Immunohistochemical expression of CD-10, BCL-6 and MUM-1 antibodies and immediate clinical response in patients of diffuse large B-cell lymphomas after six cycles of chemotherapy

To determine the expression of CD-10, BCL-6 and MUM-1 in patients with diffuse large B-cell lymphoma [DLBCL] and its association with immediate clinical response after six cycles of CHOP chemotherapy. Analytical study. Armed Forces Institute of Pathology [AFIP], Rawalpindi in collaboration with Nuclear medicine, Oncology and Radiotherapy Institute [NORI], Islamabad from September 2010 to September 2011. CD-10, BCL-6 and MUM-1 antibodies were applied on cases diagnosed as DLBCL. Immediate clinical response was noted after 6 cycles of chemotherapy with the help of oncologist and divided into complete response, partial response, stable disease and relapse/ progression. Patient's age, results of expression of CD-10, BCL-6 and MUM-1 and results of immediate clinical response to chemotherapy were noted. Regarding analysis of prognostic markers [CD-10, BCL-6 and MUM-1], chi-square test was used for immediate clinical response to chemotherapy in DLBCL. CD-10 was positive in 40% cases, BCL-6 in 58.7% cases and MUM-1 was positive in 46.7% cases. About 41.3% of patients showed complete response, 10.6% partial response, 17.3% stable disease and 30.8% showed relapse/progression. CD-10 expression in DLBCL was associated with better immediate clinical response [p = 0.011] whereas MUM-1 expression in DLBCL was associated with poor immediate clinical response [p < 0.0001]. However, there was no statistically significant association of BCL-6 with immediate clinical response [p = 0.22]. DLBCL shows expression of CD-10, BCL-6 and MUM-1 in nearly fifty percent of the cases. CD-10 is associated with good whereas MUM is associated with poor response. However, there was no association of BCL-6 with immediate clinical response

Primary pulmonary rhabdomyosarcoma

Rhabdomyosarcoma is the commonest soft tissue malignancy in children; its common sites of occurrence include head and neck regions, chest wall, abdomen, perineal and anal regions. Lung is an unusual site. We report a case of two years old female child who presented with fever cough, shortness of breath and chest pain. Radiological examination showed a bullous lesion in the left lower lobe. Histological examination of bullectomy specimen revealed sheets and clusters of round blue cells with mild to moderate atypia. There were some hypocellular areas containing characteristic perivascular arrangement of tumour cells. Tumor cells showed strong positivity for Desmin. Based on histopathological and immunostain findings, diagnosis of Embryonal Rhabdomyosarcoma was made

Role of immunohistochemistry [IHC] in diagnosis of ovarian malignancies - is there any change from before?

Ovarian malignancies account for about 3% of all cancers in women. After the development of immunohistochemishy, it is now considered an essential part in diagnosing malignant ovarian tumours, including metastatic tumours. To compare between the frequencies, histological patterns and histogenesis of malignant ovarian tumours before and after the advent of immunohistochemistry. This descriptive cross sectional study was conducted at department of histopathology, Armed Forces Institute of Pathology [AFIP] Rawalpindi from 1[st] Jan 2010 to 10[th] Dec 2011. A total of 128 cases of malignant ovarian tumours were included. After gross and histological examination, a panel of immunohistochemistry markers was applied and tumours were classified according to WHO classification. Most frequent malignant tumours were surface epithelial tumours [54.8%] followed by metastatic tumours [12.7%]. Frequency of metastatic tumours was higher in our study as compared to other studies. Immunohistochemistry plays an important role in correct diagnosis of malignant ovarian tumours and also in identifying metastatic tumours.

Morphological characterization of renal tumours according to decades of life: experience at AFIP Rawalpindi, Pakistan

To evaluate morphological characterization of renal tumours according to decades of life and to compare it with other national and international studies. Descriptive study Place and duration of study: The retrospective study was carried out in the Department of Histopathology, Armed Forces Institute of Pathology [AFIP] Rawalpindi during the years 2005 to 2008. Data of 236 nephrectomy specimens diagnosed as renal tumours during the years 2005 to 2008 was retrieved from tumour registry of AFIP, Rawalpindi. The morphological characterization of these tumours according to decades of life was done and compared with the international data. Of 236 cases of renal tumours, 169 [72%] were males and 67 [28%] were females. The mean age of the patients was 50 years [SD=18.5] ranging from 1 to 80 years. The most common histological diagnosis in adults was conventional renal cell carcinoma in 172 [73%] patients followed by papillary renal cell carcinoma in 20 [8.5%] patients. Among children Wilm's tumour was the most common in 21 [9%] of patients. Conventional renal cell carcinoma was most commonly diagnosed in the patients aged between 51 to 60 years [52 cases] where as 17 out of 21cases of Wilm's tumour were diagnosed in the age group of 1 to 10 years. Renal cell tumours are diagnosed in all ages. Conventional renal cell carcinoma and papillary renal cell carcinoma are the most common types in non pediatric age group whereas Wilm's tumor is most common type in pediatric age group. The chromophobe renal cell carcinoma was very rare in our study. Males had a greater incidence as compared to females and incidence of renal tumours has the trend of increase over the years

Gunshot wounds - autopsy findings at AFIP Rawalpindi

To provide information about details of firearm injuries as observed during autopsies performed at the Department of Histopathology AFIP, Rawalpindi, Pakistan. This was a descriptive study. A total of 300 autopsies carried out during the years [Sep 2005 - Dec 2008] were retrieved from the autopsy record of Armed Forces Institute of Pathology, Rawalpindi. Out of these, 28 autopsies were performed after death due to firearm injuries. The variables selected were: age of deceased, time of death, weapon used, number and site of entry and exit wounds, mode of death and distance of the used firearm from the body at the time of gunshot as indicated in circumstantial evidence. Out of total of 300 autopsies, 28[9.33%] died of gunshot injuries. Most deaths occurred in the 3[rd] decade [67.9%]. Most of the subjects had single [60.7%] entry wound while half had a single [50%] exit wound. Most of the entry wounds [60.7%] had diameter < 2cm and exit wounds [35.7%] had a maximum diameter in the range of 2-5cm. Most frequent used weapon was rifle [82.1%]. Anterior chest [n=12] [42.9%] sustained the highest number of injuries. In suicidal deaths, heart and left lung [n= 4] [57.14%] were most commonly hit anatomical site. The weapon was in contact with the body at the time of gunshot in all suicidal deaths. The distance was less than ten meters in accidental deaths [7.1%]. Out of 6 [21.4%] homicidal deaths, distance was in the range of 100-200 meters in 3[50%] cases and 300-400 meters in remaining 3[50%] cases. Mode of death [suicidal/homicidal/accidental] could not be determined on postmortem examination only. Circumstantial evidence was necessary in the assistance of these findings. All details of firearm wounds including site, size, shape and appearance of surrounding tissue are required to be documented in autopsy reports to ascertain the exit and entry wounds. The detailed description of wounds provided additional information to ascertain possible distance of weapon from body and help in confirming mode of death