Results in Journal Archives of Pathology and Clinical Research: 30
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Published: 3 January 2022
Archives of Pathology and Clinical Research, Volume 6, pp 001-004; https://doi.org/10.29328/journal.apcr.1001028
Treatment options in multiple myeloma (MM) based on novel agents are often limited by dose-related neurotoxicity. Bortezomib, a highly active reversible proteasome inhibitor, frequently causes peripheral neuropathy (PN). Bortezomib-induced PN (BIPN) is characterized by a length-dependent, sensory, axonal polyneuropathy (PNP) with predominant small fiber-affection. Following dose reduction or drug discontinuation, BIPN resolves within 3-4 months in the majority of patients. The pathophysiological mechanisms of BIPN are unclear. Rare cases of a severe demyelinating or mixed BIPN with prominent motor involvement have been attributed to autoimmune or inflammatory reactions. A case report, including nerve pathology, is presented of a 59-year-old man with stage III IgG-κ MM who was treated with bortezomib on the occurrence of progressive disease. After the fourth cycle, he developed a painful distal symmetric sensory PNP followed by gait instability and muscle weakness increasing over 3 months despite early cessation of bortezomib. Neurological examination revealed a distal flaccid tetraparesis mainly of the lower limbs with sensory loss and severe ataxia, electrophysiological features of a mixed axonal-demyelinating PNP, and pathomorphological evidence of neuritis. Steroid treatment was initiated, and partial recovery of the neurological symptoms within 6 months was observed. While a neurotoxic effect may explain the initial distal sensory disturbances, the worsening of neurological dysfunction after bortezomib withdrawal and the clinical pattern with steroid-responsive muscle weakness predominantly of the legs are consistent with an immune-mediated mechanism. This is in line with the sural nerve biopsy findings. Toxic BIPN followed by an immune-mediated BIPN in the same patient has not been reported before.
Published: 18 February 2022
Archives of Pathology and Clinical Research, Volume 6, pp 009-012; https://doi.org/10.29328/journal.apcr.1001030
A case of post-operative agranulocytosis which occurred in a 66-year-old woman following surgery for endometrial carcinoma is reported. The agranulocytosis had a rapid onset, being detected on the first post-operative day. The causative agent, cefazolin was given to the patient intraoperatively. The agranulocytosis persisted until the 22nd postoperative day. A bone marrow biopsy performed on post-operative day four showed a left-shifted myeloid maturation pattern but not a maturation arrest. The pathogenesis of drug-induced neutropenia/agranulocytosis is discussed. It is postulated that reversible binding of cefazolin to albumin accounts for the prolonged duration of agranulocytosis.
Published: 31 December 2021
Archives of Pathology and Clinical Research, Volume 5, pp 034-036; https://doi.org/10.29328/journal.apcr.1001026
A 69-year-old man presented with a one-month history of a painful mass in the right breast. Pathologic evaluation of the excision of the mass revealed a proliferation of both glandular and stromal elements consistent with gynecomastia. In addition, histologic examination revealed peripheral nerves in the deep portion of the specimen were entrapped in the proliferative changes associated with gynecomastia. It is proposed that the expansile proliferation led to compressive pressure on the nerves and caused the pain associated with gynecomastia.
Published: 31 December 2021
Archives of Pathology and Clinical Research, Volume 5, pp 037-041; https://doi.org/10.29328/journal.apcr.1001027
Purpose: To evaluate the presentation and outcome of periocular capillary hemangioma treated with low-dose oral propranolol. Method: Thirty cases of periocular capillary hemangioma prospectively studied from 1st June 2015 to 31st May 2017 who received oral propranolol on an outpatient basis. Hemangioma causing any threat to vision or disfigurement was included and age below 3 months and multiple lesions were excluded. Starting dose of propranolol was 1 mg/kg and increased to 2 mg/kg after 2 weeks as a maintenance dose. The tapering dose was 1 mg/kg of body weight before discontinuing the medication. Treatment was continued till the child is 1 year of age or no further change in color or size of the lesion in two successive follow-ups. Results: Presenting age was 6.36 ± 3.36 months (ranged 3–24 months) with female predominance (70%). In 86.6% of cases, the vision was Central Steady and Maintained and cycloplegic refraction showed marked astigmatism in 3 children which resolved after treatment. Forty-six percent of children showed color change as an initial response to treatment. Most children (33.3%) responded completely within 5 months after starting the treatment. One third patients (33.3%) showed 100% resolution, 50% showed 90% to 70% resolution. Pretreatment and post-treatment lesion size was1.60 ± 0.86 cm2 and 0.30 ± 0.40 cm2 respectively (p - value < 0.0005). None showed any significant adverse effect of oral propranolol. Conclusion: Low-dose oral propranolol is an effective and cost-effective treatment modality for periocular capillary hemangioma and is safe as an outpatient basis.
