Angiomyofibroblastoma of the vulva

A 30 year old female presented with unilateral labial enlargement. The clinical impression was that of a benign cyst. The microscopic features were that of angiomyofibroblastoma showing hyper and hypocellular areas containing spindle and plump stromal cells admixed with blood vessels. This tumour is benign with extremely low rate of recurrence. Surgery is the only treatment as in this case

Symplastic leiomyoma of uterus: a rare histological variant

Symplastic leiomyoma is a rare histological variant of leiomyoma. This is a case report of a young nulliparous patient who presented with primary infertility for 2 years and swelling in lower abdomen for 6 months. Intramural fibroid was diagnosed during a pelvic ultrasound. Histopathology of that myomectomy showed symplastic leiomyoma with absent mitotic figures. The patient was managed as for a benign tumor

AgNOR proliferative index in malignant pleural and peritoneal effusions

The inability to decide on the presence or absence of malignant cells in cytologic specimens casts a difficult problem in clinical management. Over the last decade, silver staining of the nucleolar organizer regions-associated proteins [AgNORs] in interphase cells has become a widely used alternative method for assessing proliferation in tumour pathology. A great deal of work has been done to evaluate the usefulness of AgNOR counts in the study of various neoplasms. It has been established that new predictor of biologic aggressiveness in a neoplasm, AgNOR proliferative index [pAgNOR] correlates with the proliferative activity of a cell. In this study, AgNOR silver staining was done on 40 cases of cytologically positive malignant effusions and both mean AgNOR [mAgNOR] and pAgNOR counting was done. To measure AgNOR counts and their distribution in malignant effusions in relation to a new parameter, AgNOR proliferative index [pAgNOR] which reflects the proliferative activity of a cell? The study was carried out in the Department of Pathology, Postgraduate Medical Institute Lahore while the cases were collected from Surgical, Medical, Gynaecological and Oncology units of Services hospital, Mayo Hospital, Gulab Devi hospital and Lahore General Hospital from March 1997 to November 1999. Forty patients were selected with different types of malignancies and having cytologically positive effusions. Pleural and peritoneal fluid was collected aseptically and smears were made from the cell button after centrifugation. AgNOR silver staining technique was performed on each smear. Using the criteria of Ahsan et al 91-92, in our study highly significant [p < 0.001] difference was noted when AgNOR size of malignant effusions between 2+ and 3+ was compared with 0 - 1+. Similar significant relationship was seen [p < 0.001] when AgNOR distribution of 2+ and 3+ was compared with 0 - 1+ distribution. Most of the cases with malignant effusions had AgNOR proliferative index above 90%. However, when AgNOR proliferative index between pleural and peritoneal effusions were compared, the difference was not significant. The two simple AgNOR counting methods can be used reliably to evaluate tumour cell kinetics especially in situations in which the tissue is insufficient for flow cytometry, for example, in small biopsies and limited needle aspirates