Hep Par-1: a novel immunohistochemical marker for differentiating hepatocellular carcinoma from metastatic carcinoma

To evaluate the diagnostic utility of Hep par-1 in differentiating hepatocellular carcinoma from metastatic carcinoma taking histopathology as a gold standard. Comparative cross-sectional study. Pathology Department, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from April 2007 to February 2008. Hep par-1 immunohistochemical stain was performed on 60 cases of liver carcinoma, 30 cases each of metastatic and hepatocellular carcinoma. Information regarding patient age, gender, sign and symptoms, radiographic findings, histological grade of tumour, and expression of Hep par-1 on hepatocellular and metastatic carcinoma were recorded on proforma sheet. Sensitivity, specificity, positive and negative predictive values, and accuracy of Hep par-1 were calculated using the formulas. Hep par-1 expression was noted in 25 out of 30 cases of hepatocellular carcinoma [83%]. Out of 30 cases of metastatic carcinoma, only one case expressed staining in < 5% tumour cells and remaining 29 cases showed no reactivity. The age of the patients with hepatocellular carcinoma ranged from 40 to 76 years with a median age of 60.5 years and 40 - 75 years for metastatic carcinomas with a median age of 57.5 years. Hep par-1 is a reliable immunohistochemical marker for cases of hepatocellular carcinoma [HCC]. It can be used along with other markers in morphologically difficult cases when differential diagnosis lies between poorly differentiated HCC and metastatic carcinoma of liver

Role of p63 in differentiating morphologically ambiguous lesions of prostate

To observe the role of p63 staining in evaluation of morphologically ambiguous lesions of prostate. Descriptive [case series] study. Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from March to September 2010. p63 immunohistochemistry staining was performed on 30 cases diagnosed as morphologically ambiguous lesions of prostate by histopathologist. Patient's name, age, histology numbers, morphological features, expression of p63 and histopathological diagnosis were recorded and described as frequency percentages. The prostatic adenocarcinomas were negative for p63 and benign lesions of prostate were positive for p63. Atypical lesions show positive staining in 77.7% and negative staining in 33.3% of cases. p63 immunohistochemistry staining can be used as a reliable marker to distinguish between benign from malignant morphologically ambiguous lesions of prostate

Generalized cutaneous granulocytic sarcoma with joint involvement

Granulocytic sarcoma [GS] is a rare medullary solid tumour composed on immature myeloid cells. These tumours often display a greenish colour due to the enzymatic action of myeloperoxidase in the tumour cells. Hence, the term 'chloroma' was given to this lesion in 1853. GS commonly involves bone, periosteum, soft tissue, lymph node, and skin. Rare occurrences in muscle, meninges, breast, mediastinum, joints and ovary have been reported. Below-knee joint involvement in GS is unusual. We report a case of generalized cutaneous granulocytic sarcoma with ankle joint involvement who subsequently developed AML-M4

National study of reproductive tract infections among high risk groups of Lahore and Karachi

To estimate the prevalence of reproductive tract infections [RTIs] among the Female Sex Workers [FSWs], Male Sex Workers [MSWs], Injecting Drug Users [IDUs] and truck drivers. Cross-sectional. Lahore and Karachi, from March to August, 2004. Four hundred FSWs, 400 MSWs, 200 eunuchs, 400 IDUs and 400 truck drivers were interviewed and examined. Biological testing included PCR and ELISA. The mean prevalence of syphilis was 17.7% [95% CI: 15.1-20.3%]. Genital gonorrhoea was found among 0.8-12.3% of subjects with mean of 4.5% [95% CI: 0.8-5.2%]. Genital chlamydia was seen in 0.2-11% individuals with mean of 2.6% [95% CI: 2.1-3.1%]. Trichomonas was present in 19.3% FSWs of Lahore and 5.52% FSWs of Karachi. Only 0.8% truckers in Lahore had trichomonas. In Lahore, 47.6% FSWs and in Karachi, 27.4% FSWs were positive for bacterial vaginosis. A vast majority of IDUs, 91.8% in Lahore and 87% in Karachi were hepatitis C positive. The prevalence of syphilis is very high among all high-risk groups; particularly so among eunuchs [60.2% in Karachi and 32.3% in Lahore]. Such a high levels of RTIs indicate a serious threat for HIV epidemic because of socially transmitted infection

Langerhan's cell histiocytosis presenting as bilateral bleeding nasal polypi

Langerhan's cell histiocytosis is a rare clinical entity. Cases have been described in medical literature affecting head and neck region. In this first reported case, a 40 years old male presented with recurrent epistaxis. On examination he had bilateral bleeding nasal polypi originating from the lateral nasal wall in the middle meatus region, proceeding backward towards the nasopharynx as well as anteriorly, filling the nasal cavity completely with bilateral submandibular lymphadenopathy: Diagnosis was made on histopatohlogy and using special immunohistochemical stains [S-100 positive]. Surgical curettage, steroids, cytotoxic chemotherapy and low dose radiotherapy, 7x2 Gy in 4 fractions to the head and neck region achieved local control of the disease fairly rapidly