Published: 4 January 2022
Archives of Pathology and Clinical Research, Volume 6, pp 005-008; https://doi.org/10.29328/journal.apcr.1001029
Pseudofungus structures in lymph node tissues have been reported on multiple occasions. Despite a variety of investigative tests including histochemical special stains and energy dispersive spectral analysis, the underlying nature and origin of these pseudofungus structures has never been clearly defined. The most common hypothesis suggests that they represent collagen fibers that become coated with iron and calcium. Herein, evidence is given that the pseudofungus structures identified in the lymph node tissues represent fragments of polyurethane catheters. The evidence includes both a comparison of these pseudofungus structures to fragments of polyurethane well documented in the literature and a comparison of polyurethane catheter scrapings to the pseudofungus structures identified in the literature. In both of these comparisons, the morphology of the polyurethane fragments are identical to the pseudofungus structures. This is the first definitive report identifying polyurethane catheter fragments as representing the true nature and etiology of pseudofungus structures in lymph node tissues.
Published: 8 November 2021
Archives of Pathology and Clinical Research, Volume 5, pp 026-033; https://doi.org/10.29328/journal.apcr.1001025
SARS-CoV-2 a virulent disease that established the entire wide world due to its severity. Its 1st case was rumored in Wuhan, China within the year 2019 and it had been the beginning of this pandemic. This virus killed virtually a complete of 4,465,683 folks round the globe until date. Despite the fact that viral co-infections have the ability to alter the host’s illness pattern, few research have looked at the disease outcomes in patients who are infected with HIV and hCoVs. Despite the fact that HIV-positive people can be infected with hCoVs, researchers are now revealing that their chances of acquiring serious CoV-related disorders are typically similar to what is seen in the general population. The relation between SARS-CoV-2 and HBV was summarized rather HBV effects the severity of COVID patient or not. SARS-CoV-2 could be a severe acute metabolic process syndrome. Scientists found ways in which to treat this virus, some were useful and alternative weren’t that a lot of effective. Immunizing agent was one among the most important considerations for the entire world. This virus conjointly fashioned an entry for alternative co-infections too. SARS-CoV-2 and influenza virus, both causes respiratory diseases which confer as an extensive array of illness from asymptomatic or benign to critical disease and death. Also the mode of transmission and symptoms of influenza virus and SARS-CoV-2 are same. Viral and bacterial rate is higher in SARS-CoV-2 negative patient but are comparable. Serologies facts confirmed that patients with effective results for dengue virus (DENV) NS1 antigen and anti-dengue IgM were also attentive to COVID-19 speedy antibody tests, suggesting dengue COVID-19 co-infection. Mixed infection of dengue and COVID-19 needs unique interest from all dengue-common nations in Asia, especially the ones with limited resources. To our knowledge, this is the primary showed case of co-infection of dengue and COVID-19 in Indonesia. During patient’s TB course, COVID-19 can occur at any time with worse consequences for the patients who are affected by active pulmonary disease.
Published: 22 October 2021
Archives of Pathology and Clinical Research, Volume 5, pp 020-025; https://doi.org/10.29328/journal.apcr.1001024
Psoriasis is a chronic inflammatory skin disease with a complex mechanism, which is believed to be mainly based on immune disorders and activation of inflammatory pathways. However, we have combed through the literature and found that the pathogenesis of psoriasis might involve a “mobius loop” of “immunity-inflammation-oxidative stress-proliferation” process. The disordered immune environment of the skin might act as the basis, the outbreak of inflammatory factors as the mediator, and the imbalance of oxidative stress homeostasis as the activator. These factors work together, leading to abnormal proliferation of keratinocytes and further immune abnormalities, finally aggravating psoriasis. Therefore, here we review the latest evidence and advance in the pathogenesis of psoriasis, trying to contribute to further understanding and treatment of psoriasis.
