dilatation and proliferation of lymphatic spaces, which are found predominantly in children. Symptomatic mesenteric cyst accounts for only 1 in 20,000 in acute pediatric admission. We describe hereby a case of a previously healthy 6-year-old girl who presented acute three-day pain localized over the right upper abdominal quadrant due to intestinal obstruction.

Citation: Fernandez-Vega I (2017) Cystic Lymphangioma: an Uncommon Cause of Pediatric Abdominal Pain. Int J Pathol Clin Res 3:053. doi.org/10.23937/2469-5807/1510053



 Original Article 


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Published Date
February 20, 2017

Vol. 3, Issue 1

Aortopathy in Bicuspid Aortic Valve and Marfan Syndrome is Characterized by a Lack of Activation Potential of the Epicardium in the Ascending Aorta

Nimrat Grewal, Marie-Jose Goumans, Marco C DeRuiter, Robert JM Klautz, Robert E Poelmann, Barbara JM Mulder, Ad JJC Bogers, Adriana C Gittenberger-de Groot

Corresponding author: Adriana Gittenberger de Groot, Department of Cardiology, Leiden University Medical Center, Postal zone: S-5-24, P.O. Box 9600, 2300 RC Leiden, Netherlands, Tel: +31-71-526-3704/9306, Fax: +31-71-526-6809, E-mail: acgitten@lumc.nl

Patients with a bicuspid aortic valve (BAV) and Marfan syndrome (MFS) have increased susceptibility for development of aortopathy. In the heart, epicardial cells expressing Wilms tumor suppressor protein (Wt1) are known to become activated after myocardial infarction. We hypothesize that epicardium covering the aorta might show a similar response in BAV and MFS in pathologic conditions.

Citation: Grewal N, Marie-Jos G, DeRuiter MC, Klautz RJM, Poelmann RE, et al. (2017) Aortopathy in Bicuspid Aortic Valve and Marfan Syndrome is Characterized by a Lack of Activation Potential of the Epicardium in the Ascending Aorta. Int J Pathol Clin Res 3:051. 10.23937/2469-5807/1510051.



 Case Report 


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Published Date
January 12, 2017

Vol. 3, Issue 1

Chronic Traumatic Encephalopathy-like Neuropathological Findings without a History of Trauma

Andrew F Gao, David Ramsay, Richelle Twose, Ekaterina Rogaeva, Charles Tator and Lili-Naz Hazrati

Corresponding author: Dr. Lili-Naz Hazrati, Department of Laboratory Medicine, Hospital for Sick Children and the Canadian Concussion Centre, Black wing, 3rd floor, Room #3205, 555 University Avenue, M5G 1X8, Toronto, ON, Canada

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease characterized by neurocognitive decline and abnormal neuronal and glial deposition of hyperphosphorylated-tau in a pattern distinct from other tauopathies. These changes are hypothesized to occur following repeated mild traumatic brain injury. We report a case of CTE-like neuropathological changes, and features of motor neuron disease in a patient without history of either head trauma or participation in activities associated with increased risk of concussive or sub-concussive blows.

Citation: Gao AF, Ramsay D, Twose R, Rogaeva E, Tator C, et al. (2017) Chronic Traumatic Encephalopathy-like Neuropathological Findings without a History of Trauma. Int J Pathol Clin Res 3:050. 10.23937/2469-5807/1510050



 Case Report 


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Published Date
November 28, 2016

Vol. 2, Issue 4

A Case of Dedifferentiated Leiomyosarcoma of the Uterus

Kanae Nosaka, Hiroaki Komatsu, Tetsuro Oishi, Yasushi Horie, Tasuku Harada and Yoshihisa Umekita

Corresponding author: Yoshihisa Umekita, MD, PhD, Faculty of Medicine, Division of Organ Pathology, Department of Pathology, Tottori University, 86 Nishicho, Yonago, Tottori 683-8503, Japan

Dedifferentiation of leiomyosarcoma is a rare phenomenon that associates pleomorphic histology and loss of smooth muscle differentiation. Although the leiomyosarcoma is well known sarcoma in the uterus, and the dedifferentiated leiomyosarcoma is well recognized in the soft parts, there are only a few reports of dedifferentiation of leiomyosarcoma in the uterus. Herein we present a case of dedifferentiated uterine leiomyosarcoma and discuss its relation to the undifferentiated uterine sarcoma.

Citation: Nosaka K, Komatsu H, Oishi T, Horie Y, Harada T, et al. (2016) A Case of Dedifferentiated Leiomyosarcoma of the Uterus. Int J Pathol Clin Res 2:049.



 Case Report 


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Published Date
October 31, 2016

Vol. 2, Issue 4

A Battle against the Odds: Intensive Therapy in Thrombotic Storm

Priyanka Raheja, Pavel Olivera, Veronica Pons, Mercedes Perez, Joan Balcells, Romy Rossich and Amparo Santamaria

Corresponding author: Amparo Santamaria Ortiz, Hemostasis and Thrombosis Unit, Department of Hematology, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 109-119, 08035 Barcelona, Spain

Thrombotic storm (TS) is a rare life-threatening entity that is characterized by multiple thrombotic events affecting diverse vascular sites occurring over a short period of time (days to weeks). We describe a case of a young boy who developed extensive and rapidly progressive thrombosis which required intensive treatment that included the use of triple antithrombotic therapy, pharmacomechanical thrombectomy, systemic thrombolytic therapy, and the combined use of plasmapheresis and immunosuppression.

