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Background and Objectives: Urine serves as a vital diagnostic fluid, and urine cytology analysis plays a crucial role in identifying urinary system illnesses such as bladder cancer and kidney stones. The Paris System for Reporting Urinary Cytology establishes a uniform method for diagnosing urinary tract cancer. This study aimed to provide valuable insights that can inform diagnostic strategies related to kidney stones and ultimately improve patient outcomes via the early detection of the cellular changes associated with kidney stones and their relation to kidney function tests. Materials and Methods: A comparative study was conducted and comprised two groups: group 1, consisting of 50 patients diagnosed with kidney stones, and group 2, comprising 50 patients diagnosed with other kidney diseases. Renal function tests and urinalysis (via the PAP staining of urine cellular deposits to detect nuclear changes) were performed, and the results were analyzed. Results: There was a statistically significant increase in urinary red blood cells, white blood cells, and nuclear reactive atypical changes in urinary sediments of kidney stone patients compared to the patients without stones, while there was a decrease in the estimated glomerular filtration rate (eGFR). eGFR showed a 96.7% specificity in detecting cases with nuclear reactive atypia. Conclusions: eGFR emerges as a reliable diagnostic marker for the comprehensive assessment of kidney stones, particularly when associated with nuclear atypia. The significant correlation between the indicators of chronic kidney disease, such as decreased eGFR, and the presence of kidney stones emphasizes the urgent need for efficient diagnostic practices. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Castleman's Disease should be considered in the differential diagnosis of retroperitoneal masses, especially in equivocal cases. Clinician should not presume all cases of retroperitoneal masses as a malignancy. Castleman's Disease is a heterogeneous group of lymphoproliferative disorders, that can develop in lymph nodes or in extranodal sites. It has three distinct histological subtypes; hyaline vascular, plasma cell or mixed. It can be unicentric or multicentric, and sometimes oligocentric or regional. In this article, we report a case of a 30‐year‐old male who presented with a palpable left lumbar mass, clinically suspected as sarcoma vs GIST, which was surgically excised and pathologically examined revealing a rare condition of intra‐abdominal unicentric Castleman's Disease with good prognosis. Castleman's Disease should be considered in the differential diagnosis of retroperitoneal masses, especially in equivocal cases. [ABSTRACT FROM AUTHOR]

Background: Chronic endometritis (CE) is a persistent inflammation of the uterine lining. Although it has a minimal clinical presentation, CE adversely affects the reproductive ability of women. The aims of this study were to detect pathological endometrial patterns in D&C biopsies and to evaluate chronic endometritis in patients living in a high-altitude area (1800 m above sea level) in order to determine the clinical pathological features and prevalence. Materials and methods: A cross-sectional study conducted at King Faisal Maternity Hospital included 100 samples of D&C biopsies from women complaining of various gynecological symptoms not due to gestational causes. The biopsies underwent tissue processing, H&E staining, and CD138 detection. Blood samples were taken for serological detection of infectious diseases, complete blood count, and chemical parameters. Results: The mean age of women in the study with CE was 48.5 ± 8.5 years, and that of those without CE was 46.9 ± 9.7 years. The most common complaints were abnormal uterine bleeding, accounting for 83%. CE was present in 8% of cases, and there was a nonsignificant difference in hematological parameters between women with CE and those with other pathological diagnoses. There were also nonsignificant differences in chemical parameters, except for FSH and LH levels, which showed a significant difference, with p-values of 0.05 and 0.02, respectively. It can be concluded that the most common gynecological complaint of women in this study was abnormal uterine bleeding. Conclusions: The most commonly diagnosed pathological endometrial disorder in D&C biopsies was disordered proliferative endometrium, followed by endometrial polyps and endometrial hyperplasia. All of these are usually associated with hormonal disturbance, which appeared to be very common in the women in this study. The prevalence of chronic endometritis detected in our study was 8%, which is relatively high. [ABSTRACT FROM AUTHOR]

Laryngeal cancer, particularly the squamous cell carcinoma subtype, is prevalent globally and is characterized by a poor prognosis and high mortality rates. Currently, no definitive prognostic markers exist for predicting the behavior of the tumor. The aim of this study is to examine the correlation between cyclin D1 and E-cadherin expression with some clinicopathological parameters in laryngeal squamous cell carcinoma (LSCC). 60 cases of LSCC were retrospectively studied concerning the clinicopathological features and the potential prognostic role of cyclin D1 and E-cadherin expression in laryngeal carcinoma, using immunohistochemical staining scores on paraffin-embedded cancer tissues from patients who were treated with surgical excision. Reduced Ecadherin expression was significantly correlated with tumor grade (p = 0.0288), T stage (p = 0.041), and lymph node metastasis (p = 0.003). Regarding Cyclin D1, a statistically significant correlation was found with lymph node metastasis (p=0.019). In contrast, cyclin D1 expression was not significantly correlated with TNM stage or tumor grade (p=0.99 and 0.66, respectively). Evaluating expression of cyclin D1 in conjunction with E-cadherin expression in laryngeal squamous cell carcinoma may prove beneficial in identifying patients with lymph node metastasis. Tumor grade, stage, and nodal metastasis can significantly affect E-cadherin expression in patients with LSCC. However, further studies using genetic testing are recommended to assess the role of E-cadherin in tumor progression. [ABSTRACT FROM AUTHOR]

