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Article ; Online: Interpretive Errors in Fine-Needle Aspiration of Thyroid: A 13-Year Institutional Experience in Lebanon.

Khaled, Chirine S / Khalifeh, Ibrahim M / Shabb, Nina S

2021 Volume 66, Issue 1, Page(s) 23–35

Abstract: Introduction: Fine-needle aspiration (FNA) is a worldwide established diagnostic tool for the assessment of patients with thyroid nodules. All thyroid FNA interpretive errors (IEs) were reviewed at the American University of Beirut Medical Center over a ...

Abstract	Introduction: Fine-needle aspiration (FNA) is a worldwide established diagnostic tool for the assessment of patients with thyroid nodules. All thyroid FNA interpretive errors (IEs) were reviewed at the American University of Beirut Medical Center over a 13-year period, in order to identify and analyze them. Materials and methods: All FNAs and their corresponding pathology results are correlated yearly for quality assurance. Discrepant cases are segregated into sampling errors and IEs. All thyroid FNAs with IEs were collected from 2005 to 2017. FNA and pathology slides were reviewed by trained, board-certified cytopathologists, adhering to the latest Bethesda criteria. Reasons for erroneous diagnoses were studied. Results: There was a total of 11 IEs out of 340 thyroid FNAs followed by surgical resection. Five benign follicular nodules (BFNs) were misinterpreted as suspicious for carcinoma. Focal nuclear atypia in cyst-lining or follicular cells and a monotonous population of macrophages misinterpreted as Hurthle cells (HCs) were the causes of IEs in this category. Four Hashimoto's thyroiditis (HT) cases were misinterpreted as suspicious for malignancy. Innate atypia of HCs and sampling misinterpretation were the causes of IEs in HT. One medullary and 1 follicular carcinoma were misinterpreted as suspicious for follicular neoplasm and BFN, respectively. Nine cases were better classified after review. Conclusion: Thyroid FNA IEs can be mitigated by meticulous screening and identification of all elements on FNA smears. Awareness of focal nuclear atypia in reactive cyst-lining and follicular cells in BFN, as well as HCs in HT, is highlighted. Adherence to The Bethesda System for Reporting Thyroid Cytopathology and consulting experienced cytopathologists significantly decrease IEs.
MeSH term(s)	Adenocarcinoma, Follicular/diagnosis ; Adenocarcinoma, Follicular/pathology ; Biopsy, Fine-Needle/methods ; Humans ; Lebanon ; Retrospective Studies ; Thyroid Neoplasms/pathology ; Thyroid Nodule/diagnosis ; Thyroid Nodule/pathology
Language	English
Publishing date	2021-09-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	80003-x
ISSN	1938-2650 ; 0001-5547
ISSN (online)	1938-2650
ISSN	0001-5547
DOI	10.1159/000519075
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Article ; Online: High-risk human papillomavirus in ruxolitinib-associated sebaceous neoplasms.

Hamie, Lamiaa / Bardawil, Tara / Khalifeh, Ibrahim

Indian journal of dermatology, venereology and leprology

2021 Volume 87, Issue 3, Page(s) 404–408

MeSH term(s)	Adenocarcinoma, Sebaceous/diagnosis ; Adenocarcinoma, Sebaceous/etiology ; Adenoma/diagnosis ; Adenoma/etiology ; Alphapapillomavirus ; Humans ; Male ; Middle Aged ; Nitriles/adverse effects ; Papillomavirus Infections/diagnosis ; Papillomavirus Infections/etiology ; Primary Myelofibrosis/drug therapy ; Pyrazoles/adverse effects ; Pyrimidines/adverse effects ; Sebaceous Gland Neoplasms/diagnosis ; Sebaceous Gland Neoplasms/etiology
Chemical Substances	Nitriles ; Pyrazoles ; Pyrimidines ; ruxolitinib (82S8X8XX8H)
Language	English
Publishing date	2021-12-13
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	416068-x
ISSN	0973-3922 ; 0019-5162 ; 0378-6323
ISSN (online)	0973-3922
ISSN	0019-5162 ; 0378-6323
DOI	10.25259/IJDVL_197_20
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Article: Characteristics of Breast Cancer Metastasizing to Bone in a Mediterranean Population.

Bannoura, Sami / Nahouli, Hasan / Noubani, Aya / Flaifel, Abdallah / Khalifeh, Ibrahim

Cureus

2020 Volume 12, Issue 11, Page(s) e11679

Abstract: Aim: This study examines clinicopathological, molecular, and radiological characteristics of breast cancer metastasizing to the bone in a Mediterranean population.: Methods: Cases of breast cancer with metastasis to bone were retrieved from the ... ...