Citation: Raheja P, Olivera P, Pons V, Prez M, Balcells J, et al. (2016) A Battle against the Odds: Intensive Therapy in Thrombotic Storm. Int J Pathol Clin Res 2:048.



 Case Report 


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Published Date
October 30, 2016

Vol. 2, Issue 4

Intra-Abdominal Abscess Caused by Perforated Jejunal Diverticulitis: A Case Report

Sornsupha Limchareon, Chomsorn Suparuxjinda and Varachaya Sawasdeemongko

Corresponding author: Sornsupha Limchareon, M.D., Division of Radiology and Nuclear Medicine, Faculty of Medicine, Burapha University, 169 Longhard-Bangsaen Road, Saensook Subdistrict, Muang District, Chonburi, Thailand

Jejunal diverticulitis with complication is a rare entity. Diagnosis is usually made intra-operatively. A case of 46-year-old female with acute upper abdomen is presented. Computed tomography demonstrated jejunal perforation with abscess formation. Operative findings revealed perforating jejunal diverticulitis with abscess formation. Though jejunal diverticulitis is rare but should be included in the differential diagnosis of jejunal perforation.

Citation: Limchareon S, Suparuxjinda C, Sawasdeemongkol V (2016) Intra-Abdominal Abscess Caused by Perforated Jejunal Diverticulitis: A Case Report. Int J Pathol Clin Res 2:047.



 Case Report and Literature Review 


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Published Date
October 30, 2016

Vol. 2, Issue 4

Spontaneous Duodeno-Colic Fistula: A Case Report and Literature Review

Meizhuo Gao, Tie Wang, Lining Tian and Jinlu Zhao

Corresponding author: Dr. Meizhuo Gao, Department of General Surgery, The Forth Affiliated Hospital of Harbin Medical University, Nangang, Harbin, China

Duodeno-colic fistula is an unnatural connect between the duodenum and the colon, which occurs rarely with the onset in the middle-aged. This report summarized the clinical manifestation and surgical treatment of the sixth case of spontaneous duodenum-colic fistula and reviewed the published other five cases.

Citation: Gao M, Wang T, Tian L, Zhao J (2016) Spontaneous Duodeno-Colic Fistula: A Case Report and Literature Review. Int J Pathol Clin Res 2:046.



 Review Article 


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Published Date
October 03, 2016

Vol. 2, Issue 4

Evaluation of Hematologic Exams in Parturient Adolescents Assisted at a Public Hospital in Brazil

Ana Karina Marques Salge, Maria TheresaCeravolo Laguna Abreu, Janaina Valadares Guimaraes, Fabiola de Azevedo Mello, Renata Calciolari Rossi e Silva, Douglas Reis Abdalla, George Kemil Abdalla, Thaila Correa Castra, Marilia Cordeirode Souza, Livia Roberta Rodrigues Conceicao and Eumenia Costa da Cunha Castro

Corresponding author: Dr. Ana Karina Marques Salge, Nursing School, Goias Federal University, Goiania, Goias, Brazil

Pregnancy during adolescence is a high-risk condition that prompts research interest due to frequent obstetrics complications in this age group. We aimed to identify potentially significant hematologic alterations in parturient adolescent patients at a public hospital in Goiania, Goias State, Brazil. Data from the medical charts of 45 parturient adolescents (aged 10 to 19 years) seen from 2013-2014 were analyzed, including their hemogram results, neonatology records, and labor and delivery notes.

Citation: Salge AKM, Abreu MTCL, Guimaraes JV, Mello FdA, Silva RCRe, et al. (2016) Evaluation of Hematologic Exams in Parturient Adolescents Assisted at a Public Hospital in Brazil. Int J Pathol Clin Res 2:045.



 Review Article 


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Published Date
August 31, 2016

Vol. 2, Issue 3

Clinicopathological Study of Angiogenesis in Gastric Cancer

Evangeli S Lampri, Anna C Goussia and Niki J Agnantis

Corresponding author: Niki J Agnantis, MD, PhD, FRCPath, Emeritus Professor of Pathology, Department of Pathology and Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece

Many models of multistage tumorigenesis have been proposed to explain the conversion of a normal cell into a neoplastic one. In addition to all genetic and epigenetic changes, angiogenesis is necessary for the growth and expansion of tumors. Besides, no neoplastic lesion could not exceed the size of 2 mm if not supported by a rich vascular network.

Citation: Lampri ES, Goussia AC, Agnantis NJ (2016) Clinicopathological Study of Angiogenesis in Gastric Cancer. Int J Pathol Clin Res 2:044.



 Review Article 


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Published Date
August 31, 2016

Vol. 2, Issue 3

A Review of Carcinoma Ex-Pleomorphic Adenoma of the Salivary Glands

Saeedeh Khalesi

Corresponding author: Saeedeh Khalesi, Department of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran

One of the malignant forms of pleomorphic adenomas (PA) is carcinoma ex pleomorphic adenoma (CA-ex-PA). Carcinoma ex pleomorphic adenoma is an uncommon malignant tumor with high aggressive behavior and poor prognosis. However, there are a few studies in this topic in the recent literature. Furthermore, the lesions are uncommon and often have a difficult diagnosis by clinicians and pathologists, because the residual small PA component and various malignancy subtypes may be present. In this study, we reviewed the recent studies in about clinical, radiographical, histopathological and molecular features of CA-ex-PA.

