World Pathology Week

Biography

Adoke Kasimu Umar is a young consultant Pathologist from a resource poor setting in Nigeria with special interest in molecular Pathology and translational medicine. He has published more than 20 papers in reputable local and international journals

Abstract

Head and neck squamous cell carcinoma (HNSCC) is the eight most common cancers worldwide and the majority of HNSCC occur in the oral cavity.. Tobacco and alcohol are the major risk factors in addition to infection by human papillomavirus (HPV). HPV-16 is the most common high risk HPV type in oropharyngeal cancers. The prevalence of HPV in oral cavity squamous cell carcinoma is 4-6% with studies showing improved prognosis for HPV-associated HNSCC compare with HPV-negative cancers. Tumour budding at the invasive front has been reported as a promising prognosticator in HNSCC, in this report we did a one year prospective study of twelve patients with oral cancers with the use of two immunohistochemical stains.

Methods

The clinical details of sex, age, site distribution, social habits and sexual partners were collected by means of a structured proforma. Tissue sections were cut at 3μm and mounted on glass slides processed with haematoxylin and eosin (H&E). P16 immunohistochemical stains were used for HPV infection while AE1/AE3 was used for tumour budding identification. DB biotech (Slovakia) protocol was used in both stains. All statistics were calculated using IBM SPSS version 21.

Results

The age range of occurrence of oral SCC was 31-80±21.8 years. The buccal mucosa, palate and tongue were the commonest site for squamous cell carcinoma with four (33%), Six (50%) and two (16.7%) cases respectively. Six (50%) of the 12 cases of squamous cell carcinoma were positive for p16 IHC stain.  Most of these patients, four (33%) with p16 positive oral SCC were less than 45 years old while, the remaining two (16.7%) were above 80 years. Tumour budding was seen in seven (58.3%) of these patients. There is significant association between tumour budding and Squamous cell carcinoma with those with tumour buds associated with poor prognosis.

Conclusion

HPV 16 is the most common cause of oral SCC in our environment with tendency to affect young adults. Those with tumour buds tend to have poor overall survival.

Biography

Dr. Somil Singhal has completed his Bachelor Of Medicine and Surgery ( MBBS) at the age of 25 years of age from Beijing Medical University, China and Post Doctoral Studies in Doctor Of Medicine In Pathology from Ragiv Gandhi University Of Health Sciences, Bangalore, India. Currently he is working as Senior Consultant Pathologist in the Haematology Departrment at Kriti Scanning and diagnostic center, Allahabad, India. He has attended various Conferences, CME’s and published Case studies , Dessertation in reputed journals like IJLSSR, Index Copernicus, Poland Journal Of Dermatology and is the life member of Indian Medical Association and Allahabad Medical Association. Besides this he had worked as a resident in AIIMS Trauma Center in the department of emergency medicine, Cardiac resident at Fortis Hospital Okhla, Delhi and attended various ITO and blood bank camps for service to the society

Abstract

Hypochromic anemia in adults is a complex problem owing to variations in various haematological parameters. Many studies in India and abroad had evaluated the causes and its appropriateness. In spite of this , there is diagnostic dilemma in diagnosing the appropriate cause of hypochromic anemia‟s. Hence, this necessity need to take up the study on haematological profile on hypochromic anemia.

OBJECTIVES:

The aim of the study was to perform haematological investigations required for diagnosing hypochromic anemia, to estimate the iron status of bone marrow aspirations and to assess which type of haemoglobin is responsible for

causing hypochromic anemia by using haemoglobin electrophoresis.

METHODS:

100 cases diagnosed with hypochromic anemia on peripheral blood smear were evaluated during one and half year study at Department of Pathology, S. Nijalingappa Medical College and HSK Hospital, Bagalkot, Karnataka. Other relevant investigations like bone marrow aspiration study, bone marrow biopsy, biochemical

investigations were performed. Conditions associated with hypochromic anemia were studied and categorized. Haemoglobin electrophoresis was performed to evaluate the cause of hypochromic anemia.

