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ANALYSIS OF FALSE POSITIVE AND FALSE NEGATIVE FINE NEEDLE ‎ASPIRATION CYTOLOGY OF BREAST LUMP : A PERSONAL ‎EXPERIENCE

Author: Sawsan S, Al-Haroon ‎
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2004 Volume: 10 Issue: 2 Pages: 30-37
Publisher: Basrah University جامعة البصرة

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Abstract

This study aimed to determine the reasons for sampling and interpretative errors in false ‎negative and false positive diagnoses of breast carcinoma on fine-needle aspiration ‎cytology (FNAC) material. The study design is that a totally 912 cases of breast FNAC were ‎performed between 2000 and 2004, and 126 cases of them were diagnosed as breast ‎carcinoma. Only those cases with cytohistological discrepancies were cytologically reviewed, ‎in which the cytological material was abnormal and to some extent misinterpreted or both. ‎There were 8 false negative diagnoses (false negative rate 6.3%) and 3 false positive ‎diagnoses (false positive rate 2.3%). The results of this study showed that among 8 false ‎negative cases, 5 showed hypocellular smears with minimal nuclear pleomorphism of the ‎cells. Histology revealed 3 infiltrating ductal carcinomas of scirrhous subtype and 2 ‎infiltrating lobular carcinomas. The smears of other 2 false negative cases, which ‎histologically verified as well-differentiated infiltrating ductal and pure intraductal carcinomas, ‎were hypercellular and composed predominantly of groups of cohesive, small, and uniform ‎cells simulating fibroadenoma or fibrocystic changes. Smear of the last false negative case ‎‎(histologically verified as infiltrating ductal carcinoma with extensive cystic degeneration) ‎revealed large sheets of macrophages and degenerated epithelial cells on inflammatory ‎background. In 3 false positive cases, 2 were histologically proved as fibroadenoma and 1 ‎fibrocystic changes. Smears of the 2 false positive fibroadenomas showed very high ‎cellularity, overlapped clusters, and frequent stripped bipolar nuclei. The fibrocystic case ‎showed tight clusters of apocrine cells and sheets of loosely aggregated macrophages that ‎were over interpreted. The conclusion of this study is that hypocellularity and relatively ‎nuclear monomorphism are the reasons for failure to diagnose breast carcinoma. Careful ‎attention should be paid to extreme nuclear monomorphism and absence of naked bipolar ‎nuclei. So awareness of smear cellularity and subtle cytological features will aid in the correct ‎preoperative diagnosis of lobular; scirrhous; and intraductal carcinomas, and false negative ‎diagnoses can be minimized. A cytologically atypical or suspicious diagnosis together with ‎positive mammographical and clinical findings should suggest a diagnosis of malignancy. ‎Hypercellular smears with overlapped clusters should be carefully assessed for uniformity of ‎the cells and detailed nuclear features. If the full-blown malignant cytomorphological features ‎are not visible, a diagnosis of suspicious or inconclusive should be made and frozen section ‎Created by Wameed Al-Hashimy intraoperative imprint cytology is recommended before ‎surgery.‎

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Article
5- EVALUATION OF ENDOSCOPY BASED METHODS (HISTOPATHOLOGY, CYTOLOGY AND UREASE TEST) FOR THE DETECTION OF HELICOBACTER PYLORI

Authors: Sawsan S Al-Haroon --- Sarkis K Strak --- Rafid Adil Abood
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2009 Volume: 15 Issue: 1 Pages: 21-24
Publisher: Basrah University جامعة البصرة

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Abstract

This study aimed to assess the accuracy of histopathology, brush cytology, andurease test in the diagnosis of Helicobacter pylori and to evaluate the effect of testduration on the sensitivity and specificity of positive urease test for the detection of H.pylori.Fifty patients [25 patients with gastritis group A and 25 patients with duodenal ulcergroup B] selected from those attending endoscopy unit for dyspeptic symptoms, wereenrolled in the study. Four endoscopic biopsies were taken from each patient. Onebiopsy from each of antrum and body were obtained for urease test (Urease test wasread at 30 min, 1, 4 and 24 hour after biopsy insertion into the reagent), and onebiopsy from each of antrum and body were used for histopathological examination.Antral brush cytology was taken also from each patient. The patients were consideredH. pylori positive when minimum concordances of 2 out of 3 tests (Histopathology,brush cytology, and urease test) were positive.Fourteen patients were positive for H. pylori in group A, in comparison to seventeenpatients in group B. The sensitivities of the histopathological examination, brushcytology, and urease test at 24 hours in group (A) were 58%, 79%, and 93%respectively. Corresponding figures for the specificity were 100%, 91%, and 46%respectively. While in group (B) the sensitivities were 82%, 82%, and 100% and thespecificities were 100%, 100%, and 88% respectively.It is concluded that among the invasive methods, the association of the urease testwith brush cytology constituted the best choice for confirming the diagnosis of H.pylori, due to the high sensitivity of the urease test and high specificity of brushcytology.


