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Article
Soft tissue sarcomas in Mosul: a pathologic evaluation

Authors: Bedoor AK. Al-Irhayim بدور عبد القادر الارحيم --- Ahmad F. Lazim احمد لازم
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2008 Volume: 34 Issue: 2 Pages: 152-160
Publisher: Mosul University جامعة الموصل

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Abstract

Objective: Histochemical and immunohistochemical examination of soft tissue sarcomas(STS) in Mosul to assess the value of these techniques in verifying the primary diagnosis.Methods: Paraffin embedded tissue blocks of 35 cases of soft tissue sarcomas collected over a period of 20 months in Mosul, were utilized. H&E, reticulin ,and Van Gieson's staining techniques and immunohistochemical marker for S-100 protein were applied to all the cases.Results: Soft tissue sarcoma accounts for 16.4%of the total of 213 cases of benign and malignant soft tissue neoplasms,with a mean age of 30.5 years ,and a male preponderance( Male: Female ratio of1.7:1). The most common histologic subtypes are extraskeletal Ewing’s sarcoma(ES), dermatofibrosarcoma protuberans(DFSP) ,and spindle cell sarcoma, not other wise specified (NOS). The extremities are affected in 51.4% of all cases, particularly the lower limbs. The majority of soft tissue sarcomas belong to the high grade category by applying French Federation of Cancers Centers Sarcoma Group ( FFCCSG) and American Joint Cancer Committee (AJCC) grading schemes .Both reticulin and Van Gieson's stains have been successfully depicting the growth patterns of different subtypes. Immunoreactivity for S-100 protein was positive in two cases.Conclusions: High quality H&E stained sections remain the best method for establishing the diagnosis of sarcomas .Reticulin stain proved extremely helpful in subclassifying sarcomas and S-100 protein was instrumental in changing the diagnosis of sarcoma in one case.

الهدف: استعمال الفحوصات الكيمياوية النسيجية والكيمياوية النسيجية المناعية للتوصل إلى التشخيص النهائي لسرطانات (غرن) الأنسجة الرخوة في الموصل.النموذج المستخدم: القوالب الشمعية الخالصة بنسيج 35 حالة لسرطانات (غرن) الأنسجة الرخوة خلال فترة 20 شهر. الطريقة: استعمال الصبغات النسيجية (H&E, reticulin, Van Gieson's) الكيمياوية النسيجية المناعية من نوع S-100 protein في كل الحالات.النتائج: مثلت حالات سرطانات (غرن) الأنسجة الرخوة نسبة 16,4% من أصل 213 حالة شملت أيضاً الحالات الحميدة وكان معدل العمر 30,5سنة مع زيادة طفيفة للمصابين من الذكور نسبة للإناث (1.7:1) أكثر الحالات هي من نوع (ES) Ewing's sarcoma.الاستنتاج: الصبغة النسجية من نوع H&E هي أفضل طريقة للتشخيص مع بقية الصبغات المستخدمة.

Keywords

Sarcomas --- soft tissue


Article
Soft Tissue Sarcomas: A review of 40 cases

Author: Nada S. Al-Rubai’ee
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2006 Volume: 5 Issue: 1 Pages: 87-93
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Soft tissue sarcoma (STS) represents a heterogeneous group of rare malignant tumors. Many diagnostic problems and difficulties are often encountered in the differential diagnosis of these tumors. The variety of appearance gives a wide range of tumor types and subtypes with a high discrepancy rate in tumor typing among pathologists. METHODS: This study was conducted at the Military Medical Academy (EGYPT) during the period from (1989-1990). The study aimed to reexamine a routinely processed H and E stained slides of cases previously diagnosed as STS by a group of pathologist and match the old and new diagnoses, with the application of some special stains; histochemical and immunohistochemical, then evaluate the results. Forty cases previously diagnosed as STS were reexamined and classified according to the criteria of Enzinger and Weiss. A descriptive or morphological classification was also used; as spindle, round, myxoid and pleomorphic STS. The results were compared to, and matched with the previous diagnoses. Histochemical stains used are, Picro Sirius red (PSR), Masson trichrome (MT), and Periodic-acid schiff stain (PAS). Myoglobin was used as immunohistochemical marker for the detection of cross-striated muscle cell differentiation by peroxidase antiperoxidase method (PAP). RESULTS: Agreement in diagnosis between the previous and the recent diagnosed STS was found to be 47.5%. For spindle cell malignant tumors the agreement was 58.8%, while for round cell malignant tumors was 33.3%. Agreement in diagnosis in mixed malignant soft tissue tumors was 62.5%. PSR and MT demonstrate the amount and distribution of collagen. MT also demonstrates muscle fibers. Using Myoglobin immunohistochemical marker in the previously diagnosed STS: one out of four cases diagnosed as Rhabdomyosarcomas gave a positive result, while two cases from the unsuspected group gave positive results. In the recently diagnosed tumors: all cases diagnosed as Rhabdomyosarcoma gave positive results, while from the unsuspected group one gave positive result. CONCLUSION: While the ordinary H and E stain will suffice to permit recognition of many of STS, it will not do so for all. Limitation of diagnosis of these tumors, especially the rare ones, to specialized centers or highly qualified pathologists is recommended. Histochemical stains are supportive rather than exclusive for the diagnosis of STS. Myoglobin immunohistochemical marker could be used to aid in the diagnosis of rhabdomyosarcomas. Definite diagnosis of many STS needs further special stains and/or electron microscopy and other sophisticated procedures

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