RESULTS:

Majority of cases were females as compared to males in a age group of 18 – 38 years of age with most common sign and symptom being pallor followed by fever and anorexia. The most common category of diagnosis among these cases was inadequate dietary intake and infections. 61 % cases showed lymphocytosis followed by neutrophilia and eosinophilia. The most frequent peripheral blood smear picture was Dimorphic type in 39 % cases followed by pancytopenia in 33 % cases. Bone marrow iron grade being 3 + in 41 % cases. Haemoglobin electrophoresis showed HbA2 > 3.5 % in 2 % cases suggestive of Beta Thalassemia Trait.

CONCLUSION

Correlation of morphology of peripheral blood smear , bone marrow aspiration , biopsy with RBCs indices and special techniques ; complete iron profile along with serum ferritin levels and Hb electrophoresis proved highly valuable in distinguishing the various sub types of hypochromic anemia.

Biography

Jeng-Long had completed her PhD from the Institute of Basic Medical Science, National Cheng Kung University. She is presently the Dean of the College of Nursing, Chung Hwa University of Medical Technology, a historic school that fostered many medical personnel in the south of Taiwan. She has published more than twenty-five research articles in reputed journals and has been serving as a reviewer of many repute journals.

Abstract

Musculoskeletal disorders represent a global threat to healthy ageing, and are ranked as the second most common cause of disability. Significantly contributing to the global disability burden associated with the musculoskeletal system are inflammatory arthritis and tendinopathy. Alteration of hormone levels affects both disease progression. A higher risk of rheumatoid arthritis (RA) was associated with the tendinopathy. We previously showed that estrogen receptor-β (ER-β) expression was higher in patients with tendinopathy and it resulted in apoptosis. The expression of ERs may be associated with RA. To examine if the expression of ER-β are correlated with disease activity of RA and the molecular mechanisms underlying the regulation of ERs. Synovial tissue from patients with RA was collected, the tissues were examined by immunochemical staining. A collagenase-induced arthritis (CIA) model of rat was established. The expression of ER-β and cytokines, chemokines of RA synovial fibroblast (RASF) was examined by real-time PCR and ELISA. A lentiviral vectors that encoded ER-β short-hairpin RNA (shRNA) was intraarticularly injected into the rats. Immunohistochemical staining revealed higher expression of ER-β in synovial tissues from patients with RA and rats with CIA compared with that in synovial tissue from patients with osteoarthritis and normal rats. The quantitative analysis showed that the expression of ER-β, IL-6, CCL5, and c-met of RASF was higher than that of control counterparts. ER-β shRNAs inhibited ER-β expression, which alleviate the disease manifestation.

Our study revealed that ER-β regulated the inflammatory response in RA. Local inhibition of ER-β might have therapeutic effect of RA.

Biography

Dr Miriam S Eden has completed MD Pathology from CMC, Vellore, MGRU University in year 2016 and presently is a Head section in Department of  Pathology, Wanless Hospital Miraj Medical Centre, Miraj, Maharashtra, India..  Presently has three publications at hand.

Abstract

This is the study about the use of   p53 as a prognostic marker to detect early lymph node metastasis in carcinoma of penis so as to avoid unnecessary lymphadenectomy.   Amputed specimens of penis were studied using p53 immuno marker, and correlation  with the histopathological variables and clinical stage was done. It was a retrospective study  of 49 cases of partial /total amputation with lymphadenectomy of penile cancers  were divided into metastatic and non metastatic groups on H&E sections in which 16/49 had metastasis. The slides were processed for  immunohistochemical technique using anti‑p53 antibodies.  The p53 tumor density was calculated in 100 cells with 20% cut off and  was graded as positive when more than 20% of the tumor cells with positive  nuclear staining.   All the pathological and clinical variables were calculated by Chi square test.  Results showed that 13 /49 cases showed increased p53 tumor density, pvalue of 0.05 was considerd significant in our study.  P53 did not correlate statistically with histopathological and clinical variables like phimosis, BXO, clinical node status, tumor type, tumor grade, depth of invasion, LVI.  P53 had low positive predictive value. Therefore in our study p53 cannot predict the early lymph node metastasis because of low positive predictive value, even though they are sensitive.

 Therefore   P53 Immunomarker had low specificity and low positive predictive value, which suggest that it is not able to predict early lymph node metastasis even though it is sensitive and thus it is not helpful to decide for prophylactic lymphadenectomy. 