Citation: Khalesi S (2016) A Review of Carcinoma Ex-Pleomorphic Adenoma of the Salivary Glands. Int J Pathol Clin Res 2:043.



 Review Article 


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Published Date
July 31, 2016

Vol. 2, Issue 3

Basaloid Salivary Gland-Analogue Tumors of the Mammary Gland: Clinicopathologic Assessment of a Rare Subtype

Andrew L Walls, Lavinia P Middleton, Adel K El-Naggar and Aysegul A Sahin

Corresponding author: Aysegul A Sahin, MD, Professor, Division of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

Salivary and mammary glands share common ontology, but variable prevalence of tumor subtype frequency. Common primary salivary gland-type tumors are rare and less recognized in breast. Analogous to primary basaloid salivary tumors, basaloid mammary carcinomas, as in primary salivary, exhibit a spectrum of features from benign to malignant. The rarity and unfamiliarity of these tumors may lead to diagnostic and management challenges.

Citation: Walls AL, Middleton LP, El-NaggarAK, Sahin AA (2016) Basaloid Salivary Gland-Analogue Tumors of the Mammary Gland: Clinicopathologic Assessment of a Rare Subtype. Int J Pathol Clin Res 2:042.



 Short Commentary 


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Published Date
June 30, 2016

Vol. 2, Issue 3

Images and Text Operation Records: Xi'an Agreement

Xiaopeng Yan, Liang Han, Xuemin Liu, Lin Fan, Zheng Wu and Yi Lv

Corresponding author: Yi Lv, MD, PhD, Department of Hepatobiliary Surgery, First Affiliated Hospital, Xi'an Jiaotong University, 277 Yanta West Road, Xi'an Shaanxi Province, China

Operation notes are a very important part of a patient's medical record. They not only record the operation process during the surgery, but also objectively describe the organs lesions. They play a useful role in the referral disease communication, pathological diagnosis, medical practice education, and cases review. However, the current operation notes are hand-written texts therefore many deficiencies as follows: 1. It is difficult to describe the difficult and complicated operation process accurately with the hand-writte notes; 2. It is hard to objectively describe the degree of pathological changes of complex lesions and the relationship with the surrounding organs, which may reduce the basic value of the operation notes. It difficult for pathology doctors to comprehensively understand the disease and make an accurate diagnosis.

Citation: Yan X, Han L, Liu X, Fan L, Wu Z, et al. (2016) Images and Text Operation Records: Xi'an Agreement. Int J Pathol Clin Res 2:041.



 Short Communication 


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Published Date
June 30, 2016

Vol. 2, Issue 2

Hypercholesterolemic Diet: Its Effect on Colorectal Precancerous Lesions Induced by Dimethylhydrazine

Franciane da Silva Franca, Rodrigo Zeni Cora, Helena Cristina Ferreira Franz and Flavia Martinello

Corresponding author: Flavia Martinello, Departamento de Analises Clinicas, Centro de Ciencias da Saude, Campus Reitor Joao David Ferreira Lima, Universidade Federal de Santa Catarina, sala 109, Trindade, Florianopolis, Santa Catarina, 88040-970, Brazil

Objective: Evaluate the effects of dietary cholesterol, without the addition of cholic acid in the initial stage of carcinogenesis and on the bifidobacteria into the colon. Methods: Rats were grouped according to their diets and dimethylhydrazine treatment (DMH): standard diet (CN); CN + cholesterol 1% (CHOL); CN + DMH (CNDMH) and CN + cholesterol 1% + DMH (CHOLDMH). After eight weeks of treatment were analyzed weight gain, faecal pH, lipid profile, hepatic and faecal cholesterol, faecal bifidobacteria, cell proliferation and the pre-neoplastic colorectal lesions (aberrant crypt foci (ACF)).

Citation: Franca FDS, Cora RZ, Franz HCF, Martinello F (2016) Hypercholesterolemic Diet: Its Effect on Colorectal Precancerous Lesions Induced by Dimethylhydrazine. Int J Pathol Clin Res 2:040.



 Review Article 


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Published Date
May 30, 2016

Vol. 2, Issue 2

Japanese Crisis of HPV Vaccination

Masayuki Sekine, Risa Kudo, Sosuke Adachi, Manako Yamaguchi, Yutaka Ueda, Tomomi Takata, Akiko Morimoto, Yusuke Tanaka, Asami Yagi, Etsuko Miyagi and Takayuki Enomoto

Corresponding author: Masayuki Sekine, MD, PhD, Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Science, Niigata 951-8510, Japan

Cervical cancer has been increasing in younger generation, especially in 20's and 30's, so it has been a serious problem that the disease leads to loss of fertility as an urgent issue in Japan. HPV vaccine was added to the national list of routine vaccinations for Japanese girls aged 12 to 16 years by law since April, 2013. Three months later, however, the Japanese Ministry of Health, Labour, and Welfare suspended recommendations for HPV vaccination after several reports of possible adverse events.

