Pathology Commons^™

Retinoblastoma Tells The Story Of Our Health Care System, Irshad Soomro, Muhammad Nadeem Khan, Suhail Muzaffar, Naila Kayani, Shahid Pervez, Akbar Shah Hussainy, Rashida Ahmed, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

Objective:

To review cases of retinoblastoma.

Setting:

Department of Pathology Aga Khan University Hospital Karachi.

Method:

Twenty three specimens from cases of retinoblastoma received over a period of eight years were routinely processes and stained with haematoxylin and Eosin stain Other stains were used for tuberculosis and melanin. Immunochemistry was resorted to in undifferentiated tumors.

Results:

Over 60% cases of retinoblastoma were diagnosed after 5 years and nine cases showed involvement of opti-nerve.

Conclusion:

Late diagnosis of retinoblastoma effects the stage of the tumors and the prognisis.

Granular Cell Tumor Of The Breast: An Uncommon Lesion That Mimics Carcinoma, S Muzafar, M S. Siddiqui, Naila Kayani, I K. Lodhi, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

No abstract provided.

Histological Pattern Of Ovarian Neoplasma., Zubair Ahmad, Naila Kayani, Sheema H. Hasan, Suhail Muzaffar, Muhammad Shafiq Gill

Department of Pathology and Laboratory Medicine

Abstract

Objective: To see the morphological pattern of benign and malignant ovarian neoplasms. Method: Retrospective study of all consecutive cases of ovarian neoplasms diagnosed at Aga Khan University Hospital between 1st January 1993 and 30th September 1998. Setting: The Section of Histopathology, AKUH, Karachi. Observation: Of 855 ovarian tumours 506 (59.18%) were benign and 349(40.81%) malignant. Surface epithelial - stromal tumours comprised 63.50% of all tumours. Benign cystic teratoma was the commonest benign tumour (35.17% of all benign tumours) and serous cystadenocarcinoma was the commonest malignant tumour (33.33% of all malignant tumours). Mucinous cystadenocarcinomas are more common in our population …

Endocrine Cell Dysplasia (Nesidioblastosis): A Relatively Unrecognized Entity In Pakistan?, Nasim Sabir, Irshad Nabi Soomro, Zafar Nazir, Abdul Jabbar, Sheema Hasan

Section of Paediatric Surgery

Nesidioblastosis is quantitative as well as qualitative abnormality of pancreatic endocrine cells. There is scattering of small endocrine cell clusters arranged haphazardly rather than the peripheral location within the lobule^1,2. Islet contours are irregular, tailing off into parenchyma³. These islets are present in intimate association with ducts forming ductuloinsular complexes¹ We recently encountered a new born baby with signs and symptoms of endocrine cell dysplasia.

Dna Ploidy Analysis Of Borderline Epithelial Ovarian Tumours, Saba Lodhi, Sabeen Najam, Shahid Pervez

Department of Pathology and Laboratory Medicine

Objective: Borderline epithelial ovarian tumors not uncommonly pose a great difficulty to surgical pathologists as morphologically they may show very similar features as those of malignant epithelial tumors except invasion. However it is important to separate these from their invasive counterparts because of their superior prognosis. Recently, attention has been focussed on the prognostic value of flow cytometric analysis of DNA ploidy in borderline epithelial ovarian tumors. The purpose of this study is to investigate whether flow cytometric analysis of cellular DNA content acts as a useful adjunct to the histopathological diagnosis of borderline malignancy.

Materials and Methods: Fifteen histologically …

Genetic Diversity Of Beta-Thalassemia Mutations In Pakistani Population, B Khateeb, T Moatter, A M. Shaghil, S Haroon, G N. Kakepoto

Department of Pathology and Laboratory Medicine

Background:
beta-thalassemia is one of the most common inherited single gene disorder in Pakistan. It is characterized by reduced or absent beta-globin gene expression resulting in abnormal maturation and survival of red blood cells. Due to high prevalence of this disease in the local population, it has become important for the health care providers to encourage people to utilize laboratory facilities for carrier and prenatal genetic testing.
Objective:
To study the frequency of beta-thalassemia mutations in Pakistani population.
Setting:
A tertiary care teaching hospital.
Methods:
Blood samples of 72 couples and chorionic villus (CV) biopsy specimen collected at the Aga …

Audit Of Lymph Node Biopsies In Suspected Cases Of Lymphoproliferative Malignancies: Implications On Tissue Diagnosis And Patient Management, Mohammad Zeeshan Qamar, Mehrukh Mujib, Shahid Pervez

Department of Pathology and Laboratory Medicine

Aims: To carry out an audit ascertaining the importance of condition of lymph node specimen, submission of clinical history including site of biopsy and imrnunohistochemcial studies on conclusiveness of diagnosis made.

