Frequency of primary solid malignant neoplasms in both sexes, as seen in our practice

To determine the frequency of various histologic types of primary solid malignant neoplasms in males and females, in our practice, in a large series of surgical biopsies. A retrospective study of 20,000 consecutive surgical biopsies in the section of Histopathology, Aga Khan University Hospital [AKU], Karachi, in 2004. Squamous cell carcinoma of oral cavity was the commonest malignant neoplasm in males followed by diffuse Large B cell, Non-Hodgkin's lymphoma and Prostatic adenocarcinoma. In females, infiltrating Ductal carcinoma of the breast was overwhelmingly the commonest malignant neoplasm followed by Squamous cell carcinoma of the oral cavity and esophagus. Out of 20,000 biopsies, there were 4616 [23.08%] malignant neoplasms. Carcinoma of oral cavity is very common in our population in both sexes

Frequency of primary solid malignant neoplasms in different age groups as seen in our practice

To determine in a large series of surgical biopsies, the frequency of various histologic types of primary solid malignant neoplasms in males and females in different age groups. A retrospective study of 20,000 consecutive surgical biopsies reposted in the section of histopathology, AKU in 2004. Malignant neoplasms are commonest in the fifth and sixth decades of life. The commonest malignant neoplasms in the first decade were Hodgkin's lymphoma and Wilm's tumor in males and females respectively. In the second decade, osteosarcoma in males and Ewing's sarcoma/PNET in females. In the third decade, colorectal adenocarcinoma in males and infiltrating Ductal carcinoma of breast in females. In the fourth decade, squamous cell carcinoma of oral cavity in males and infiltrating ductal carcinoma of breast in females. In the fifth decade squamous cell carcinoma of oral cavity in males and infiltrating ductal carcinoma of breast in females. In sixth decade, squamous cell carcinoma of oral cavity in males and infiltrating ductal carcinoma of breast in females and in the seventh decade, prostatic adenocarcinoma in males and infiltrating ductal carcinoma of the breast in females. Above age of 70 years, the commonest malignant were again prostatic adenocarcinoma in males and infiltrating ductal carcinoma of breast in females. Malignant neoplasms are commonest in the fourth, fifth and sixth decades of life

Intra-abdominal desmoplastic small round cell tumor

Intra-abdominal desmoplastic small round cell tumor [IDSRCT] is a unique, highly aggressive neoplasm that chiefly affects male adolescents and young adults and most frequently presents as a large abdominal mass with widespread peritoneal involvement at the time of diagnosis. We present two cases of IDSRCT in a young male and a female. Both typically presented with diffuse peritoneal involvement

Desmoplastic small round cell tumour

Desmoplastic small round cell tumour [DSRCT] is a unique, highly aggressive neoplasm that chiefly affects adolescent male and young adults and most frequently presents as a large abdominal mass with widespread peritoneal involvement at the time of diagnosis. Histologically, it is composed of nests of small, undifferentiated round or oval hyperchromatic cells embedded in abundant desmoplastic stroma. Co-expression of epithelial, mesenchymal, and neural antigens in the same cell provides evidence of origin from a primitive pluripotent stem cell with multiphenotypic differentiation. A multidisciplinary treatment including high-dose chemotherapy, aggressive debulking surgery, radiation and myeloablative chemotherapy with stem cell rescue might be the proper approach to treat this rare malignancy and may improve progression-free survival

Frequency and characteristics of breast lymphomas presenting to a tertiary care hospital Pakistan

To assess the relative frequency of [primary and secondary] mammary lymphomas presenting to a tertiary care hospital, Pakistan and its categorization according to WHO classification of lymphoid neoplasms. All NHLs [nodal and extra nodal] diagnosed in the section of histopathology during 1992-2004 were retrieved and reviewed. All patients [n=30] diagnosed with lymphomatous involvement of the breast were selected. Distinction between primary and secondary breast lymphomas was not made owing to lack of availability of clinical information. A total of 5637 breast malignancies were diagnosed in our department during the study period of 10 years and the total number of NHLs [Nodal and extra Nodal] was 2632. Thirty [n=30] patients accounting for 1.13% were diagnosed to have lymphomatous involvement of the breast. The Female to Male ratio was13.5:1; age range was 12-92 years with a median age of 43 years [Mean age 46.5 years and Standard deviation of age was 16.88 years]. The sites of the lesions were the right breast in 11 cases [37.93%], left breast in 9 cases [31.03%] and both breasts in 2 cases [6.89%], while the location of 8 masses [27.58%] was unknown. Immunohistochemical studies were negative for cytokeratins [MNF and Cam 5.2] in all cases. All cases of DLBCL expressed B cell lineage antigens and were positive for LCA and Pan B [CD20 and 79a]. We concluded that breast lymphomas represent 1.13% of all NHL and 0.5% of all breast malignancies in this study. The most frequent morphologic type was diffuse large B-cell lymphoma. As patients with primary breast lymphoma have a better prognosis than those with carcinoma of the breast or patients with extranodal lymphomas, a multidisciplinary approach including surgery, radiotherapy, and chemotherapy when needed would result in a more favourable outcome

