9:15



ANNUAL RESEARCH DAY PROGRAM

DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE

UNIVERSITY OF OTTAWA

APRIL 29th, 2009

ROOM 2021

ROGER GUINDON HALL

HEALTH SCIENCES BUILDING

8:55 WELCOME

9:00-9:15 PEDIATRIC MALIGNANT PERIPHERAL NERVE SHEATH TUMOUR OF THE RADIAL NERVE – CASE REPORT AND REVIEW OF THE LITERATURE.

B.M Purgina2, Dr. TA Flood2, Dr. J. Michaud2, Dr. MF Shamji1, Dr. E. Ventureyra1,3.

1Division of Neurosurgery, The Ottawa Hospital, Ottawa, Ontario. 2Department of Anatomical Pathology, The Ottawa Hospital, Ottawa, Ontario. 3Division of Neurology, Children’s Hospital of Eastern Ontario, Ottawa, Ontario.

9:15-9:30 EXPRESSION OF TISSUE TRANSGLUTAMINASE IN FORMALIN-FIXED, PARAFFIN-EMBEDDED TISSUE IS IT USEFUL IN THE DIAGNOSIS OF CELIAC DISEASE?

I Teo, H Marginean and EC Marginean.

Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada.

9:30-9:45 RENAL CELL CARCINOMA WITH HYBRID FEATURES OF CONVENTIONAL AND CHROMOPHIL CYTOMORPHOLOGY: A FLUORESCENT IN SITU HYBRIDIZATION STUDY.

H. Faraji, Susan J. Robertson, MD, Eric C. Belanger, MD, Kien T. Mai, MD. Department of Pathology and Laboratory Medicine, The Ottawa Hospital and University of Ottawa, Ontario, Canada.

9:45-10:00 LUPUS MILIIARIS DISSEMINATUS FACIEI OF THE EYELIDS: REPORT OF TWO CASES

W. Liao1,2, S. Brownstein1,2, D.R. Jordan1, S. Gilberg1, S.S. Jolly1,2, R. Prokopetz2. 1University of Ottawa Eye Institute, Ottawa, ON, Canada; 2Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada.

10:00-10:15 COMPARATIVE IMMUNOHISTOCHEMICAL STUDY OF SEROUS AND MUCINOUS CYSTIC NEOPLASMS OF THE PANCREAS: SIMILAR STROMA PHENOTYPE SUGGESTING A POSSIBLE HISTOPATHOGENIC RELATIONSHIP

A.D Edgecombe 1, BN Nguyen1, MM Gomes1, J Côté2, KT Mai1.

1Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada and 2Pathology, Saint-Luc Hospital, CHUM, Montreal, Quebec, Canada

10:15-10:30 UNUSUAL PRESENTATION OF A COMMON INFECTIOUS DISEASE IN THE BREAST

T. Jayasinghe, PGY2 Resident Anatomical Pathology

Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada

10:30-10:45 INVESTIGATION OF CADHERIN AND CATENIN EXPRESSION IN INVASIVE DUCTAL CARCINOMA OF THE BREAST VIA TISSUE MICROARRAY

I Teo, L Pelletier and S Islam

Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada.

10:45-11:00 BREAK

11:00-11:15 LETHAL RUPTURE OF A TRAUMATIC ANEURYSM OF THE POSTERIOR INFERIOR CEREBELLAR ARTERY A CASE REPORT AND REVIEW OF THE LITERATURE.

B.M Purgina1, Dr. C. Milroy1,2, and Dr. G. Jansen1.

1The Ottawa Hospital, Department of Anatomical Pathology, Ottawa, ON and 2Eastern Ontario Regional Forensic Pathology Unit, Ottawa, ON.

11:15-11:30 SPONTANEOUS PNEUMOTHORAX AND LUNG CARCINOMA: SHOULD ONE CONSIDER SYNCHRONOUS MALIGNANT PLEURAL MESOTHELIOMA?

T.A .Flood Sekhon HS, Seely J, Shamji F and Gomes MM. Department of Pathology and Laboratory Medicine, The Ottawa Hospital and University of Ottawa, Ontario, Canada.