Methodology: Computer records of the Aga Khan University Hospital, Histopathology Laboratory were used to analyze all cases of lymphoproliferative malignancies presented at the hospital from 1992 to 1998.

Results: Out of a total of 466 cases studied, in 283 (61%) the lymph nodes were fragmented. The site of biopsy was mentioned in 361 (77.5%) cases with the cervical region forming the most common site (56.5%). A clinical history was …

Association Of Epstein Barr Virus (Ebv) With Nasopharyngeal Carcinoma (Npc), S H. Shah, I N. Soomro, S Haroon, T Moatter

Department of Pathology and Laboratory Medicine

Aim:
To observe the frequency of nasopharyngeal carcinoma (NPC) and its association with Epstein Barr Virus (EBV) infection.
Setting:
This study included consecutive cases of nasopharyngeal carcinoma, which were diagnosed in the Department of Pathology at the Aga Khan University Hospital, Karachi in the period of two years (1996-97).
Methods:
These tumors were initially evaluated on H&E stained sections. The tumors showing evidence of keratinization were excluded from the study. The Epstein Barr Virus was detected with the help of Polymerase chain reaction in formalin fixed, paraffin embedded tissue sections.
Results:
During the study period, seventeen cases of nasopharyngeal carcinoma …

Central Nervous System Lymphomas: A Histologic And Immunophenotypic Analysis, Suhail Muzaffar, M. Shahid Siddiqui, Irshad Nabi Soomro, Shahid Pervez, Naila Kayani Naila Kayani, Sheema H. Hasan Sheema H. Hasan Sheema H. Hasan, Lmran Siddiqui Lmran Siddiqui

Department of Pathology and Laboratory Medicine

Objective: To observe the spectrum of non-Hodkin’s lymphomas involving the central nervous system including morphological subtypes and immunophenotypic status.

Setting: Retrospective analysis of eleven years (1986 to 1996) data from surgical pathology files of Department of Pathology.

Results: orty-three cases of non-Hodgkin’s lymphomas were diagnosed during the period of eleven years (from 1986 to 1996), all of which were diffuse types. A total of 1177 Central Nervous CNS biopsies were examined, out of which 937 cases were diagnosed as CNS neoplasms, the remaining were non-neoplastic in nature. Among 937 CNS neoplasms, 43 cases (4.6%) were reported as non-Hodgkin’s lymphomas. As …

Morphological Pattern Of Testicular Tumors, M S. Gill, S H. Shah, I N. Soomro, Naila Kayani, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

Objective:
To find out the mode of presentation, age distribution and the prevalence of various histological subtypes of testicular tumors.
Method:
All consecutive cases of testicular tumors diagnosed in the department of pathology, the Aga Khan University Hospital, Karachi, during the period of eight years (1991-98) were included in this study. Relevant clinical details such as age, clinical presentation and side of involvement of the testis were also recorded, where available.
Results:
During the span of eight years (1991-98), 170 cases of testicular tumors were diagnosed at the Aga Khan University Hospital, Karachi. Most of the tumors were diagnosed in …

Childhood Non-Hodgkin's Lymphoma: An Immunophenotypic Analysis., Sajid Hussain Shah, Suhail Muzaffar, Shahid Pervez, Sheema H. Hassan

Department of Pathology and Laboratory Medicine

Objective: To observe the frequency of histological subtypes of childhood non-Hodgkin`s lymphoma and its immunohistochemical profile.

Setting: All cases of non-Hodgkin’s lymphoma diagnosed in children (<15 years) in the section of histopithology at the Aga Khan University Hospital Karachi during the period of three years.

Methods: These consecutive cases were evaluated on H&E stained sections and then immunohistochemistry analysis of these tumors was performed by employing Peroxidase Anti-Peroxidase (PAP) technique.

