bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating Antioxidant Enzyme Parameters in Rats Treated with Berberine-Loaded Bovine Serum Albumin Nanoparticles and Scopolamine
Authors: Abdelmonem M , Hemdan A , Ghareeb D , El demellawy M , Wasim H , El sayed M 
Published: October 2024

Abstract

Introduction/Objective
Introduction: Berberine (BER) has garnered attention for its antioxidant properties demonstrated in various studies, showing its ability to scavenge or inhibit reactive oxygen species (ROS) and reactive nitrogen species (RNS), including nitric oxide, superoxide anion, and peroxynitrites.

Methods/Case Report
Methods: Forty-two male Wistar rats were randomly assigned to seven groups, each comprising 6 rats: Sham control (no treatment), BSA-NPs orally administered, BRB-NPs orally administered, SCO intraperitoneally injected, BER followed by SCO injection, BSA-NPs with SCO injection, and BER-NPs with SCO injection. Treatments were administered daily for 28 days. The cholinergic status was evaluated by assessing acetylcholinesterase (AChE) activity in brain homogenates, and brain homogenate Aβ-42 levels were measured using the ELISA technique. Additionally, brain prooxidant markers (NO, TBARS, XO), nonenzymatic antioxidants (GSH), and enzymatic antioxidants (GPx, GST, and SOD) were measured.

Results (if a Case Study enter NA)
Results: The study revealed that treatment with BRB NPs resulted in the lowest AChE activity and Aβ-42 levels. Scopolamine administration significantly increased brain NO, TBARS, and XO activity, accompanied by a progressive depletion in GSH content (p&lt;0.05). Treatment with BRB-free or BSA decreased NO levels, while the BSA or BRB-NPs groups exhibited higher brain TBARS levels than the sham group. All treated groups exhibited similar activity to the sham control, except for the BSA-treated group. Furthermore, all treated groups showed comparable GSH levels to the sham control, except for the scopolamine group. Treatment with BRB NPs normalized GPx activity and showed the highest GST activity. The BRB-NPs treated group also exhibited the highest SOD level. The p-value was &lt;0.001 among all studied groups.

Conclusion
Conclusion: Injection of SCO induced oxidative impairments in brain tissue, evidenced by increased prooxidants such as NO and depletion of antioxidant capacity (GPx, GST, and GSH). SCO also disrupted glutathione metabolism, enhancing the level of lipid peroxidation in the brain. Treatment with BRB-NPs or free BRB progressively increased antioxidant capacity and mitigated the harmful effects of oxidative damage in the brain by reducing prooxidant levels.
HPV-Independent Cervical Adenocarcinoma Discovered by Cytology-Based Screening: A case report of gastric type adenocarcinoma of the uterine cervix from cytopathology to histopathology
Authors: Hull A , Guo T 
Published: October 2024

Abstract

Introduction/Objective
In recent years, the relative prevalence of adenocarcinoma has increased, comprising 20–25% of all cervical carcinomas in developed countries. Approximately 15% of cervical adenocarcinomas are unrelated to human papilloma virus (HPV) infection. With the shift toward HPV primary testing, an increased understanding of HPV-independent cervical adenocarcinomas becomes more important.

Methods/Case Report
This case report demonstrates a rare case of gastric-type adenocarcinoma (GAS) of the cervix discovered during a routine well-woman exam. Patient-reported episodes of vaginal spotting were noted prior to screening. HPV testing by PCR on the initial pap smear was negative. Cytology findings raised concerns about endocervical glandular cell abnormalities. Subsequent cervical biopsy revealed GAS, a finding supported by positive CK7, MUC5AC, CDX2, and aberrant (mutant) p53 expression by immunohistochemistry. HPV independence was further confirmed by negative results on mRNA ISH for high-risk HPV and HPV16/18.

Results (if a Case Study enter NA)
NA

Conclusion
Here we discuss the impact of cytology-based screening on HPV-independent cervical cancers, with focus on adenocarcinoma. While the move to primary HPV screening has been shown to be effective at identifying HPV-related neoplasms, it ineffectively addresses HPV-independent malignancies. In this particular population, cytology-based screening remains indispensable.
The described case demonstrated subtle cytologic features consistent with endocervical glandular abnormality, ultimately correlating with subsequent histologic findings of HPV-independent GAS. Negative HPV results combined with subtle cytomorphologic changes displayed by some adenocarcinomas on PAP smear could present a significant diagnostic pitfall. Additionally, p16+ expression attributable to aberrant p53 pathways (rather than HPV) may further contribute to potential diagnostic errors.
While further research into best practices for early detection of HPV-independent cervical neoplasias should be conducted, this team suggests both clinical survey and referral for cytologic screening following reports of abnormal vaginal bleeding and/or watery discharge and screener education focused on cervical GAS.
Rare Case of Cutaneous Rosai Dorfman Disease Involving the Nail
Authors: Tahir M , Phung T , Nguyen Luu T , Nguyen H T 
Published: October 2024

