Epstein-Barr virus [EBV] in Saudi patients with Hodgkin's disease: relationship to age and subtype

The aim of the study was to define the aetiological association of Epstein-Barr virus [EBV] and Hodgkin's disease [HD] among Saudi patients. The relationships between HD and associated EBV, patients age and the various histological subtypes of HD are also assessed. Paraffin - embedded material from 92 cases of histologically proven HD was studied using a sensitive in situ hybridization technique based on the detection of EBV encoded RNA in addition to an immunocytochemical technique for the detection of EBV encoded latent membrane protein [LMP]. The tissue studies consisted of 18 specimens from children, younger than 15 years [mean 7.3 +/- 3.5 years], 54 from young adults between 16 - 45 years of age [mean 36.4 +/- 4.5 years] and 20 from older adults between 46 - 71 years of age [mean 62.3 +/- 4.5 years]. The statistical differences between different age categories were assessed and p-values less than 0.05 was considered significant. In the 92 cases of HD studied, mixed cellularity [MC] was the most common histological subtype [50%] followed by nodular sclerosis [NS] [30.4%], lymphocyte depleted [LD] [10.9%] of cases and lymphocyte predominant [8.7%]. EBV genome was detected in 56 patients [61% of the total number of cases]. There was an almost complete agreement between the results obtained by the two techniques used. Despite the relatively small number of patients which were investigated in this study, it was concluded that EBV infection in Saudi patients is predominantly associated with the mixed cellularity subtype of Hodgkin's disease. The rate of EBV positivity was found to be higher among children and young adults [78 and 63% respectively] than that found in older adults [40%] with a significant statistical p-value of less than 0.05

Intra-operative cytology and frozen sections of breast lesions: a comparison from a Saudi teaching hospital

Evaluate the usefulness of intraoperative cytology in providing rapid and accurate diagnosis for various breast lesions and to compare its diagnostic yield with that of frozen and paraffin sections. Setting: All surgically excised breast lesions submitted to the Histopathology and Cytology Department at King Khalid University Hospital [KKUH], Saudi Arabia during a period of 18 months [May 1993 till October 1994]. Subjects: Fifty Saudi female patients admitted to the surgical wards at KKUH because of breast-related clinical complaints and who have had subsequent surgical excision of their breast lesions. Design: Touch imprints and scalpel blade scrapes were made from the cut surfaces of 50 different breast lesions. The cytological preparations were stained using the "Diff-Quick" method. Frozen sections were also performed on all cases. There were 28 benign and 22 malignant lesions. There were three cases of significant discrepancies between the intra-operative cytology and frozen section diagnosis. Our findings indicate that intra-operative cytology alone gave the correct diagnoses in 94% of the cases examined. Intraoperative cytology is a reliable and cost-effective technique which can be used as an adjunct to frozen section of breast lesions. The histopathologist should, however, be aware of the patient's clinical details, mammographic findings and the macroscopic appearances of the lesions examined

Bone marrow histopathological changes in visceral leishmaniasis

Over a period of two years [June 1989-May 1991], bone marrow trephine biopsies from 16 patients with visceral leishmaniasis were examined histologically to assess the correlation between the peripheral blood counts and bone marrow status. Only 25% of patients had normal peripheral blood counts. Of the remainder, 25% had anemia alone, 25% had anemia with thrombocytopenia, and 25% had pancytopenia. The anemia was microcytic/hypochromic in 88.7% of cases and normocytic in 12.3% of cases. Thrombocytopenia was a notable feature, with mean platelet count of 115 +/- 72.47 x 10 9/L, and eight patients having thrombocytopenia below 120 x 10 9/L. There was diffuse bone marrow hypercellularity in 13 cases and focal hypocellularity in three. The increased cellularity was attributable to trilineage hyperplasia, with a predominance of erythroid activity in most cases. Increase in the histiocytic population was a prominent feature in all the cases. In 10 cases, most of the histiocytes were found to be full of LD bodies, while in the other six, the parasite load was much less. Megakaryocytes were abundant in number, forming aggregates in most cases. Other notable features included erythrophagocytosis [nine cases] and moderate perivascular plasmacytosis [13 cases]

Squamous papilloma of the esophagus- A clinicopathologic study of 10 cases and review of the literature

Esophageal squamous papilloma [ESP] is considered to be a rare finding during endoscopy or autopsy. Over a 10 year period, 10 cases were identified among 14,232 patients who were endoscoped in the King Khalid University Hospital [KKUH], Riyadh. The calculated incidence was 0.07%. There were eight males and two females whose ages ranged from 24 to 65 years. The presenting symptoms were mostly dyspepsia and heartburn. All the ESP[s] were single growth, most of which were located in the lower segment of the esophagus. Immunoperoxidase staining was negative for human papilloma virus in all the tissue samples. It is calculated that ESP[s] may not be very rare in the Saudi population. Awareness of its occurrence may lead to increasing diagnosis among endoscopy patients

accuracy of frozen section diagnosis-exprience of a teaching hospital in Saudi Arabia

A retrospective study of Frozen Section [FS] diagnosis was performed in a 400-bed teaching hospital in the Eastern Province of Saudi Arabia, to determine the indications, advantages and accuracy of this method. A total of 580 specimens were examined during the period 1983 - 1991 with an overall diagnostic accuracy rate of 89.3%. Ninety seven of the specimens received [16.7%] were for evaluation of resection margins, detection of lymph node metastasis or identification of tissue type, with an accuracy rate of approximately 99%. The rest, [n = 483, 83.3%] were for tissue diagnosis of unknown pathological processes, with an accuracy rate of 87.4%. The five most common sites for FS procedures were: Central nervous system [CNS] 19.1%, gastrointestinal tract 18.3% thyroid 15.3%, lymph nodes 13.1%, and breast 7.2%. FS failure was due to sampling error, insufficient sampling by the surgeon or pathologist, judgment error by the pathologist or because further laboratory investigations and stains were needed to reach a diagnosis

Immunostaining in Hirschsprung's disease: Al-Khobar experience

The role of immunoperoxidase stains in the diagnosis of Hirschsprung's disease was evaluated in a total of 60 sections from 40 cases originally diagnosed based on the findings from hematoxylin-eosin staining done in our laboratory. Neuron-specific enolase was very effective in highlighting rare scanty ganglion cells in two cases that had been classified as aganglionic. S-100 protein was effective in illustrating nerve fiber proliferation in submucosa and lamina propria, which may be difficult to demonstrate using hematoxylin-eosin alone. We recommend the use of immunoperoxidase stains as an important adjunct to hematoxylineosin for the diagnosis of Hirschsprung's disease when using paraffin sections

Histologic patterns of lymphadenopathy in the Eastern Province of Saudi Arabia

We reviewed the histological findings in 1000 consecutive lymph node biopsy specimens obtained from both Saudi and non-Saudi patients. Mean patient age was 33.4 +/- 17.03 years, with a male to female ratio of 3:1. Analysis of the data indicated the following histopathological findings: 37%, relative; 30%, granulomatous lymphadenitis; 14.3%, metastatic neoplasm; 8.7, non-Hodgkin's lymphoma; and 6.8%, Hodgkin's disease. The cervical lymph nodes constituted the most common group [59.6%], whereas paraaortic lymph nodes were the least common site [2.2%]