Citation: Sekine M, Kudo R, Adachi S, Yamaguchi M, Ueda Y, et al. (2016) Japanese Crisis of HPV Vaccination Int J Pathol Clin Res 2:039.



 Letter to the Editor 


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Published Date
May 25, 2016

Vol. 2, Issue 2

Myofibroblasts Role in Wound Healing of Εyelid Lesions

Trisevgeni Ntinioti, Georgia-Heleni Thomopoulou, Eugene Danas, Nikolaos G Kavantzas, Emmanuel Agapitos and Andreas C Lazaris

Corresponding author: Trisevgeni Ntinioti, MD, Doctoral fellow, 2nd Department of Ophthalmology, 'Attikon' General Hospital, School of Medicine, National and Kapodistrian University, Chaidari, Athens, Greece

In injured tissues, the repair of the extracellular matrix is organized by activated myofibroblasts. The latter cells support harmonious mechanical tissue organization. At the end of the normal repair process, myofibroblasts disappear by apoptosis but in pathological situations, myofibroblasts likely remain leading to excessive scarring. The eyelids are movable folds of tissue the core of which is represented by a tarsal plate, composed of dense connective tissue, embedded in loose connective tissue. Τhe correlation between the healing process of surgically treated eyelid lesions and histological parameters is worth investigating.

Citation: Ntinioti T, Thomopoulou GH, Danas E, Kavantzas NG, Agapitos E, et al. (2016) Myofibroblasts Role in Wound Healing of Εyelid Lesions. Int J Pathol Clin Res 2:038.



 Case Report 


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Published Date
May 25, 2016

Vol. 2, Issue 2

Atypical Retinal Arterial Macroaneurysm

Hans Hoerauf, Philipp Steven and Nicolas Feltgen

Corresponding author: Hans Hoerauf, Department of Ophthalmology, University of Goettingen, 37075 Gottingen, Germany

A patient with an atypical retinal arterial macroaneurysm masked by a persistent vitreous haemorrhage mimicking a neoplasm is presented. During vitrectomy a pigmented peripapillary tumour located at large vessels with circinate lipid exsudates was detected. Examination of removed tissue revealed haemosiderin-loaded macrophages resulting in pigmentation. The histologic finding of phagocytosis of intraretinal blood remnants allowed to diagnose an atypical retinal arterial macroaneurysm.

Citation: Hoerauf H, Steven P, Feltgen N (2016) Atypical Retinal Arterial Macroaneurysm. Int J Pathol Clin Res 2:037.



 Review Article 


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Published Date
May 25, 2016

Vol. 2, Issue 2

BRAF V600E Immunohistochemistry in Cutaneous Langerhans Cell Histiocytosis: An Analysis of 20 Cases

Ryan C Romano, Wonwoo Shon, Sarah M Jenkins and Karen J Fritchie

Corresponding author: Ryan C. Romano, D.O., Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA

Twenty dermatologic biopsy specimens from 14 patients (9 adults and 5 children) were retrieved. All cases were immunostained with BRAF mutation-specific antibody. Selected BRAF V600E IHC-positive cases were analyzed for BRAF V600E mutation by pyrosequencing. Clinical parameters were correlated with IHC status. BRAF V600E protein overexpression was identified in 15 of 20 (75%) cases (9/14 patients; 5 adults and 4 children). All pediatric patients with bone involvement were BRAF V600E IHC positive. 4/5 (80%) patients without BRAF V600E expression had CNS involvement (p = 0.02). The presence of BRAF V600E mutation was identified in 1/5 (20%) BRAF V600E IHC-positive cases.

Citation: Romano RC, Shon W, Jenkins SM, Fritchie KJ (2016) BRAF V600E Immunohistochemistry in Cutaneous Langerhans Cell Histiocytosis: An Analysis of 20 Cases. Int J Pathol Clin Res 2:036.



 Case Report 


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Published Date
April 30, 2016

Vol. 2, Issue 2

Severe Complication of POPS: Mesh Malposition in the Bladder

Sabine Kersting, Dirk Kusche, Klaus-PeterJung and Eugen Berg

Corresponding author: Sabine Kersting, Department of Coloproctology, Prosper-Hospital, Muhlenstr 27, 45659 Recklinghausen, Germany

The authors present a case of a 68-years-old woman suffering of persistent urinary tract infections accompanied by intermittent fever. She had a history of pelvic organ prolapse suspension (POPS) for descending perineal syndrome with rectal prolapse, carried out elsewhere 15 months ago. Cystoscopy revealed a part of the prolene mesh that was incrusted along the fundus of the bladder to be the source of symptoms. This is probably the first case that reports a complication of POPS, which is a relative new surgical technique that gains more and more widespread use. At present no data exist about long-term results and complications. Although POPS is a minimally invasive procedure our case report shows that the risk of serious complications has to be taken in mind.

Citation: Kersting S, Kusche D, Klaus-Peter J, Berg E (2016) Severe Complication of POPS: Mesh Malposition in the Bladder. Int J Pathol Clin Res 2:035.