Abstract

Introduction/Objective
Rosia-Dorfman Disease (RDD) is a rare benign non-Langerhans cell histiocytic disorder of unknown etiology with heterogeneous clinical features. RDD was first described by Destombes in 1965 under the term “adenitis with lipid excess.” However, it is named after Rosai and Dorfman, who characterized the further histopathological features of the disease in 1969. The characteristic presentation of RDD is lymphadenopathy, and extra nodal sites include bone, upper respiratory tract, central nervous system, retroperitoneum, and skin. The management of RDD depends on the site of involvement and the presence or absence of the symptoms. Multifocal and refractory diseases require systemic treatment. Surgical resection can be considered in symptomatic and resect- able diseases.

Methods/Case Report
A 16-year-old Asian female with no significant past medical history presented with a painful verrucous lesion on the left 5th finger for one year with bleeding and purulent discharge. Excision was performed, and histologically, there was extensive infiltration of large histocytes in the dermis with occasional lymphocytes and plasma cells. The histiocytes were engulfing the intact inflammatory cells, exhibiting the emperipolesis phenomenon.
Immunohistochemically, S100 and CD68 were positive in the large histiocytes, and leukocyte common antigen (LCA) was positive in the background lymphocytes. Based on histology and immunohistochemistry, RDD diagnosis was rendered.

Results (if a Case Study enter NA)
N/A

Conclusion
RDD is a rare condition that poses challenges in diagnosis and management. The key diagnostic factors are histological features and immunohistochemistry to exclude other pathological disorders. Treatment should be tailored according to the needs of each patient and as required to optimize the outcome. We recommend an appropriate diagnosis of this entity in a timely manner to prevent any further long-term complications.
Pigmented Purpuric Dermatoses in Children: A case Report & Importance of Clinicopathological Correlation
Authors: Fatima F , Khurram M S , Siddiqui H F , Zahid H 
Published: October 2024

Abstract

Introduction/Objective
Pigmented purpuric dermatoses are characterized by chronic but benign cutaneous eruptions featuring petechiae, purpura, or yellow to brown patches. It is more common in adult males and adolescents is generally localized on the lower limbs and has been reported in children multiple times. Our objective is to bring to consideration that it is not very uncommon in children and clinicopathological correlation is very important for a confirmed diagnosis.

Methods/Case Report
In our study, we report a case of 9 years 9-year-old girl with asymptomatic brown patches on lower legs bilaterally but asymmetrically since &gt; 6-8 months. Histopathology was suggestive of typical features suggestive of PPD, including dilated blood vessels, endothelial cell swelling, hemosiderin deposition, red cell extravasation, and perivascular lymphocytic-macrophage infiltration. Pediatric instances of PPD are infrequently documented, due to their exclusion from the other differential diagnosis of purpura, post-inflammatory hyperpigmentation, and atopic dermatitis in this age group. Because these conditions lack systemic findings and share similar clinical presentations with other skin disorders, they may be overlooked or mistaken for more common conditions in pediatric patients. Histopathology plays a vital role in case of patches of persistent pigmentation on the skin especially lower limbs to rule out PPD. In many cases of pediatric PPD, it is usually considered self-resolving, but there is complete resolution has also been reported with Vitamin C, rutoside, narrow-band ultraviolet B treatment, and topical corticosteroids.

Results (if a Case Study enter NA)
In many cases of pediatric Pigmented purpuric dermatosis is usually considered as self-resolving, but there is complete resolution has also been reported with Vitamin C, rutoside [3] narrow-band ultraviolet B treatment and topical corticosteroids.

Conclusion
Our study aims to emphasize improving diagnostic accuracy, especially in pediatric cases, enhancing outcomes, and understanding the necessity of histopathological diagnosis in pediatric PPD cases. We also seek to abate the risk of misdiagnosis or underdiagnosis, and the need for increased awareness of this diagnosis in pediatric cases so that we can counsel and manage patients and their families accordingly. Through a comprehensive review of existing literature, we advocate for the inclusion of Schamberg’s type purpura as a differential diagnosis for purpuric eruptions or cutaneous discoloration in childhood.
Phyllodes - like Tumor of the Anogenital Mammary - like Glands – A Rare Entity
Authors: Mukherjee R , Szeto W , Zerhouni Y , Mannan R , Centeno L 
Published: October 2024

Abstract

Introduction/Objective
Phyllodes tumor (PT), a biphasic fibroepithelial tumor typically found in the breast, is an exceedingly rare finding outside the mammary gland, with only about 160 cases reported to date. We describe a rare case of PT arising from anogenital mammary-like glands (AGMLG).

