Malignant triton tumor of thigh: a case report and review of literature

Malignant triton tumor [MTT] is a tumor arising from Schwann cells with divergent rhabdomyoblastic differentiation.It is a relatively rare and aggressive variant of malignant peripheral nerve sheath tumor [MPNST]. We present a case of a 33 years old male with thigh swelling. Surgical excision was done followed by histopathological and immunohistochemical [IHC] workup which revealed a tumor showing two types of cell populations including pleomorphic spindle cells and large cells with pleomorphic eccentric nuclei. Spindle cells showed positivity for S-100 IHC stain confirming their neural origin while large cells with eccentric nuclei showed positivity for desmin and myogenin IHC stains confirming their rhabdomyoblastic origin. Hence, the diagnosis of MTT was made. A 5 years survival rate for MTT is 5-15% compared to 50-60% for MPNST. Considering it is a rare entity with aggressive clinical behavior and poor prognosis, correct diagnosis is essential that can be achieved by careful histological and IHC evaluation

Disseminated peritoneal leiomyomatosis: a case report and review of the literature

Disseminated peritoneal leiomyomatosis [DPL] is a very rare condition. It occurs in females of reproductive age, initiated or promoted by hormonal factors. During operation, it may appear as metastases. This entity should be kept in mind whenever multiple peritoneal nodules are encountered especially in young pregnant females. Here, we present a case report of a 30 year old woman with DPL found incidentally during caesarean section

retrospective study of ovarian tumours and tumour-like lesions

Ovaries are common site of non-neoplastic and neoplastic lesions. They can present from the neonatal period to post menopause. Most are functional in nature and resolve with minimal treatment. Objective of the study was to determine the nature of various ovarian lesions and to ascertain the frequency and distribution of the various non-neoplastic and neoplastic lesions. The study was a retrospective review of all cases of ovarian cancer, benign ovarian neoplasm and functional ovarian cysts received during Jan-Dec 2008 at Chughtai's Lahore Laboratory. The clinical data of the patients was obtained from their respective files. A total of 498 different non-neoplastic and neoplastic lesions were seen during one calendar year 2008. Non-neoplastic cysts were more common [343, 68.87%] than neoplastic tumours [155, 31.12%]. The commonest non-neoplastic cyst was luteal cyst followed by follicular cyst. Among the neoplastic tumours 78.70% were benign and 21.29% were malignant. Benign serous cysts were the commonest benign tumour followed by mature cystic teratoma and mucinous cyst. Serous cystadenocarcinoma was the commonest malignant tumour followed closely by endometrioid carcinoma and granulosa cell tumour. Krukenberg tumour, tumour metastatic to ovaries and non-Hodgkins lymphoma was also diagnosed during this period. Malignant germ cell tumours were seen in much younger age group followed by sex cord stromal tumours. Epithelial tumours were seen in much older age group. The morphologic diversity of ovarian masses poses many challenges. A specific diagnosis can usually be made by evaluating routinely stained slides but sometimes immunohistochemistry is required in difficult cases. Gross features also provide useful diagnostic clues

Clinico-morphological pattern of bone lesions in children

The present study was performed to find the spectrum of bone diseases in children and to correlate with age, sex, and site of origin. This was a retrospective study and consists of 95 cases of hone biopsies which were diagnosed in the Department of Pathology at the Institute of Child Health and Children's Hospital, Lahore during a period of six years [Jan 2003-Dec 2008]. These biopsies were evaluated on haematoxylin and eosin stained sections from paraffin embedded tissue blocks. Special stains were performed whenever required. Pyogenic osteomyelitis [OM] accounted for 35.78% of all bone pathologies followed by tuberculous osteomyelitis in 22.10%. Osteosarcoma [OS] was the most frequent [primary tumour of bone followed by Ewing's sarcoma [ES]. One case of metastatic bone tumour was also recorded. Osteochondroma, osteoma, aneurysmal bone cyst, fibro-osseous dysplasia, chondroma and simple bone cyst were also found in children. The bone tumours are relatively more prevalent in males

