Patterns of pulmonary morphological lesions seen at autopsy

Chronic respiratory diseases are a group of chronic diseases affecting the airways and the other structures of the lungs. Hundreds of millions of people around the world suffer from preventable chronic respiratory diseases. Prompt investigation and diagnosis are essential to improving patient survival. The objective of this study was to observe the frequencies of different lung diseases on the basis of histopathological examination of lung tissue specimens removed at autopsy. This study was a non-interventional, cross - sectional and was conducted on 810 specimens of lungs at Pathology department of Allama Iqbal Medical College, Lahore in collaboration with the Forensic Medicine department of King Edward Medical University, Lahore. Relevant autopsy data was recorded in a proforma. The tissue specimens were fixed and processed. Paraffin sectioning was done followed by Haematoxylin and Eosin staining. The sections were then examined by a panel of consultant Histopathologists. Autopsies of 810 subjects with respiratory diseases were reviewed, and the following data were obtained: age, sex and cause of death. During a period of one year, a total of 810 lungs and hilar lymph nodes specimens from autopsy subjects were studied. Maximum numbers of cases [68.14%] were in 20 - 49 years age group. The commonest cause of death [42.96%] was tuberculosis. On microscopic examination of the sections from the lungs, there were 348 cases of tuberculosis, 324 out of 810 [40%] cases of emphysema and silicosis was present in 89 [11%] cases. Squamous metaplasia was present in 49 [6%] and Pneumonia in 4% cases. Advances in diagnostic technology have not reduced the value of autopsy and a goal directed autopsy remains a vital component for the study and evaluation of the disease process. Emphysema and tuberculosis are quite common in our population

Pattern of benign morphological myometrial lesions in total abdominal hysterectomy specimens

Hysterectomy is one of the most common major surgical procedure performed all over the world. Indications for total abdominal hysterectomy include dysfunctional uterine bleeding, leiomyoma, adenomyosis, chronic pelvic pain and pelvic inflammatory disease. Other causes include endometrial hyperplasia, cervical intraepithelial neoplasia. invasive cancer and endo-metrial malignancy. Hysterectomy specimens contribute a major component of histopathological work in Pathology laboratories. The present study was undertaken in Pathology department, Allama Iqbal Medical College, Lahore to find out the morphology and frequency of different benign histopathological lesions in myometrium of uterus in total abdominal hysterectomy specimens. A descriptive case series study of one hundred total abdominal hysterec-tomy specimens was carried out in Allama Iqbal Medical College, Lahore. One hundred total abdominal hysterectomy specimens were studied. The ages of the patients ranged from 30 - 69 years with maximum [73%] cases in 40 - 49 years age group. The commonest presenting complaint was menorrhagia [68%]. The two benign histopathological lesions in myometrium were leiomyoma and adenomyosis. Myometrium revealed leiomyoma in 6g% cases and foci of adenomyosis in 47% cases. The commonest benign histopathological lesion in myometrium was leiomyoma [69%] followed by adenomyosis [47%]

Efficacy of pipelle as a tool for endometrial biopsy

This study was carried out to determine the accuracy of Pipelle sampling in the diagnosis of abnormal uterine bleeding by comparing it with histopathology of the hysterectomy specimens taken as gold standard. One hundred patients with abnormal uterine bleeding in perimenopausal or postmenopausal age group scheduled for hysterectomy had endometrial sampling with Pipelle, in the department of Obstetrics and Gynaecology Unit I, Sir Ganga Ram Hospital, Lahore, from Dec. 2003 to Dec. 2004. The specimens were sent for histopathology. Among 100 patients, 66 underwent hysterectomy. In the remaining 34 patients, 6 had inadequate specimen on Pipelle sampling and in 28 patients hysterectomy was planned but postponed because of medical problems. Among the 66 patients the results of Pipelle Endometrial Sampling [PES] were compared with histological results of hysterectomy specimen. Among the 66 patients the results of PES were compared with the histological results of hysterectomy specimen. In 61 cases the histopathological results were identical indicating a correlation of 92.42%. In 5 cases results were different, 4 having slight variation and in one case PES reported complex hyperplasia and on hysterectomy it turned out to be a case of carcinoma cervix. It is concluded that Pipelle biopsy is definitely a useful and cost effective method. It can reduce the number of D and C performed in the theatre. Moreover it has an advantage of taking biopsy on the first visit of patient thereby time taken for the diagnosis of malignancy can be reduced

Role of fine needle aspiration cytology [FANC] in diagnosis of uni-locular ovarian cysts - a Cytohistological correlation