Published: 27 August 2021
Archives of Pathology and Clinical Research, Volume 5, pp 016-019; https://doi.org/10.29328/journal.apcr.1001023
We report a case of a right gluteal mass from the sacroiliac joint to the knee of an infant girl. Biopsy showed histopathological features similar to infantile fibrosarcoma (IFS). However, unlike most IFS, no ETV6-NTRK3 fusion gene abnormality was detected. Molecular analysis with TruSight RNA Pan-Cancer Panel detected the presence of KIAA1549-BRAF translocation and an oncogenic NF2p.Q459* SNV with potential clinical significance. A review revealed that the combination of this patient’s tumor site with the presence of a KIAA1549-BRAF translocation abnormality and an accompanying single nucleotide variant has not been previously described. The detection of this translocation abnormality raises the possibility that the spindle cell tumors in infants with an absence of the ETV6-NTRK3 fusion gene abnormality might have a distinct pathogenetic mechanism different from the previously known IFS and congenital mesoblastic nephroma. Furthermore, the discovery of BRAF translocation and its aberrant signaling of the mitogen-activated protein kinase (MAPK) pathway in this tumor contributes to the promise of clinical benefit of using the MEKi trametinib for the treatment of progressive disease that is refractory to conventional chemotherapy.
Published: 24 August 2021
Archives of Pathology and Clinical Research, Volume 5, pp 010-015; https://doi.org/10.29328/journal.apcr.1001022
Flow cytometry (FCM) is a unique technique that allows rapid quantitative measurement of multiple parameters on a large number of cells at the individual level. FCM is based on immunolabelling with fluorochrome-conjugated antibodies, leading to high sensitivity and precision while time effective sample preparation. FCM can be performed on tissue following enzymatic or mechanical dissociation. The expression of epithelial antigens and cytokeratin isoforms help in distinguishing tumor cells from adjacent epithelial cells and from tumor infiltrating leukocytes. Tumor phenotypes can be characterized on expression intensity, aberrancies and presence of tumor-associated antigens as well as their cell proliferation rate and eventual heteroploidy. FCM can measure quantitative expression of hormone or growth factor receptors, immunoregulatory proteins to guide adjuvant therapy. Expression of adhesion molecules tells on tumor’s capacity for tissue invasion and metastasis seeding. Tumor heterogeneity can be explored quantitatively and rare, potentially emerging, clones with poor prognosis can be detected. FCM is easily applicable on fine needle aspiration and in any tumor related biological fluids. FCM can also be used to detect circulating tumor cells (CTC) to assess metastatic potential at diagnosis or during treatment. Detecting CTC could allow early detection of tumors before they are clinically expressed although some difficulties still need to be solved. It thus appears that FCM should be in the pathologist tool box to improve cancer diagnosis, classification and prognosis evaluation as well as in orientating personalized adjuvant therapy and immunotherapy. More developments are still required to better known tumor phenotypes and their potential invasiveness.
Published: 15 April 2021
Archives of Pathology and Clinical Research, Volume 5, pp 004-009; https://doi.org/10.29328/journal.apcr.1001021
Currently, the emergence of highly virulent mutants in Europe and the United States has caused refractory recurrent Clostridium difficile infection (RCDI) to be a problem in clinical practice. In 2013, the Netherland group demonstrated breakthrough therapeutic efficacy in fecal microbial transplant (FMT) treatment clinical trials for RCDI, and FMT treatment is rapidly gaining attention. In addition to RCDI, FMT treatment has been attempted in various gastrointestinal diseases such as inflammatory bowel disease, irritable bowel syndrome and chronic constipation, as well as extragastrointestinal diseases. In this review, I would like to describe the current status, complications and prospects of FMT treatment.
Published: 3 March 2021
Archives of Pathology and Clinical Research, Volume 5, pp 001-003; https://doi.org/10.29328/journal.apcr.1001020
The article describes the interaction of anorexic patients, hospitalized in the Regional Pilot Psychiatric Service for the treatment of Anorexia in the Molinette Hospital of Turin, with the reading volunteering group. On the basis of said interaction, the Creative Self is searched for in patients and shows into be present in different ways. It seems anyway enhanced by the presence in the reading group.