 Case Report and Literature Review 


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Published Date
April 30, 2016

Vol. 2, Issue 2

Opana-Induced Renal and Hepatic Injury: A Case Report and Review

Yahya M Kurdi, Sergey Brodsky and Martha Yearsley

Corresponding author: Yahya M Kurdi, MD, MS, Akron General Avenue, Department of Internal Medicine, Akron General Medical Center, Akron, OH, USA

A 34-year-old Caucasian female presented with headache, fatigue, mild abdominal pain, and dehydration. She admitted to intravenous abuse of "melted" Opana ER tablets (extended-release oral formulation of oxymorphone hydrochloride). Noted clinical signs included tachycardia, tachypnea, and trace peripheral edema. Abnormal laboratory tests included low creatinine clearance, hemoglobin, hematocrit, and platelet. Histological studies of hepatorenal biopsies showed evidence of severe active thrombotic microangiopathy (TMA) involving the arterioles and small arteries of the kidney and scattered portal and lobular granulomata and hepatic vascular changes involving the hepatic artery branches in some portal tract. To our knowledge of the published English literature, this is probably the first case report of Opana induced thrombotic microangiopathy (TMA) with evidence of histological involvement to both the kidney and the liver.

Citation: Kurdi YM, Brodsky S, Yearsley M (2016) Opana-Induced Renal and Hepatic Injury: A Case Report and Review. Int J Pathol Clin Res 2:034.



 Case Report and Literature Review 


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Published Date
April 01, 2016

Vol. 2, Issue 2

Anaplastic Large Cell Lymphoma as a Potential Diagnostic Challenge and Pitfall in Aspiration Biopsies of Thoracic Tumours

Justin Bateman, Celeste Morley, Bruce F. Burns and Shahid Islam

Corresponding author: Shahid Islam, MD, PhD, FRCPC, FCAP, The Ottawa Hospital, General Campus Site, Critical Care Wing, 501 Smyth Road, K1H 8L6, Ottawa, ON, Canada

The patient is a 54 year-old male who presented in January 2015 with increasing dyspnea and weight loss over several months, eventually requiring intubation and admission to ICU for respiratory failure. He had a remote history of testicular seminoma and 'melanoma'. A trans-bronchial Wang needle aspirate biopsy of the right sub-carinal lymph node was preformed and showed sheets of large malignant cells with pleomorphic nuclei, multiple prominent nucleoli, and abundant cytoplasm. The tumour cells are positive for CD45, CD3, CD30 and ALK-1.

Citation: Bateman J, Morley C, Burns BF, Islam S (2016) Anaplastic Large Cell Lymphoma as a Potential Diagnostic Challenge and Pitfall in Aspiration Biopsies of Thoracic Tumours. Int J Pathol Clin Res 2:033.



 Review Article 


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Published Date
April 01, 2016

Vol. 2, Issue 2

Epigenomic Explanations for the Uncertainty of Cancer Biomarkers

Shou-Tung Chen, Chia-Chen Hsu, Yu-Wei Leu and Shu-Huei Hsiao

Corresponding author: Shu-Huei Hsiao, PhD, Human Epigenomics Center, Department of Life Science, Institute of Molecular Biology and Institute of Biomedical Science, National Chung Cheng University, 168 University Drive, Min-Hsiung, Chia-Yi, 62102, Taiwan

Inheritable epigenetic modifications, like histone modifications and DNA methylation, were once considered somatically stable and tissue-specific, yet accumulating evidence suggests the contrary. Environmental encounters are transduced into the cell through signaling pathways and these signals are relayed to the nucleus and memorized as epigenetic marks on target genes. Signaling-specific epigenomic changes provide selectable outlines for further lineage determination during differentiation and serve as traceable biomarkers of specific signaling pathways during transformation. Current "big data" interrogation employs signal-specific reduction methods to identify epigenetically modified genes as possible signal targets.

Citation: Shou-Tung C, Chia-Chen H, Yu-Wei L, Shu-Huei H (2016) Epigenomic Explanations for the Uncertainty of Cancer Biomarkers. Int J Pathol Clin Res 2:032.



 Mini Review 


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Published Date
April 01, 2016

Vol. 2, Issue 2

BerEP4 and AE1/3 are Reliable Markers of Epithelial Content for Biomarker Discovery Using Reverse Phase Protein Arrays (RPPA)

Ola H Negm, James C Hassall, Wakkas Fadhil, Alain Pitiot, Patrick J Tighe, Cedric Marchessoux and Mohammad Ilyas

Corresponding author: Mohammad Ilyas, Academic Unit of Molecular Pathology, The University of Nottingham, Queen's medical centre, Nottingham NG7 2UH, UK

Biomarker studies are notorious for their high failure rate. Despite huge investment by both academia and industry, very few biomarkers make the transition from interesting laboratory data to tests with clinical utility. The reasons for this are manifold. Some biomarkers are "true" biomarkers inasmuch as they are robust and reproducible but the information they provide does not help to improve patient management beyond that informed by traditional clinical parameters.

Citation: Negm OH, Hassall JC, Fadhil W, Pitiot A, Tighe PJ, et al. (2016) BerEP4 and AE1/3 are Reliable Markers of Epithelial Content for Biomarker Discovery Using Reverse Phase Protein Arrays (RPPA). Int J Pathol Clin Res 2:031.