Results: The present series included 61 cases of non-Hodgkin’s lymphoma. NHL was more common in males as compared to females with male to female ratio of 5.8:1. High grade NHL comprised 87% of childhood lymphoma. The mode of presentation in majority of NHL (57%) was extranodal. Burkitt’s lymphonia (33%) …

Frequency Of Malignant Solid Tumors In Children, Sajid Hussain Shah, Shahid Pervez, Sheema H. Hassan

Department of Pathology and Laboratory Medicine

Objective: To find out the frequency of malignant solid tumors in children (cTl5 years).

Setting: All cases of pediatric malignant solid tumors which were diagnosed in the section of histopathology at the Aga Khan University Hospital, Karachi during the period of two years.

Methods: These tumors were initially evaluated on H&E stained sections and special stains were also performed whenever indicated. The undifferentiated tumors were evaluated immunohistochemically by using a panel of antibodies on sections from routinely processed, fornialin fixed, paraffin embedded tissu.e blocks.

Results: Of two hundred and fifty three (253) consecutive cases of paediatric malignant solid tumors, lyinphorna …

Micronutrient And Iron Supplementation And Effective Anti-Malarial Treatment Synergistically Improve Childhood Anaemia, H. Ekvall, Zul Premji, A. Bjorkman

Pathology, East Africa

The control of childhood anaemia in malaria holoendemic areas is a major public health challenge for which an optimal strategy remains to be determined. Malaria prevention may compromise the development of partial immunity. Regular micronutrient supplementation has been suggested as an alternative but its effectiveness remains unsettled. We therefore conducted a randomised placebo-controlled intervention trial with 207 Tanzanian children aged 5 months to 3 years on the efficacy of supervised supplementation of low-dose micronutrients including iron (Poly Vi-Sol with iron) three times per week, with an average attendance of ≥ 90%. The mean haemoglobin (Hb) level increased by 8 g/l …

Acute Adenolymphangitis Due To Bancroftian Filariasis In Rufiji District, South East Tanzania, D.B. Gasarasi, Zul Premji, P.G.M. Mujinja, R. Mpembeni

Pathology, East Africa

A longitudinal prospective surveillance for acute adenolymphagitis (ADL) was carried out in three villages in Rufiji district. A sample population of 3000 individuals aged 10 years and above was monitored fortnightly for a period of 12 months. The annual incidence of ADL was found to be 33 per 1000 population and was significantly higher in males than females (52.7/1000 and 18.7/1000 respectively). ADL episodes were more frequent in the age group of 40 years and above. Individuals with chronic manifestations seemed to be more vulnerable to ADL attacks with 62.2% of the total episodes occurring in this group. Furthermore, individuals …

Learning Approaches And Academic Performance Of Undergraduate Medical Students In Pakistan, Zoon Naqvi, Rashida Ahmed

Department for Educational Development

Objective: To classify undergraduate medical students according to their learning approaches and to correlate the learning approaches with their academic achievements.
Materials and Methods: A questionnaire to appraise learning approaches of undergraduate medical students was administered and collected at the end of the regular certifying examinations. The responses were analysed through the principal component factor analysis.
Results: The results did not depict formation of demonstrable learning approaches during academic years. However, increased self-awareness about the approaches was indicated by the responses of final year students as compared to the third year students. The correlation of the learning approaches with the …

Risk Of Imported Filariasis In Pakistan, M A. Beg

Department of Pathology and Laboratory Medicine

No abstract provided.

Gastric Carcinoma With Lymphoid Stroma: Association With Epstein Virus Genome Demonstrated By Pcr, Irshad N. Soomro, Samina Noorali, Syed Abdul Aziz, Suhail Muzaffar, Shahid Pervez, Akbar S. Hussainy, Tariq Moatter

Department of Pathology and Laboratory Medicine

No abstract provided.

Arthritis And Rosai-Dorfman Disease Of The Skin: A Diagnostic Dilemma, Irshad Nabi Soomro, Kamran Hameed

Department of Pathology and Laboratory Medicine

No abstract provided.

