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Acinic cell carcinoma (ACC) is a low or intermediate-grade malignant epithelial neoplasm of the salivary glands that generally shows an indolent behavior. Most cases arise in the major salivary glands, especially the parotid gland. ACC is usually known as a low-grade malignant tumor; however, poorly differentiated and high-grade transformed variants have been reported and may tend to be late recurrence and metastasis. Our case was a 49-year-old woman with a history of a right parotid rapidly growing mass lesion, which was cytologically diagnosed as monomorphic adenoma on fine-needle aspiration (FNA). Finally, the diagnosis of ACC with dedifferentiated components was reported, followed by parotidectomy. After 30 sessions of radiotherapy, she presented with hemifacial paresis. An imaging examination of the brain showed intracranial hemorrhage, and she underwent a craniotomy. We performed histopathological and immunohistochemical (IHC) examinations and diagnosed metastatic ACC with dedifferentiated components. Few ACC cases with dedifferentiated components and with aggressive behavior have been reported in the literature , and to the best of our knowledge, this article is the first English report in Iranian population.

Background & objective There is currently inadequate information about the expression of immunohistochemical markers in pediatric tumors. Paired box genes 2 and 8 (PAX2 and PAX8) genes have an essential role in kidney organogenesis. This study aimed to investigate the IHC expression of PAX2 and PAX8 in Wilms tumor. Such study would be helpful in diagnosis and possibly in differentiation of this tumor from other mimics, especially in those of poorly differentiated type in small needle biopsy specimens. Methods We performed a cross-sectional study on 45 Wilms tumor cases referred to Bahrami pediatric hospital between 2005 and 2015. Demographic data were collected from medical documents. Sections from related paraffin blocks were provided by the tissue microarray method, and immunohistochemical (IHC) staining was done for PAX8 and PAX2. Results The mean tumor size was 9.98±4.95 cm. Favorable histology was seen in 84.4% of samples. PAX2 was expressed in 41 cases (91.1%), and PAX8 in 37 patients (82.2%). PAX2 and PAX8 expression was mostly seen in both blastemal and epithelial components (77.8% and 66.6%), respectively. Tumors with favorable and unfavorable histology did not significantly differ in PAX2 and PAX8 expression (P=0.637). We found a statically significant relationship between PAX8 expression and tumor size (P=0.033). Conclusion PAX2 and PAX8 markers might helpful in diagnosis of Wilms tumor and may differentiate it from other histologically similar kidney tumors. PAX8 expression may be associated with larger tumor size. Tumors with favorable and unfavorable histology may not be different in PAX2 and PAX8 expression.

Background Glomus tumor is an uncommon soft tissue tumor. However, as the tumor causes significant disability, its early diagnosis is essential. It involves subungual areas of fingers and toes in most cases, and its extra-digital involvement is rarely seen. To the best of the authors' knowledge, only a few chest wall involvement cases have been reported in the literature. Case presentation In this paper, we describe a 63-year-old patient with a chest wall glomus tumor presenting with axillary paroxysmal pain and limitation in his shoulder range of motion that had been missed for nearly 15 years. His symptoms were relieved immediately following surgical excision. Conclusion Glomus tumors may involve any part of the human body. It is curable with surgical excision in most cases. Therefore, a correct early diagnosis has paramount importance. A high index of suspicion is needed for early diagnosis, especially when the tumor involves uncommon anatomic areas.

Synovial sarcomas are soft tissue neoplasms mostly located in the lower extremities of young adults. A case of synovial sarcoma of the thigh in a 35-year-old male with the predominant epithelial component is reported. Microscopically the tumor showed variable-sized well-differentiated glands lined by the cuboidal cells with small foci of spindle cell component between glandular structures. Immunohistochemically glandular components showed positivity for the pan CK and EMA while CD99 and TLE1 were positive in both glandular and spindle cell components. This type of synovial sarcoma could be indistinguishable from metastatic adenocarcinoma and malignant adnexal tumor, thus, immunohistochemistry and molecular studies play an essential role in the exact diagnosis of this type of tumor.

Background Abnormal activation of the β-catenin signaling pathway is involved in various malignancies, including breast carcinoma.Aberrant expression of β-catenin has been associated with more aggressive behaviors of breast cancer in some previous studies. . In the present study, we intend to evaluate the β-catenin expression in breast cancer specimens and study its relationship with clinicopathological parameters. Materials and method In this cross-sectional study,88 samples diagnosed as invasive ductal breast carcinoma from 2007 to 2017 were evaluated. The slides and paraffin blocks were retrieved from the archive of pathology department. Patients' clinical characteristics and other information were also extracted from medical documents. Sections from related paraffin blocks through the tissue microarray method were provided, and immunohistochemistry staining for β-catenin was done. Then different patterns of β-catenin expression and the relationship between different patterns and clinicopathological parameters were investigated. Results Of the 88 breast cancer samples, 94% were female, and 6% were male. In 70% of the samples, normal membrane expression of β-catenin was observed. Whereas in 30% of them, aberrant expression of β-catenin was observed. A close significant relationship was observed between aberrant β-catenin expression and age over 50 years (p-value: 0.093) and negative HER2 (p-value: 0.07). Conclusion In the present study, a correlation was observed between aberrant β-catenin expression and age over 50 years in patients and HER2 negativity, although this association was not statistically significant.