This study was carried out to assess the ability of fine needle aspiration cytology [FNAC] in the diagnosis of ovarian cysts by comparing the results with histological findings of tissue biopsies. This study includes 48 cases by ovarian cysts reported to Pathology department, Allama Iqbal Medical College, Lahore and Author's Lab. mainly from Jinnah Hospital, Lahore, Sir Ganga Ram Hospital, Lahore and Services Hospital, Lahore. In 28 cases, aspiration was done per-operatively while in 20 cases preoperatively. These aspirates were examined cytologically by making the appropriate smears. The same cysts removed surgically were then examined histologically and results were compared. In a total of 48 cases, on FNAC, serous, follicular, luteal, mucinous and endometriotic cysts were diagnosed in 12, 8, 7, 5 and 5 cases respectively with inconclusive aspirate in 11 cases. When histology was done on excised specimens of these ovarian cysts, serous cysts were found in 17 patients, follicular cysts in 10, luteal cysts in 12, mucinous cysts in 6 and endometriotic cysts in 3 patients. On correlating the FNAC and histopathology results, a sensitivity of 58.34% to 100% and a specificity of 60% to 100% were calculated in different types of cysts. It is concluded that FNAC of ovarian cysts is a fairly useful diagnostic technique which can further improve by more experience and ancillary techniques

Pattern and frequency of various utrine tumours: a retrospective study over a period of 26 months

This is a retrospective study to find out the frequency of various uterine tumours. It includes hystrectomy specimens, tumour excisions and endometrial curettings which were sent to Department of Pathology, Allama Iqbal Medical College, Lahore and author's laboratory during a period from January 2001 to March 2003. A total of 471 cases are analysed. Leiomyomas were seen in 369 patients [78.34%] and endometrial polyps in 49 cases [10.41%]. Malignant tumours were found less frequently with adenocarcinoma in 23 patients [4.88%] followed by leiomyosarcoma in 8 patients [1.70%], Endometrial stromal tumours in 7 patients [1.49%], Choriocarcinoma in 6 patients [1.27%] and Mixed Mullarian tumours in three patients [0.64%]. NonHodgkin's Lymphoma was seen in one patient [0.21%] while in five patients [1.06%], metastatic tumours were found. Three were squamous cell carcinomas, two from cervix and one from lung while two were invasive ductal carcinomas coming from breasts. It is concluded that in the uterus benign tumours and tumour like conditions are more common with leiomyomas as the most common uterine neoplasms whereas malignant tumours are less common and endometrial adenocarcinoma being the most common uterine malignant tumour

Chromoblastomycosis: an unusual cutaneous dematiaceous fungal infection

Chromoblastomycosis is a chronic fungal infection with a slow evolution, caused by dematiaceous fungi inducing skin lesions being difficult to treat and have frequent recurrences. The clinicopathological features and diagnosis of one such case is reported here to share our experience with others. A nine years old male with a three years history of a slowly spreading painless skin lesion involving the whole of right cheek and nose. The patient gave a typical history of trauma in that region followed by a dark red skin eruption, which gradually grew to form erythematous papule. Physical examination revealed large hyperkeratotic, raised, thick crusted, verrucous plaques with areas of scaring and ulceration on the right cheek and nose extending down in a tumorous fashion. A small scaly lesion was observed next to the right eyebrow. However, the borders of the lesion were well defined and the surrounding skin was normal. No lymphadenopathy was seen

Role of fine needle aspiration cytology in the diagnosis of focal liver lesions

Fine Needle Aspiration [FNAC] of focal liver lesions was carried out at Allama Iqbal Medical College / Jinnah Hospital, Lahore and author's lab. in 108 patients between January 2000 to August 2002 to evaluate the role of FNAC in diagnosis of focal liver lesions and to find out different patholigies which present as focal liver. Out of these 108 patients, most of them [87.96%] were above the age of 40 with male preponderance [55.55%]. Morphologically, malignant lesions were more common [74.08%] with hepatocellular carcinoma[HCC] as the most common malignancy [42.59%] followed by metastatic malignancies [23.15%], undifferentiated malignancies [5.55%] and Non-Hodgkin's Lymphoma in 3[2.78%] patients while in two patients [1.85%] only normal hepatocytes were aspirated. In 13 [12.04%] patients aspirates were inadequate for any morphological evaluation. It is concluded that FNAC is a useful technique in evaluating the liver masses. However there are some difficulties which can be overcome by more experience in aspiration and better coordination between radiologist, pathologist and clinicians