P53 And Pcna Expression In Benign, Atypical And Malignant Meningiomas, R Ahmed, I N. Soomro, S A. Aziz, S H. Hasan

Department of Pathology and Laboratory Medicine

Objective: Alterations: p53 genes are turning out to be the most common genetic alterations in human cancers. Due to long half-life of mutated p53, its detection is possible by immunohistochemistry. Proliferating cell nuclear antigen (PCNA) is expressed by dividing cells, hence has been shown to correlate with prognosis. We have used monoclonal antibodies protein DO-7 (p53) and PC10 (PCNA) to see whether their expression correlates with histological grading in meningethelial tumour.
Material and Methods: a Twenty nine meningiomas (20 benign, 7 atypical and 2 malignant) were selected from the records of our laboratory. p53 and PCNA expression was sought by …

Spinal Cord Compression Caused By Metastatic Epithelial Myoepithelial Carcinoma Of The Parotid Gland, I N. Soomro, A S. Hussainy, K Chishti, M H. Pui, S A. Khan, R Ahmed, S H. Hasan

Department of Pathology and Laboratory Medicine

No abstract provided.

Spectrum Of Hodgkin's Disease In Children And Adults: Impact Of Combined Morphologic And Phenotypic Approach For Exclusion Of Look-Alikes, Tanya Siddiqui, Shahid Pervez

Department of Pathology and Laboratory Medicine

Objective:

To determine the prevalence of Hodgkin’s disease (HD) and its various subtypes in children and adults and assess the use of immunohistochemical (IHC) studies in confirming HD cases and excluding its close mimicries/look-alikes.

Material and Methods:

All 265 Hodgkin’s disease cases diagnosed at The Aga Khan University Hospital, Karachi over the last 6 years (July 1991 - July 1997) were included. Of these 219 were diagnosed on routine H&E examination while in the remaining 46 cases, diagnosis was made after a thorough IHC workup. (This group initially included 161 cases labelled as lymphoproliferative disorder with HD as one of …

Morphological Pattern And Frequency Of Thyroid Tumors, S H. Shah, S Muzaffar, I N. Soomro, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

Objective:
The present study was done to evaluate the frequency of thyroid cancer and to find out the prevalence of histological types of thyroid tumor with respect to age and sex group.
Setting:
This study included consecutive cases of malignant tumors of thyroid gland, which were diagnosed in the Department of Pathology at the Aga Khan University Hospital, Karachi during the period of three years (1995-1997).
Methods:
These cases were evaluated on H & E stained sections from paraffin embedded 10% buffered formalin fixed tissue blocks. Special stains and immunohistochemical analysis were performed whenever required.Results: A total of 8541 malignant …

Fine Needle Aspiration Cytology (Fnac) In The Management Of Thyroid Pathology - The Aga Khan University Hospital Experience, Mubasher Ikram, Jamil Hyder, Sohail Muzaffar, Sheema H. Hasan

Section of Otolaryngology, Head & Neck Surgery

Objective: To report the efficacy of FNAC in patients with thyroid disease.
Methods: Between January 1990 and December 1994 the records of all patients treated surgically for thyroid disease at ENT Head and Neck Surgery of Aga Khan University were reviewed. All the patients had pre­operative FNAC as the first line of evaluation and the histopathologist examined post-operative thyroid specimen.
Results: Forty-five patients (36 female and 9 male) had thyroid surgery. In 26 patients out of 45, FNAC was conclusive in diagnosing the nature of disease, while in 19 patients the FNAC was inconclusive because of the presence of follicular …

Clinico-Morphological Pattern And Frequency Of Bone Cancer, Sajid H. Shah, Suhail Muzaffar, Irshad N. Soomro, Shahid Pervez, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

Objective:

The present study was done to find out the frequency of malignant tumors of bone and to categorize the prevelence of various histological types of osseous malignancies with respect to age, sex and site of origin.

Setting:

This study included consecutive cases of malignant bone tumors, which were diagnosed in the department of pathology at the Aga Khan University Hospital, Karachi during the period of three years (1995-1997).

Methods:

These tumors were initially evaluated on H & E stained section from paraffin embedded tissue blocks. Special stains and immunohistochemical analysis was performed whenever required.

Results:

A total of 169 …

Immunohistochemical Evaluation Of Small Round Cell Tumors Of Childhood, Sajid H. Shah, Irshad N. Soomro, M. Shahid Siddiqui, Shahid Pervez, Sheema H. Hassan

Department of Pathology and Laboratory Medicine

Objective:

This study was done to evaluate the pediatric undifferentiated small round cell tumors with immunohistochemical staining.

