Evaluation of the diagnostic accuracy of serology test kit for detection of h.pylori infection in patients presenting with nonulcer dyspepsia taking histopathology as gold standard

To evaluate the diagnostic accuracy, specificity, sensitivity, positive predictive value and negative predictive value of serological testing in detection of H. pylori infection taking histopathology as gold standard. This study was a cross sectional survey carried out at the Histopathology department of Shaikh Zayed Federal Postgraduate Medical Institute Lahore from 27[th] December 2005 to 23[rd] November2006.A total of 100 adult patients of both genders with complaints of non-ulcer dyspepsia from whom gastric biopsies were taken by endoscopy in the Gastroenterology Department were included in the study. Two tests namely, histopathological identification of H. pylori [gold standard] and serological test were carried out on each patient. The diagnostic accuracy, specificity, sensitivity, positive predictive value and negative predictive value of serological test were calculated. The diagnostic accuracy of serological testing in detection of H. pylori infection was 62% in the present study. The sensitivity was 88.6% and Specificity was 41.07%. Positive predictive value and negative predictive value was 54.16% and 82.1% respectively. This test is useful for detecting a newly infected patient, but it is not a good test for follow up of treated patients because the results do not indicate if this is a recent infection with H. pylori or otherwise

Renal amyloidosis in juvenile rheumatoid arthritis

We report a case of a rare disorder of renal amyloidosis occurring as a complication of juvenile rheumatoid arthritis in a 16-year-old adolescent male. He presented with generalized edema and hypertension. The laboratory work-up showed nephrotic-range proteinuria and hypoalbuminemia and normal renal function despite bilateral shrunken kidneys revealed by the abdominal ultrasound. His renal biopsy showed deposition of amyloid fibrils in the form of homogenous eosinophilic material within the glomeruli demonstrating the pathognomonic apple-green birefringence by polarized light microscopy

Analysis of 404 cases of radiologically guided fine needle aspiration cytology [FNAC] of space occupying lesions of liver

Radiologically guided Fine needle aspiration cytology [FNAC] is a valuable technique for diagnosing benign and malignant space occupying masses of liver. It is a cost effective and safe method that can differentiate benign and malignant lesions accurately. The objective of this study was to analyze 404 cases of radiologically guided fine needle aspiration cytology of space occupying lesions of liver. The study was conducted at Histopathology Department SZFPGMI in collaboration with the Radiology Department. The aspirates were done by senior radiologist in Radiology Department. Most of the aspirates were from males. Five cases were considered inadequate, there were more malignant cases [295 cases] as compared to benign lesions [99 cases]. Metastatic lesions were more common as compared to hepatocellular carcinoma [HCC], however, the ratio of metastatic adenocarcinoma and primary HCC was almost equal. Thus radiologically guided FNAC is the simple, quick and complication free procedure for diagnosing space occu pying lesions of liver

Cystic lymphangioma of the small-bowel mesentery: case report

Cystic lymphangioma of the small-bowel mesentery is a rare manifestation of an intraabdominal tumor in elderly patients. We present a case of a small-bowel mesentery lymphangioma, causing fever and chills and present clinical and pathologic features. Furthermore, etiology and differential diagnosis of this tumor are discussed

Evaluation of ultrasound guided fine needle aspiration cytology in diagnosis of space occupying lesions of liver

From March 1992 to February 1995, Two hundrad and three [203] cases of space occupying lesions of liver were aspirated under ultrasound guidance. These aspirates were mostly done by senior radiology staff at Sheikh Zayed Hospital, Lahore. The smears and cell blocks when available, were studied by consultant pathologists. Based on histological, cytological and clinical findings, final diagnosis was reached. In 2.5% cases the material aspirated was reported as inadequate. Among the benign aspirates, liver abscess was the most common lesion diagnosed in 26 [59.1%] cases. Age changes with mild dysplasia and fatty change were other two common benign diagnostic features. In malignant aspirate, metastatic adenocarcinoma was tlie most common diagnosis seen in 77 [50%] cases and primary hepatocellular carcinoma was diagnosed in 58 [37.6%] cases. In cases where cell blocks were available, validity of cytological diagnosis showed high degree of sensitivity and specificity with no false positive reports. Overall results indicate high prevalence of infections, liver disease and primary hepatocellular carcinoma in our study group as compared to results in other parts of the world. Value of ultrasound guided aspiration, importance of coagulation screening and usefulness of the microhistology [cell block preparations] is stressed. The cytological features of primary hepatocellular carcinoma, and of metastatic lesions are described

Primary malignant carcinoid tumour of the kidney

A primary malignant carcinoid tumour of right kidney in a 40 years old male patient is described. The neoplasm displayed histological features resembling the carcinoid tumours of gastrointestinal or respiratory tracts with trabecular pattern predominating. It revealed focal argyrophil positivity and was argentaffin negative. Despite an extensive search, no primary tumour else-where in the body was detected