Biography

Jumanazarov Nazarbek Associate Professor, 2009, Author of more than 140 scientific publications, of which more than 40 in the near and far foreign publications, of which 2 are scientific works with impact factors. The participant of international scientific conferences and congresses in the cities: Moscow, Bishkek, Dushanbe, Samarkand, Barnaul, Sochi, Izmir (Turkey).

Abstract

Material and methods: The study carried out morphological and immunohistochemical analysis of 55 observations (26 boys and 29 girls under the age of one year), which were diagnosed with IUI based on an immuno-morphological study. After studying the histories of diseases and autopsy results, a systematic morphological study of the pancreas was performed. The material is fixed in 10% neutral formalin solution. For histological examination, pieces were cut from the body, the tail of the pancreas.

In parallel, we conducted an immuno-histochemical study of the pancreas on the severity of the functional activity of such major cells as insulin, glucagon, somatostatin, and serotonin.

Results and discussion: As shown by the results of an immuno-morphological study, according to the autopsy of fetuses and newborns, an increase in the number of deaths from intrauterine infection of the fetus and newborns (IUI) shows 6.4 and 6.8 times, respectively. This may be due both to an absolute increase in the number of cases, and to an improved diagnosis of infectious diseases in connection with the introduction of various laboratory research methods. Of these, boys - 47.2%; girls –52.8%;

In premature infants, morphological immaturity of internal organs and fetal hypoxia caused by various factors (maternal anemia, diseases of the placenta, et.al.) play a large role in the onset of an unfavorable outcome.

The morphological picture of these cases coincides with the results of similar studies of domestic and foreign scientists. In some cases, marked organ plethora, flabbiness or sclerotic consolidation of the gland, as well as lymphohistiocytic infiltration, atrophy and dysplasia of endocrine parenchymal cells. In the lumen of the majority of the ducts there is an accumulation of a pinkish, amorphous type of secretion. Inside the islet apparatus, numerous cellular elements are located non-compact, with voids being defined between the elements. The diameter of the cell element is of various sizes, distinct, rounded nuclei. In individual cells, small-point granularity is detected. For children in the first days of life up to one year, there is a characteristic abundance of coarse fibrous connective tissue, the division into segments is indistinct. In the stroma, the number of elastic fibers decreases and the mass of collagen fibers increases.

According to literary data, the connective tissue system has several critical periods of functioning and development, among which are the prenatal period and the first 2 years of a child’s life.

In our studies, the virus influenced the pancreas in such a way that serotonin was observed in small numbers in the islets of Langerhans while reducing the number of B-cells. In isolated cases of viral intoxication, positive immunohistochemical reactions to serotonin were observed in the exocrine pancreas, but the majority of observations had a negative reaction.

 Thus, we can conclude that when IUI in the pancreas can be noted such changes:

- the degree of severity of morphological changes in the structures of the pancreas depends on the duration of exposure to viral infections;

- plethora, hemorrhages and inflammatory cellular infiltrates are more common in acute viral infections;

- pronounced disintegration of acinous tissue, pronounced fibrosis and moderate lipomatosis are observed when viral infections manifest on the body during the height of the disease more than 5-7 days.

Biography

Dr. Bouchikhaoui Hiba is a pathologist at EHUO hospital of Oran and a 4th year resident in pathologic laboratory. She is a teacher of Histologie and Physiologic courses in Belgaid university, and INESM university & also she teaches medical English at university of biology. She is a Member of AIP (International academic of Pathologi).

She published her poster in Maghrebin day in Algeria, International congress of Oncology.

Abstract

Methodology:
 

• Metaplastic carcinoma of the breast is one from the most rare type of breast cancer, with a pejorative prognosis . The purpose of the present study is to diagnose this type of carcinoma in pathologic by macroscopic and  specially microscopic studies and finnaly to confirm it by immunohistochemical study in order to an eventual therapy.
• Patients and Methods: We received 02 cases in this last 3 years, we shoosed  the most typicall specially on point of view microscopic , and we strengthened the researchers and the tools diagnosis to be useful to learning how to diagnose this type of carcinoma.

