Co-relation of sentinel lymph node metastases with the size of primary breast carcinoma

This is a cross-sectional study designed to explore the co-relation between the tumour size and incidence of metastases in the sentinel lymph node and was conducted at Departments of Pathology, Punjab Medical College, Faisalabad and Sheikh Zayed Hospital, Lahore and Departments of Surgery, Allied and DHQ Hospitals, Faisalabad from July 2002 - June 2003. The sentinel lymph node [SLN] was identified in 80 cases of early [T1 and T2] breast carcinoma by a localization technique using 1% Isosulphan Blue. The maximum size of the tumour was measured on gross examination and the margins were labelled with Alcian blue and fixed in Bouin's fluid. The entire tumour was embedded and the size of the tumour was confirmed on microscopic examination. Similarly the entire SLN was embedded and the microscopic measurement of tumour deposit was made in every case. The SLN was successfully isolated in 80 cases. Right sided carcinoma was seen in 52.5%. Stage T1 was seen in 37.5% and 62.5% were of stage T2. Most of the tumours [65%] were located in the upper outer quadrant. Nearly all [97.5%] were infiltrating ductal carcinomas. The microscopic measurement of the size of tumour varied between 5-70 mm and the size of the metastatic deposit of the tumour in the SLN varied from 2-22mm. It was noted that the involvement of SLN and non sentinel lymph node [NSLN] increased in relation to an increase in size of the primary tumour. The study concluded that as the size of the tumour increases, the chances ofmetastases occurring increases and thus has a linear relationship

Tuberculosis of the liver

A fifty years old lady underwent elective extended right hemicolectomy for a mass of ascending and transverse colon along with incision and drainage of abscess in the right lobe of liver. Histopathology turned out to be tuberculous liver abscess and tuberculous colitis. Although tuberculosis is very common in our country, but tuberculosis of liver is rare this case is one of that, showing the decreased immunity of the patient and local spread of disease. The tuberculous liver abscess is rare [1], when present is associated with focus of infection in the lungs or the GIT

Coexistence of endometrioid adenocarcinoma of the ovary and the uterus

The coexistence of carcinoma of the endometrium and ovaries is uncommon and occurs in about 10% of women with ovarian carcinoma. We are presenting such as a case with a review of the relevant literature

Significant incidence of typhoid in hepatitis C patients

Only proven way of transmission of Hepatitis C is through blood. The origin is unknown in nearly half the cases. Pollution is suspected as a cause but it is impossible to prove this relationship directly. We thought that typhoid being a proven pollution related disease, determination of its confection in Hepatitis C patients representing same Socio-economic group would be of interest. A typhoid in Hepatitis C patients can easily be overlooked because symptoms like fever and abdominal discomfort are present in both diseases. Blood samples were collected from three groups of study as mentioned in materials and methods. These samples were processed for 4[th] generation HCV ELISA. PCR for HCV, PCR for typhoid. Blood culture for typhoid and widal test as required [details are given in methodology]. Finally the data thus obtained was analysed and conclusions were drawn. Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering [NIBGE] and Millat Laboratory Faisalabad. April 2004 to Oct 2004. The parameters included were PCR, blood culture and widal test. There were three groups of study, PCR and ELISA positive patients of Hepatitis C [105] - further subdivided into two groups, with history of exposure to known causes of spread of HCV in last one year [65] and those without such history [40]; clinically diagnosed cases of typhoid [30]; and healthy controls [50]. In the three groups, PCR was positive in 9.5[7.7 and 12.5], 63.3, and 2.0% cases respectively. Figures for blood culture were 4.7[3.1 and 7.5], 33.3, and 0% in the same order, and the respective figures for widal test were 34.2[33.8 and 35.0], 56.6, and 24.0%. The increase in PCR and blood culture positivity in Hepatitis C cases as compared with normal subjects is statistically significant [P< 0.05]. These results clearly suggest that the source of infection for the two diseases is same in many cases, and therefore, provides a strong indication of a relationship between pollution and Hepatitis C

Early detection of typhoid by polymerase chain reaction

Typhoid is a common problem in developing countries. Cultivation of bacteria and serology [especially Widal test] give unacceptable levels of false-negative and false-positive results, respectively. Patients and In this study, a recently introduced polymerase chain reaction-based technique [which has 100% specificity for Salmonella typhi] was compared with blood culture and Widal test during the first week of illness of 82 suspected cases of typhoid. The respective figures of positivity for PCR, blood culture and Widal test were 71.95%, 34.1%, and 36.5%. A control group of 20 healthy persons gave figures of 0%, 0%, and 33.3%, respectively. We conclude that this PCR-based technique is not only absolutely specific, but also very sensitive and, therefore, much superior to blood culture and Widal test for the early diagnosis of typhoid