Methods/Case Report
A 68-year-old woman presented with a small perianal mass that was incidentally detected during hemorrhoidectomy procedure. It appeared as a pedunculated olive-sized mass on the perianal skin. A papillectomy was performed, and upon sectioning, a solid-cystic lesion measuring 2.0 x 1.4 x 0.9 cm was observed. Microscopic examination revealed a biphasic pattern comprising of glandular epithelium and a stromal component, with a predominance of the latter and together they formed leaf-like slits. These spaces were lined by a bilayered epithelium consisting of secretory (apocrine)-type cells and myoepithelial cells resembling mammary glandular epithelia. Focal clusters of benign glands, morphologically consistent with AGMLGs, were identified at the periphery of the tumor. Immunohistochemically, epithelial components reacted positively for GATA3, mammoglobin, CK7, estrogen receptor and progesterone receptor, while the myoepithelial cells were highlighted by calponin and p63. The AGMLGs in the periphery also stained for GATA3, estrogen receptor and progesterone receptor. The mitotic rate was low (1 to 2 per 50 high-power fields), without atypical mitoses. The lesion was diagnosed as a benign PT.

Results (if a Case Study enter NA)
NA

Conclusion
The current case highlights the importance of recognizing PT when it occurs at extra-mammary locations. The entity merits greater attention not only for its malignant potential but also due to the mystery surrounding its origin and the histogenetic link to breast tissue.
A case of Russell body gastritis associated with psychiatric disorder
Authors: Kumar V , Hammad A 
Published: October 2024

Abstract

Introduction/Objective
Russell body gastritis is a benign and rare entity characterized by infiltration of lamina propria with plasma cells stuffed with spherical eosinophilic cytoplasmic inclusions known as Russell bodies which represent immunoglobulins. Russell bodies accumulate due to dysfunction in secretion pathway of plasma cells. Plasma cells with Russell bodies are also termed Mott cells. Although exact etiology is unknown, but it can be seen in association with other conditions like mucosa associated lymphoid tissue (MALT) lymphoma, multiple myeloma and plasmacytoma. This condition most commonly affects the antrum and may present as erythema or sometimes nodular lesion. Definitive diagnosis is based on histology.

Methods/Case Report
A middle-aged male with past medical history significant for polysubstance use disorder, bipolar disorder, and osteoarthritis was evaluated for bleeding per rectum and dyspepsia in the setting of chronic nonsteroidal anti-inflammatory drugs (NSAID) and ethanol use. Physical examination was remarkable for an external hemorrhoid and complete blood count showed anemia. Upper GI endoscopy and colonoscopy was performed. Patchy erythema was seen in antrum and duodenal bulb, and colonoscopy was unremarkable. Microscopic examination showed numerous plasma cells with Russell bodies (Mott cells) in the lamina propria and mild chronic inflammation in gastric mucosa. H. Pylori was negative by immunohistochemistry (IHC). Plasma cells were polyclonal and positive for CD138, and negative for cytokeratin which excluded plasmacytoma and signet-ring adenocarcinoma, respectively.
Patient was placed on proton pump inhibitor therapy and discharged.

Results (if a Case Study enter NA)
Russell body gastritis can be seen in patients with and without H. Pylori infection. Cytokeratin, kappa and lambda immunohistochemistry stains, and gene rearrangement studies may be needed to exclude frequent lesions that may enter in the differential diagnosis. Long term effects and clinical significance of russell bodies accumulation is yet to be determined.

Conclusion
Russell body gastritis is a rare morphologic variant of chronic gastritis that may enter in the differential diagnosis with other more serious lesions. A careful morphologic examination and occasionally IHC stains / molecular studies are needed to make the correct diagnosis.
Splenic Epidermoid Cyst arising within an Intrapancreatic Accessory Spleen Masquerading as a Pancreatic Mucinous Cystic Neoplasm-a diagnostic enigma
Authors: Kakodkar P , Diudea D , Kanthan R 
Published: October 2024

Abstract

Introduction/Objective
Accessory spleens are congenital embryological aberrations usually found within the splenic hilum with no clinical significance. An IntraPancreatic Accessory Spleen (IPAS) is an uncommon benign pancreatic lesion encountered clinically. A splenic epidermoid cyst arising within an IPAS is exceedingly rare and is discussed below.

