Lymph node metastasis in breast carcinoma: clinicopathologic correlations in 3747 patients

Histological axillary node involvement [ANI] evaluated by axillary dissection remains the most accurate predictive factor for patients with invasive breast cancer. Axillary node involvement implies the necessity of systemic adjuvant treatment and locoregional irradiation. Is to detect the relative frequency of node positivity in relation to histopathology through studying a large mastectomy series. This study included 3747 mastectomy specimens performed al NCI Cairo in the period 1993-2003. In each case we assesed the age at time of diagnosis. pathologic tumor size and number, histologic subtype [including grade], tumor location, number of lymph nodes dissected and number of positive nodes [burden of node positivity]. Females constituted 96.8% of cases, 60.7% of them were premenopausal. The mean age was 47.1 +/- 10.5 years. Tumor size ranged from 0.5 to 20 cm. The global ANI rate in the entire cohort was 70.6%. In univariate analysis. five variables were significantly correlated to ANI, these were laterality, multiplicity, tumor size, histologic subtype and grade, while multiplicity, tumor size, histologic subtype and grade correlated significantly with metastatic burden, Multivariate analysis showed that older women [40-60 and> 60 years] have at least half the risk of developing LN metastasis compared to those < 40 years with the odds of 0.51[0.35-0.73] and 0.31[0.18-0.55], respectively. Tumor size >2cm put the women with breast cancer at 3 [if 2-5cm] to 9 [if> 5cm] folds of developing lymph node [LN] metastasis. Tumor size> 5 cm increases the likelihood of higher metastatic burden [> 3 +ve nodes] with odds of 1.5 [1.24-1.9]. Unfavorable histology also, increases the liklihood of more positive nodes to the double when compared to favourable histology. The results of this study reflected the unfortunate presentation of breast cancer patients. In addition, some factors could be used as useful guidlines in the management of those patients. These factors include age, tumor size and histologic type of the tumor

Metabolic deficit in rats after low level lead exposure

Male albino rats were injected intraperitonealy with subclinical doses of lead acetate for 50 days to determine any effect on their rate of metabolism. The parameters studied were: 1] The rate of oxygen consumption [Q0[2]] and glucose utilization by cortical brain tissues, liver and kidney slices. b] Liver and kidney function tests viz, SGOT, SGPT and serum creatinine [c] Histopathological examination of the 3 organs to detect any associated damage. The results showed that intraperitoneal injection of rats by the small dose [1 mg] of lead acetate daily for 50 days did not affect significantly all the parameters studied, while marked reduction in Qo[2] and glucose utilization of cortical brain tissues and renal cortical slices and marked increase in serum creatinine, SGOT and SGPT were obtained following injection of the high dose [2 mg daily]. Histopathological examination of the liver, kidney and brain revealed non-specific degeneration which were more apparent on using the higher dose

Clinical and histopathological correlation between pre-operative presumptive and post-operative definitive diagnosis for cases subjected to abdominal hysterectomy

This study was carried on 50 cases of abdominal hysterectomy. Post-operative gross and histopathology was carried out for the specimens received after the operation [uterus, cervix, tubes, and ovaries], and the results were matched with the preoperative clinical diagnosis. The main indications for abdominal hysterectomy were, uterine myoma, dysfunctional uterine bleeding and ovarian masses or cyst. The post operative diagnosis of adenomyosis was recorded in 38% of cases compared to 4% pre-operatively. The endometrial lesion detected post-operatively were, adenomatous hyperplasia without atypia in 20% of cases, cystic glandular hyperplasia [10%] retrogressive endometrial hyperplasia [8%]. Cases with uterine myoma was associated with, follicular cyst of the ovary [18%], adenomyosis [16%], endometrial hyperplasia [8%], and adenocarcinoma [2%]. Post-operative pathological confirmation of cases diagnosed pre-operatively on account of ovarian mass or cyst was found to be, simple serous cyst [43.5%], malignant granulosa cell tumor [14.5%], mucinous cystadenoma [14.5%], tubo ovarian abscess [14.5%]. This makes the past-operative pathological examination as essential step for both the confirmation of the diagnosis and follow up treatment. So whenever hysterectomy is planned for women with dysfunctional uterine bleeding, the abdominal approach should be chosen because the first step in the operation is to make certain that an organic lesion has not been overlooked. Moreover the preoperative perparation of the patient must he carried out in such away as to identify all disorders that might complicate the operation or the convalescence

Gastric mucosal changes in ulcer, chronic gastritis and carcinoma

Gastric biopsy specimens were examined in 34 ulcer cases, 49 chronic gastritis cases and 24 carcinoma cases. Each biopsy was assessed for dysplasia, intestinal metaplasia and atrophy and each variable was scored. Scores of dysplasia were highly significant for carcinoma compared with both ulcer and gastritis, respectively. Intestinal metaplasia scores were significant for carcinoma compared with ulcer. Atrophy scores were significant for carcinoma compared with ulcer. Both metaplasia and atrophy scores did not show asignificant difference between carcinoma and gastritis. Dysplasia was the most significant change associated with carcinoma. It was concluded that dysplasia of gastric mucosa with or without metaplastic and atrophic changes constituted important risk factor in the development of malignancy and its presence justified follow up endoscopy and when convenient surgical intervention