14^th Asia Pacific Pathology Congress November 13-14, 2017 Osaka, Japan

Biography:

Amber Valentine is a Speech-Language Pathologist who graduated from the University of Kentucky with her MS in Communication Disorders.  She is a Board Certified Specialist in Swallowing and Swallowing Disorders and an International Board Certified Lactation Consultant.  She worked for Baptist Health Systems, Inc for 8 years before moving to Florida where she worked for Wolfsons Children’s Hospital and Mayo Florida.  She is now back in Kentucky working for Baptist Health Lexington.  She has experience in adults and pediatrics with feeding and swallowing difficulties including:  bedside swallow evaluations, Modified Barium Swallow studies, FEES, and pediatric feeding evaluations including NICU.  She has provided guest lectures for the University of Kentucky and the University of Louisville on feeding and swallowing topics. She has presented at the hospital level, local, state, national, and international levels on pediatric feeding/swallowing and breastfeeding. 

Abstract:

The Speech-Language Pathologist is often seen in settings as the expert for infants with feeding difficulties, predominantly for bottle feeding or feeding aversions.  In today’s society, with breast feeding becoming more and more “the norm,” the SLP has become more involved in the area of feeding assessment with not only bottle fed infants but infants who are attempting breast feeding as well.  The SLP brings an interesting background to the area of breast feeding with a knowledge of the oral mechanism, infant respiratory system, and swallowing mechanisms.  In many NICU and pediatric facilities, the SLP is now providing pre-feeding readiness assessments on infants, and by doing these, allowing many infants to get in on the ground floor with breast feeding. These infants in the NICU and early pediatric setting can be provided with more opportunities to become successful breast feeders, especially those infants who were previously thought to be unable to complete this task.  As the literature shows, it is so critical to provide human breast milk as soon as possible to these fragile infants in NICU and other pediatric populations, by allowing them to have earlier opportunities at the breast, they will be more likely to become not only successful breast feeders, but more successful feeders for a lifetime.  This presentation will discuss the role of the SLP in lactation clinically, as well as how we can work together between disciplines to improve breastfeeding success.

Biography:

Dr. Mirza completed his MBBS from the Aga Khan University in Karachi, Pakistan and PhD from University of Illinois in Chicago, IL. He trained in combined anatomic and clinical pathology, with fellowships in hematopathology, thoracic pathology and medical education at the University of Chicago. He is an Assistant Professor of Pathology and Medical Director of Molecular Pathology at Loyola University Chicago Stritch School of Medicine in Maywood, IL. He is the recipient of numerous pathologist-in-training awards, teacher-of-the year awards, and honors such as induction into the Alpha Omega Alpha honor society and selection into American Society for Clinical Pathology's 40 Under Forty 2017.

Abstract:

Molecular diagnostics and personalized medicine is revolutionizing the way we approach medicine and treatment of disease. Hematopathology was one of the first of the pathology subspecialities to welcome molecular classification into it's classification scheme when it introduced the WHO classification in 2001. Since then, the validity and importance of molecular data has increased million fold and continues to increase every day. As pathologists, we need to harness and embrace the power of molecular pathology in our daily practice and hematopathology has led the way. This lecture serves as a historical overview from the discovery of the t(9;22) in CML and the inclusion of the "AMLs with recurrent cytogenetic abnormalities" and how the classification scheme has evolved, from WHO 2001, to 2008 and now to 2016. This lecture will serve to update the audience on the changes in the WHO 2016 update to leukemia diagnosis in the WHO classification, discuss next generation sequencing and where it's utility stands in the diagnosis of leukemia, and the future of the field.

Biography:

Will be updated soon..!

Abstract:

Objectives: Vascular graft failure is one of the most common finding in patients undergoing coronary artery bypass graft (CABG) surgery and still remains the major problem after surgery. The aim of the present study was to investigate features of pathomorphological changes in different type of grafts after CABG in patients with isolated coronary artery disease and associated with hypertensive heart disease.

Material and Methods: Histopathological study was performed on 207 fragments of autopsy sections of autoarterial and autovenous grafts using light microscopy.

Results: It is shown that the condition of the vascular wall is depend on hemodynamics leading to degenerative changes of the graft as a result of destructive and proliferative processes in the intima and the middle layer. Active replacement of smooth muscle cells of the media by fibrous tissue and then connective tissues leads to thickness of the vascular wall, stenosis on one hand and on the other hand is a cause of development of unstable atheromatous plaques.

Conclusions: Morphological changes of the venous grafts in patients how undergone CABG and had died after surgery from coronary heart disease associated with hypertensive heart disease were more acute with more aggressive course of atherosclerotic changes with diffuse proliferation of processes and formation of unstable plaques.

Biography:

Dr. Kim Vaiphei is currently working as a Professor at Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. She had hold various levels of faculty positions in the department of Histopathology, PGIMER, Chandigarh and remained Professor since 2006. She has more than 300 publications in area of Research Molecular pathways of cancer development. She attended 50 national conferneces and more than 20 International conferneces. She has 15 Awards by national and international academic bodies.

Abstract:

Background. Significance of non goblet (GC) columnar mucosa (CM) present at lower end esophagus (LEE) remains controversial, and there is limited information of the follow-up data.  Aim. to evaluate outcome of Barrett's mucosa (BM) and NGCM in long term follow-up biopsies. Methods. retrospectively evaluated biopsies reported as columnar mucosa (CM) with and without GC and correlated with clinical outcome. Results. There were 178 patients, mean age of 52.1±15.6, 7 <20 years, M:F=5:1; 70% had reflux symptom and 30% had dysphagia. Endoscopy: only BM in 130(73%), ulceronodular in 17%, stricture in 5% and small polyps in 5%.  Sixty (34%) cases had long segment (LSBM) and 70(54%) short segment (SSBM); 11% had hiatus hernia. Histology: GCs were identified in 83% of the biopsies, 94% with LSBM. Dysplasia was observed in 65 (37%), low grade (LGD) in 68% and high grade (HGD) in 32%, 26( 14%) had carcinoma associated with BM and HGD. Thirty (17%) biopsies with no GC showed alcian blue (AB) positive cells, 7(4%) had LGD and 3(2%) had HGD, none had associated carcinoma. Follow-up biopsy showed regression and normalization of mucosa and symptomatic relieve in many. Majority of LGD remained static with few progressing to HGD. Majority of HGD progressed to frank carcinoma over the years. Conclusion: high percentage of non-GCCM showed AB positivity and dysplasia. Many of cases with BM, LGD and HGD developed carcinoma. Ulceronodular and stricturous lesions associate frequently with BM and carcinoma. Present study emphasizes equal importance of follow-up biopsy in BM and NGCM.