Methods/Case Report
A 68-year-old male presented with intermittent post-prandial epigastric pain radiating to the left flank for &gt;1.5 years. Radiological imaging identified a 5.2 cm calcified cyst in the pancreatic tail with a differential of mucinous pancreatic neoplasm/ pancreatic pseudocyst. Additionally, a 2.8cm lobulated solid hypoechoic mass was seen at the porta hepatis with a differential of enlarged lymph node/benign neoplasm. Laboratory biochemical tests were within normal limits except for mildly elevated ferritin. Fine needle aspiration biopsy was indeterminate. The patient elected to proceed with surgical resection. A laparoscopic distal pancreatectomy with splenectomy and excision of the hilar mass was performed. The hilar mass was analyzed by hematopathology and revealed a hyaline- vascular variant of Castleman disease. On gross examination of the distal pancreatic/splenectomy specimen, a well- demarcated cystic lesion with brownish fluid was noted within the pancreatic tail. Microscopic examination revealed a nonpathological pancreas separated by a fibrous capsule with a large cyst arising within an intrapancreatic accessory spleen. The cyst was lined with multilayered non-keratinized CK5/6, and p63 positive squamous epithelium with no lymphocytic infiltrates and absent hair/ dermal appendages confirming a splenic epidermoid cyst. Post-operative follow-up at 6 weeks was uneventful.

Results (if a Case Study enter NA)
NA

Conclusion
An epidermoid cyst arising within an intrapancreatic accessory spleen (ECIAS) is extremely rare thus precluding accurate preoperative diagnosis as this entity shares similar radiological imaging characteristics as other cystic lesions such as mucinous pancreatic cysts. It is important for anatomic pathologists to recognize and consider the intrapancreatic compartment as a possible location for accessory spleens. Accurate preoperative diagnosis can prevent unnecessary surveillance and/or extensive surgical resection.
EVERY KERATIN-POSITIVE MALIGNANT TUMOR IN THE ADRENAL GLAND IS NOT METASTATIC CARCINOMA- A CASE REPORT
Authors: Wade C , CHAUDHARY R , Maheshwari T , Manucha V 
Published: October 2024

Abstract

Introduction/Objective
Angiosarcoma is a rare subtype of sarcoma arising from the vascular endothelial cells. Primary adrenal angiosarcoma (PAA) is an exceedingly rare entity, with only 53 cases documented in the literature so far.

Methods/Case Report
A 78-year-old female presented with left upper quadrant abdominal pain and early satiety. A computed tomography scan of the abdomen revealed a 15 x 13 x 16 cm, heterogeneous enhancing mass with interspersed calcifications, possibly originating from the left adrenal gland. The mass was found to be displacing the spleen and the left kidney. An ultrasound-guided biopsy of the mass was inconclusive, and the patient subsequently underwent resection of the left retroperitoneal mass, left adrenalectomy, splenectomy, and left partial nephrectomy. Gross examination revealed a slightly ruptured, red-brown mass (19.5 x 12.7 x 12.6 cm, 1784g), which was serially sectioned to reveal diffusely hemorrhagic and necrotic cut surfaces. On microscopic examination, the tumor was almost entirely hemorrhagic and necrotic, with a few viable areas that were composed of solid sheets of markedly pleomorphic epithelioid cells with a high nuclear-cytoplasmic ratio, prominent nucleoli, and increased mitotic figures. There were also a few ectatic vascular spaces lined by these markedly pleomorphic epithelioid cells.
Immunohistochemical stains of the tumor cells showed positive results for cytokeratins, CD31, ERG, and friend leukemic integration 1 (FLI-1), while Inhibin and SF-1 were negative. A diagnosis of epithelioid angiosarcoma was rendered.

Results (if a Case Study enter NA)
NA

Conclusion
PAA can be difficult to diagnose since it is rare, and thus it is not typically considered in the initial differential diagnosis. Most PAA have an epithelioid morphology, and they frequently test positive for cytokeratins. Biopsy diagnosis can also be challenging, as the mass may exhibit extensive necrosis and hemorrhage. Considering its rarity, large adrenal masses with heterogeneous features on imaging PAA should be considered as a differential diagnosis.
Exploring Immunohistochemical Profiling in High-Grade Endometrial Stromal Sarcoma - A Case Study
Authors: Jain D , Ballouk C 
Published: October 2024

Abstract

Introduction/Objective
High grade endometrial stromal sarcoma (HGESS) is a rare and aggressive tumor of endometrial stromal origin comprising about 0.2% of all uterine malignancies. It is often misdiagnosed preoperatively as uterine leiomyoma, leiomyosarcoma or endometrial carcinoma due to lack of well defined clinical and radiological features. We present an unusual case of HGESS with fibroid uterus and abnormal vaginal bleeding.

