Primary extraskeletal osteosarcomata of liver, kidney, breast and thigh

Extraskeletal or soft-tissue osteosarcoma is rare, occurring approximately as 1.2% of all soft-tissue sarcomas and 4% of all osteosarcomas. The peak occurs in patients, which are in the 6th decade of life. The males are slightly more frequently affected. Symptoms often include a slowly growing painful mass, with a history of trauma [1 2% of cases]. Common sites of involvement are the deep soft tissues of the thigh [47% of cases], upper extremity [20%], and retropcritoneum [17%]. The identification of neoplastic osteoid matrix formation and aggressive characteristics are necessary for histological diagnosis of osteosarcoma. We are going to discuss 06 cases of extraskeletal osteosarcomas including primary renal, primary hepatic osteosarcoma, one arising in a cystosarcoma phylloides and 03 cases involving the thigh regions

Osteosarcoma: review and diversity of cases

Osteosarcoma is the most common primary malignant tumour of bone in adolescents and young adults. It accounts for approximately 15% of all primary bone tumors confirmed at biopsy. There are numerous types of primary osteosarcoma, including are intramedullary osteosarcoma, juxtacortical [surface] osteosarcoma, and extra skeletal osteosarcoma. Osteosarcoma may also occur as a secondary lesion in association with underlying benign conditions. The identification of neoplastic osteoid matrix formation and aggressive characteristics are necessary for histological diagnosis of osteosarcoma. In all bone tumors, differential diagnosis is best assessed with radiographs, whereas staging is performed with computed tomography or magnetic resonance imaging. Beside literature review, we are going to discuss 26 cases of primary osteosarcomas of bone [majority are of conventional type] and 03 cases of extra- skeletal ostcosarcomas

Analysis of 404 cases of radiologically guided fine needle aspiration cytology [FNAC] of space occupying lesions of liver

Radiologically guided Fine needle aspiration cytology [FNAC] is a valuable technique for diagnosing benign and malignant space occupying masses of liver. It is a cost effective and safe method that can differentiate benign and malignant lesions accurately. The objective of this study was to analyze 404 cases of radiologically guided fine needle aspiration cytology of space occupying lesions of liver. The study was conducted at Histopathology Department SZFPGMI in collaboration with the Radiology Department. The aspirates were done by senior radiologist in Radiology Department. Most of the aspirates were from males. Five cases were considered inadequate, there were more malignant cases [295 cases] as compared to benign lesions [99 cases]. Metastatic lesions were more common as compared to hepatocellular carcinoma [HCC], however, the ratio of metastatic adenocarcinoma and primary HCC was almost equal. Thus radiologically guided FNAC is the simple, quick and complication free procedure for diagnosing space occu pying lesions of liver

Affect of combined oral contraceptives on routine coagulation parameters

The present study was designed to estimate the coagulation parameters like fibrinogen degradation products [FDPs], fibrinogen levels, thrombin time [TT], Prothrombin time [PT] and activated partial thromboplastin time [APTT]. In this study, 40 subjects on combined oral contraceptives [COCs] with a contraceptive duration from 3-18 months and 20 normal females without hormonal contraceptives were included. Blood samples were collected for coagulation parameters in accordance with the standard protocol. FDPs and fibrinogen levels were significantly elevated whereas PT, APTT and TT were shortened in subjects using combined oral contraceptives [COCs] as compared to normal controls

Analysis of 210 cases of radiologically guided FNAC of intraabdominal masses

Two hundred and ten cases of intraabdominal masses were aspirated under ultrasound and CT scan guidance. These aspirates were done by senior radiology staff at Sheikh Zayed Postgraduate Medical Institute Lahore. The smears and cell blocks were studied by consultant pathologists and final diagnosis was obtained. Seven cases were considered as inadequate, these were excluded from study. The remaining 203 cases included in the study consisted of 147 cases of liver masses,29 cases of nodal masses ,16 cases of retroperitoneal masses, 10 cases of GIT masses and one case of ovarian mass. Most of the malignant aspirates were from liver followed by nodal masses and retroperitoneal masses. The diagnostic yield was 97.4% and diagnostic yield of malignancy was 69.9%. In liver masses. HCC was the commonest lesion found followed by lesions from GIT metastatic to liver. In nodal masses, NHL was the commonest malignancy found. We successfully aspirated retroperitoneal masses and diagnosed these lesions cytologically with cl inical correlation. The accuracy rate for diagnosing GIT lesions was 100%. Thus radiologically guided FNAC is simple, quick accurate and essentially risk free procedure for diagnosis of intraabdominal masses

Spectrum of intrathoracic lesions by guided fine needle aspiration cytology [FNAC]

This study was done to evaluate the spectrum of various intrathoracic lesions by radiologically guided fine needle aspiration cytology FNAC was performed on 62 patients [48 males and 14 females] at Shaikh Zayed Hospital, Lahore under ultrasound and CT scan guidance. The cytologic diagnoses were classified as primary lung lesions and mediastinal lesions. Four major groups were made; Non Diagnostic, Benign or negative for malignancy, inflammatory lesions and malignant lesions. Diagnostic yield was 95.1%. Thirty cases [48.4%] were malignant, 19 cases [30.7%] belonged to inflammatory group, 10 cases [16.7%] were diagnosed as benign or negative for malignant cells, and 3 cases [4.9%] were non-diagnostic due to F inadequate aspirate inspite of repeated aspirations. Malignant lung lesions comprised of 9 cases [31.1%] 1 small cell carcinoma, 2 cases [6.9%] broadly categorized as non-small cell carcinoma, 7 cases [24.1%] of squamous cell carcinoma, 5 cases [17.2] of metastatic adenocarcinoma, 4 cases [13.8] of undifferentiated carcinoma and a single case each of mesothelioma and of malignant round cell tumor [3.4%]. Out of mediastinal lesions there was only one case of malignancy that was malignant round cell tumour of child hood. Nineteen out of total 62 cases were of inflammatory group. Out of which 10 cases [52.6%] had, chronic granulomatous inflammation, and nine cases [47.4%] were of abscesses. Tuberculosis was found 1 in 6 cases and the remaining 4 cases were suggestive of tuberculosis. Majority of lung lesions were encountered in 6`h decade of life. As the method is simple, rapid, and cost effective, it can be easily practiced in any centre, where specialized radiologists and pathologists are available. It reduces the patient`s stay in hospital and thus the cost of treatment is markedly reduced