 Mini Review 


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Published Date
March 29, 2016

Vol. 2, Issue 1

Reduced and Thinned Elastic Fibers in Skin Tag

Ahmed Abdullah Alhumidi

Corresponding author: Ahmed Abdullah Alhumidi, Associate professor, and consultant of pathology and dermatopathology, Department of pathology, King Khalid university hospital, College of medicine, King Saud University, Riyadh 11461, Saudi Arabia

This is a retrospective study in which thirty histopathological specimens of fibroepithelial polyp (skin tag) were examined. Their paraffin blocks were collected from the archives of the Pathology Department, king khalid University hospital, Riyadh, Saudi Arabia, during the period from 2010 to 2012. Age of the patient, sex, and site, of the lesions as well as type of skin tag were recorded. Sections from each paraffin block were cut by a microtome at 5-micron thickness, stained with hematoxylin and eosin for histopathologic revision and with elastic-van Gieson stain for dermal elastic fiber evaluation.

Citation: Alhumidi AA (2016) Reduced and Thinned Elastic Fibers in Skin Tag. Int J Pathol Clin Res 2:030.



 Mini Review 


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Published Date
February 29, 2016

Vol. 2, Issue 1

Micronutrients Deficiencies in Rheumatoid Arthritis Patients

Graziela Biude Silva, Bruna Zavarize Reis and Silvia Maria Franciscato Cozzolino

Corresponding author: Graziela Biude Silva, Faculdade de Ciencias Farmaceuticas, Universidade de Sao Paulo, AvProf Lineu Prestes, 580, Bloco 14, 05508-000 Sao Paulo, SP, Brazil

Rheumatoid arthritis (RA) is a chronic inflammatory disease that predominantly involves synovial joints and affects up to 2% of adults worldwide. Poor nutrient status in RA patients has been reported and some drug therapies, such as nonsteroidal anti-inflammatory drugs (NSAIDs), prescribed to alleviate RA symptoms, may increase the requirement for some nutrients and reduce their absorption. The importance of micronutrients in this disease is related to their cofactor role in immune system functions and in different metabolic processes in articular tissues.

Citation: Silva GB, Reis BZ, Cozzolino SMF (2016) Micronutrients Deficiencies in Rheumatoid Arthritis Patients. Int J Pathol Clin Res 2:029.



 Mini Review 


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Published Date
February 29, 2016

Vol. 2, Issue 1

Research Progress of STK33 in Cancer Biology

Chen Chen and Jianfeng Li

Corresponding author: Jianfeng li, Department of Otolaryngology-Head and Neck Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, P.R. China

In recent years, serine/threonine kinase 33 (STK33) has attracted considerable attention in tumor biology. STK33 displays a heterogenous expression pattern, and in most tissues, expression level is low. It belongs to the CAMK family, and differentiates itself from other members of the CAMK family due to its expression pattern. STK33 is likely to participate in the dynamic changes of intermediate filament cytoskeleton depolymerization by phosphorylating vimentin, and thereby influencing the cell structure and a series of important functions.

Citation: Chen C, Li J (2016) Research Progress of STK33 in Cancer Biology. Int J Pathol Clin Res 2:028.



 Mini Review 


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Published Date
February 29, 2016

Vol. 2, Issue 1

JAK2V617F Mutation Affects Downstream LIN28A and HMGA2 Methylation in Myeloproliferative Neoplasms

Chih-Cheng Chen, Chia-Chen Hsu, Kuan-Der Lee, Chia-Chen Chiu, Hong-Chi Chen, Tim H.-M. Huang, Yu-Wei Leu and Shu-Huei Hsiao

Corresponding author: Shu-Huei Hsiao, Human Epigenomics Center, Department of Life Science and Institute of Molecular Biology, National Chung Cheng University, 168, University Rd., Min-Hsiung, Chiayi, Taiwan

The lineage/clonal selection theory for cellular transformation may help identify the effector genes whose functions are crucial for MPN tumorigenesis. MPNs originate from hematopoietic stem cells carrying compartmental mutations such as JAK2V617F. JAK2 signaling regulates target gene expression by altering the phosphorylation and nuclear localization of STATs. To provide selectable gene expression that promotes transformation of certain cellular lineages, specific signals relayed to the cell nucleus could be memorized as heritable codes such as epigenetic modifications.

Citation: Chih-Cheng C, Chia-Chen H, Kuan-Der L, Chia-Chen C, Hong-Chi C, et al. (2016) JAK2V617F Mutation Affects Downstream LIN28A and HMGA2 Methylation in Myeloproliferative Neoplasms. Int J Pathol Clin Res 2:027.



 Mini Review 


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Published Date
February 26, 2016

Vol. 2, Issue 1

The Cardiovascular Risk Prognostication in Diabetes Mellitus: The Role of Myeloid-related Protein Complex Calprotectin

Alexander E. Berezin

Corresponding author: Alexander E. Berezin, Professor, MD, PhD, Consultant of Cardiology Unit, Internal Medicine Department, State Medical University, 26, Mayakovsky av, Zaporozhye, Ukraine

The low-intense inflammation is discussed as a one of the clue of various faces of pathogenesis of diabetes mellitus (DM) including insulin resistance, mitochondrial dysfunction, lipotoxity, oxidation injury that contributed in cardiovascular (CV) disease and clinical outcomes. However, there are a lot of candidates for on early biological marker that could stratify DM patients at CV risk. The myeloid-related protein 8/14 known as calprotectin is a heterodimeric complex of calcium-binding proteins, which is predominantly expressed in activated human neutrophils, monocytes, adipocytes, and innate immunity cells including macrophages, but not in normal tissue macrophages.