Methods/Case Report
A 73-year-old female with a past medical history of uterine fibroids presented with abnormal vaginal bleeding for 6 months. Her MRI uterus revealed enlarged uterus measuring 6.8 X 9.9 X 9.3 cm, multiple fibroids, and endometrial thickness of 4 mm. Hysteroscopic dilation and curettage revealed endometrial polyp and submucosal fibroid. Histopathology of submucosal fibroid revealed loosely cohesive tumor cells with high nuclear/cytoplasmic ratio, scant cytoplasm, and large prominent nucleoli, arranged in solid sheets with myxoid stroma. No glandular formation was identified. Tumor cell necrosis, bizarre tumor cells, and markedly increased mitotic activity, including atypical mitotic figures were present. Immunohistochemistry (IHC) revealed tumor cells diffusely positive for smooth muscle actin, CD10, p53, negative for AE1/AE3, CK7, cam5.2, EMA, ER, PR, desmin, and caldesmon. Ki-67 labels close to 50% of the tumor cells. Combined morphologic and IHC features favored the diagnosis of high-grade sarcoma, including leiomyosarcoma and HGESS. However, the possibility of carcinosarcoma (CS) could not be ruled out. Patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy.
Final histopathological diagnosis revealed HGESS, pT1b. Lack of carcinomatous component and negative IHC staining for CK7, CAM 5.2, AE1/AE3 ruled out CS. IHC showed tumor cells diffusely positive for CD10, actin, desmin and CD 56, focally positive for caldesmon, cyclin D1 and CD 117 and negative for DOG 1, further supporting the diagnosis for HGESS over leiomyosarcoma.

Results (if a Case Study enter NA)
NA

Conclusion
Definitive diagnosis of HGESS is achieved through histology and IHC. An appropriate panel of IHC markers is essential to differentiate between endometrial stromal tumors from leiomyosarcoma and CS. Accurate diagnose of this rare clinical entity is critical especially in its initial stages owing to its poor prognosis and aggressive nature.
Conclusive evidence for the origin of the carcinoid component in strumal carcinoids and a new morphological pattern
Authors: Liu Y , Feroze A , Yang L , Balakrishnan R 
Published: October 2024

Abstract

Introduction/Objective
There has been debate whether strumal carcinoids are carcinoids with areas resembling thyroid or arise from bonafide thyroid tissue in struma. While the thyroid nature has been proven by demonstrating positive TTF-1 in the struma component, evidence for the origin of the carcinoid component is sparse. Herein, we describe a case of strumal carcinoid and use a panel of markers to show definitive morphological and immunohistochemical evidence of the evolution of the neoplasm from struma ovarii to struma carcinoid, within the same lesion. We also report a unique component of a more sinister single cell pattern of invasion apart from the usual insular, trabecular, and mucinous patterns.

Methods/Case Report
A 40-year-old woman with an adnexal mass underwent bilateral salpingo- oophorectomy/hysterectomy. Microscopic analysis identified thyroid tissue consistent with struma ovarii, juxtaposed with a neuroendocrine neoplasm. The interface between the two showed strong PAX-8 and uniform TTF-1 staining in the struma but gradual loss of TTF-1 with retained/weak PAX-8 staining, moving away from the struma component and into the carcinoid. Additionally, a pattern of single cell invasion was identified, away from the main tumor and at the ovarian surface. These cells closely resemble luteinized ovarian stromal cells but are stained like the carcinoid tumor. Two months postoperatively, the patient had no evidence of recurrence or metastasis.

Results (if a Case Study enter NA)
NA

Conclusion
We have provided conclusive morphological and immunohistochemical evidence that strumal carcinoid develops from native neuroendocrine cells of thyroid tissue in struma ovarii. Specifically, retained/weak PAX-8 with interspersed TTF-1 in an adnexal carcinoid provides valuable insight when dealing with tumors of unknown etiology, strongly favoring an ovarian primary (specifically, from struma ovarii) and not metastasis from the gastrointestinal tract or other Mullerian tissue. Lastly, the single cell pattern of invasion that we elucidate here is something to be aware of in the context of metastases or frozen sections.