Dr. Taher  Reza Kermanshahi  Md image

Dr. Taher Reza Kermanshahi Md

30 Page St
Pinehurst NC 28374
904 431-1075
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: MD36887
NPI: 1730343930
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Biliary Adenofibroma with Invasive Carcinoma: Case Report and Review of the Literature. - Case reports in pathology
We report a case of biliary adenofibroma with an invasive carcinoma in a 71-year-old female who presented with bilateral upper abdominal pain. Imaging revealed a 6.3 cm heterogeneously enhancing mass in the left lateral segment of the liver. Histologically, the adenofibroma showed the characteristic components as previously described of biliary adenofibromata, namely, cystic and tubular structures lined by cuboidal to low columnar biliary type epithelium and a dense fibrous stroma composed of spindled cells. Intimately admixed with the adenofibroma was a distinct tumor composed of malignant clear cells which demonstrated stromal and vascular invasion. Although mitotic figures were inconspicuous, Ki67 was brisk and p53 demonstrated 25-50% positivity. Sections also showed a von Meyenberg complex located adjacent to the tumor. This case expands the understanding of this rare tumor and proves two important assertions from previous case reports. First, the presence of an associated von Meyenberg complex with similar morphology and immunohistochemical staining pattern suggests that biliary adenofibromata and von Meyenberg complexes may share related histogenesis. Second, biliary adenofibromata harbor malignant potential and may show malignant transformation. Furthermore, this case highlights the need for these rare tumors to be followed aggressively, as their biological behavior is poorly understood.
Comparison between PAS and GMS stains for the diagnosis of onychomycosis. - Journal of cutaneous pathology
Onychomycosis is the most common nail disease in adults. Periodic acid-Schiff (PAS) stain has been considered the most sensitive method for diagnosis. By comparing originally stained PAS slides (i.e. without repeating PAS) with newly stained Grocott methenamine-silver (GMS) slide, D'Hue et al. concluded that GMS is superior to PAS. We conducted a similar study with the addition of repeating PAS stain and compared the newly stained PAS and GMS slides in tandem.We performed both PAS and GMS stains on 30 clinically suspected onychomycosis cases. The presence or absence of fungal organisms was evaluated. The results were also compared with the original PAS stain.Twenty-two cases were positive with PAS, staining three cases more than GMS, which stained only 19 cases. The difference between the two stains is statistically insignificant. Repetition of GMS stain on these three cases (cutting in a deeper level in the paraffin block) resulted in positive results. Four out of 30 cases were negative with original PAS stain, but stained positive both with new PAS and GMS.PAS and GMS stains are quantitatively similar. Sensitivity of both methods can be increased by preparing two slides from different levels in the paraffin block.

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30 Page St Pinehurst, NC 28374
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