Background& Objective: Micro-vascular proliferation is an important histological feature of brain glioma with more vascular proliferation is present in higher grades of glioma. CD 105 is expressed in new actively proliferating and immature endothelial cells in tumor environment and appears to be capable to distinguish between malignant neo-vasculature and normal vessels. Methods: This study was designed to evaluate the Micro-Vessel Density(MVD) in different grades of brain glioma based on CD 105 expression by Immunohistochemistry method to determine whether it can be a helpful marker for rumor grading or not. Paraffin blocks of formalin fixed samples of brain astrocytic glioma were retrieved and IHC was performed using anti-CD105 monoclonal mouse antibody. Results: Total number of 48cases of low and high grade astrocytic gliomas were evaluated.We noted that there was a positive correlation between MVD evaluated by CD105 and tumor grade, meaning that expression was significantly greater in tumors with higher grade (P=0.019). Conclusion: We concluded that MVD quantified by CD 105 has positive correlation with tumor grade. Also we think that expression of CD 105 specially in low-grade glioma can serve as a basis for selective treatment option in combination with current standard care .

Back ground: Prostate-Specific membrane Antigen has been known as a tumor associated neovasculature marker in some solid malignant tumors and targeting of that by cytotoxic- conjugated antibody can represent powerful tool for vascular targeted therapy in malignant tumors. In thyroid, it appears that angiogenesis factors are involved in neoplastic growth and aggressiveness of tumors. This study was conducted to evaluate the expression of PSMA as an angiogensis factor by immunohistochemistry in neovasculature of thyroid follicular neoplasms to determine its usefulness for distinguishing between adenoma and carcinoma . Methods: Paraffin Blocks of formalin fixed samples representing 48 cases of Follicular Thyroid adenoma and 15 cases of Follicular Thyroid Carcinoma were evaluated. Results: Among Carcinomas, capsular and vascular invasion were present in 12 and 11 cases , respectively. The intensity of PSMA staining was significantly higher in carcinoma group(p=0.028). However, no significant difference in extent of PSMA expression in adenoma and carcinoma groups was observed(p=0.239).Thyroid follicular cells in adenoma, carcinoma also non neoplastic area were negative for PSMA. Conclusion: Our findings do not support usefulness of PSMA in differentiating between FTA and FTC. However ; expression in neovasculature of differentiated thyroid tumors can represent a potential utility for PSMA-targeted radionuclide therapy in advanced differentiated thyroid cancers. DOI:10.21276/APALM.1511

Background: Diagnostic Peritoneal Lavage (DPL) is a routine method for evaluating internal organ damage in patients with blunt or penetrating torso trauma. Internal organ damage can lead to elevated alkaline phosphatase (ALP) levels in the DPL fluid. In this study, the researchers aimed to assess the prognostic value of elevated alkaline phosphatase levels and the need for laparotomy. Methods: In this study, the researchers evaluated 42 patients with torso trauma (18 penetrating and 24 blunt traumas). The ALP was positive for all the patients in DPL (2 IU/mL

Background & objective: Micro-vascular proliferation is an important histological feature of brain glioma with more vascular proliferation is present in higher grades of glioma. CD 105 is expressed in new actively proliferating and immature endothelial cells in tumor environment and appears to be capable to distinguish between malignant neo-vasculature and normal vessels. Methods: This study was designed to evaluate the Micro-Vessel Density(MVD) in different grades of brain glioma based on CD 105 expression byImmunohistochemistry method to determine whether it can be a helpful marker for rumor grading or not. Paraffin blocks of formalin fixed samples of brain astrocyticglioma were retrieved and IHC was performed using anti-CD105 monoclonal mouse antibody. Results: Total number of 48cases of low and high grade astrocyticgliomas were evaluated.We noted that there was a positive correlation between MVD evaluated by CD105 and tumor grade, meaning that expression was significantly greater in tumors with higher grade (P=0.019). Conclusion: We concluded that MVD quantified by CD 105 has positive correlation with tumor grade. Also we think that expression of CD 105 specially in low-grade glioma can serve as a basis for selective treatment option in combination with current standard care.