Setting:

The present study included consecutive cases of small round cell tumors which were diagnosed in children (<15 years) in the section of Histopathology at the Aga Khan University Hospital, Karachi during the period of two years.

Methods:

The group of undifferentiated small round cell tumors were evaluated immunohistochemically by using a panel of antibodies on sections from routinely processed, formalin fixed, paraffin embedded tissue blocks.

Results:

The category of undifferentiated small round cell tumors included rhabdomyosarcoma (23.2%), primitive neuroectodermal tumor (17.9%), non-Hodgkin’s lymphoma (16.1%), neuroblastoma (14.2%), Ewing’s sarcoma (10.7%) in order of frequency. Osteosarcoma (Small cell variant), retinoblastoma and medulloblastoma comprised …

Clinico-Morphological Pattern Of Intracranial Tumors In Children, Sajid H. Shah, Irshad N. Soomro, Akbar S. Hussainy, S H. Hassan

Department of Pathology and Laboratory Medicine

Objective:
The objective of present study was to observe the histopathological pattern of intracranial tumors in children (< 15 yrs) and to correlate the site of lesion along with the histological diagnosis.
Setting:
The study included consecutive cases of intracranial tumors diagnosed in children (< 15 yrs.) in the section of histopathology at the Aga Khan University Hospital, Karachi during the period of three years.
Methods:
The initial histological evaluation of these lesions was performed on H and E stained section of paraffin embedded tissue. Special stains and immunohistochemical analysis was done whenever indicated.
Results:
During the study period, fifty-four cases of intracranial tumors were diagnosed in children. The age ranged from 1-1/2 years to 4 years with male to female ratio of 1.1:1. Astrocytoma comprised 39% of all intracranial tumors of childhood. Medulloblastoma …

Current Clinical Efficacy Of Chloroquine For The Treatment Of Plasmodium Falciparum Infections In Urban Dar Es Salaam, United Republic Of Tanzania, Zul Premji, C. Makwaya, J.N. Minjas

Pathology, East Africa

Reported is the use of a 14-day WHO protocol, which takes into account the clinical, parasitological and haematological responses to antimalarial drugs, to determine the efficacy of chloroquine in the treatment of uncomplicated malaria in young children (n = 200) in urban Dar es Salaam. Chloroquine failure was found in 43% of the children. Of these, 12.5% were considered to be early treatment failures and were given a single dose of sulfadoxine-pyrimethamine. Fever subsided in all children treated with sulfadoxine-pyrimethamine and there were no parasitological failures. In addition, children treated with sulfadoxine-pyrimethamine because of early treatment failure with chloroquine had …

Autoimmune Hemolytic Anemia In Visceral Leishmaniasis, Salman Adil, Mohammad Khurshid, Lkram A. Burney

Department of Pathology and Laboratory Medicine

A case of an 8-month old male child, who presented with lgG mediated Coomb’s positive hemolytic anemia and visceral leishmaniasis is presented. The hemolytic anemia resolved following the treatment of leishmaniasis. Although various other mechanisms of anemia have been described, so far the association between IgG-mediated hemolytic anemia and visceral leishmaniasis has not been reported.

Primary Cutaneous Actinomycosis, Anjum Kanjee, Zamaz Wahid, Shahid Pervez

Department of Pathology and Laboratory Medicine

No abstract provided.

Spinal Cord Compression: Histologic Spectrum Of Lesions, I. N. Soomro, N.Kayani N.Kayani, Shahid Pervez, A. S. Hussainy, R. Ahmed, S. Muzaffar, S. A. Aziz, S. H. Hasan

Department of Pathology and Laboratory Medicine

Histologic diagnosis ultimately determines the prognosis and treatment of lesions causing spinal cord compression. Modem imaging techniques have revolutionized the procedure of localizing lesions pre¬senting with signs and symptoms of spinal cord compression. As a result, these lesions are more accessible for fine needle aspiration and biopsy. A quick diagnosis is possible if cytologic preparation is made. Similarly, intraoperative frozen section facility not only provides rapid diagnosis, but also offers oppor tunity of appropriate management decision there and then. Histology in many cases needs help of special stains and immunocytochemistry. This study looks at the histologic spectrum of these lesions, …