Tehran University Medical Journal

Background: Gastric cancer (GC) is considered as one of the most common types of cancer worldwide with poor prognosis and generally limited treatment options. Recent studies have indicated that HER2, MDM2, MYC, MET, and TP53 play an important role in the development of gastric cancer. Therefore, the aim of this study was to evaluate the incidence of amplification/deletion of these genes in patients with gastric cancer.
Methods: In this descriptive study, a total of 37 gastric cancer tissue samples from GC patients including 23 males (62.2%) and 14 females (37.8%) referred to the Hematology-Oncology and Stem Cell Research Center of Shariati Hospital, Tehran, from March 2015 to February 2016 were evaluated. The patient's age at diagnosis ranged from 33 to 85 years (median: 65 years). The amplification pattern of HER2, MDM2, MYC and MET genes and TP53 deletion were investigated by fluorescence in situ hybridization (FISH) technique performed on 3 to 5 micron section obtained from formalin-fixed and paraffin-embedded cancer tissues.
Results: The tumors were preferably identified at the distal stomach (54.05%) in comparison to tumors arising from the gastric cardia. The tumor size varied between 2 and 5 cm (average, 3.5 cm). Seven of the cases (19%) had advanced tumors at the time of diagnosis. HER2, MDM2, MYC, MET and TP53 copy number alteration were successfully determined in all samples obtained from the GC patients. HER2, MDM2, and c-MYC genes were amplified in 2 (5.41%), 1 (2.7%) and 3 (8.11%) of 37 patient samples, however, MET gene amplification and TP53 deletion were not observed in the obtained GC tissue samples. Co-amplification of HER2, MDM2, and MYC genes, and co-amplification of HER2 and MYC genes were detected in one patient.
Conclusion: The results of this study indicate the low frequency of MDM2, HER2 and MYC genes in gastric cancer patient and their copy number alterations may provide diagnostic and prognostic marker for GC patients.

Background: Hypereosinophilic syndrome is commonly found in various diseases such as allergic diseases, parasitic diseases, malignancies, etc. Fasciolosis may present with different clinical features, and it can make a difficult diagnosis of the disease. Laboratory manifestations of fascioliasis are eosinophilia. The purpose of this report was to introduce a child with hypereosinophilia that her diagnosis was fascioliasis.
Case Presentation: The patient was a 3-year-old girl who was referred for prolonged fever (more than two weeks) and abdominal pain from another medical center, and she was hospitalized. In abdominal and pelvic ultrasound, splenomegaly was seen and in laboratory tests, she had hypereosinophilia. In the flow cytometry of bone marrow aspiration, the only finding was increased eosinophil level. Abdominal and thoracic a computerized tomography (CT) scans showed an increased size of para-aortic lymph nodes. On her examination, lymphadenopathy was present in the inguinal region. Therefore, a biopsy of an inguinal lymph node was performed to rule out lymphoma. Lymph node biopsy was negative for lymphoma. Fasciola serology was performed for the patient, and the stool exam was collected three times (for one day in between) to rule out parasitic disease, including Fasciola, etc. Due to weakly positive serology Fasciola hepatica, triclabendazole was started for the patient (it was given in two doses, 12 hours apart), despite the absence of Fasciola parasitic eggs in her stool. During hospitalization, the patient’s fever was stopped and by starting the use of mentioned drug, eosinophilia was reduced. The patient received a complete improvement in the follow-up.
Conclusion: In patients with hypereosinophilia, parasitic diseases such as fascioliasis should be considered even if the fecal specimen is negative for Fasciola eggs.