ABSTRACT
Objective: To evaluate ER and PR expression in epithelial ovarian cancers [EOC] and to determine its association with clinical stage
Study Design: Cross sectional study
Place and Duration of Study: Histopathology department, Armed Forces Institute of Pathology [AFIP] Rawalpindi, from Mar to Oct 2017
Material and Methods: A total of thirty three [n=33] histologically confirmed EOCs were analyzed. ER and PR expression status was assessed by immunohistochemistry using Allred scoring system and was compared with the clinical stage defined by The International Federation of Gynecology and Obstetrics [FIGO] staging system
Results: A total of thirty three [n=33] females were enrolled. Mean age of the study females was 50.8 +/- 12.9 years. Most frequent histologic type was serous carcinoma [SC] 60.6 percent [n=20] followed by mucinous carcinoma [MC] 15.2 percent [n=5], endometrioid carcinoma [EC] 9.1 percent [n=3], clear cell carcinoma [CC] 9.1 percent [n=3], Brenner tumor [MBT] 3 percent [n=1] and seromucinous carcinoma [SMC] 3 percent [n=1]. Most patients were in clinical stage I 61 percent [n=20] followed by stage II 24 percent, [n=8] and stage III 15 percent [n=5]. Among SC, 90.0 percent [n=18/20] were ER and 65 percent [n=13/20] were PR-positive. All MC and CC were ER/PR negative. Two of the three ECs were ER and one was PR-positive. Higher percentage of stage I tumors exhibited ER 65 percent [n=13/20] and PR 45 percent [n=9/20] positive status [p>0.5]. The correlation was very weak positive between clinical stages and both ER and PR scores [Allred] r=0.11 and 0.15 respectively p>0.05
Conclusion: Higher percentages of stage I tumors exhibited ER and PR positive status yet not statistically significant from stage II/III. Estimation of ER and PR receptor status may help to select the women with ovarian malignancy for hormonal therapy, which is more likely to improve the response rate
ABSTRACT
Objective: To analyse the clinicopathological spectrum of synovial sarcoma cases presenting in our institution. Study Design: Descriptive case series. Place and Duration of study: Armed Forces Institute of Pathology [AFIP] Rawalpindi, from Jan 2010 to Jan 2015
Material and Methods: All cases of synovial sarcoma diagnosed on histopathological examination were recovered from the Armed Forces Institute of Pathology [AFIP] laboratory information management system. The inclusion criteria consisted of optimally processed Haematoxylin and Eosin stained slides. Positive immunohistochemistry for epithelial membrane antigen/cytokeratin and CD99. Both genders were included. Patients' gender, age, tumour size, site, histological subtype, grade, microscopic margin status, depth and stage were noted. The data were analysed using SPSS Version 21. Frequencies and percentages were calculated for qualitative data and the standard deviation and mean for quantitative data
Results: Sixty-seven cases of synovial sarcoma [SS] were included in this study. The mean age of the patients was 35.1 years, with males at 55.2%. The most common site was the lower extremity 41.8%. The average size was 8.5 cm. The most common stage was pT2b [64.2%]. Monophasic histological subtype was more common at 58.2%. Grade 2 tumours were 77.6%. Microscopic positive margins were 30.0%. Specimens that were fragmented or not oriented properly were 33.3%
Conclusion: The clinicopathological spectrum of synovial sarcoma in our institution is similar to that of other parts of the world. This study has highlighted that a significant proportion [33.3%] of resection specimens were fragmented or unmarked; therefore surgical margins could not be evaluated in these cases, increasing the chances of inadequate surgeries
ABSTRACT
Objective: To analyze the clinicopathological characteristics of triple negative breast cancer. Study Design: Descriptive case series. Place and Duration of Study: Armed Forces Institute of Pathology [AFIP], from Jan 2014 to Dec 2014
Material and Methods: All cases of triple negative breast cancer diagnosed on histopathological examination followed by immunohistochemistry were retrieved from AFIP tumour registry. Patient's gender, age, tumour laterality, tumour size, histological tumour type, histologic grade, lymphovascular invasion, involvement of surgical margins and lymph node status were noted. The data were analyzed by using computer software program SPSS version 19. Descriptive statistics, frequencies and percentages were calculated