Pilomatricoma - study on 27 cases and review of literature

The purpose of this study was to report the clinicopathological spectrum of Pilomatricoma, an uncommon benign tumour of hair matrix. The study is a retrospective review of 27 cases of pilomatricoma reported in a private Laboratory of Lahore from 2006-2008. The clinical data of the patients was obtained from their respective files. Age range of the patients was from 8-76 years. Maximum number of cases was observed in the second decade. Female to male ratio was 2:1. The size of the tumour ranged from 4-90 mm in diameter. The most common site for the occurrence of pilomatricoma was head and neck followed by upper extremities. Majority of the specimens were submitted as unspecified lumps. Other provisional diagnoses included enlarged cervical lymph nodes, sebaceous cysts, tuberculoma, haemangioma, keloid and granulation tissue. All the patients presented with solitary lump. Preoperative diagnosis of pilomatricoma is most often confused clinically with other skin diseases due to its wide variety of clinical characteristics. Careful clinical examination would result in a more accurate diagnosis; however, definite diagnosis is only possible after microscopy of the lesion

Occurence of carcinoma in situ in association with invasive cancer of breast

The objectives of this study were to find out the frequency and the pattern of carcinoma in situ occurring in association with different types of breast cancers. This study was conducted in the Department of Clinical Oncology and the Department of Pathology, King Edward Medical University/ Mayo Hospital, Lahore on breast cancer patients diagnosed between 1[st] January 2001 and 31[st] December 2005. The age, menopausal status, histopathological type, grade, and presence or absence of carcinoma in situ were recorded. Histopathological features were recorded according to WHO system. Grade was recorded only when it was assigned according to the Elston-Ellis modification of Scarff-Bloom-Richardson grading system. A total of 1230 histopathologically documented invasive and non-invasive breast cancers patients were included in the study. DCIS alone was seen in seven patients [00.57%] and LCIS alone in two patients [00.16%]. Invasive ductal carcinoma was seen in 998 patients [81.14%] and invasive lobular carcinoma in 96 patients [07.80%]. Majority of breast cancers were grade II whereas grade I seen in 23.90% patients only. Areas of carcinoma in situ in different types of invasive cancers were seen in 328 [26.86%] patients. Majority of these patients were below 50 years of age. DCIS was present in 246 of 998 patients [24.65%] of invasive ductal carcinoma [NOS]. Comedo pattern was seen in 154 of 290 [53.10%] of DCIS. LCIS was present in 38 of 96 patients [39.58%] of invasive lobular carcinoma. Carcinoma in situ of breast is a turely diagnosed disease entity in our setting. It is seen mostly in association with invasive carcinoma of breast cancer. Ductal carcinoma in situ with comedo pattern is most frequent

Primary carcinoid of the urinary baldder

The occurrence of a primary carcinoid tumour of the urinary bladder is extremely rare. The case of a 35 year-old male with carcinoid tumour arising in the urinary bladder is presented. Transurethral resection of a polypoid small tumour [1.0 cm in diameter] was performed. Immunohistochemical study using neuroendocrine markers allowed a straightforward diagnosis of a low-grade neuroendocrine tumour [carcinoid tumour] of the urinary bladder to be made. This tumour shows specific clinical, gross and histological features and should be considered in the differential diagnosis of bladder neoplasms

Analysis of the liver biopsies: a histopathological study

To evaluate the spectrum of childhood liver diseases. Design: A department-based retrospective study. Place and Duration of Study: It was carried out at the department of Pathology, Children's Hospital and the Institute of Child Health, Lahore, over a period of two years [October 1998 to October 2000]. Subjects and The histopathological data of total 50 percutaneous needle biopsies, wedge biopsies and partial hepatectomy specimens of both the sexes between 1 month - 16 years age were collected and compared with the findings reported from centers in other parts of the country. The commonest cause of hepatomegaly was hepatic inflammatory disorder in 43 cases [29%] followed by biliary atresia in 40 cases [27%]. Other causes of hepatomegaly were hepatic neoplasia 11 cases [7.3%], cirrhosis 10 cases [7%], glycogen storage disease 10 cases [7%] and fatty change in 8 cases [5.3%]. Hepatic diseases are quite common in paediatric population in Pakistan and percutaneous needle liver biopsy is an important and helpful diagnostic procedure in undiagnosed cases of hepatomegaly