Biography:

Dr. Mudaliar completed his MD from Ross University School of Medicine followed by a research fellowship at Weill Cornell Medical College/NY Presbyterian Hospital. Subsequently, he trained in combined anatomic and clinical pathology at Loyola University Medical Center followed by fellowships in Surgical Pathology fellowship at MD Anderson Cancer Center and a Dermatopathology fellowship at Loyola University Medical Center. He is currently an Assistant Professor of Pathology at Loyola University Chicago Stritch School of Medicine in Maywood, IL.

Abstract:

Assessment of dense lymphoid cutaneous proliferations is often challenging. It can be difficult to distinguish benign cutaneous lymphoid infiltrates from malignant lymphomas, and at times, definite classification as either benign or malignant cannot be reached. One of the challenges lays in needing to have a solid understanding of what constitutes normal benign findings and separating these from malignant pathologic change. Also, in order to exclude malignant lymphomas, a working knowledge of all cutaneous lymphomas is required. In addition, apart from considering the clinical history and the histologic findings, an ability to interpret potential immunohistochemical and gene re-arrangement studies is necessary. This lecture serves as an introduction to cutaneous lymphoid proliferations and will serve to provide an algorithmic approach to assessing such proliferations that will be useful for general pathologists, dermatopathologists, and hematopathologists.  

Biography:

Dr. H. Khoja completed his MBBS Degree in King Saud University, Riyadh, Kingdom of Saudi Arabia.  He completed anatomic pathology training at King Faisal Specialist Hospital in 2008.  Then he joined the University of Toronto, Mount Sinai Hospital, ON, CANADA, as a Bone and Soft tissue Pathology fellow from 2011-2012 followed by another year of fellowship in Head and Neck pathology in the same center.  Currently, he is a Consultant Pathologist at King Faisal Specialist Hospital and research Center specialized in bone and soft tissue/head and neck pathology.    

He has published several papers in peer reviewed journals and has been invited as speaker in several conferences locally and internationally.

Abstract:

Bone pathology is one of the difficult subspecialties in surgical pathology. Several reasons are behind this concept including rarity, complexity, and great morphological overlap between primary bone neoplasms. Multiple cases of bone neoplasms -including primary and secondary neoplasms- will be discussed highlighting the importance of combining clinical features, diagnostic imaging, pathological, and molecular findings to reach a precise and specific diagnosis. Finally, a general approach to bone lesions will be discussed to avoid pitfalls in bone pathology

The presentation will highlights some common pitfalls in bone pathology with a simple approach to avoid mistakes/pitfalls in bone pathology for general pathologists and trainees.

Biography:

Dr. Al-Hussain completed his MBBS Degree in King Saud University, Riyadh, Kingdom of Saudi Arabia. He completed pathology training at King Faisal Specialist Hospital in 2008. Then he joined the University of North Carolina, at Chapel Hill, NC, USA, as renal pathology fellow from 2009-2010. In 2011, he completed another year of fellowship in genitourinary pathology at John Hopkins Hospital, Baltimore, USA. Currently, he is a Consultant Pathologist specializing in Nephropathology and urologic pathology.
He is also the Director of Pathology Residency Training Program. He has published 27 papers in peer reviewed journals and has been invited as speaker in several conferences locally and internationally.

Abstract:

Prostatic adenocarcinma is the second most common malignancy worldwide. There have been new updates on pathology of prostatic adenocarcinoma. Recently, the International Society of Urological Pathology held a consensus conference in 2014 which was published in 2015. This conference predominantly deliberated with definition of various grading patterns of usual prostatic adenocarcinoma, grading of intraductal carcinoma and the new Grade Groups. Most of these updates were implemented and applied in the new 2016 WHO Classification of Tumors of the Prostate.
The presentation will discuss the new update of prostatic adenocarcinoma with focus on grading system.
Biography

Biography:

Dr Anju Pradhan is a consultant Pathologist at B. P. Koirala Institute of Health Sciences (BPKIHS), Nepal. She completed her MD in 2008 from the same university. Having special interest in cytopathology, gastrointestinal and liver pathology and medical education, she completed short term training in cytopathology from Siriraj hospital, Mahidol University, Bangkok, Thailand in 2015, in adult and pediatric liver pathology from Geneva University Hospitals, Geneva, Switzerland in 2016 and in Problem-based Learning in Medicine, Health and Behavioural Sciences from Maastricht University, Maastricht, The Netherlands in 2012. She is also working as a coordinator of Phase I MBBS Program.

Abstract:

Background and Objectives

In diagnosing a neoplastic lesion from any area, fine needle aspiration cytology can provide a level, as to whether the lesion is benign or malignant. Cell block preparation in a way will mimic the histopathological sections, thus help in sub classifying various neoplastic lesions as well. The objectives of this research was to evaluate the diagnostic utility of cell block in fine needle aspiration of malignant lesions.

Materials and Methods

This was a prospective hospital based study conducted in the department of pathology, BPKIHS over a period of 1 year. A total of 41 cases who were suspected or diagnosed as cases of malignancy in FNAs smear of whom cell block and histopathology specimens, available were included in this study.