11:30-11:45 UNUSUAL ADENOCARCINOMA WITH FEATURES SUGGESTIVE OF MESONEPHRIC ADENOCARCINOMA OF THE PROSTATE

H. Faraji, Susan J Robertson, Eric Belanger, Kien T Mai,. Division of Anatomical Pathology, Department of Laboratory Medicine, Hospital and Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada

11:45-12:00 ATYPICAL SMALL ACINAR PROLIFERATION WITH AND WITHOUT ASSOCIATED PROSTATIC ADENOCARCINOMA

T.A. Flood, Hamid Faraji, Susan J. Robertson, Eric Belanger, Kien T. Mai.

Department of Pathology and Laboratory Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada

12:00-1:15 LUNCH AND POSTER VIEWING

(ATRIUM 2ND FLOOR, FACULTY OF MEDICINE)

1:15-2:15 GUEST SPEAKER

Dr. LUAN TRUONG

RENAL TUBULAR CELL APOPTOSIS IN TUBULOINTERSTIAL RENAL

Pathologist and Director of Nephropathology, The Methodist Hospital, Houston, Texas

2:15-2:30 RESPIRATORY SUNCYTIAL VIRUS (RSV) DETECTION IN CLINICAL SPECIMENS USING A NANOLITER REAL TIME PCR RESPIRATORY PATHOGEN PANEL

R. Slinger, F. Chan, D. Goldfarb, N. Barrowman, I. Moldovan, H. Ji, J. Brooks

1Children's Hospital of Eastern Ontario, 2University of Ottawa, Ottawa, ON, CANADA, 3National HIV & Retrovirology Laboratories, Public Health Agency of Canada.

2:30-2:45 UNUSUAL HISTOPATHOLOGICAL PATTERN OF A NEPHROGENIC ADENOMA IN A URETHRAL DIVERTICULUM

A.D Edgecombe, M Lamba, KT Mai, V Acharya. Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada

2:45-3:00 PROSTATIC ADENOCARCINOMA AND STATUS OF RESECTION MARGIN OF RADICAL PROSTATECTOMY ASSOCIATED WITH CORE BIOPSIES WITH ATYPICAL SMALL ACINAR PROLIFERATION OR MINIMAL CANCER

T.A Flood, BN Nguyen, EC Marginean, BM Purgina, KT Mai. The Ottawa Hospital, Ottawa, ON, Canada; The University of Ottawa, Ottawa, ON, Canada

3:00-3:15 BREAK (ATRIUM)

3:15-3:30 A RETROSPECTIVE REVIEW OF OCTAPLEX UTILIZATION AT THE OTTAWA HOSPITAL

M. Wozniak and J. Bormanis.

Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, K1H 8L6

3:30-3:45 IMMUNOHISTOCHEMICAL AND IN SITU HYBRIDIZATION STUDIES OF MULTILOCULAR CYSTIC RENAL CELL CARCINOMA

Bibianna M. Purgina MD, Trevor A. Flood MD, Eric C. Belanger MD FRCPC, Kien T. Mai MD FRCPC.

Division of Anatomical Pathology, Department of Laboratory Medicine, The Ottawa Hospital and Department of Pathology and Laboratory Medicine, University of Ottawa, Ontario, Canada.

3:45-4:00 FLUORESCENT IN SITU HYBRIDIZATION OF NON-PAPILLARY ONCOCYTIC/EOSINOPHILIC RENAL CELL CARCINOMA

Itrat Ahmed, MD, Susan J Robertson, MD, Eric Belanger, MD, Kien T. Mai, MD

Division of Anatomical Pathology, Department of Laboratory Medicine, Hospital and Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada

4:00-4:15 ANNOUNCEMENT OF PRIZE WINNERS AND CONCLUSION

• Nadia Mickhael Award for Best Paper presented by a Junior Resident

• 2nd Best paper by a Junior Resident

• Virbala Acharya Award for Best Presentation by a Senior Resident or Fellow

• 2nd Best paper by a Senior Resident or Fellow

• Best Poster Presentation by a Graduate Student

• Best Poster Presentation by a Resident

• 2nd Best Poster Presentation by a Resident

• Dr. M. Orizaga Award for Best Teacher

POSTERS

1. ROLE OF p300 IN REGULATION OF Myf5 GENE EXPRESSION

Tanja Francetic and Qiao Li

Department of Pathology and Laboratory Medicine, Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ontario, Canada.