Abstract	Aim: This study examines clinicopathological, molecular, and radiological characteristics of breast cancer metastasizing to the bone in a Mediterranean population. Methods: Cases of breast cancer with metastasis to bone were retrieved from the pathology department archives. Descriptive statistics and bivariate inferential statistics of retrieved clinical (demographic, focality, laterality, axillary lymph node status, and metastasis-free interval), radiological (skeletal site of bone metastasis, type of bone lesion), and microscopic (grade, subtype of breast cancer, lymphovascular status, perineural status, lymph node involvement, nodal extracapsular extension, molecular subtype) data were conducted. Results: Out of 123 cases analyzed, 93.5% were ductal, 90% had axillary lymph node metastasis, 60.5% were luminal A, 59.6% were osteolytic, and 54.4% had grade III. Discordance in the status of ER, PR, and HER2 between the primary breast tumor and the corresponding bone metastases was noted, with the highest rate of change reported for PR (35.7%). Significance was detected at the level of difference between the subtype of breast cancer with regards to the radiologic features where the ductal subtype was found to be mostly osteolytic while the lobular subtype was mostly either osteoblastic or mixed (p-value=0.05). The metastasis-free interval was significantly associated with the number of metastatic bone lesions (P=0.001). Conclusion: The significant association between metastasis-free interval and the number of metastatic bone lesions suggests that a higher interval allows more time for tumors to manifest multiple lesions. The high rate of discordance in the status of PR, ER, and HER2 was congruent with the literature highlighting the need to further investigate underlying mechanisms.
Language	English
Publishing date	2020-11-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.11679
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Article ; Online: Fatal Visceral Leishmaniasis Caused by Leishmania infantum, Lebanon.

El Hajj, Rana / El Hajj, Hiba / Khalifeh, Ibrahim

Emerging infectious diseases

2018 Volume 24, Issue 5, Page(s) 906–907

Abstract: Visceral leishmaniasis, a fatal disease if not treated, is caused by Leishmania parasites. This disease might be overlooked in the Middle East because of limited awareness and low incidence. We report 5 patients who died of visceral leishmaniasis in ... ...

Abstract	Visceral leishmaniasis, a fatal disease if not treated, is caused by Leishmania parasites. This disease might be overlooked in the Middle East because of limited awareness and low incidence. We report 5 patients who died of visceral leishmaniasis in Lebanon and make recommendations to improve faster diagnosis and treatment.
MeSH term(s)	Child ; Child, Preschool ; Fatal Outcome ; Female ; Humans ; Lebanon/epidemiology ; Leishmania infantum ; Leishmaniasis, Visceral/epidemiology ; Leishmaniasis, Visceral/parasitology ; Leishmaniasis, Visceral/pathology ; Male ; Refugees ; Syria/epidemiology
Language	English
Publishing date	2018-04-16
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid2405.180019
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Article ; Online: Loss of KLK4::KLKP1 pseudogene expression by RNA chromogenic in-situ hybridization is associated with PTEN loss and increased risk of biochemical recurrence in a cohort of middle eastern men with prostate cancer.

Bakker, Andrea / Slack, Jonathan C / Palanisamy, Nalla / Carskadon, Shannon / Ghosh, Sunita / Khalifeh, Ibrahim / Bismar, Tarek A

Journal of cancer research and clinical oncology

2022 Volume 149, Issue 7, Page(s) 3721–3728

Abstract: Background: KLK4::KLKP1 fusion is a recently described pseudogene that is enriched in prostate cancer (PCa). This new biomarker has not been characterized in the Middle Eastern population.: Objective: To establish the incidence and prognostic value ... ...

