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Breast tumors in females: A Review Of 500 Malignant Cases.

Author: Lubab F.Talal
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 4 Pages: 456-459
Publisher: Baghdad University جامعة بغداد


Background:Breast carcinoma is the most common malignant tumor and the leading cause of carcinoma death in women, with more than 1,000,000 cases occurring worldwide annually.(1) as a matter of fact , the mortality rate for breast carcinoma changed very little from the 1930s to the early 1990s, because of the combined action of earlier diagnosis and improved therapy .
Materials and methods: The prospective study included 500 cases of breast carcinoma who went total mastectomy , between October 2006- April 2007, where taken from private pathology laboratory , sections(4microns) are taken and stained with H&E stain and over-reviewed.
Results: Clinicopathological analysis of the 500 cases of breast carcinoma, including the age, clinical presentation, the site of the tumor, the mammography results, the microscopic morphology, the stage and the grade of the tumor. The age in relation to the morphological classification also analyzed.
Conclusion: The commonest breast carcinoma in women is invasive ductal carcinoma, followed by lobular carcinoma, with mean age 44.5 year, mainly in the left breast, and that mammography approach is so useful in early detection of breast carcinoma.

Case reportSacrococcygeal teratoma with yolk sac elements(endodermal sinus tumors) in two years old child

Authors: Enam A. Khalid --- Lubab F. Talal`
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 1 Pages: 109-111
Publisher: Baghdad University جامعة بغداد


Background: Sacrococcygeal teratoma is seen in 1 in every 35000 live births, and is the most common tumor presenting in newborn and children but also reported in adults.(1)Sacrococcygeal teratoma are the most common type of germ cell tumors (both benign and malignant) diagnosed in neonates , infants and children younger than 4 years.(2Case report: A 2 years old male child presented with a visible lump or mass under the skin at the top of the buttocks crease after falling on the ground on his buttocks, and the parents give a history that the child had a constipation since birth.The case was diagnosed as endodermal sinus tumor with yolk sac elements on the bases of clinical examination, ultrasonography, CTscan and fine-needle aspiration cytology..After diagnoses patient referred to the oncologist for multi-drug chemotherapy and surgical removal by the pediatric surgeon after shrinkage of the tumor mass.Conclusion: Infants and young children present with a palpable mass in the sacropelvic region have a greater likelihood of being malignant.

Male Breast Lesions: A review of 124 cases diagnosed by Fine Needle AspirationCytology

Authors: NADA A. AL-Alwan --- LUBAB F. Talal --- SAZAN A. Al-Atrooshi
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 3 Pages: 365-371
Publisher: Baghdad University جامعة بغداد