2. ROLE OF THE RETINOID X RECEPTOES IN SKELETAL MUSCLE DIFFERENTIATION

Melanie Le May, Tanja Francetic, Qiao Li

Department of Pathology, Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa.

3. ROLE OF THE 26S PROTEASOME IN THE EXPRESSION OF RETINOIC ACID INDUCED GENES

Aliaa Higazi, Mahmoud abed and Qiao Li

Department of Pathology and Laboratory Medicine, Department of Cellular and Molecular Medicine, Faculty of Medicine, Ottawa University, Ottawa, Ontario, K1H 8M5, Canada.

4. INVOLVEMENT OF PML BODIES IN CBP DEGRADATION VIA PROTEASOME PATHWAY

Jonathan St-Germain, Jihong Chen and Qiao Li

Department of Pathology and Laboratory Medicine, Faculty Medicine, University of Ottawa, Ottawa, Ontario, Canada

5. EFFECTS OF P300 HAT ACTIVITY ON SKELETAL MUSCLE DIFFERENTIATION

Sourianna Awada (Honours student), Supervisor: Qiao Li

Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of Ottawa

6. SODIUM TRANSPORT INTO THE CENTRAL NERVOUS SYSTEM AND SALT SENSITIVE HYPERTENSION

Md Shahrier Amin, Frans H H Leenen

University of Ottawa Heart Institute, Ottawa, ON, Canada

7. EXPRESSION PROFILE OF P16 (INK 4A) and MIB1 (KI-67) IN HIGH GRADE SQUAMOUS INTRAEPITHELIAL LESION (HSIL) AND IMMATURE SQUAMOUS METAPLASIA (ISM) OF THE UTERINE CERVIX

Md Shahrier Amin, MD, PhD candidate; Mary Senterman, MD, FRCSC, FRCPC and Shahidul Islam, MD, PhD, FCAP

Division of Anatomical Pathology, The Ottawa Hospital, Eastern Ontario Regional Laboratory Association (EORLA), The Department of Pathology and Laboratory Medicine, The University of Ottawa, Ontario, Canada.

8. MALE BREAST CARCINOMA: PROGNOSTIC MARKERS, AGE AS A VARIABLE?

M. Marinescu, S.J. Robertson. Department of Pathology, University of Ottawa; Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario.

9. PRIMARY MELANOMA OF THE LUNG: A CASE REPORT AND REVIEW OF THE LITERATURE

M. Marinescu1, M. Gomes1, F.M. Shamji2, J.M. Seely3, H. Sekhon1.

1Department of Pathology, 2Department of Thoracic Surgery, 3Department of Radiology, University of Ottawa , The Ottawa Hospital, Ottawa, Ontario.

10. UROTHELIAL CARCINOMA ASSOCIATED WITH CLINICALLY DIAGNOSED PROSTATIC ADENOCARCINOMA

TA Flood, B Nguyen, EC Marginean, BM Purgina, KT Mai. The University of Ottawa, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada

11. RING CHROMOSOME 7 AND TRISOMY 8 IN A PEDIATRIC CASE OF HEPATOSPLENIC T-CELL LYMPHOMA

M. Wozniak, L. Sinclair-Bourque, M. Lamba, K. Mandel, F. Alseraye, E. McCready

Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, K1H8L6

Cytogenetics Laboratory, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, K1H8L1

12. LUPUS MILIIARIS DISSEMINATUS FACIEI OF THE EYELIDS: REPORT OF TWO CASES

W. Liao1,2, S.S. Jolly1,2, S. Brownstein1,2, D.R. Jordan1, S. Gilberg1, , R. Prokopetz2. 1University of Ottawa Eye Institute, Ottawa, ON, Canada; 2Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada.