Abstract	Background: KLK4::KLKP1 fusion is a recently described pseudogene that is enriched in prostate cancer (PCa). This new biomarker has not been characterized in the Middle Eastern population. Objective: To establish the incidence and prognostic value of KLK4::KLKP1 fusion in a cohort of Middle Eastern men with PCa and explore the relationship of this marker to other relevant biomarkers (PTEN, ERG, SPINK1). Design, setting, and participants: We interrogated a cohort of 340 Middle Eastern men with localized PCa treated by radical prostatectomy between 2005 and 2015. KLK4::KLKP1 fusion status was assessed by RNA Chromogenic in situ hybridization (CISH) and correlated to pathological and clinical parameters. Outcome measurements and statistical analysis: RNA-CISH expression of KLK4::KLKP1 was correlated with prognostic factors, ERG, PTEN, and SPINK1 expression, and biochemical recurrence (BCR) following prostatectomy. Results and limitations: 51.7% of patient samples showed positive KLK4::KLKP1 expression; more commonly in cores of PCa (38%) versus non-cancer (20.6%) (p < 0.0001) and in lower Gleason Grade Group tumors (1-3) vs (4-5). KLK4::KLKP1 expression positively correlated with ERG positivity and inversely associated with PTEN loss. No significant association was found with SPINK1 expression, seminal vesicle invasion, positive surgical margin, pathological stage, or patient age (< 50 or ≥ 50). The association between PTEN loss and BCR increased when combined with KLK4::KLKP1 negativity (HR 2.31, CI 1.03-5.20, p = 0.042). Conclusions: KLK4::KLKP1 expression is more common in this cohort of Middle Eastern men than has been reported in North American men. It is associated with ERG positivity and inversely correlated with PTEN loss. In isolation, KLK4::KLKP1 expression was not significantly associated with clinical outcome or pathological parameters. However, its expression is associated with certain molecular subtypes (ERG-positive, PTEN-intact) and as we demonstrate may help further stratify the risk of recurrence within these groups.
MeSH term(s)	Humans ; Male ; Biomarkers, Tumor/genetics ; Prognosis ; Prostatectomy/methods ; Prostatic Neoplasms/genetics ; Prostatic Neoplasms/surgery ; Prostatic Neoplasms/pathology ; Pseudogenes ; PTEN Phosphohydrolase/genetics ; PTEN Phosphohydrolase/metabolism ; Transcriptional Regulator ERG/genetics ; Trypsin Inhibitor, Kazal Pancreatic/genetics
Chemical Substances	Biomarkers, Tumor ; PTEN Phosphohydrolase (EC 3.1.3.67) ; PTEN protein, human (EC 3.1.3.67) ; SPINK1 protein, human ; Transcriptional Regulator ERG ; Trypsin Inhibitor, Kazal Pancreatic (50936-63-5) ; KLKP1 protein, human ; kallikrein 4 (EC 3.4.21.-)
Language	English
Publishing date	2022-08-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	134792-5
ISSN	1432-1335 ; 0171-5216 ; 0084-5353 ; 0943-9382
ISSN (online)	1432-1335
ISSN	0171-5216 ; 0084-5353 ; 0943-9382
DOI	10.1007/s00432-022-04279-5
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Article: Carcinoid Tumor Arising from the Sphenoid Sinus Treated with Definitive Intensity-modulated Radiation Therapy: A Case Report.

Hilal, Lara / Jammal, Mustafa / Khalifeh, Ibrahim / Tfayli, Arafat / Youssef, Bassem

Cureus

2019 Volume 11, Issue 3, Page(s) e4288

Abstract: Head and neck neuroendocrine tumors (NET) are a rare type of cancer. NET can be classified according to the histopathological features. The typical carcinoid tumor is a well-differentiated tumor that is the least common among other types. Owing to its ... ...

Abstract	Head and neck neuroendocrine tumors (NET) are a rare type of cancer. NET can be classified according to the histopathological features. The typical carcinoid tumor is a well-differentiated tumor that is the least common among other types. Owing to its indolent behavior and variable radiological and pathological features, treatment of carcinoid tumors remains a challenge. We report a case of a 54-year-old man presenting with a non-operable carcinoid tumor arising in the sphenoid sinuses treated with radiotherapy with stable disease control after three years follow-up.
Language	English
Publishing date	2019-03-21
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.4288
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Article: Large esophageal schwannoma: En-bloc resection with primary closure by esophagoplasty.

Degheili, Jad A / Sfeir, Pierre / Khalifeh, Ibrahim / Hallal, Ali H

International journal of surgery case reports

2019 Volume 61, Page(s) 77–81

Abstract: Background: Gastrointestinal schwannomas are submucosal tumors accounting for 2-7% of mesenchymal gastro-intestinal neoplasms; the stomach being the most common site. Esophageal schwannomas are more frequent in women, and are usually located in the ... ...

Abstract	Background: Gastrointestinal schwannomas are submucosal tumors accounting for 2-7% of mesenchymal gastro-intestinal neoplasms; the stomach being the most common site. Esophageal schwannomas are more frequent in women, and are usually located in the upper to mid portion. Dysphagia is the main presenting symptom. A definitive diagnosis requires confirmation by histopathological and immunohistochemical studies. Case presentation: A 50-year-old healthy lady, presented with gradual increasing onset of dyspnea, with minimal dysphagia to solid food, over a period of several years. Enhanced CT scan of the chest revealed a well-defined soft tissue mass arising from the proximal third of the esophagus, measuring 7.8 × 5.4 x 10.5 cm. Esophagogastric endoscopy with ultrasonography showed an elevated, smooth surface lesion, arising from the submucosal layer of the esophagus, with a hypervascular mucosa. Enucleation of this large tumor, with preservation of the overlying mucosa, was difficult to accomplish due to its large size. Making use of a dilated proximal esophageal segment, total en-bloc excision of the mass rendered a 15 cm esophagotomy gap, which was easily closed, in two layers, without affecting the overall caliber thus achieving a good esophagoplasty result. Histologically, abundance of spindle-shaped cells with positive S-100 proteins, confirmed the diagnosis of esophageal schwannoma. Conclusion: Variations in mesenchymal gastrointestinal tumors is vast, rendering diagnosis by radiology alone difficult. As such, characteristic histologic and immunostaining features are cornerstones in precise diagnosis of esophageal schwannomas. Despite being rare in incidence, symptomatic esophageal schwannoma lesions can be excised entirely, with low rate of recurrence and favorable overall outcomes.
Language	English
Publishing date	2019-07-19
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2019.07.038
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Article ; Online: Isolated lipstick-like ulceration of the ileocecal valve: A hallmark of cytomegalovirus colitis.