Results

Smear were diagnostic in 93% of cases while Cell block were diagnostic in 80% of cases Smear supplemented by Cell block improved diagnosis which reached to 98%.The cell block diagnosis confirmed that of smear diagnosis in 56% cases. It established specific diagnosis in 24% cases and hence contributed especially in cases where smears were non-diagnostic. Therefore, CB were found to be superior to smears in these cases. The cell block was non-confirmatory in 20% cases. The main non-confirmatory nature of cell block was mainly due to the non-diagnostic yield of cell block.

Conclusion

This study concludes that Cell Blocks have a synergistic effect on Conventional Smear diagnosis. In selected cases where CS falls into suspicious for malignancy category, Cell Blocks can render a specific diagnosis.

Keywords: Cell block, Malignant lesion, Smear diagnosis

Biography:

Tiago Marques Godinho has completed his Master's Degree in Computer and Telematics Engineering from the University of Aveiro in 2013. In the same year, he started the Computer Science PhD program. He was awarded a national scholarship for conducting his research on performance optimization in medical imaging information systems. Since then, he has published 5 papers in international peer-reviewed journals with impact factor and has participated in the fields major conferences. Last year, he focused his research on computer systems for digital pathology. Currently, he is in the last stage of his PhD.

Abstract:

Nowadays, the field of digital pathology is in the spotlight thanks to advances in whole-slide imaging technologies. In this area, the exploitation of digital laboratories has significant advantages, namely, faster and more accurate diagnostic, better support for telepathology as well as new clinical and research applications. Despite these advantages, there has been a very slow adoption of whole-slide imaging. In fact, it raises several technical challenges which may jeopardize the benefits of its operation, most notably the performance issues associated with storage and distribution of huge volumes of data, and the lack of interoperability with other hospital information systems, such as Picture Archive and Communications Systems (PACS) based on the DICOM standard.

We developed an architecture of a Web Pathology PACS that is able to overcome these challenges and unlock the full potential of digital pathology and whole-slide imaging for clinical practice. Our solution is fully compliant with the DICOM standard both for communications and data formats. It includes a PACS archive capable of storing whole-slide images along with other medical imaging modalities as well as a zero-footprint viewer that runs in any common web-browser. In summary, it enables the integration of digital pathology and whole-slide imaging with other medical imaging modalities while being very competitive in terms of efficiency and usability.

Biography:

Ahmed Abdullah Alhumidi is currently working as an associate prof, and consultant of dermatopathology at King Saud University, Saudi Arabia. He attend many national and inetrnational conferences. His articles got published in may reputed journals.

Abstract:

Most adnexal neoplasms are uncommonly encountered in routine practice, and pathologists can recognize a limited number of frequently encountered tumors. In this review, I provide a simplified histological approach to be used by general pathologists and residents of pathology and dermatology programs. These tumors are classified into 1) tumors connected to epidermis, 2) tumors not connected to epidermis, 3) sebaceous tumors, and 4) dermal cysts.

Biography:

Tariq Al johani has completed his MBBS and residency of pathology from king saud University and  he did his postdoctoral studies in renal pathology from imperial college and hammersmith hospital London UK. He is the director of immunohistochemistry in the pathology department. He has published few papers and he has many ongoing work in histopathology and renal pathology.

Abstract:

Renal pathology is a unique part of pathology involving both native and transplant pathology.  Today I will present a combinations of both. All the cases I will present are unusual and give us something to learn. With un expected finding in histology not matching the presentation or the history.one case is of Intraglomerular metastases of malignant tumor? Resembling crescent and endocapillary formation. The case was a surprise for nephrologist and for us with only few are reported. We confirm the diagnosis using immunohistochemistry with different antibodies. The other case is a transplant case with a diagnosis of Suspicious for acute T-cell-mediated rejection for the first two biopsies then patient get treatment but still he get worse and a  third biopsy showed same finding but clinically there was positivity in the serum for ? So all the biopsies reviewed and show the same positivity by immunohistochemistry. Also there are no case reported with this finding.   A third with previous confirmed diagnosis of C3 glomerulopathy presenting with same clinical presentation after 5 years and biopsy done but it show that there is no more C3 glomerulopathy with complete negative stains for C3  and an new diagnosis ?

Biography:

Will be updated soon..!

Abstract:

Background and Objectives: Numerous Molecules in the tumor microenvironment orchestrate the body’s immune response against tumor cells thereby affecting tumor cell growth and proliferation. Adenosine is produced in the hypoxic tumor milieu and by stimulating its receptors (A2AR) plays an important immunosuppressive effect that helps tumor cells evade the body s immune mechanisms. Stimulation of these receptors also has a profound role in promoting the vasculature and contributing to tumor aggressiveness.

The present study aims at investigating A2AR expression in breast cancer tissue and its association with different clinico-pathological parameters.

Methods: This study was conducted on 30 FFPE human breast cancer tissues. Sections were immunohistochemically stained with of A₂AR antibodies. Clinical and pathological data were retrospectively obtained from the patients’ records in the archives of the pathology department in Alexandria University, Egypt.

Results: A2ARs were expressed in 73.3% (n=22) of breast cancer tumors. Its expression was significantly higher in younger age patients (< 50 years) (88.2%) compared to older ones (54.5%)[p=0.044]. A2AR expression was significantly associated with a Luminal B molecular subtype and triple negative tumors [p=0.028] compared to Luminal A, and Her2-enriched tumors. Patients expressing A2A receptors had significantly higher expression of Progesterone receptors [P=0.031] compared to ER expression [P=0.098]. The majority of A2AR expressing tumors had a mitotic index score of 2 [p=0.013] as well as a significantly higher proliferative index (ki-67 >30%) [p=0.018]. No association was observed between A2A expression and tumor size, type, grade, Lymph node status or outcome after 2 years of follow-up.

