Correlation of tumor size and grade with axillary lymph node status in carcinoma breast

Objectives: to evaluate the size and grade of carcinoma breast and to correlate these with the axillary lymph node status

Design and place of study: it was a case series observational study conducted in the Department of Histopathology, Shaikh Zayed Hospital, Lahore

Subjects and methods: the study comprised convenient sampling of 30 female patients of age over thirty years undergoing modified radical mastectomy for breast carcinoma during six months from December 2004 to May 2005

Results: in all, 56.25% of cases of tumor size >5cm had >9 axillary nodes positive for metastatic breast carcinoma while 69.2% of grade 3 neoplasms had >9 positive axillary nodes. There was a significant correlation [P <0.01] of tumor size and grade with number of positive nodes

Conclusion: greater the tumor size and grade, more was the number of axillary lymph nodes positive for metastatic breast carcinoma

Primary extraskeletal osteosarcomata of liver, kidney, breast and thigh

Extraskeletal or soft-tissue osteosarcoma is rare, occurring approximately as 1.2% of all soft-tissue sarcomas and 4% of all osteosarcomas. The peak occurs in patients, which are in the 6th decade of life. The males are slightly more frequently affected. Symptoms often include a slowly growing painful mass, with a history of trauma [1 2% of cases]. Common sites of involvement are the deep soft tissues of the thigh [47% of cases], upper extremity [20%], and retropcritoneum [17%]. The identification of neoplastic osteoid matrix formation and aggressive characteristics are necessary for histological diagnosis of osteosarcoma. We are going to discuss 06 cases of extraskeletal osteosarcomas including primary renal, primary hepatic osteosarcoma, one arising in a cystosarcoma phylloides and 03 cases involving the thigh regions

Audit of 100 cases of space occupying lesions of brain

Brain tumors comprise 10% of all tumors and account for the most common tumors of childhood. Peak incidence is seen at 5th decade. Supratentorial tumors are present in adults and Infratentorial tumors are frequent in childhood. In this study, 100 cases of SOL [space occupying lesion] brain were received as biopsies or as whole specimens fixed in 10% formal in. Out of the total 100 cases, male to female ratio was 61: 39.Highest number of cases was seen in ages 51 years and above. Out of the total of 100 tumors, 47 were benign and 53 were malignant tumors. Among the benign tumors, following cases were reported: Meningioma, 24; Pituitary adenoma, 12; Schwannoma, 09; Choroid plexus papilloma, 01 and Neurofibroma, 01. Among the malignant tumors ,following types were seen: Glioblastoma multiforme, 12; Metastatic carcinoma, 08; Fibrillary astrocytoma, 08; Anaplastic astrocytoma, 08; Medulloblastoma, 06; Oligodendroglioma, 03; Gemistocytic astrocytoma, 03; Ependymoma, 03; Pilocytic astrocytoma, 01 and subependymal gia nt cell astrocytoma [SEGA], 01. Thus, the commonest benign tumor reported was classical meningioma and commonest malignant tumor was glioblastoma multiforme

Goblet cell sialomucin, sulphomucin and O-acylated sialomucin content in ulcerative colitis

This study was carried out to investigate the pattern of goblet cell sialomucin, sulphomucin and O-acylated sialomucin in ulcerative colitis. Endoscopic biopsy material was obtained from 15 cases of ulcerative colitis, and stained with High iron diamine / alcian blue and periodic acid borohydrate saponification PAS technique. The mucin profile was correlated with degree of dysplasia. Three [27.27 %] out of 11 cases without dysplasia and one [25 %] out of 3 cases with dysplasia showed increased sialomucin content. The content, of O-acylated sialomucin was normal in 66.66%and reduced in 33.33% of the cases. The reduction in the O-acylated sialomucin was seen in 75% of the dysplastic lesions and in 18.18% of the cases with no evidence of dysplasia. It can be concluded that composition of mucin is changed in ulcerative colitis. An increase in sialomucin and reduction in O-acylated sialomucin content was seen in some of the cases, the later change was associated more frequently with dysplasia