Daniel, Fady / Ghaoui, Nohra / Karaoui, Walid R / Sabatto, Bassel-Zein / Khalifeh, Ibrahim / El-Cheikh, Jean

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology

2020 Volume 31, Issue 3, Page(s) 274–275

MeSH term(s)	Colitis/pathology ; Colitis/virology ; Cytomegalovirus ; Cytomegalovirus Infections/pathology ; Cytomegalovirus Infections/virology ; Humans ; Ileal Diseases/pathology ; Ileal Diseases/virology ; Ileocecal Valve/pathology ; Ileocecal Valve/virology ; Male ; Medical Illustration ; Middle Aged ; Ulcer/pathology ; Ulcer/virology
Language	English
Publishing date	2020-06-18
Publishing country	Turkey
Document type	Case Reports ; Letter
ZDB-ID	1340275-4
ISSN	2148-5607 ; 1300-4948
ISSN (online)	2148-5607
ISSN	1300-4948
DOI	10.5152/tjg.2020.19116
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Article ; Online: Clinical, microscopic and molecular presentation in pediatric versus adult old world cutaneous Leishmaniasis.

Dunya, Gabriel / Loya, Asif / Taraif, Suad / Adib Houreih, Mohammad / Khalifeh, Ibrahim

Pediatric dermatology

2020 Volume 37, Issue 4, Page(s) 656–660

Abstract: Background: Cutaneous leishmaniasis (CL) is an emerging uncontrolled tropical parasitic disease in endemic and nonendemic areas with a high prevalence in the pediatric age group.: Method: A total of 382 individuals from Lebanon, Saudi Arabia, ... ...

Abstract	Background: Cutaneous leishmaniasis (CL) is an emerging uncontrolled tropical parasitic disease in endemic and nonendemic areas with a high prevalence in the pediatric age group. Method: A total of 382 individuals from Lebanon, Saudi Arabia, Pakistan, and Syria diagnosed with CL by punch biopsy/scrapings were grouped into adults (>18 years) and pediatrics (≤18 years). Data recorded included clinical features [number, location, type, size, and extensiveness (size larger than 3 cm, more than 5 lesions per patient, lesion present for more than 12 months, special types, disfiguring lesion or closeness to vital sensory organs) of lesions] and microscopic findings [Ridley's Parasitic Index and Ridley's Pattern]. In addition, molecular confirmation and speciation were performed. Results: In comparison with adults, patients in the pediatric group (n = 158, 41.4%) showed significantly higher number of lesions, more facial involvement, and more extensive disease (P < .05). Microscopically, a more advanced Ridley's pattern was observed. The other variables did not show statistical difference between the two groups. Conclusion: Historically, CL has been known to be a neglected tropical disease of poverty and pediatric predilection. In our pediatric group, CL manifests with more extensive disease clinically mirrored by more advanced lesions microscopically.
MeSH term(s)	Adult ; Child ; Humans ; Leishmaniasis, Cutaneous/diagnosis ; Leishmaniasis, Cutaneous/epidemiology ; Neglected Diseases/diagnosis ; Neglected Diseases/epidemiology ; Pediatrics ; Saudi Arabia ; Skin
Language	English
Publishing date	2020-05-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	605539-4
ISSN	1525-1470 ; 0736-8046
ISSN (online)	1525-1470
ISSN	0736-8046
DOI	10.1111/pde.14195
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Article: Acute disseminated encephalomyelitis and reactivation of cerebral toxoplasmosis in a child: Case report.

Bannoura, Sami / El Hajj, Rana / Khalifeh, Ibrahim / El Hajj, Hiba

IDCases

2018 Volume 13, Page(s) e00434

Abstract: Toxoplasma ... ...

Abstract	Toxoplasma gondii
Language	English
Publishing date	2018-08-06
Publishing country	Netherlands
Document type	Journal Article ; Case Reports
ZDB-ID	2745454-X
ISSN	2214-2509
ISSN	2214-2509
DOI	10.1016/j.idcr.2018.e00434
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