Conclusion: Our study confirmed that A2AR receptors are strongly expressed on breast cancer cells of younger patients particularly those of luminal B and triple negative subtypes. Their expression is associated with a higher proliferative index suggesting that the addition of A2AR antagonists to the current treatment protocols might further improve the outcome of this group of patients.

Biography:

Prof Neelkamal Kapoor completed her MD in Pathology in 1986. Since then she is in the field of medical education working in various medical colleges of India. She is currently working as Dean Research and Head Department of Pathology and Lab Medicine at All India Institute of Medical Sciences Bhopal. She has various national and international awards notably EML Haagedoorn prize of EACE & Sir Sriram memorial NAMS award to her name and a number of publications and presentations in national and international journals.

Abstract:

Carcinoma of the uterine cervix is the second most common cancer among Indian women. It accounts for 12.5% of all female cancers in Bhopal, India. Cervical cytology is a simple, cost effective and reliable technique for cervical cancer screening; however its accurate interpretation depends on variables such as obtaining adequate samples, proper staining and optimal reporting. The quality of cervical cytology reports can be assessed by various quality indices such as relative percentages of various diagnoses, including the rate of unsatisfactory smears and the atypical squamous cells (ASC) - squamous intraepithelial lesion (SIL) ratio.

A total of 7813 cervical cytology cases were screened at our center. Of these, 96.6% had no abnormality detected and one hundred and five cases were reported as epithelial cell abnormalities (1.34%). All the epithelial abnormalities reported were categorized and their individual percentages were calculated and results were compared with the CAP benchmarks.

Biography:

Katanyoo has completed her medical school and postdoctoral studies from faculty of medicine, Khon kaen university. Now she just finished her study and works as new pathologist at Khon kaen university.

Abstract:

Tonsillectomy is one of the most common procedures in the hospital. Recent studies reveal that histopathological findings of routine tonsillectomy in the young patient has no significant pathology findings and consume times and human resource. The need of routine microscopic examination in tonsillectomy from the young patient is questioned. The objective is to study the necessity of microscopic evaluation of tonsillectomy specimen in the young patients and pathological findings in tonsillectomy specimems.

A retrospective medical record review was performed at Srinagarind Hospital. The pathological specimens of 401 patients who underwent tonsillectomy at the age under 19 years old in 2011-August 2016 were analyzed and the histopathological findings, macroscopic examination, indication of surgery and underlying disease were reviewed. A total of 401 patients were included. The age distribution was one to 19 years (mean 7.4 years, SD 4.4). There were 251 males (62.6) and 150 females (37.4%). Lymphoid hyperplasia was detected in all patients (100%).  No unexpected malignancies were found in pediatric patients.

Conclusions: No unexpected finding in routine tonsillectomy specimens from the young patients is identified. However, microscopic examination should be considered in clinically or macroscopically suspicious cases for malignancy.

Biography:

Nannaphat Atsawaphidsawat has completed her MD from Khon Kaen University in 2016. Soon after
graduated, she continued her specialty in Anatomical Pathology. She is currently a second-year resident in Anatomical Pathology Department, Faculty of Medicine, Khon Kaen University, Thailand.

Abstract:

Introduction: Beare-Stevenson cutis gyrata syndrome (BSS) is a seriously extremely rare genetic
disorder characterized by skin abnormalities and the premature fusion of certain bones of the skull (craniosynostosis) Recently, evidence was presented that BSS is caused by a mutation of the FGFR2 gene. Here, we demonstrate the first Thai case of BSS (the 27th case in English publication) with full bodyautopsy.
Case Report: A full-term Thai male infant, without any evidences of congenital anomalies in his family, was found having bilateral ventriculomegaly during intrauterine period. Soon after birth, the baby developed cyanosis and immediate intubation was given. His condition became worsen, until his death in second day of life. Consent for full body autopsy was given by the family members. External examination revealed classical features of BSS including clover-leaf skull shape, cutis gyrata, prominent umbilical stump, ambiguous genitalia, but acanthosis nigricans was not detected. Internal examination revealed craniosynostosis, Arnold-Chiari malformation type II, hydrocephalus and agenesis of corpus callosum. Interestingly, microscopic study of skin at the nape of neck showed glomuvenous malformation and glomangiomyoma-like lesions that was the first perivascular tumor described in BSS. Molecular analysis of FGFR2 gene confirmed a heterozyguous p.Tyr375Cys, which was identical to that detected in previous fourteen cases.
Conclusion: BSS should be considered in patients presented with craniosynostosis and cutis gyrata.
Associated vascular malformations in BSS was first described in this case. The further study of additional patients will provide more information about the clinical phenotypes.

Keywords: Beare-Stevenson cutis gyrata syndrome, craniosynostosis, FGFR2

Biography:

Will be updated soon..!

Abstract:

Background: Several diseases have been caused by contamination of surface and groundwater. 

Aim: The aim of the present work is to investigate the impact of iron overload in drinking water on liver pathology.

Materials and Methods: Samples of drinking water, blood and true cut liver biopsies were taken from selected inhabitants, who attended in some Dakahlia governorate hospitals. Those inhabitants (16 patients) from Mit-ghamr and Aga districts were suffering from liver disorders (had hepatitis C) and 4 patients had chronic cholecystitis from Mansoura district as control cases. Measurement of iron level in water samples was carried out by the use of an atomic absorption spectrophotometer, analyzed for serum iron level with a micro lab 200 spectrophotometer.

Results: The mean value of iron in surface water is lower than the permissible limit of Egyptian ministry of health (EMH) and World health organization (WHO). However, the mean value of iron in groundwater samples is higher than that permissible limit and than those of surface drinking water. Comparison between iron level in drinking water and human blood samples shows positive relationship. The control group depended on drinking surface water and had normal liver function tests, whereas the patient group that depended on drinking groundwater had abnormal values in liver function tests. These data suggest that the polluted iron drinking water is the reason for the liver disorder of the patients. Siderosis was apparent among those patients drinking polluted iron water in comparison to control cases. The siderosis appears to be responsible for resistance to treatment of HCV and progression of fibrosis.