Background:Gynecomastia and breast cancer are the two most common diseases of the male
breast. Most other diseases found in male breast arise from the skin and subcutaneous tissues.
Male breast cancer is relatively rare, in contrast to gynecomastia, which is relatively common.
Objectives: The aim of this report is to determine the prevalence of the different breast
lesions among males; based upon the findings of fine needle aspiration cytology .
Patients and method:This study was carried out within the Main Referral Training Center
for Early Detection of Breast Tumors, Medical City Teaching Hospital, Baghdad (from the
beginning of January 2003 till the end of November 2007). One hundred twenty four males
presenting with different breast lesions were included; all were subjected to physical breast
examination, ultrasonography of the breast and fine-needle aspiration.
Results:Pathologically, 112 cases (90.3%) were diagnosed as benign lesions, including: 103
cases (83.1%) of gynecomastia, and 9 cases (7.2%) of other miscellaneous benign lesions: six
cases (4.8%) diagnosed as inflammatoty conditions [three cases of acute mastitis and three
cases of suberolar abscess], two cases (1.6%) diagnosed as granlomatous mastitis, and one case
(0.8%) as lipoma. On cytological examination, 14 cases (13.6%) of gynecomastia showed
varying degree of cellular atypia. Breast cancer was diagnosed in twelve patients (9.7%); all
were infilterative ductal carcinoma. The mean age of patients with gynecomastia was 20.3
years, while it was 61.8 years in breast cancer patients. Sixty six cases (53.2%) of male breast
masses were located within the left breast, 47 cases (37.9%) were located within the right
breast, while eleven cases (8.9%0) were bilateral (all were gynecomastia). The chief
complaints of patients with gynecomastia were as follows: painless mass in 38 cases (30.7%),
painful mass in 45 cases (36.3%), pain without mass in 13 cases (10.5), while evidence of
bilateral swelling was observed in seven cases (5.6%). Ten patients (8.1%) with breast cancer
presented with painless mass, while in only two (1.6%) the chief complaint was painful lump.
On ultrasonographic examination of patients with gynecomastia, 58 conditions (46.7%)
presented with proliferation of fibroglandular tissue (no definite mass), 35 conditions (28.2%)
showed well defined discoid lesions, while in ten cases (8.1%) the findings revealed ill defined
retroareolar masses. On the other hand, in patients diagnosed as having male breast carcinoma,
the ultrasound findings showed ill defined eccentric masses in eight cases (6.5%) and multiple
masses in four (3.2%).
Most cases of gynecomastia were idiopathic since patients gave no history of hormonal therapy
or exposure to other relevant risk factors.
Conclusions:Most palpable masses in the male breast are due to gynecomastia followed by
breast carcinoma. Because both present clinically as palpable masses, fine-needle aspiration
cytology is extremely useful for the diagnosis.

The role of Wilm̛̛s Tumor1 immunohistochemical marker in surface epithelial ovarian tumors
دور المناعي النسيجي للمعلم WT1 في أورام المبيض الطلائية السرطانية

Authors: Lubab F. Talal لباب فاضل --- Sahira A. Ali ساهرة عبود --- Muna I. AL Hafedh منى اسماعيل
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2015 Volume: 57 Issue: 2 Pages: 145-150
Publisher: Baghdad University جامعة بغداد


Background: Wilms’ tumor 1 is a tumor suppressor gene. The gene is located in chromosome 11p13. And its expression was found in many solid tumors (including ovarian tumor) and also expressed in hematologic malignancies, Recent studies found that WT1 to be involved in angiogenesis.Objectives: To evaluate the expression of WT1 in surface epithelial ovarian tumorand study the possibility of using WT1 as replacement of both;ovarian tumor marker CA125 and a endothelial cell phenotypic marker CD34.Patients and methods: This is a study of a retrospective ( cross sectional ) of sixty cases with total abdominal hysterectomy and bilateral salpingo - oopherectomy collected from department of Histopathology – Teaching Laboratories / Medical City Teaching Hospital , as well as Al alwya hospital and Al Habibia hospital in Baghdad during the period of study from December 2007 to December 2012. Thirty cases diagnosed as surface epithelial ovarian tumors and thirty cases of histologically normal ovarian tissue which were included as a control group. Formalin - fixed, paraffin - embedded ovarian tissue blocks from 60 cases were used . Three section of 4 micron for each taken and stained with WT1, CD34, and CA125 immunohistochemical marker on positively charged slides.Results: there were a significant correlation between expression of WT1 and histological types of surface epithelial ovarian tumor with a higher expression in serous tumors among other cancer types (P-value < 0.001).There was a significant positive correlation between the expression of WT1 and CA125 scores ( p-value < 0.001).There was a significant correlation between WT1microvessel density (MVD) expression and CD34- microvessel density (MVD) expression in ovarian tumors (P-value = 0.05).On the other hand, there were no significant correlation of WT1 with the age of cases (P-value = 0.9) and with the grade of ovarian tumors ( P-value = 0.23) . Conclusions: The present study demonstrates high expression of WT1 in both tumor and endothelial cells in surface epithelial ovarian tumors, and it had dual usages in evaluation of both ovarian tumor cells and the vascular density. That was proved by demonstrating a significant correlation between WT1 and CA125 expression, and between WT1-MVD and CD34- MVD . There was no statistically significant association between WT1 expression and different tumor grades. There was significance differences in WT1expression among different histological subtypes of primary ovarian carcinomas, with serous carcinoma as the most frequent type. Key words: Ovarian tumor; WT1; CA125; CD34.