Follicular dendritic cell sarcoma of lymph node - a rare entity

Follicular dendritic cells [FDC] are non-lymphoid, non-phagocytic accessory cells in the immune system that are essential for antigen presentation and germinal center reaction regulation1. These cells are CD21+, CD35+, CD1a- and S100 protein + and they show desmosomes ultrastructurally. The most commonly involved sites by FDC tumors are lymph nodes but may arise at a variety of extranodal sites including oral cavity, tonsil, gastrointestinal tract and liver. Most studies represent single case reports or case series. Our patient presented with tumor in the lymph nodes. Histology revealed tumor cells with abundant eosinophilic cytoplasm, hyperchromatic and pleomorphic nuclei, and prominent nucleoli. The tumor cells were found to be positive for CD21 which is a specific marker for follicular dendritic cells

Dermatofibrosarcoma protuberans in a patient with alopecia areata univerisalis

Dermatofibrosarcoma protuberans [DFSP] is an uncommon locally infiltrative, low grade soft tissue sarcoma. Alopecia areata universalis is a severe form of non-scarring alopecia involving the whole body. We are reporting a rare case where both of these occured in the same patient

Bronchial carcinoid presenting with abdominal pain

Bronchial carcinoid tumors are very rare pulmonary neoplasms. They usually present with pulmonary symptoms or paraneoplastic syndromes. Typical [well-differentiated] tumors are usually indolent with survival exceeding 90% after resection. Atypical carcinoids have a worse prognosis. They are much more likely to recur locally or to have distant metastases. This case report describes a patient who presented with abdominal pain and hepatic lesions who was subsequently diagnosed to have bronchial carcinoid

Heterotopic glial tissue in tonsil: a case report

We describe a six month old boy with a mass in the left tonsil. It was present since birth and was enlarging progressively. It was completely excised. Histopathology showed a choristoma of neural origin composed of glial cells - astrocytes in a fibrillary background, and a choroid plexus. Immunohistochemistry confirmed the findings

Metanephric adenoma: a rare benign renal tumor

Metanephric adenoma is a rare benign renal tumour. We are reporting one histologically proven such case in a 23 year old male from Afghanistan. He presented with severe right flank pain since 3 weeks. Nephrectomy was done and histopathology was consistent with the diagnosis of metanephric adenoma. This novel renal mass has been reported to have benign clinical course despite its symptomatic presentation and large tumour size. There is no distinguishing radiological feature with can differentiate it from malignant tumours. So far, a uniformly benign clinical course has been associated with Metanephric adenoma, but given its relatively recent identification and rarity and the lack of clinical, radiographic, or cytologic means to establish a definite diagnosis, Metanephric adenoma remains primarily a pathologic diagnosis

Lymphoepithelioma-like carcinoma of urinary bladder: [LELCA]

Lymphoepithelioma-like carcinoma of the bladder [LELCA] is an uncommon neoplasm of the urinary bladder and up till now only 49 cases have been reported in the English literature. It is imperative to distinguish between lymphoepithelioma-like carcinoma and malignant lymphoma as primary bladder lymphoma is extremely rare. We report a case of a 55 year old lady who presented with the complaint of burning micturition and gross hematuria for the past 5 months. There were no other known co-morbids. Pelvic ultrasound was normal. Cystoscopy showed a 4x4 cm sessile mass in the bladder. Histopathological examination was consistent with the diagnosis of lymphoepithelioma like carcinoma of the urinary bladder

Non-Hodgkin's lymphomas presenting as cutaneous lesions

To analyze the spectrum of Non-Hodgkin's Lymphomas [NHL] presenting as skin lesions and to see the histological type, age, sex incidence and site predilection of different types of NHLs and to correlate our findings with western published data. Design: A retrospective descriptive case series study. Materials and All NHLs [nodal and extra nodal] diagnosed between January 1991-December 2001 in the section of Histopathology, Department of Pathology, The Aga Khan University, Karachi were retrieved by using SNOMED coding system. Cases were reviewed and those presenting with skin involvement were selected. Further characterization of these tumours was done by morphology and Immunohistochemistry. Panel of antibodies included leukocyte common antigen [CD45], Pan B markers [CD20 and CD 79a], Pan T markers[UCHL1], Ki-1[CD30] and epithelial membrane antigen [EMA]. The total number of NHLs [nodal and extra nodal] diagnosed in our department during the study period of 10 years were 1610. Out of these, 133 cases [8.26%] of NHLs presented with skin involvement. Out of these 44.4% [n=59] were NHLs of B cell phenotype while 23.3% [n=31] cases were of T cell phenotype. Out of 133 cases, 14[10.5%] were of mycosis fungoides [MF], and 3 [2%] each were of anaplastic large cell lymphoma [ALCL:Ki-1], lymphoma and lymphoblastic lymphoma/leukemia. In 17.3% [n=23] cases the phenotype could not be ascertained. There were 97[73%] males and 36[27%] females with a M:F ratio of 2.7:1. All types of NHLs showed a site predilection for the head and neck region except MF which presented mainly as generalized body lesions. NHLs presenting as skin lesions are more commonly of B cell phenotype followed by T cell phenotype [NOS] and mycosis fungoides. Probable reasons for the high frequency of cutaneous involvement by B-cell NHL are the advanced nature of the disease at the time of presentation and biological behavior of the tumors in our population