Conclusion; The accumulation of iron in liver leads to fibrosis. Iron depletion therapy could interfere with fibrosis development and possibly reduce the risk of hepatocellular carcinoma (HCC).

Keywords; Water, blood, liver, Iron

Biography:

Ahmed M. Abdelaziz, M.D. is a Professor & Head of Pathology Department, Faculty of Medicine, Cairo University (Kasr Al-Ainy) in Egypt.  He has completed his M.D. in Pathology in 1991.  He graduated from medical school, 1982 from Cairo University. He joined Department of Pathology, completed his pathology training and received M.Sc. degree in Pathology in 1987. He is a consultant & Head of Pathology Unit in Almokhtabar Lab (one of the largest Lab in Egypt), since 2004 up till now.

Abstract:

Immunohistochemistry (IHC) combines anatomic, immunologic, and biochemical techniques to identify specific tissue components using a specific antigen-antibody reaction labeled with a visible reporter molecule. This binding is then visualized through the use of various enzymes that are coupled to the antibodies being used. The enzyme acts on a chromogenic substrate to cause deposition of a colored material at the site of antibody-antigen bindings. IHC is not only critical for the accurate diagnosis of malignancies but also plays a pivotal role in prognostic evaluation (e.g., estrogen and progesterone receptors in breast cancer) and treatments strategies (e.g. Her2/neu in certain breast cancers).    It is recommended that hormone receptor and Her2/neu testing be done on all primary invasive breast carcinomas and on recurrent or metastatic tumors.   If hormone receptors and Her2/neu are both negative on a core biopsy, repeat testing on a subsequent specimen should be considered, particularly when the results are discordant with the histopathologic findings.  Other biomarker tests (eg, Ki-67 or multigene expression assays) are optional and are not currently recommended for all carcinomas.  Guidelines published by the American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) require recording specific preanalytic and analytic variables that can affect test results. Information regarding assay validation or verification should be available in the laboratory. Any deviation(s) from the laboratory’s validated methods should be recorded. Appropriate positive and negative controls should be used and evaluated.

Biography:

Dalia Abd El-Kareem,M.D. is a Lecturer of Pathology at Faculty of Medicine, Cairo University (Kasr Al-Ainy) in Egypt. She has completed her M.D. in Pathology and Pulmonary Pathology in 2016. She graduated from medical school, 2007 from Cairo University. She received training in pulmonary medicine and respiratory ICU at Cairo University Hopsitals, then she joined Department of Pathology, completed her pathology training and received M.Sc. degree in Pathology in 2013. She was trained in the field of Pulmonary Pathology at University of Texas Medical Branch (UTMB), Galveston, U.S.A. She had talks in many conferences and publications in reputed journals.

Abstract:

Idiopathic pleuroparenchymal fibroelastosis (IPPFE) is an entity recently classified by the American thoracic society/ European respiratory society as a rare idiopathic interstitial pneumonia (IIP). This might be uncertain, based on some clinical experiences.

As part of a large Egyptian study that included patients with diffuse parenchymal lung diseases (DPLD), we encountered 6 patients with DPLD diagnosed as IPPFE by surgical lung biopsy over a period of one year.

Clinical data, high resolution chest computed tomography (HRCT) findings and histologic criteria from thoracoscopic lung biopsies were correlated in a multidisciplinary approach.

Most of our patients were young age, with female predominance and living in the same area (Upper Egypt). Exertional dyspnea and cough were the main presenting symptoms. Low body weight, flat chest wall and stretched skin were the main signs. HRCT showed upper lobe volume loss, traction bronchiectasis, visceral pleural thickening and ground glass opacity. Histologic features included thickening of the visceral pleura, subpleural parenchyma and interlobular septa with deposition of large amounts of elastic fibers (by elastic stain), and non-specific interstitial pneumonia (NSIP) histologic pattern.

Conclusion: IPPFE should get more attention being more prevalent than we used to know. Although other IIPs may represent initial phase in IPPFE or may coexist together but it should still be considered as a separate entity. Multidisciplinary approach is required for diagnosis. Further studies to reach etiologic factors are highly needed.

Biography:

Sudha Pottumarthy Boddu has completed her graduation from Medical School in India. She has completed her Pathology/Microbiology Fellowship training with the Royal College of Pathologists of Australasia. She is a recipient of various awards and scholarships, including the Neil Prentice Memorial Prize of RCPA. She has gained experience in various hospital, research and public health laboratories in the US, publishing over 30 articles in peer-reviewed journals.

Abstract:

Application of State-of-the-Art technology in clinical microbiology has recently seen the dramatic evolution of bacterial identification methods to enable rapid laboratory diagnosis, bringing the clinical microbiology laboratory to the forefront. While rapid bacterial identification plays a crucial role in empiric antibiotic treatment, in some instances it may also assist in determining the epidemiology of the infection. The current clinical environment thus demands that the clinical microbiologists maintain close communication with the clinicians, enabling timely translation of laboratory results to patient care. The above concepts along with increasing antimicrobial resistance will be illustrated further with clinical scenarios encountered in daily clinical practice.

Biography:

Dr. Shroque Zaher is a consultant histopathologist with a specialist interest in Haematopathology, pulmonary pathology and medical education. She completed her pathology training at the London and East of England deaneries and gained her CCT in 2016. She gained her FRCpath from the Royal College of pathologists, United Kingdom in 2015.