Results: A total of 35 cases of triple negative breast cancer were included in the study. The age at presentation ranged from 32-79 years with mean age of 50.9 +/- 11.7 years. Most of the patients were females [n=34, 97.1%], out of which 51.4% cases [n=18] belonged to premenopausal age group. Right sided breast tumours were more common [n=17, 54.8%]. The most common T stage at presentation was p T2 [n=20, 57.1%], while the mean tumour size was 5.2 +/- 2.2 cm. The most common histological type was invasive ductal carcinoma, NOS [n=32, 91.4%] while the commonest histological grade was Grade II [n=22, 67.7%]. Lymphovascular invasion was observed in 54.3% [n=19] of the cases while lymph node metastasis was seen in 74.1% [n=20] of the cases. Five cases [14.3%] had positive surgical margins
Conclusion: Triple negative breast cancer was more common in premenopausal females. Most common tumour type was invasive ductal carcinoma, NOS [Grade II] with a pT2 stage at presentation. Lymphovascular invasion and lymph node involvement was also seen in a large number of cases
ABSTRACT
Objective: To determine the frequency of expression of epidermal growth factor receptor [EGFR] by immunohistochemistry in head and neck squamous cell carcinoma [HNSCC]
Study Design: Cross-sectional study
Place and Duration of Study: Armed Forces Institute of Pathology [AFIP], Rawalpindi, from September 2015 to March 2016
Methodology: Fifty-two cases of head and neck squamous cell carcinoma diagnosed on H and E stain were included in the study. Patients' gender and age were noted. Immunohistochemistry for EGFR was applied and the results were recorded. The data were analyzed by using computer software program SPSS version 19. Descriptive statistics, frequencies and percentages were calculated
Results: Out of the 52 patients of HNSCC, 37 patients were males and 15 females. The age of the patients was between 21 and 80 years with an average age of 58.58 +/- 12.63. Out of 52 cases, 45 cases [86.53%] were positive for EGFR while 7 cases [13.46%] were negative for EGFR. Significant statistical association was not seen between the tumour grade and EGFR expression [p=0.162]
Conclusion: The high expression of EGFR in head and neck cancers among Pakistani patients suggests its value as a therapeutic target. EGFR inhibitors have become well-known part of HNSCC treatment; therefore, patients with EGFR positive HNSCC can be benefitted from the therapy
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Immunohistochemistry , Head and Neck Neoplasms , Carcinoma, Squamous Cell , Cross-Sectional StudiesABSTRACT
Objective: To determine the frequency of expression of positive diagnostic marker alpha methylacyl-COA RACEMES [AMACR] in the examination of prostate needle biopsy specimens from patients of adenocarcinoma prostate from a subset of Pakistani population
Study design: Cross-sectional study
Place and Duration of Study: Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi from Apr 2015 to Oct 2015
Material and Methods: All specimens of adenocarcinoma prostate diagnosed at Armed forces institute of pathology on the basis of immunohistochemistry and routine histopathology irrespective of age of patient, histological type or grade of the tumor were analyzed. Mean and Standard deviation were calculated for quantitative variables like patient's age and frequencies along with percentages were calculated for qualitative variables like AMACR expression
Results: Out of the total 80 cases, 68 [85%] were positive for AMACR while 12 [15%] were negative. Among the cases that were negative 9 [11.3%] showed 1 +/- staining [Weak, non-circumferential] and 3 cases [3.8%] displayed 0 staining [No cytoplasmic staining]
Conclusion: Positive staining for AMACR can be used to support a diagnosis of cancer on prostate needle core biopsies when the focus in question is <1mm in maximum dimension. The results of AMACR expression in a subset of Pakistani population are comparable to the western studies. AMACR staining must be interpreted in the context of basic haematoxylin and eosin criteria for malignancy along with the results expansion of other supportive markers, such as a basal cell specific marker like p63 or 34betaE12
ABSTRACT
We report a case of an extremely rare inflammatory condition of appendix, malakoplakia, in a 22 years old female, who presented with chronic abdominal pain. The clinicopathological features of this condition will be discussed, along with a review of the literature
