ABSTRACT
Background and Objective: Pleomorphic xanthoastrocytoma [PXA] is a rare primary WHO Grade II astrocytic tumor comprising of < 1% of all astrocytomas. It is generally benign and slow growing however disease progression and malignant transformation with anaplastic features have been infrequently reported. Our objective was to assess clinicopathological characteristics of this rare tumor at our center
Methods: A retrospective study was conducted at Aga Khan University Hospital from January 1992 till January 2016. Data was entered on a proforma including patient demographics, clinical features, tumor location, histological features and follow-up, where available
Results: Forty Seven cases of PXA were retrieved during the study period. The mean age was 23.8 years [SD=15.1] and median age was 19 years. The most frequent symptom was head ache [n=31]. Male were more frequently affected [n=26]. The commonest location was temporal lobe. On microscopic examination, tumors were pleomorphic without mitoses or necrosis, however two cases showed increased mitotic activity, and one case revealed associated gliosarcoma. Follow-up of only 29 cases was available for a period ranging between 2 and 184 months [85 months +/- 56 months]. Outcome was good in 27 patients with the last follow up showing no radiographic or clinical evidence of tumor recurrence
Conclusions: PXA is an infrequent tumor in our population also, with less than 50 cases identified in two decades study period. Due to its rarity and its bizarre histomorphology, it should be diagnosed correctly, as it has got better prognosis than other astrocytic tumors
ABSTRACT
Screening for cancer of the cervix remains a neglected health care issue in Pakistan. To provide baseline data for future efforts to improve screening, we conducted a retrospective analysis of cervical smears taken in the obstetrics and gynaecological clinics of the Aga Khan University Hospital, Karachi, Pakistan. Method: We collected data on cervical smear cytology for cervical smears taken from January 1, 1990 to December 31,1996. We assessed risk factors for dysplasia, including age, age at first marriage, and number of pregnancies. The overall prevalence of abnormal smears in our study was 0.5%. Of 20,995 cervical smears, 12,451 [59.3%] smears showed non-specific inflammation, 7302 [34.8%] were reported as normal, 809 [3.85%] showed monillial infection, 148 [0.71%] showed atypia, 105 [0.5%] had dysplastic cytology, and 52 [0.25%] samples were inadequate. The highest incidence of dysplastic smears was seen in the age group 35 to 44 years. Of 105 patients with dysplasia, 12 were pregnant, and all were asymptomatic, while in 93 non-pregnant women, 33 were symptomatic. The low prevalence of abnormal smears, compared with data from Western populations, could be due to the inherent bias of health awareness in the women who attended our hospital. The results of this study may serve as a baseline for future comparisons. A larger community-based study may establish the exact prevalence of malignant and premalignant lesions so as to plan for future screening