Abstract:

This case represents a rare entity- primary pulmonary myxoid sarcoma, of which to the best of our knowledge only 10 other cases have been reported in the literature. (Thway et al, 2011). They are defined by distinctive histomorphological features and characterized by a recurrent fusion gene. All tumours involved pulmonary parenchyma with a predilection for the endobronchial component. They appear to have a predilection for females, with 7 of the 10 reported cases , occurring in women. Microscopically, they are lobulated tumours comprising cords of polygonal, spindle, stellate cells with myxoid stroma, morphologically reminiscent of extraskeletal myxoid chondrosarcoma. Tumours were immunoreactive for only vimentin and weakly focal for EMA, although our specific case was negative for these markers. In 7 of the 10 tumours, a specific EWSR1-CREB1 fusion gene was demonstrated by reverse transcription-polymerase chain reaction. This gene fusion has been described previously in 2 histologically and behaviorally different sarcomas: clear cell like sarcoma-like tumours of the gastrointestinal tract and angiomatoid fibrous histiocytoma, however this is a novel finding in tumours with the morphology described and occurring in the pulmonary region.

Biography:

Ahmed A.Yameny is the head of Society of Pathological Biochemistry and Haematology. He is Union chief Medical Laboratory in Egypt, he was the Chairman for five international conferences of medical laboratory and two international conferences of the Society,he is  Expert and medical laboratory consultant. He is chief editor Journal of Bioscience and Applied Research (www.jbaar.org), he is a Doctor of Microbiology, high diplomas in (1- bacteriology 2-Public health of parasitology and medical entomology 3-Analytical Biochemistry 4- Haematology 5- Genetic Analysis) , he has a B.Sc. in Biochemistry (Alexandria University in Egypt ), and he has a B.Sc.in Biochemistry/Chemistry(Tanta University in Egypt). 

Abstract:

The Molecular Pathology Laboratory offers molecular diagnostic testing for a variety of clinical indications across the health-care continuum, including testing for disease susceptibility, population screening, diagnosis, prognosis, therapeutic decision making, and disease monitoring. Molecular Pathology(MP) is at the heart of modern diagnostics and translational research.It has become evidenthat, to advance in the translation of biomarker discovery into diagnostic  and therapeutic application , the purpose of this article is to advance MP into Digital Molecular Pathology(DMP) ,depending on known biomarkers especially miRNA and proteomics,to resolve  many of the demands in the clinical laboratory , as screening for cancer , endemic or rare virus infection and biological war. We would like to suggest an integrated model of DMP, from biomarkers to form  two stepes of diagnosis and two stepes of treatment,the first step for fast diagnosis and fast therapy to stop spreading of disease, the secod step for complete diagnosis and effectiveness treatment,  many biomarkers were discovered so must divided into groups, DMP can allow facilities to outsource all or a portion of the demands data such as cloud computing, bioinformatics pipelines, variant data management, and knowledge curation. Exchange of electronic molecular data allows laboratories to perform validation of rare diseases using foreign data, check the accuracy of their test results against benchmarks.

Biography:

Dr. Kim Vaiphei is currently working as a Professor at Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. She had hold various levels of faculty positions in the department of Histopathology, PGIMER, Chandigarh and remained Professor since 2006. She has more than 300 publications in area of Research Molecular pathways of cancer development. She attended 50 national conferneces and more than 20 International conferneces. She has 15 Awards by national and international academic bodies.

Abstract:

Sporadic colorectal cancer (CRC) in patients is increasing rapidly in Indian population and half of the patients are less than 50 years of age. No comprehensive molecular study has been carried out to analysis the basis for the disease occurring in younger individuals. The study investigated frequency of hMLH1 and hMSH2 genes and hMLH1 and hMSH2 proteins expressions, their prognostic significance and correlated with the adenomatosis polyposis coli (APC) gene mutational status by DNA sequencing in young CRC patients. Protein expression and promoter methylation of APC, hMLH1 and hMSH2 and mismatch repair genes (MMR) were analyzed by immunohistochemistry and methylation-specific PCR (MSP) respectively and correlated with patients data. Of 100 CRC, hMLH1 and hMSH2 loss were observed in 18 and 12, reduced expressions in 50 and 38 respectively, 5 failed to express. Promoter hypermethylation for hMLH1 was detected in 50 and hMSH2 in 10.   Combination of methylation of hMLH1 and hMSH2 gene was observed in 8 tumors. Significant correlation was observed between histological tumor grade, methylation status and  hMLH1 gene expression (p< 0.05). Normal expression for hMLH1 and hMSH2 was observed in all unmethylated tumors. Promoter methylation of hMLH1 and hMSH2 failed to influence survival and correlated with loss of protein. APC gene mutation observed in 45% patients with no differential in distribution.  Conclusion: Our observations suggest inactivation of MMR gene via hypermethylation lead to functional loss resulting in tumor aggressiveness and role of APC gene appeared not to play a major role in tumor progression in these young patients.

Biography:

Rabia Butt did her M.B.,B.S. from University Of Health Sciences in 2006. She did her postgraduate training from Services Institue Of Medical Sciences and completed her training in 2012. She is also member of International Academy Of Cytology. Currently she is working as consultant histopathologist, department co-ordinator and incharge post-graduate residency program (F.C.P.S) Histopathology at Chughtai Lab. Lahore.

Abstract:

Cell-cell junctions are important to maintain cell and tissue polarity and integrity. E-cadherin/beta-catenin complex plays significant role in maintaining epithelial integrity. Disruption of this complex not only affects the adhesive properties of cells but also activates the Wnt signaling pathway, which is observed in many malignancies and fibrotic disorders. We conducted this study to compare the dysregulation of this complex in inflammatory nasal polyps (INP), sinonasal inverted papillomas (SIP) and nasopharyngeal carcinomas (NPC). A cross-sectional study was conducted on 82 cases, retrieved from archives of Chughtais Lab. Lahore, out of which 68 cases were of INPs, 9 cases were of SIP and 5 cases were of NPC using non-probabilty consecutive sampling technique. Our study showed dysregulation of this complex in 19 (27.9%) cases of INPs, which were predominantly accompanied by fibrosis, 7 (77.8%) cases of SIP and in all 5 (100%) cases of NPC. Nuclear staining was evident in all 5 cases of NPC. Our study concluded that this complex is dysregulated in INPs associated with fibrosis and in neoplastic disorders. Dysregulation of E-cadherin/beta-catenin complex may be involved in recurrence and malignant transformation of INP and SIP. Therefore close followup is required for such patients of INP and SIP, to prevent recurrence and progression of disease.