Analysis of 210 cases of radiologically guided FNAC of intraabdominal masses

Two hundred and ten cases of intraabdominal masses were aspirated under ultrasound and CT scan guidance. These aspirates were done by senior radiology staff at Sheikh Zayed Postgraduate Medical Institute Lahore. The smears and cell blocks were studied by consultant pathologists and final diagnosis was obtained. Seven cases were considered as inadequate, these were excluded from study. The remaining 203 cases included in the study consisted of 147 cases of liver masses,29 cases of nodal masses ,16 cases of retroperitoneal masses, 10 cases of GIT masses and one case of ovarian mass. Most of the malignant aspirates were from liver followed by nodal masses and retroperitoneal masses. The diagnostic yield was 97.4% and diagnostic yield of malignancy was 69.9%. In liver masses. HCC was the commonest lesion found followed by lesions from GIT metastatic to liver. In nodal masses, NHL was the commonest malignancy found. We successfully aspirated retroperitoneal masses and diagnosed these lesions cytologically with cl inical correlation. The accuracy rate for diagnosing GIT lesions was 100%. Thus radiologically guided FNAC is simple, quick accurate and essentially risk free procedure for diagnosis of intraabdominal masses

Spectrum of intrathoracic lesions by guided fine needle aspiration cytology [FNAC]

This study was done to evaluate the spectrum of various intrathoracic lesions by radiologically guided fine needle aspiration cytology FNAC was performed on 62 patients [48 males and 14 females] at Shaikh Zayed Hospital, Lahore under ultrasound and CT scan guidance. The cytologic diagnoses were classified as primary lung lesions and mediastinal lesions. Four major groups were made; Non Diagnostic, Benign or negative for malignancy, inflammatory lesions and malignant lesions. Diagnostic yield was 95.1%. Thirty cases [48.4%] were malignant, 19 cases [30.7%] belonged to inflammatory group, 10 cases [16.7%] were diagnosed as benign or negative for malignant cells, and 3 cases [4.9%] were non-diagnostic due to F inadequate aspirate inspite of repeated aspirations. Malignant lung lesions comprised of 9 cases [31.1%] 1 small cell carcinoma, 2 cases [6.9%] broadly categorized as non-small cell carcinoma, 7 cases [24.1%] of squamous cell carcinoma, 5 cases [17.2] of metastatic adenocarcinoma, 4 cases [13.8] of undifferentiated carcinoma and a single case each of mesothelioma and of malignant round cell tumor [3.4%]. Out of mediastinal lesions there was only one case of malignancy that was malignant round cell tumour of child hood. Nineteen out of total 62 cases were of inflammatory group. Out of which 10 cases [52.6%] had, chronic granulomatous inflammation, and nine cases [47.4%] were of abscesses. Tuberculosis was found 1 in 6 cases and the remaining 4 cases were suggestive of tuberculosis. Majority of lung lesions were encountered in 6`h decade of life. As the method is simple, rapid, and cost effective, it can be easily practiced in any centre, where specialized radiologists and pathologists are available. It reduces the patient`s stay in hospital and thus the cost of treatment is markedly reduced

Xanthogranomatous pyelonephritis [XGPN] with xanthogranulomatous fungal infection: a case report

A case of xanthogranulomatous pyelonephritis with fungal infection is described. The patient was a known case of nephrolithiasis and thalassemia. He had developed pyrexia of unknown origin since two years. On further workup he was found to have hepatomegaly, para-aortic lymphadenopathy, massive left kidney and advanced renal failure with deranged renal function tests. The patient underwent left nephrectomy with the provisional diagnosis of advanced renal failure secondary to nephrolithiasis or renal Koch`s. Histopathological examination revealed XGPN with numerous fungi present both in snore form and septate hyphae. Post operative recovery was un-eventful