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BACKGROUND: Hepatocellular carcinoma (HCC) is a highly incident malignancy with a dreadful prognosis. It evolves through a multistep process, with a contribution from different stromal cells like cancer associated fibroblasts. Podoplanin is a glycoprotein that influences epithelial mesenchymal interplay facilitating the tumor invasion. AIM: The aim of the study was to evaluate the immunohistochemical expression of Podoplanin in HCC in cancer associated fibroblasts (CAFs) and malignant hepatocytes as well as assessing the lymphovascular density, and correlating them with the clinicopathological parameters. METHODS: Sixty formalin-fixed paraffin-embedded HCC tissue blocks were retrieved from the pathology Department of the National Hepatology and Tropical Medicine Research Institute and Kasr Al-aini Hospital during the period of January 2012 till December 2019. The specimens were obtained through partial or total hepatectomy inclusion criteria included HCC cases obtained through resection type biopsy and those having no history of pre-operative cancer therapy, while cases with insufficient data, core biopsy, and marked necrosis were excluded from the study. Tumor tissue blocks were immunostained for Podoplanin and its expression was interpreted in lymphatic vessels, CAFs, and malignant hepatocytes. RESULTS: Podoplanin expression in CAFs and malignant hepatocytes was detected in the majority of HCC cases (81.7%) and (88.3%), respectively. The malignant hepatocytes showed increased expression of Grade 1 immunostaining (36.7%). High lymphovascular density was detected over the majority of the cases (73.3%). Podoplanin expression was significantly correlated with higher mean age, male gender, presence of viral infection, cirrhosis, and higher tumor grade. Unifocal tumor mass, tumor size <5 cm, and presence of invasion showed a significant correlation with Podoplanin in malignant hepatocytes and CAFs for the formers and the later, respectively. CONCLUSION: Podoplanin is highly expressed in HCC, which could be used as a prognostic marker for lymphangiogenesis. Furthermore, within the malignant hepatocytes and CAFs suggesting a role in hepatocellular tumorigenesis. Podoplanin targeted therapy can be investigated to slow down the tumor progression and metastasis.

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This parasitic occupation does not remain without counter-resistance by the host. A humoral immune reaction occurs in response to various parasite antigens, the most famous of which is the sugarantigen tyvelose. A predominantly IgG1, IgG2 and IgE response prevails during the chronic phase of trichinosis [5] . The cell-mediated immune response results in a mixed cytokine state, where IL-10, IL-5 and IFN-ɣ were found to persist for up to 3 years postinfection [6] .In addition to the production of cytokines, the immune response to trichinosis also includes NO production which when combined with oxygen free

Background: Characterization of an ovarian lesion is a diagnostic challenge. A correct preoperative assessment is of great importance so as to arrange adequate therapeutic procedures. The aim of the current study is to evaluate the diagnostic performance of functional MRI in differentiation between malignant, borderline, and benign ovarian masses. Results: This study included 56 adnexal lesions. Bilateral synchronous ovarian lesions are detected in 16 cases. Postoperative histologically proved to be benign in 17 (30%), borderline (low potential malignancy) in 12 (22%), and malignant in 27 (48%). The overall diagnostic performance of conventional MRI in the diagnosis of adenexal lesion was a sensitivity of 74%, specificity of 47%, positive predictive value (PPV) of 76%, negative predictive value (NPV) of 44%, and an accuracy of 66%. Functional pelvic MRI examination showed an increase in overall diagnostic performance compared to conventional values with the highest sensitivity of 90% and NPV of 67% using DWI, and the highest specificity of 88%, PPV of 94%, and an accuracy of 82% using DCE MRI. Conclusion: Functional MRI in conjugation with conventional MRI plays a key role in the ovarian lesion detection, characterization, and staging. Functional MRI is currently being evaluated as possible predictive and prognostic biomarkers in ovarian lesions.