Biography

Amber Valentine is a Speech-Language Pathologist who graduated from the University of Kentucky with her MS in Communication Disorders.  She is a Board Certified Specialist in Swallowing and Swallowing Disorders and an International Board Certified Lactation Consultant.  She recently received her credentials to become a Certified Neonatal Therapist (CNT).  She worked for Baptist Health Systems, Inc for 8 years before moving to Florida where she worked for Wolfsons Children’s Hospital and Mayo Florida.  She is now back in Kentucky working for Baptist Health Lexington.  She has experience in adults and pediatrics with feeding and swallowing difficulties including:  bedside swallow evaluations, Modified Barium Swallow studies, FEES, and pediatric feeding evaluations including NICU.  She has experience with head and neck cancer patient including evaluation and treatment of swallowing difficulties, PMV use, and voice after total laryngectomy including TEP.  She has provided guest lectures for the University of Kentucky and the University of Louisville on feeding and swallowing topics. She has presented at the hospital level, local, state, national, and international levels on pediatric feeding/swallowing and breastfeeding. 

Abstract

The Speech-Language Pathologist is often seen in settings as the “go-to” for infants with feeding difficulties, predominantly for bottle feeding or feeding aversions.  In today’s society, with breast feeding becoming more and more “the norm,” the SLP has become more involved in the area of feeding assessment with not only bottle fed infants but infants who are attempting breast feeding as well.  The SLP brings an interesting background to the area of breast feeding with a knowledge of the oral mechanism, infant respiratory system, and swallowing mechanisms.  In many NICU and pediatric facilities, the SLP is now providing pre-feeding readiness assessments on infants, and by doing these, allowing many infants to get in on the ground floor with breast feeding. These infants in the NICU and early pediatric setting can be provided with more opportunities to become successful breast feeders, especially those infants who were previously thought to be unable to complete this task.  As the literature shows, it is so critical to provide human breast milk as soon as possible to these fragile infants in NICU and other pediatric populations, by allowing them to have earlier opportunities at the breast, they will be more likely to become not only successful breast feeders, but more successful feeders for a lifetime.  This presentation will discuss the role of the SLP in lactation clinically, as well as how we can work together between disciplines to improve breastfeeding success.  

Supports the following categories:

1.  Removing barriers to skilled lactation support
2.  The value of breastfeeding for our global environment
3.  Support for embodied caregiving and all caregivers
4.  Supporting lactation and access to human milk for all
5.  The value of breastfeeding and human milk for health

Biography

Amber Valentine is a Speech-Language Pathologist who graduated from the University of Kentucky with her MS in Communication Disorders.  She is a Board Certified Specialist in Swallowing and Swallowing Disorders and an International Board Certified Lactation Consultant.  She recently received her credentials to become a Certified Neonatal Therapist (CNT).  She worked for Baptist Health Systems, Inc for 8 years before moving to Florida where she worked for Wolfsons Children’s Hospital and Mayo Florida.  She is now back in Kentucky working for Baptist Health Lexington.  She has experience in adults and pediatrics with feeding and swallowing difficulties including:  bedside swallow evaluations, Modified Barium Swallow studies, FEES, and pediatric feeding evaluations including NICU.  She has experience with head and neck cancer patient including evaluation and treatment of swallowing difficulties, PMV use, and voice after total laryngectomy including TEP.  She has provided guest lectures for the University of Kentucky and the University of Louisville on feeding and swallowing topics. She has presented at the hospital level, local, state, national, and international levels on pediatric feeding/swallowing and breastfeeding. 

Abstract

Cancer diagnostic and treatment has evolved into more organ preservation including increased chemo and radiation therapy as well as decreased incident of organ removal.  The field of Speech-Langauage Pathology has been diagnosing and treating deficits related to head and neck cancer for many years.  Over this time, diagnosis and treatment includes areas such as cognitive/communication difficulties and swallowing deficits related to cancer, radiation, and weakness associated with the disease process.  Many are unaware that radiation treatment to the head and neck area can cause lasting swallowing deficits.  It is imperative to begin evaluation of swallowing during diagnosis process to obtain baseline swallowing function and continue to evaluate throughout treatments.  It is also indicative to provide prophalatic dysphagia exercises to help assist patient in maintaining swallowing function as long as possible.  The other area of concern that the SLP will assist in cancer diagnosis and treatment is voice after total laryngectomy.  There are very limited options for funcitonal communication after a total laryngectomy, most are nearly improbable and very inconvenient.  The most functional is use of a Tracheo-esophageal voice prosthesis.  The SLP can assist in the evaluation and treatment process of voice after total with fitting and continual management of the TEP for the patient.  The procedure of the tracheo-esophageal puncture as well as fitting of the prosthesis also allows the patient to have complete recovery of swallowing function.  

