Castleman's disease: a clinicopathological study in a tertiary care hospital, Lahore

Castleman's Disease is a rare, localized or generalized lymphoproliferative disorder of unknown etiology and varying clinical manifestations with a frequent mediastinal location but can be found in any other nodal or extranodal site. We report 4 patients with Castleman's Disease diagnosed over a 2 year period [June 2011 to July 2013] at KEMU / Mayo Hospital, Lahore. The age, history, clinical presentation, laboratory investigations, radiological findings, gross and microscopic features of the lesions are presented indicating the heterogenous nature of this unique form of lymphoid hyperplasia

morphological spectrum of salivary gland tumours at Kemu and Mayo hospital, Lahore

Salivary gland tumours constitute an important aspect of oral and maxillofacial pathology. The aim of this study was to classify and analyse the diverse spectrum of major and minor salivary gland tumours according to the revised WHO Classification [2005] of Salivary Gland Tumours [SGT]. This was a 4 year descriptive cross - sectional study [from 1[st] July 2008 - 30[th] June 2012] of 259 salivary gland tumours reported at the Department of Pathology, King Edward Medical University, Lahore. In a total 0/259 salivary gland tumours, 162 tumours [62.54%] were classified as benign and 97 tumours [37.45%] as malignant. The male to female ratio was almost equal and patients ranged in age from 8 years to 80 years. Maximum number of tumours were diagnosed in the 3[rd] to 5[th] decade of life. The commonest benign SGT was pleomorphic adenoma PA which constituted a total of 146 cases [90.12%] followed far down in frequency by Warthin tumour which comprised of 8 cases [4.93%]. Tlie commonest malignant SGT was mucoepidermoid carcinoma which constituted 43 cases [44.32%] followed by adenoid cystic carcinoma constituting 30 cases [30.92%]. A total of 200 tumours [77.22%] were reported in the major salivary glands of which 134 cases [67%] were classified as benign and 66 cases [33%] were malignant. The commonest benign tumour in the major salivary glands was pleomorphic adenoma constituting 118 cases [80.05%] out of 134 benign tumours and the commonest malignant tumour was mucoepidermoid carcinoma constituting 37 cases [56.06%] out of 66 malignant tumours. Fifty nine tumours [22.78%] were reported in the minor salivary glands of which 28 cases [47.45%] were benign and 31 cases [52.54%] were malignant. Pleomorphic adenoma was the sole benign tumour reported in the minor glands and adenoid cystic carcinoma was the commonest malignant tumour of minor salivary glands constituting 20 cases [64.51%] followed by mucoepidermoid carcinoma constituting 6 cases [19.35%]. The palate constituted the commonest site of minor salivary gland tumours harbouring 35 cases [59.32%] followed by the lips containing 10 cases [16.94%]. Other sites of minor salivary gland tumours included the buccal region [10.16%], pharynxgeal wall [5.08%], nasal cavity [3.39%], maxillary sinus [3.39%] and tongue [1.69%]. In the major salivary glands, benign tumours are much more common than the malignant tumours with the parotid being the most common location of both benign and malignant tumours. The sublingual gland harbours only a minor fraction of salivary tumours of which malignant tumours are more common than the benign. In the mmor salivary glands, malignant tumours outnumber the benign tumours and the palate constitutes the most common location of minor salivary gland tumours. In fact the palate harbours more tumours than the submandibular and the sublingual glands thus constituting the 2[nd] most common site of salivary gland tumours after the parotid gland

Metanephric adenoma: case report and review of literature

Metanephric Adenoma [MA] is a histologically and clinically unique and rare benign renal epithelial tumour. Only a few reports are found in literature regarding this novel tumour entity. We report this neoplasm in a 40-year old male who presented with flank pain and microscopic haematuria. USG and operative findings were suggestive of Renal Cell Carcinoma. Microscopic examination showed a tumour composed of small bland cells forming small tubular structures in an acellular stroma. Occasional papillary formations were also seen but no blastema was identified. The case was finally diagnosed as Metanephric Adenoma. It has a histological similarity to developing metanephric tubular epithelium and is considered to represent the benign counterpart of Wilms' Tumour. The unique pathological features of Metanephric Adenoma should be recognised because of its invariable indolent clinicobiological behaviour

Use of AgNOR index in grading and differential diagnosis of astrocytic lesions of brain

This study was conducted to see the importance of AgNOR staining in grading and differential diagnosis of Astrocytic lesions. It was a descriptive and prospective study conducted in Department of Pathology King Edward Medical University, from June-December 2002. AgNOR staining was performed on 60 randomly selected brain specimens of Astrocytic lesions including Astrogliosis and Astrocytoma. AgNOR count, size and dispersion were normal in Astrogliosis, low in Pilocytic Astrocytoma, high in grade II, higher in grade III and highest in grade IV. AgNOR counts of different grades of astrocytoma [2.97 +/- 0.96, 3.97 +/- 0.43, 6.01 +/- 2.74 and 8.01 +/- 3.56] were significantly [P< 0.01] greater as compared with counts of normal brain [0.40 +/- 0.01], and reactive gliosis [0.60"0.01]. There was no statistical difference in normal brain tissues and inflammatory lesions of the brain. AgNOR size and dispersion were of higher grade in significantly greater proportion in malignancy as compared to benign conditions. [P <0.05]. AgNOR size and dispersion were normal in Astrogliosis. Typing of AgNOR count, size and dispersion was found to be an important marker in grading and differential diagnosis of Astrocytic lesions, especially in Astrogliosis and low grade Astrocytoma

clinicomorphological study of thyroid tumours in children and adolescents

This study was initiated to determine the clinicopathological aspects and frequency of various benign and malignant thyroid tumours in children and adolescents presenting with nodular and diffuse thyroid enlargement. Although numerous studies on thyroid tumours in adults are on record, data regarding thyroid tumors in children and adolescents in Pakistan is very scanty. Study design Descriptive cross sectional study. It was a 7-year retrospective study commencing from 1st July 1999 to 30th June 2006, conducted at the Department of Pathology, King Edward Medical University. Lahore, Pakistan. All thyroid specimens of children and adolescents aged 20 years and younger, submitted and reported at the Department of Pathology, King Edward Medical University, Lahore, Pakistan, during a 7-year period, were included in this study. Of the total 492 thyroid surgical specimens, 396 [80.48%] constituted of non-neoplastic lesions and 96 specimens [19.52%] were reported as tumours / neoplasms. Nearly all tumours were seen in the 2nd decade and girls outnumbered boys in a ratio of 5.4:1. Benign tumours constituted 86 [86.58%] cases and malignant constituted 10[10.42%] cases. The commonest benign tumour was Follicular Adenoma constituting 85 cases [98.54%] and Papillary Carcinoma was the commonest malignant tumour constituting 9 out of the 10 [90%] malignant cases. On clinical examination and scintiscans most of these tumours presented with cold solitary thyroid nodules. 3 cases of Papillary Carcinoma were associated with cervical lymph node metastases. There was a single case of Medullary Thyroid Carcinoma in a 12 year old boy with MEN 2 A syndrome. There was no case of Follicular Carcinoma in our study. Conclusions: Benign thyroid tumours far outnumber the malignant tumours in children and adolescents. The commonest tumour in this age group is Follicular Adenoma, followed by Papillary Carcinoma