Background and Objectives: Hepatocellular carcinoma (HCC) is a prevalent form of malignancy that is characterized by high mortality rates and prognosis that remain suboptimal, largely due to treatment resistance mechanisms. Recent studies have implicated cancer stem cells (CSCs), particularly those expressing epithelial cell adhesion molecule (EpCAM), in HCC progression and resistance. In the present study, we sought to assess EpCAM expression in HCC patients and its correlation with various clinicopathological parameters. Materials and Methods: Tissue samples from 42 HCC patients were subjected to immunohistochemical staining to evaluate EpCAM expression. Clinicopathological data were obtained including the size, grade and stage of tumors, vascular invasion status, alpha-fetoprotein levels, and cirrhosis status. The Chi square and Fisher's exact tests were employed to assess the association between categorical groups. Independent Student-t test or Mann–Whitney U test was used to investigate the association between continuous patient characteristics and survival. Results: Immunohistochemical analysis revealed EpCAM expression in 52.5% of HCC cases. EpCAM-positive tumors exhibited characteristics indicative of aggressive disease, including larger tumor sizes (p = 0.006), greater tumor multiplicity (p = 0.004), higher grades (p = 0.002), more advanced stages (p = 0.003), vascular invasion (p = 0.023), elevated alpha-fetoprotein levels (p = 0.013), and cirrhosis (p = 0.052). Survival analysis demonstrated that EpCAM expression was significantly associated with lower overall rates of survival and higher rates of recurrence in HCC patients. Conclusions: Our findings suggest that EpCAM expression may serve as a prognostic biomarker for HCC with a potential role in patient management. Targeting EpCAM-positive CSCs may represent a promising approach to overcome treatment resistance and improve clinical outcomes in HCC. However, further investigation into the molecular mechanisms underlying EpCAM's role in HCC progression is warranted to facilitate the development of personalized therapeutic interventions. [ABSTRACT FROM AUTHOR]

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This article discusses the case of a Yemeni woman in her fifties who presented with a disfiguring enlargement of her nose and fleshy lesions on her nose and lips. The woman experienced a negative impact on her self-esteem and social life due to the cutaneous lesions. Clinical examination revealed multiple papules and nodules on the nose, as well as annular erythematous plaques on other parts of the body. The diagnosis was cutaneous sarcoidosis, specifically lupus pernio. Treatment with prednisolone and azathioprine led to improvement, but the patient experienced a recurrence of the facial lesion and nasal cartilage destruction. The article also discusses the characteristics and treatment options for lupus pernio. [Extracted from the article]

Hemangiomas are common lesions in medical practice, but those arising in the nasal cavity and/or paranasal sinuses are rare. Inverted papilloma is a rare benign tumor with a high incidence rate in both the nasal cavity and sinuses. The presence of both lesions in the same patient is even rarer. Here we present a case of a male patient with an unusual presentation and dual pathologies of cavernous hemangioma and inverted papilloma of the sinonasal tract that underwent endoscopic surgery and showed no recurrence of disease after a 2‐year follow‐up. The association of nasal cavernous hemangioma at one side and inverted papilloma at the other side is a very rare occasion that requires further studies and histopathology is the only diagnostic tool. [ABSTRACT FROM AUTHOR]

Introduction: The identification of bladder detrusor muscle invasion in urothelial cancer is essential for prognosis and management. We studied the clinical, histological, and immunohistochemical expression of p16, p53, and Ki-67 in urothelial detrusor muscle-invasive bladder cancer (MIBC) and urothelial non-detrusor muscle-invasive bladder cancer (NMIBC) in Egyptian patients. Methods: Sixty-two bladder urothelial cancer cases obtained through TURBT were included and divided into two groups: (MIBC, stage T2) and NMIBC (T1). Tissue blocks were recut and re-examined microscopically; then, the immunostaining of p16, p53, and Ki-67 was performed to compare both groups and evaluate the 13% cut-off for Ki-67, 20% for p53, and p16 intensity in various conditions aided by telepathology technology. Results and conclusion: Hematuria was the main clinical first presentation, with no significant difference between either group. The mean age was 61.6 years, with male predominance (52 males and 10 females). The absence of papillary histological pattern was associated with a higher stage, including detrusor muscle invasion (p = 0.000). The overall average percent of p53 immunostaining was 12.9%, revealing no significant difference between MIBC and NMIBC when a cut-off of 20% was implicated. The Ki-67 expression was correlated with higher grade and muscle invasion; however, no association was found with the other two markers' expression. The negative immunostaining of p16 was associated with low grade and NMIBC in the case of the preservation of the papillary pattern. We recommend further studies on the cut-off of widely used markers and more immunohistochemical and genetic studies on the p16(INK4A), taking into consideration the histological pattern of conventional carcinomas. [ABSTRACT FROM AUTHOR]