Citation: Berezin AE (2016) The Cardiovascular Risk Prognostication in Diabetes Mellitus: The Role of Myeloid-related Protein Complex Calprotectin. Int J Pathol Clin Res 2:026.



 Commentary 


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Published Date
February 26, 2016

Vol. 2, Issue 1

Integration to Advance Translation

Estela S. Estape

Corresponding author: Estela S. Estape, MT, PhD, FASAHP, DHL, Director and Principal Investigator, Post-doctoral Master of Science in Clinical and Translational Research (MSc) and Hispanics in Research Capability (HiREC) Endowment Programs, School of Health Professions and School of Medicine, Medical Sciences Campus-University of Puerto Rico, PO Box 365067, San Juan, PR, 00936, USA

The science of translation has been taken over very fast by health stakeholders such as: investors, shareholders, sponsors, practitioners or any interested party in healthcare. The main reason is the demand to transfer discoveries faster to the ones who are in most need: the participants or patients. Translation can be seen as the art of transferring scientific knowledge into evidenced based everyday practice; paving the way to increased effectiveness and efficiency in health care. The concept of translation is not new. We can find many definitions, descriptions such as bench to bedside, classifications such as the T's, designations like Implementation Science or other characterizations; all according to the framework of the ones who are trying to explain and apply the concept.

Citation: Estape ES (2016) Integration to Advance Translation. Int J Pathol Clin Res 2:025.



 Perspective 


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Published Date
February 26, 2016

Vol. 2, Issue 1

Transforming the 24/7 Clinical Laboratories - Design Considerations, Workflow and Relocation to New Diagnostics Building

Ng Wai Yoong and Yeo Chin Pin

Corresponding author: Ng Wai Yoong, Department of Pathology, Clinical Biochemistry Laboratories, Academia, Diagnostics Tower, 20 College Road, Singapore 169856, Singapore

Laboratory services in Singapore General Hospital (SGH), a national referral centre, acute tertiary and teaching hospital has changed through the years with its beginning since 1821 and as a modern hospital in 1926. An opportunity to design new facilities to transform the delivery of clinical tests and embrace future challenges came up with the confirmation of a new purpose-built Pathology building in 2009.

Citation: Yoong NW, Pin YC (2016) Transforming the 24/7 Clinical Laboratories - Design Considerations, Workflow and Relocation to New Diagnostics Building. Int J Pathol Clin Res 2:024.



 Review Article 


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Published Date
February 07, 2016

Vol. 2, Issue 1

Glutamate Concentrations in Plasma and CSF in Patients with Glioma and Meningioma

George Dimogerontas, Alexia Polissidis, Petros Karkalousos, Epameinondas Konstantinidis, Zeta Papadopoulou-Daifoti and Charis Liapi

Corresponding author: Charis Liapi, MD, PhD, Endocrinologist, Associate Professor of Pharmacology, Medical School, National and Kapodistrian University of Athens, Greece

Glioma, a malignant intra-axial brain tumor, can release glutamate that facilitates tumor expansion, stimulates tumor-cell proliferation and motility and promotes epileptic activity. Glutamate acid is the major excitatory neurotransmitter in the mammalian Central Nervous System. We explore correlations of glutamate concentrations in blood and cerebrospinal fluid in patients with glioma in comparison to patients with meningioma which is the most common benign cerebral tumor.

Citation: Dimogerontas G, Polissidis A, Karkalousos P, Konstantinidis E, Papadopoulou-Daifoti Z, et al. (2016) Glutamate Concentrations in Plasma and CSF in Patients with Glioma and Meningioma. Int J Pathol Clin Res 2:023.



 Review Article 


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Published Date
February 03, 2016

Vol. 2, Issue 1

Potential Clinical Applications of Next Generation Fluorescence Immunohistochemistry for Multiplexed and Quantitative Determination of Biomarker in Breast Cancer

Hiroshi Tada, Kohsuke Gonda, Minoru Miyashita and Noriaki Ohuchi

Corresponding author: Hiroshi Tada, MD, PhD. Department of Surgical Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan

Assessing breast cancer tissues for expression of multiple biomarkers, such as the estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki67, provides critical information for patient management. However, the predictive power of these biomarkers for the selection of personalized therapeutic approaches is still limited. Application of fluorescence immunohistochemistry (IHC) has offered some promising breakthroughs in the multiplexed imaging and quantification of biomarker expression and may improve the sensitivity and reliability of clinical diagnostics.

Citation: Tada H, Gonda K, Miyashita M, Ohuchi N (2016) Potential Clinical Applications of Next Generation Fluorescence Immunohistochemistry for Multiplexed and Quantitative Determination of Biomarker in Breast Cancer. Int J Pathol Clin Res 2:022.