13. IMMUNOHISTOCHEMICAL STUDY OF MULTILOCULAR CYSTIC RENAL CELL CARCINOMA

BM Purgina MD, TA Flood MD, BN Nguyen MD FRCPC, EC Marginean MD FRCPC and KT Mai MD FRCPC.

Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada.

14. IMMUCYTOCHEMICAL STUDY OF THE URINE CYTOLOGICAL PREPARATIONS OF THE SECONDARY PROSTATIC ADENOCARCINOMA OF THE URINARY BLADDER

IT Ahmed1, HQ Al-Moghrabi1, S Islam1, EC Marginean1 and KT Mai1. 1Department of Laboratory Medicine, The Ottawa Hospital, Department of Pathology and Laboratory Medicine, The University of Ottawa, Ottawa, Ontario, Canada.

15. CLINICAL AND LABORATORY PROFILE COMPARISON OF T(15;17) POSITIVE AND T(15;17) NEGATIVE ACUTE PROMYELOCYTIC LEUKEMIA

Zhaodong Xu, 1 David Conrad, 2 Mitchell Sabloff, 2 Ruth Padmore 1

1Department of Laboratory Medicine and Pathology, Division of Hematology and Transfusion Medicine, 2Division of Clinical Hematology, Ottawa Hospital, Ottawa

16. VALIDATION OF ORTHO NEW FORMULATION 0.8% SURGISCREEN SCREENING CELLS.

D. Neurath, M. Pilon, M. Tokessy Transfusion Medicine, The Ottawa Hospital

Ottawa, ON, Canada

17. BLOOD TRANSFUSION IN BONE MARROW TRANSPLANTATION.

D. Neurath, A.Alsughayir, M. Tokessy, A. Giulivi,

Transfusion Medicine, The Ottawa Hospital, Ottawa, ON

Canada

18. IMPLENMENTATION OF APHERESIS PLATELET UTILIZATION TOOL TO IMPROVE INVENTORY MANAGEMENT

D. Neurath, M. Tokessy, A. Alsughayir, A. Giulivi

Transfusion Medicine, The Ottawa Hospital, Ottawa, ON Canada

WELCOME

PEDIATRIC MALIGNANT PERIPHERAL NERVE SHEATH TUMOUR OF THE RADIAL NERVE – CASE REPORT AND REVIEW OF THE LITERATURE.

Dr. BM Purgina2, Dr. TA Flood2, Dr. J. Michaud2, Dr. MF Shamji1, Dr. E. Ventureyra1,3.

1Division of Neurosurgery, The Ottawa Hospital, Ottawa, Ontario. 2Department of Anatomical Pathology, The Ottawa Hospital, Ottawa, Ontario. 3Division of Neurology, Children’s Hospital of Eastern Ontario, Ottawa, Ontario.

Malignant peripheral nerve sheath tumours (MPNST) are a group of malignant tumours that arise from cells that are differentiating or have differentiated toward those of the peripheral nerve sheath. They are extremely uncommon in the pediatric population and children appear to have a worse prognosis with a median survival of less than 2 years. We report a highly unusual case of a nine-year-old girl with a past medical history significant for Prader-Willi syndrome, vesiculoureteral reflux, and chronic pyelonephritis and a biopsy that demonstrated MPNST of the left radial nerve. She underwent local excision and no adjuvant therapy and exhibits long-term survival. She has been followed for the last 22 years and has no evidence of local recurrence or metastatic disease. The original biopsy and excision material was reviewed and immunohistochemical studies were performed. Microscopic examination reveals similar histologic features in both the biopsy and the excised specimen. Foci of typical appearing schwannoma are intermixed among larger areas with atypical epithelioid and spindle cells, mitotically active areas including atypical forms, large areas of necrosis, hemorrhage, and cyst formation. The tumour does not penetrate through the perineural capsule. The lesion demonstrated strong reactivity for S100, vimentin, and focal reactivity for GFAP. The lesion was also reactive for PGP9.5, which has been reported to be a sensitive marker for MPNST. The Ki-67 index is estimated to be up to 5% in the most active areas, which also favours the diagnosis of MPNST. There was an absence of reactivity for HMB-45. The original diagnosis of epithelioid MPNST was confirmed. The significant heterogeneity in the biological aggressiveness of MPNSTs requires further investigation into features prognosticating favourable postoperative course. Reporting histological characteristics and immunophenotype of cases with either early demise or long-term survival may help identify such features.