Article
Prevalence of Epstein - Barr virus in Malignant Lymphoid tumors in Basrah
انتشار فيروس ابشتاين - بار في أورام اللمفاوية الخبيثة في البصرة

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Abstract

Background: Different factors (genetic and environmental) appear to be involved in the pathogenesis of malignant lymphomas and one of these factors is Epstein Barr virus.Objective: To evaluate the prevalence of Epstein Barr virus in Malignant Lymphoid tumors in Basrah Method: Cross-sectional study of fifty-six cases of malignant lymphomas (Hodgkin and Non-Hodgkin) were collected. The initial diagnosis and subtyping of malignant lymphomas were performed by the microscopical examination of the hematoxylin and eosin stained sections. Then immunohistochemistry for Epstein Barr virus, Latent membrane protein was done.Results: A total of 56 cases diagnosed as malignant lymphomas, 37 cases (66.1%) were Hodgkin lymphomas and 19 cases (33.9%) were Non-Hodgkin lymphomas. For Epstein Barr virus (Latent membrane protein) immunohistochemistry, 18 of 37 cases (48.6%) of Hodgkin Lymphomas and 6 of 16 cases (31.6%) of Non Hodgkin Lymphomas had positive viral expression. Mixed Cellularity Hodgkin Lymphomas and Diffuse Large B-Cell Lymphomas were the commonest subtypes that showed Epstein Barr virus expression (64% and 37.7% respectively). The immunohistochemical viral expression was more among those less than 50 years and male sex in both Hodgkin and Non-Hodgkin Lymphomas

الخلفية: يبدو أن هناك عوامل مختلفة (وراثية وبيئية) متورطة في التسبب في الأورام اللمفاوية الخبيثة وأحد هذه العوامل هو فيروس إبشتاين بار.الهدف: تقييم مدى انتشار فيروس ابشتاين بار في أورام اللمفاوية الخبيثة في البصرةالطريقة: تم جمع دراسة مستعرضة من ستة وخمسين حالة من الأورام اللمفاوية الخبيثة (هودجكين وغير هودجكين). تم إجراء التشخيص الأولي والنماذج الفرعية للأورام اللمفاوية الخبيثة عن طريق الفحص المجهري لأقسام ملطخة الهيماتوكسيلين والأيوزين. ثم الكيمياء المناعية لفيروس ابشتاين بار، وقد تم البروتين الغشاء الكامنة.النتائج: ما مجموعه 56 حالة تم تشخيصها على أنها سرطان الغدد الليمفاوية الخبيثة، 37 حالة (66.1 ٪) كانت سرطان الغدد الليمفاوية هودجكين و 19 حالة (33.9 ٪) كانت ليمفوما اللاهودجكين. بالنسبة لفيروس Epstein Barr (بروتين الأغشية الكامنة)، فإن 18 من 37 حالة (48.6٪) من الأورام اللمفاوية هودجكين و 6 من 16 حالة (31.6٪) من الأورام اللمفاوية غير هودجكين كان لها تعبير فيروسي إيجابي. كانت الأورام اللمفاوية المكوّنة من نوع هودجكين الخلوية والأورام اللمفاوية الكبيرة من الخلايا المنتشرة هي النوع الفرعي الأكثر شيوعًا الذي أظهر تعبير فيروس إبستين بار (64٪ و 37.7٪ على التوالي). كان التعبير الفيروسي المناعي أكثر بين أولئك الذين تقل أعمارهم عن 50 عامًا والجنس الذكري في كل من الأورام اللمفاوية هودجكين وغير هودجكين.الخلاصة: إن التعبير العالي عن بروتين الغشاء الكامن -1 يؤكد ارتباط الفيروس بالأورام اللمفاوية الخبيثة ، خاصة في الأورام اللمفاوية هودجكين


Article
Occurrence of whirling disease symptoms in cultured common carp in Basrah, Iraq

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Abstract

A total of 128 fish samples including 70 Cyprinus carpio Linnaeus, 1758,10 Leuciscus vorax (Heckel, 1843), 40 Oreochromis aureus (Steindachner, 1864) andeight Planiliza abu (Heckel, 1843) were collected during the period from November2016 to May 2017. Seven different localities (floating cages, earthen ponds and naturalwater) in Basrah were investigated. Among some detected fish diseases, whirlingdisease symptoms was reported for the first time in Iraq in April 2017, from two C.carpio cultured in earthen fish ponds of Marine Science Centre, University of Basrah.The infested fish were dwarfed, with abnormal big head and small body. Grossly signsof the diseases represent fins and tail deformities in addition to open ulcers and losingof scales, and necrosis of skin and muscles. Internally, fish suffered of musclesecchymosis and vertebral deformities. Histological sections revealed that the spinalcord had healthy structure.

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