 Review Article 


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Published Date
February 01, 2016

Vol. 2, Issue 1

Intracellular Effectors of Synaptic Dysfunction and Neuroinflammation in Alzheimer's and other Neurodegenerative Diseases

Zen Kouchi

Corresponding author: Zen Kouchi, Department of Pathology, Institute for Developmental Research, Aichi Human Service Center, 713-8 Kamiya-cho, Kasugai-city, Aichi 480-0392, Japan

Synaptic morphogenesis and plasticity are regulated by neuronal activity to form efficient neuronal networks based on somatosensory inputs or behavioral experiences. Enhanced neuronal activity triggers reorganization of the actin cytoskeleton in presynaptic compartments and induces coordinated changes in apposed postsynaptic density with actin dynamics. Numerous cell-adhesion molecules are involved in these processes, and classical cadherins are most characterized and important for synaptic formation or dendritic arborization.

Citation: Kouchi Z (2016) Intracellular Effectors of Synaptic Dysfunction and Neuroinflammation in Alzheimer's and other Neurodegenerative Diseases. Int J Pathol Clin Res 2:021.



 Case Report 


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Published Date
January 29, 2016

Vol. 2, Issue 1

A De Novo Malignant Mixed Tumor (Carcinosarcoma) of the Parotid Gland: Case Report

Hussam F Tallab, David E Ricklan and Peter J Catalano

Corresponding author: Hussam F Tallab, Clinical Associate, Department of Otolaryngology, St. Elizabeth's Medical Center/Tufts Medical School, 736 Cambridge Street, Boston, MA 02135, USA

True malignant mixed tumors (carcinosarcomas) of salivary gland origin are exceedingly rare and demonstrate malignant epithelial and stromal components. The subject of this case study is a 61 year-old male who presented with mild left facial swelling with minimal discomfort and without a mass of the parotid gland. He underwent CT imaging which demonstrated a cystic lesion of the parapharyngeal space. CT guided fine needle aspiration of the lesion failed to demonstrate malignancy. The patient ultimately underwent two surgical procedures to fully excise the cancer. Histological and immunological evaluation revealed a carcinosarcoma. Carcinosarcoma (true malignant mixed tumor) of the parotid gland is an extremely uncommon tumor composed of both carcinomatous and sarcomatous elements coexisting together.

Citation: Tallab HF, Ricklan DE, Catalano PJ (2016) A De Novo Malignant Mixed Tumor (Carcinosarcoma) of the Parotid Gland: Case Report. Int J Pathol Clin Res 2:020.



 Case Report and Review of Literature 


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Published Date
January 08, 2016

Vol. 2, Issue 1

Anemia Investigation Reveals a Primary Sea-Blue Histiocyte Syndrome

Antonio Proenca Caetano, Ines de Figueiredo, Francisco Tortosa, Anabela Ferrao and Cristina Ferreira

Corresponding author: Antonio Proenca Caetano, Centro Hospitalar Lisboa Central and Faculty of Medicine, University of Lisbon, Rua da Beneficiencia no 8, 1069-166 Lisboa , Portugal

Sea-blue Histiocyte Syndrome (SBHS) is a rare and poorly understood systemic histiocytosis that is sometimes associated with haematological and lipid storage diseases as well as other miscellaneous conditions, but in most cases its cause is unknown. Patients often have very disparate clinical features but share the same histological findings of sea-blue histiocytosis in the bone marrow, i.e. characteristic lipid-laden macrophages with deep-blue or blue-green granules when stained with Romanovsky or May-Grunwald Giemsa stain. We describe a case of an 8 year-old girl admitted to the emergency department with a history of fever, adynamia, subicteric sclerotics, lymphadenopathies, anemia and leukopenia. During the investigation, histological examination of the bone marrow revealed a Sea blue histiocytosis. Patient workup revealed a spherocytosis, but it was inconclusive regarding major causes for these findings such as Niemann-Pick Disease, Gaucher Disease and other haematologic conditions, and was thus considered a Primary Sea-Blue Histiocyte Syndrome.

Citation: Caetano AP, de Figueiredo I, Tortosa F, Ferrao A, Ferreira C (2016) Anemia Investigation Reveals a Primary Sea-Blue Histiocyte Syndrome. Int J Pathol Clin Res 2:019.



 Review Article 


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Published Date
January 06, 2016

Vol. 2, Issue 1

Pathologic Reporting of the Surgical Margin after Radical Prostatectomy: Considerations for Improving Oncologic Prognostication

Michael J. Whalen and Michael B. Rothberg

Corresponding author: Michael J. Whalen, MD, Dept of Urology, Yale School of Medicine, Yale-New Haven Hospital, PO Box 208058, New Haven, CT 06520-8058, USA

Positive surgical margins (PSM) after radical prostatectomy have been identified as an adverse pathological feature predictive of higher rates of biochemical recurrence, distant metastasis, and cancer-specific mortality compared to negative margins. Such observations underlie the rationale for adjuvant radiotherapy for locally advanced disease or positive margins. Even without adjuvant radiotherapy, however, not all patients who have a positive margin will recur. While other adverse pathological features such as pathologic stage, pathologic Gleason score, and PSA likely play a role, there has been recent evidence demonstrating the importance of nuanced examination of the positive margin to enhance risk stratification and prognosis. Such features include extent involvement or multifocality, predominant Gleason grade at the PSM, and even close surgical margins.

Citation: Whalen MJ, Rothberg MB (2016) Pathologic Reporting of the Surgical Margin after Radical Prostatectomy: Considerations for Improving Oncologic Prognostication. Int J Pathol Clin Res 2:018.



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