EXPRESSION OF TISSUE TRANSGLUTAMINASE IN FORMALIN-FIXED, PARAFFIN-EMBEDDED TISSUE IS IT USEFUL IN THE DIAGNOSIS OF CELIAC DISEASE?

I Teo, H Marginean and EC Marginean.

Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Introduction: Celiac disease, also known as celiac sprue, or gluten-sensitive enteropathy, affects one in 100 to 300 people. Current diagnostic algorithms rely on a combination of findings, including the presence of tissue transglutaminase (TTG) in the serum and confirmed by a small intestinal biopsy. Research on tissue transglutaminase expression in formalin-fixed paraffin-embedded tissue has yielded equivocal results thus far, with few studies in the literature.

Materials and Methods: The files of the Department of Anatomic Pathology at the Ottawa Hospital were searched for duodenal biopsies between 2007-2009. One hundred five cases were selected, and were divided into the following groups: normal controls (30 cases), duodenitis (22 cases), celiac disease (46 cases), and treated celiac disease (7 cases). The hematoxylin and eosin slides were first reviewed and a modified Marsh score was assigned according to current criteria, and then immunohistochemistry was performed on all cases with antisera for CD3, CD4, CD8, and TTG. For CD3, CD4 and CD8, T-lymphocyte counts were recorded per one hundred enterocytes. For TTG, the degree of positivity within the surface and crypt epithelium was recorded and intensity was scored as 1+, 2+ and 3+. Both investigators assessed the specimens separately and were blinded to the initial diagnosis made upon the biopsy.

Results: TTG stains in the subepithelial lamina propria, and demonstrates variable staining within the surface enterocytes. TTG staining was variable, with normal biopsies staining from 0-3+ in intensity; duodenitis biopsies ranging from 1+ to 3+; celiac disease from 0 to 3+; and treated celiac disease 0 to 2+. Statistical analysis shows that the Marsh score correlates with the intensity of TTG staining of surface enterocytes. However, the addition of TTG to Marsh scoring, CD3 and CD8 immunohistochemical staining shows a statistically significant improvement in diagnosis.

Conclusions: As an adjunct to histologic features, CD3 and CD8, TTG is most useful in the diagnosis of celiac disease which is graded Marsh 2 and 3. However, in biopsies in the Marsh 1 category (which are the most nonspecific for celiac disease), TTG does not contribute significantly to the diagnosis of celiac disease. These findings are in concordance with other reports in the literature. This immunostain should be validated in larger studies before adding it to current clinical practice.

A RETROSPECTIVE REVIEW OF OCTAPLEX UTILIZATION AT THE OTTAWA HOSPITAL

M. Wozniak and J. Bormanis

Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, K1H 8L6

Introduction: Frozen plasma has been the standard of therapy in Canada for urgent reversal of anticoagulant effect from vitamin K antagonists. Prothrombin Complex Concentrates are plasma derived blood products that contain concentrated amounts of the four vitamin K dependent coagulation factors (II, VII, IX, and X). They are a safer, more effective alternative to frozen plasma by producing faster results with minimal infusion volumes and better overall outcome. Octaplex, a four factor prothrombin complex concentrate, has recently been approved for use in Canada.

Methods: The main objective of this chart review is to investigate the overall efficacy of Octaplex in oral anticoagulation reversal and bleeding control in patients at The Ottawa Hospital. Areas of focus include determining the efficacy of our current dosing protocol by monitoring final INR values, looking at efficiency and timing of administration, and overall achievement of hemostasis and survival. Furthermore, we plan to estimate the extent to which frozen plasma use for the replacement of vitamin K dependent factors has decreased since Octaplex has become available.

Results: This research is currently ongoing and completion is expected by May 2009. So far 200 patients have received a standardized dose of Octaplex based on the current protocol at the Ottawa Hospital since September 2008. It is reasonable to expect that most, if not all, patients achieved an INR value ................
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