خلفية عن الدراسة: المعلم المناعيWT1 هوعامل نسخ ويقع في الكروموسوم 11p13, اكتشف لأول مرة في الورم الكلوي ((Wilms حيث انه يعمل كمثبط للجينات السرطانية , كما يوجد في عدة أورام من ضمنها أورام المبيض وأورام الدم الخبيثة, وفي الآونة الأخيرة وجد بان WT1 له أيضا دور في تكوين الأوعية الدموية.هدف الدراسة: صممت هذه الدراسة للبحث عن العلاقة بين المعلمات المناعية WT1 ،CA125, CD34 وأورام المبيض الطلائية السطحية ودراسة إمكانية استخدام المعلم المناعيWT1 كبديل لكل من CA125و .CD34 المرضى وطرائق العمل: شملت هذه الدراسة )60( حالة تراجعية لاستئصال الكامل للرحم والمبايض والأنابيب والتي تم جمعها على شكل بلوكات نسيجية مطمورة بالشمع ومثبتة بالفورمالين جيدا , من قسم النسيج المرضي في مختبرات التعليمية /مدينة الطب بالإضافة إلى مستشفى العلوية ومستشفى الحبيبية في بغداد خلال الفترة من ديسمبر 2007إلى ديسمبر2012.تم دراسة ثلاثين حالة من أورام المبيض الطلائية السطحية بالإضافة إلى ثلاثون نسيج مبيض طبيعي خالي الورم والتي استخدمت كمجموعة سيطرة, قد عملت ثلاثة مقاطع نسيجية على شرائح زجاجية ذات شحنة موجبة لكل ٍ من المعلماتWT1، CD34، وCA125النتائج: كان هناك علاقة كبيرة بين المعلم المناعي WT1والنوع النسيجي لأورام المبيض الطلائي السطحي مع تعبير العالي في الأورام النسيجية المصلية بين أنواع السرطان الأخرى قيمة ( p >0.001) . ووجد بان هناك علاقة إيجابية ذات دلالة إحصائية بين المعلم المناعي WT1وCA125p<0.001)). وأيضا هناك علاقة كبيرة بين WT1-MVD و CD34- MVD في أورام المبيض (P = 0.05). أما من الناحية الأخرى فانه لم يكن للمعلم المناعي WT1 أي علاقة مع العمر في الحالات التي تمت دراستها فقيمة p= 0.9) ) , كما انه لا توجد أية علاقة مع درجات تمايز الورم في المبيض . (P = 0.23) الاستنتاجات: توضح هذه الدراسة التعبيرات العالية للمعلم المناعي WT1في كل من الخلايا السرطانية والخلايا البطانية للأوعية الدموية في أورام المبيض الطلائية السطحية ، وكان للمعلم المناعي WT1 استخدام مزدوج في تقييم كل من الخلايا السرطانية في المبيض وكثافة الأوعية الدموية.وقد اثبت ذلك من خلال وجود علاقة موجبة بين المعلمين WT1وCA125 ، وبين كثافة الأوعية الدموية الصغيرة المقاسة بواسطة المعلمين WT1وCD34 لا توجد علاقة بين المعلم المناعي WT1و درجات تمايز ورم المبيض.وقد وجد بان هنالك علاقة كبيرة في تعبير المعلم المناعي WT1 و مختلف الأنواع النسيجية لأورام المبيض مع تعبير عالي ل WT1للنوع النسيج المصلي الخبيث.مفتاح الكلمات:ورم المبيض ؛ WT1؛ CA125؛ CD34.

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