Biography

Abstract

Mauginiella scaettae is a fungal pathogen causing inflorescence rot date palm: one of the most divesting diseases in date palm growing regions worldwide. This disease was first reported by Cavara (1925) in Libya but the infection mechanisms remain obscure. To characterise the infection mechanism it was attempted to develop the model plant  Arabidopsis thaliana as an alternative host for strains of Mauginiella scaettae were isolated from different oases of East-south of Algeria: Ouargla1 (OU1) ,Ouargla2 (OU2), Ouargla3 (OU3), Hadjira (Ha),Touggour1(T1), Touggourt2 (T2), Oued1 (OE1), Oued2 (OE2), Ghardaïa (G) and Biskra (Bis). Sequencing the internal spacer (ITS) regions of indicated the phylogenetic position of M. scaettae. Upon drop-inoculation with conidia of M. scaettae, Arabidopsis exhibited white necrotic lesions with marginal yellowing appeared on leaves at 6 days post inoculation and subsequently expanded throughout the entire leaves. It was noted that strain G was the most and T2 is the least virulent. Microscopic investigations demonstrated that a preference for fungal penetration via stomata, accompanied by hyphal tip swelling which may represent a primitive haustorium. Both of these features were also observed on M. scaettae infected date palm spathes. On Arabidopsis initial biotrophic growth was followed by a necrotrophic lifestyle, similar to what happens on date palms. To investigate how host resistance mechanisms could modify the interaction were examined M. scaettae interactions with Arabidopsis mutants cpr1 and sid2 respectively increased and compromised in biotrophic resistance mechanisms, and eto2 which displays elevated resistance against necrotrophic pathogens. Interactions with eto2 appeared to be particularly affected, suggesting that anti-necrotrophic mechanisms - here linked to ethylene - could be effective in conferring resistance to M. scaettae. This study demonstrated the value of using model species in providing novel insights into previously cryptic interactions.

Biography

Dr. Lester Floyd Zamora has completed his medical training from the Cebu Institute of Medicine, Philippines. He is currently a fourth-year pathology resident at the National Kidney and Transplant Institute. He has been actively doing case reports during his residency and has ongoing retrospective research study in the field of hematopathology. Specific pathology specialty interests include hematopathology and uropathology

Abstract

Acute Myeloid Leukemia is a hematologic malignancy that results from the clonal expansion of myeloid blasts in the peripheral blood, bone marrow, or other tissues. It is the most common form of leukemia in adults and may also be present in the form of extra-medullary disease. However, published cases of leukemic infiltration of the gallbladder is quite rare.

We present a rare case of leukemic infiltration of the gallbladder in a 60 year old, male, who presented with cholecystitis. The patient was just diagnosed with AML  and had chemotherapy when a few days after discharge, he noted abdominal pain. Ultrasound findings showed gallbladder with pericholecystic fluid, slight wall thickening, multiple polyps and cholesterolosis.

Histologic examination of the gallbladder showed sheets of atypical mononuclear cells infiltrating the lamina propria and muscle layer. Review of the bone marrow flow cytometry study gated on the blast gate population showed a moderately bright CD45 expression with expression of the stem cell markers CD34 and HLA-DR; myeloid markers CD13, CD33 and CD117; myelomonocytic marker CD11c; cytoplasmic myeloid marker MPO. Immunohistochemistry studies done on the gallbladder showed positive expression for CD45, CD34 and MPO. These findings are in concordance with the bone marrow flow cytometry profile.

This case shows that AML can present with extramedullary manifestations in a form of leukemic infiltration of the gallbladder and present clinically as cholecystitis. Thus, a high index of suspicion should be given in any patient who has a history of leukemia despite the rarity of these manifestations.