Background: CL endemicity was reported worldwide including in Saudi Arabia, imposing a major challenge on the health authorities. Vitamin D and its receptor (VDR) are key modulators of the immune response where the VDR is expressed. A remarkable lack of data exists in humans about the contribution of vitamin D and polymorphisms of the VDR gene in protozoan infections, especially cutaneous leishmaniasis (CL). Objective: This is the first work conducted to assess the relationship between vitamin D status, polymorphisms of the VDR gene (BsmI, ApaI, TaqI, and FokI), and VDR haplotype with parasite tissue load and susceptibility to CL. Methods: Fifty-two patients with confirmed CL (21 patients receiving vitamin D medication and 31 patients not receiving it) and 46 control subjects participated in this cross-sectional investigation. VDR genotyping was determined by restriction fragment length polymorphism analysis. Serum levels of 25-OH vitamin D were assessed using the ELISA method in all participants. The skin biopsy quantified the parasite load based on the Ridley parasitic index. Results: The mean serum level of 25-OH vitamin D in CL patients who were not receiving vitamin D therapy was significantly lower compared to CL patients on vitamin D therapy and controls (p <0.001 for both) and CL patients with no history of vitamin D therapy had a significantly higher frequency of vitamin D deficiency compared to CL patients on vitamin D therapy and controls (p < 0.05). Compared to CL patients with no history of vitamin D therapy, CL patients receiving vitamin D therapy had a significantly lower mean size of the lesion and RPI (p = 0.02,.03 respectively). The frequency of genotype "aa" and its "a" allele in ApaI SNP of VDR was significantly lower in CL patients compared to controls (p = 0.006 and 0.03 respectively). However, patients with CL had a considerably greater frequency of the "A" allele than the controls (p = 0.03), suggesting its role in CL susceptibility. There was no statistically significant difference between the two groups in the genotype and allele frequency distributions of BsmI, TaqI, and FokI (p > 0.05). When compared to controls, CL cases had a considerably greater frequency of the "B-A-T-F" haplotype (p = 0.04), and a significantly lower frequency of the "B-a-T-F" haplotype (p = 0.01) suggesting that these haplotypes may have the potential susceptibility or protection against CL respectively. The "Aa" genotype in ApaI SNP of VDR had considerably lower levels of vitamin D with higher parasite load compared to the "AA" and: aa" genotypes (p = 0.02,0.02 respectively). A significant negative correlation was found between the parasite load and 25-OH vitamin D levels (r2 = -0.53, p< 0.001). Conclusions: According to these findings, vitamin D levels and "ApaI" VDR gene polymorphisms could affect the parasite load and susceptibility to infection, whereas BsmI, FokI, and TaqI polymorphisms did not. Correction of vitamin D levels may aid in CL management. Author summary: Cutaneous leishmaniasis (CL) is the most prevalent type of leishmaniasis with varied clinical presentations. It is caused by a group of protozoan intracellular parasites belonging to the genus Leishmania and transmitted through the bite of blood-sucking female sandfly species. few studies have examined the relationship between vitamin D and the VDR gene polymorphism and protozoal infection including leishmaniasis. Therefore, in this study, we aimed to investigate for the first time the possible association of VDR gene polymorphisms (BsmI, ApaI, TaqI, and FokI genotypes) with parasite load and susceptibility to CL and attempted to ascertain such an a ociation with serum levels of 25(OH) vitamin D in a trial to improve treatment strategies for CL.the results revealed that 25-OH vitamin D level was significantly lower among patients with CL compared to controls. The frequency of genotype "aa" and its "a" allele in ApaI SNP of VDR was significantly lower in CL patients compared to controls. However, the "A" allele frequency was significantly higher in patients with CL compared to controls, suggesting its role in CL susceptibility. The distribution of genotype and allele frequencies of BsmI, TaqI, and FokI were non-significantly different 86 between both groups. The parasite load was significantly negatively correlated with 25-OH vitamin D levels. Correction of vitamin D levels may aid in CL management. [ABSTRACT FROM AUTHOR]