Subject(s)
Humans , Female , Young Adult , Malacoplakia , Inflammation , Abdominal Pain , Review Literature as TopicABSTRACT
Objective: To determine the frequency of immunohistochemical expression of epidermal growth factor receptor [EGFR] and c-KIT in triple negative breast cancer [TNBC]
Study Design: Descriptive, cross-sectional study
Place and Duration of Study: Armed Forces Institute of Pathology [AFIP], Rawalpindi, from January to December 2014
Methodology: Fifty cases of triple negative breast cancer diagnosed on immunohistochemistry were included in the study
Patients' gender and age were noted. Immunohistochemistry for EGFR and c-KIT were applied and the results were recorded. The data were analyzed by using computer software programme SPSS version 19. Descriptive statistics, frequencies and percentages were calculated
Results: Out of 50 patients of TNBC, all patients were females. The ages of the patients ranged between 30 and 80 years with an average age of 48.9 years and standard deviation of +/- 10.0. Out of 50 cases, 29 cases [58%] were positive for EGFR while 15 cases [30%] were positive for c-KIT. Thirteen cases [26%] were positive for both EGFR and c-KIT
Nineteen cases [38%] were negative for both EGFR and c-KIT
Conclusion: EGFR expression was observed in 58% and c-KIT expression was seen in 30% of the cases. The results of EGFR expression are almost similar while those of c-KIT are different from international studies which suggest immunohistochemical differences between the studied populations
ABSTRACT
A 37-year female presented with complaint of lower abdominal pain and amenorrhoea to the Military Hospital, Rawalpindi. Ultrasound of pelvis showed a right adnexal cystic lesion. On investigation, CA-125 was raised. Her MRI scan of pelvis revealed a right adnexal mass of fluid intensity measuring 15.2 x 12.9 x 9.2 cm. Right ovarian cystectomy was performed and the specimen was sent for histopathological examination. Grossly, the mass was cystic in appearance and measured 13.5 x 10 x 10 cm. On sectioning, it was unilocular and filled with turbid material. The cyst wall showed multiple papillary structures along with a nodule measuring 1.1 x 1 cm. Microscopically, the sections revealed borderline mucinous tumour with a sarcoma-like mural nodule composed of spindle shaped cells and epulis-like giant cells. Sarcoma-like mural nodules are rare nodules which are associated with mucinous tumours of the ovary. However, they have excellent prognosis and should not be interpreted as malignant
ABSTRACT
To analyze the clinicopathological spectrum of urothelial carcinoma of urinary bladder. Descriptive case series. Armed Forces Institute of Pathology [AFIP], from 1[st] January 2012 to 31[st] October 2013. All cases of urothelial carcinoma were retrieved from AFIP tumour registry. Age, gender, histological type, grade and variant of tumour was noted. The data was analyzed by using computer software program SPSS version 19. Descriptive statistics and frequencies were calculated for age, gender, histological type, grade and variants. A total of 541 cases of urothelial carcinoma were included in the study. The age at presentation ranged from 22 to 94 years with median age of 63.56 +/- 12 years. A number [61%] of the cases were from 6[th] to 8[th] decade of life. The gender distribution showed 92.8% of patients [n=502] were males and 7.2 % [n=39] were females with male to female ratio of 12.9: 1. The most common histological type was papillary urothelial carcinoma; present in 493 cases [91.1%] followed by nonpapillary urothelial carcinoma; 48 cases [8.9%]. Among papillary urothelial carcinomas, 302 cases [61.3%] were high grade and 191 cases [38.7%] were low grade. Among nonpapillary urothelial carcinomas, all were high grade and variant histology was observed in all cases. The variants included squamoid differentiation which was present in 27 cases [56.3%], nested variant in 8 cases [16.7%]. The sarcomatoid, undifferentiated and clear cell variants in 3 cases [6.3%] each, micropapillary variant in 2 cases [4.2%], lymphoepithelial-like and plasmacytoid variant in 1 case [2.1%] each. Urothelial carcinoma is more common in males. Most of the tumours are papillary urothelial carcinomas. Most of them are high grade and pure urothelial carcinomas. A number of histologic variants are also recognized. Among them, squamoid differentiation is the most common variant histology