Biography:

Zonaira Rathore did her M.B.,B.S. from King Edward Medical University. Currently she is working as consultant histopathologist at Chughtai Lab.

Abstract:

Breast cancer is the most common female malignancy worldwide. Studies have identified different molecular subtypes including luminal A, luminal B, Her2 positive and triple negative breast cancer (TNBC) on basis of immunohistochemistry (IHC). They have different prognosis and response to adjuvant therapy. Anaplastic lymphoma kinase (ALK) is a tyrosine kinase receptor known to be expressed in many tumors and can be targeted by anti-tyrosine kinase inhibitors. Studies have shown subset of breast carcinomas to express ALK. The aim of our study is to determine ALK protein over-expression using IHC on TNBC patients, providing them with a targeted therapy option. A cross-sectional study was performed, on 43 cases of TNBC of all histologic subtypes retrieved from archives of Chughtais laboratory Lahore from 1st January 2016 to 30th July 2017, using non-probability consecutive sampling technique. Mouse anti-human monoclonal antibody against ALK from DAKO was used. Membranous and/or nuclear staining of ALK in at least 1% of tumor cells was taken as positive. All data was analysed through SPSS version 22.0. Our study showed 11 cases (25.6%) to overexpress ALK by immunohistochemistry. Only 1 case (2.3%) showed cytoplasmic granular positivity along with nuclear staining while 10 cases showed only nuclear pattern of staining (23.2%). This study concludes that a significant number of cases show ALK overexpression by IHC, predominantly nuclear. Further studies are required, using in situ hybridization (ISH), to confirm ALK gene rearrangement and validate the significance of nuclear staining of ALK as seen is our study. This subset of patient may benefit from anti-ALK therapy. However further studies are required to validate the results.

Biography:

Xiangshan Fan has completed his PhD from Nanjing University and ever been to MD Anderson Cancer Center as a visiting scholar. He is the director of Department of Pathology, the affiliated Drum Tower Hospital, Nanjing University Medical School.  He is interesting in gastrointestinal pathology, lymphoma and pulmonary pathology and has published more than 140 papers in peer-reviewed journals.

Abstract:

Here, seven very rare cases of gastrointestinal tract from Nanjing Drum Tower Hospital in China were reported, such as indolent T-cell lymphoproliferative disease of the gastrointestinal tract involving the colon and tonsil, gastric plasmablastic lymphoma, gastric cancer with lymphoid stromal caused by EB virus combined with monoclonal B-cell lymphoproliferative disease, hepatoid adenocarcinoma with liver metastasis, gastroblastoma, choriocarcinoma, pancreatic acinar-like adenocarcinoma of the proximal stomach invading the esophagus and so on. It is very important for pathologists to understand and identify these very rare diseases accurately for the appropriate treatment and patients management.

Biography:

Zhiwen Fan has achieved his MD degree in Nanjing Medical University in 2016 and currently, he works as the director of molecular pathology laboratory at Nanjing Drum Tower Hospital. Fan’s research field involves majorly in the study of liver disease related transcriptional regulation, which was mainly through post-translational modification (PTM) mediated fine tuning of transcription factors. Now he is currently hosting one project sponsored by the "National Natural Science Foundation of China." and also is the author of over 13 papers in reputed journals, among with a highest impact factor of 13.264 individually.

Abstract:

Uncontrolled inflammatory response highlights the central theme of non-alcoholic steatohepatitis (NASH), a growing global pandemic. Hepatocytes and macrophages represent two major sources of hepatic inflammation during NASH pathogenesis contributing to excessive synthesis of pro-inflammatory mediators. The epigenetic mechanism that accounts for the activation of hepatocytes and macrophages in this process remains obscure. Here we report that compared to wild type (WT) littermates, mice with a deficiency in the histone H3K9 methyltransferase Suv39h2 (KO) exhibited a less severe form of NASH induced by feeding with high-fat high-carbohydrate diet (HFD). Pro-NASH stimuli increased Suv39h2 expression in cell culture, in mice, and in human livers. In hepatocytes, Suv39h2 bound to the Sirt1 gene promoter and repressed Sirt1 transcription. Suv39h2 deficiency normalized Sirt1 expression allowing NF-kB/p65 to become hypo-acetylated thus dampening NF-kB-dependent transcription of pro-inflammatory mediators. In macrophages, Suv39h2-mediated repression of PPARg transcription favored a pro-inflammatory M1 phenotype over an anti-inflammatory M2 phenotype thereby elevating hepatic inflammation. Conclusion: Suv39h2 plays a pivotal role in the regulation of inflammatory response in hepatocytes and macrophages contributing to NASH pathogenesis.

Biography:

Dr. Enaam. Junainah has completed his surgical pathology board at the age of 30 years from Jordanian University and postdoctoral studies fellowship in breast pathology from Nottingham University. He is the director of histopathology laboratory at, Almamlaka Labs. He has published more than 25 papers in reputed journals and has been serving as an editorial board member of repute.

Abstract:

The pathological classification of breast diseases is constantly being updated, which reflect the advances in over view regarding the clinical and biological understanding of the disease. This overall examines new insights into the classification and molecular biology of the breast cancer. These advances have also resulted in increasing recognition of non-invasive breast disease, including lesions that are thought to be pre invasive precursors to breast cancer. In addition, advances have been made in breast cancer therapy and in the recognition of markers that can help predict both the natural history of disease and, in many cases, responses to particular therapies. The role of the pathologist in the management of breast cancer is evolving beyond simple diagnosis to include providing predictive information that can enhance individualized care. However, the handling and reporting of these specimens remains controversial, and , there is still marked variability in reporting in routine practice, we will try to emphasize these issue and concentrate in controversies cases till reach to a consensus agreement in reporting of these cases.