Published: 17 September 2020
Archives of Pathology and Clinical Research, Volume 4, pp 011-023; https://doi.org/10.29328/journal.apcr.1001018
Isocitrate dehydrogenase (IDH) mutations are a common event in secondary glioblastoma multiforme and lower-grade adult infiltrative astrocytomas and independently confer a better prognosis [1,2]. These are highly conserved mutations during glioma progression and thus also a useful diagnostic marker amenable to modern molecular sequencing methods. These mutations can even be detected in sites distant from the primary tumour. We use an illustrative case of a patient with radiologically suspected recurrent astrocytoma and negative histology, but positive IDH-mutated tumour DNA detected within CSF. Our results demonstrated the usefulness of liquid biopsy for recurrent glioma within the context of equivocal or negative histopathological results, whilst also showing the ability to detect a de-novo IDH-2 mutation not present in the previous resection. Building on this ‘proof-of-concept’ result, we also take the opportunity to briefly review the current literature describing the various liquid biopsy substrates available to diagnose infiltrative gliomas, namely the study of circulating tumour DNA, circulating tumour cells, and extracellular vesicles. We outline the current challenges and prospects of liquid biopsies in these tumours and suggest that more studies are required to overcome these challenges and harness the potential benefits of liquid biopsies in guiding our management of gliomas.
Published: 30 September 2020
Archives of Pathology and Clinical Research, Volume 4, pp 024-027; https://doi.org/10.29328/journal.apcr.1001019
Emergency medical care in palliative patients during the COVID-19 pandemic, it is important to provide a consistent treatment for stable patients that should be consistent with the goals and benefits, the perspective of these patients, but avoiding palliative patients with a poor prognosis that is unlikely to survive. Cancer is the second leading cause of death in the world around 8.8 million deaths a year. Worldwide, about 7-10 million patients are diagnosed with cancer each year, recently there has been a significant increase in the number of cases diagnosed with cancer. About 70% of cancer deaths are in low- and middle-income countries. The goals of emergency medical care based on the criteria of BLS and ACLS, that is should be done “Do not do resuscitation, do not intubate but continue medical treatment excluding endotracheal intubation without prospects for the patient, but offering BLS only treatment concentrated symptomatic. ED is often the only place that can provide the necessary medical interventions (e.g., intravenous fluids or pain management medications. Medications as well as immediate access to advanced diagnostic tests when needed such as CT, RM and other diagnostic and treatment procedures.
Published: 24 April 2020
Archives of Pathology and Clinical Research, Volume 4, pp 005-010; https://doi.org/10.29328/journal.apcr.1001017
Published: 14 January 2020
Archives of Pathology and Clinical Research, Volume 4, pp 001-004; https://doi.org/10.29328/journal.apcr.1001016
Published: 24 December 2019
Archives of Pathology and Clinical Research, Volume 3, pp 022-027; https://doi.org/10.29328/journal.apcr.1001015
Published: 3 December 2019
Archives of Pathology and Clinical Research, Volume 3, pp 020-021; https://doi.org/10.29328/journal.apcr.1001014
Published: 23 July 2019
Archives of Pathology and Clinical Research, Volume 3, pp 015-019; https://doi.org/10.29328/journal.apcr.1001013
Published: 18 March 2019
Archives of Pathology and Clinical Research, Volume 3, pp 008-014; https://doi.org/10.29328/journal.apcr.1001012
Published: 29 January 2019
Archives of Pathology and Clinical Research, Volume 3, pp 001-007; https://doi.org/10.29328/journal.apcr.1001011
Published: 14 December 2018
Archives of Pathology and Clinical Research, Volume 2, pp 049-093; https://doi.org/10.29328/journal.apcr.1001010
Published: 5 October 2018
Archives of Pathology and Clinical Research, Volume 2, pp 029-048; https://doi.org/10.29328/journal.apcr.1001009
Published: 1 January 2018
Archives of Pathology and Clinical Research, Volume 2, pp 020-028; https://doi.org/10.29328/journal.apcr.1001008
Published: 1 January 2017
Archives of Pathology and Clinical Research, Volume 2, pp 006-012; https://doi.org/10.29328/journal.apcr.1001006
Published: 1 January 2017
Archives of Pathology and Clinical Research, Volume 2, pp 013-019; https://doi.org/10.29328/journal.apcr.1001007
Published: 1 January 2017
Archives of Pathology and Clinical Research, Volume 2, pp 001-005; https://doi.org/10.29328/journal.apcr.1001005
Published: 1 January 2017
Archives of Pathology and Clinical Research, Volume 1, pp 005-008; https://doi.org/10.29328/journal.hjpcr.1001002
Published: 1 January 2017
Archives of Pathology and Clinical Research, Volume 1, pp 018-023; https://doi.org/10.29328/journal.hjpcr.1001004
Published: 1 January 2017
Archives of Pathology and Clinical Research, Volume 1, pp 001-004; https://doi.org/10.29328/journal.hjpcr.1001001
Published: 1 January 2017
Archives of Pathology and Clinical Research, Volume 1, pp 009-017; https://doi.org/10.29328/journal.hjpcr.1001003