Biography:

Minh Bui Huynh Quang has completed his Medical Doctor at the age of 24 years from Pham Ngoc Thach University of Medicine and Master of Science (with speciality: General Pathology) from University of Medicine and Pharmacy of Ho Chi Minh City at the age of 28 years. He is a lecturer of Department of Pathology, Pham Ngoc Thach University of Medicine with over 03 years of experience (from December, 2013 – present). He has published a case reported “Bui HQM, Pham QT (2015), Report a case: Ectopic bone formation and Extramedullary hematopoiesis in the Thyroid gland, Ho Chi Minh City Journal of Medicine, 19(5), 85-90.”. He is also attending “Faculty Development Program” in The Collaborative Educational Program 2017-2021 between Texas Tech University Health Sciences Center El Paso and Pham Ngoc Thach University of Medicine and University of Medicine and Pharmacy of Ho Chi Minh City.

Abstract:

Objectives: (1) The aim of this study was to evaluate the expression of EpCAM (Epithelial Cell Adhesion Molecule) in Hepatocellular carcinoma (HCC) and correlated the results with pathologic characteristics.

Methods: Cross sectional study. Target: 100 patients were diagnosed with HCC between 2010 and 2013 at the Department of Pathology, University Medical Center HCMC.

Results: EpCAM expression was observed in 19% of the HCCs (19/100). EpCAM expression in HCC was only significantly correlated with histological grading of HCC. However, for survival analysis, there was no statistically significant correlation with overall survival was detected in this study, only 4 factors: architectural patterns, cytological variants, groups of tumor size, microvascular invasion had a significant impact on overall survival.

Conclusion: A small subpopulation of cancer stem cells have been identified by EpCAM expression. EpCAM has been demonstrated the potential role in opening up novel pathways and therapeutic strategies as an effective immunotherapy – targeted strategy for patients with HCC.

Key words: EpCAM, Hepatocellular carcinoma,

Biography:

Devish Pyakurel has completed his medical school from Institute of Medicine, Tribhuvan University and his post graduation (MD) in Pathology from B.P.Koirala Institute of Health Sciences, Nepal. He was elected president of 19^th executive body of Nepal Medical Student’s Society. Currently he is the director of Samyak Diagnostic Pvt. Ltd, Nepal’s first ISO 15189:2012 certified Laboratory. He is editor of Journal of Pathology of Nepal. He has published numbers of article and recently engaged in couple of researches.

Abstract:

BACKGROUND: Breast Cancer is the most frequent neoplasm causing death in women between 35-55 years. Of the prognostic indicators existing for breast cancer, axillary lymph node status has been regarded as the most important one. 20-30% of all lymph-node-negative patients will still develop a recurrence of the disease within 10 years of initial treatment. Therefore, a new prognostic marker that could identify patients at high risk of tumor recurrence more accurately would be of great value, one potential indicator is tumor-induced angiogenesis.

OBJECTIVE: To determine semi quantitative micro vascular density in breast lesions and to find its association with prognostic factors as tumor size, axillary lymph node status, tumor type, histological grade and vascular invasion.

MATERIAL AND METHODS: Thirty five cases were included in the study. Angiogenesis was estimated by determining micro vessel counting after immune staining the paraffin embedded tissue sections using anti-CD34 antibody.

RESULT: Age of the patients ranged from 25 to 80 years with a mean age of 45.48 years. Most of the cases were infiltrating ductal carcinoma comprising of 33 cases (94.28%). Three (3) cases (9.10%) showed vascular invasion by the tumor. Majority showed (63.64%) vessel count of less than 200 per 10 high power fields.

CONCLUSION: Micro vascular density positively correlated with size of the tumor, lymph nodes involved by the tumor and Nottingham prognostic index. Micro vascular density and histological grade showed near significant relation. Micro vascular density although positively correlated do not have significant relationship with vascular invasion in this study.

Biography:

Ghazi Zafar did his M.B.,B.S. from University Of Health Sciences in 2013. Now he is doing his post graduate residency from Chughtai Lab. in Histopathology.  

Abstract:

Her-2 (ErbB-2) is an oncogene frequently overexpressed in breast and gastric adenocarcinomas and anti Her-2 targeted therapy can be given to such patients. Her-2 overexpression and role of anti Her-2 targeted therapy in cases of gallbladder adenocarcinomas (GBAC) is still debatable. Scoring protocols for Her-2 expression in breast and gastric carcinomas are standardized, however not for carcinomas arising in other body organs like gallbladder. This study is conducted to evaluate expression of Her-2 in patients with GBAC which may benefit from targeted therapy.

It is a cross-sectional study conducted on patients with GBAC (n = 43; 34 women and 9 men). An automated immunohistochemical technique was used with an anti-ErbB2 antibody. Scoring was conducted according to the CAP (College of American Pathologists) criteria for breast cancer, as well as for gastric and gastroesophageal junction carcinomas.

When the scoring protocol for breast carcinomas was used, positive Her-2 staining was observed in 11/43 (25.6%). Out of 11 positive cases, 5 cases (11.6%) were unequivocally positive (3+) and 6 (13.9%) showed equivocal staining. According to the gastric and gastroesophageal junction carcinomas protocol, positive Her-2 staining was observed in 16/43 (37.2%). Out of 16 positive cases, 11 (25.5%) were unequivocally positive (3+) and 5 (11.6%) showed equivocal staining.

This study indicates that significant number of GBAC cases show Her-2 overexpression when either of the two documented protocols is used. This subgroup may benefit from inhibitors of the Her-2 pathway. Standardization of scoring protocol for Her-2 expression in GBAC is needed to better evaluate predictive potential of Her-2 for treatment of these tumors.