Clinicopathological patterns and distribution of schistosomiasis in Asir Region

The objective of this study is to report, for the first time, the histopathologic pattern of Schistosomiasis from the Asir Region and to compare it to patterns reported from other regions of the Kingdom of Saudi Arabia. Several studies have reported the patterns of Schistosomiasis in other regions of the Kingdom of Saudi Arabia and other countries where Schistosomiasis is endemic. Schistosomiasis is endemic in certain areas of Asir region, however no data is available concerning the clinicopathological pattern of Schistosomiasis in the Asir Region. This is a retrospective analysis of 217 cases of Schistosomiasis from surgical and biopsy files of Asir Central Hospital during a period from January 1990 to October 1999. Our study revealed that Schistosomiasis was more common among the expatriate population of Asir Region than Saudi nationals residing in this area. The urinary tract was most commonly involved, and then in descending frequency came the vermiform appendix, liver and large bowel. These findings are somewhat different from those observed in the Riyadh Region where the vermiform appendix was the most commonly affected organ. Based on the histopathologic pattern, our study describes the pattern of Schistosomiasis in the Asir Region and may serve as a base-line for future research work

Idiopathic granulomatous lobular mastitis

To study the histologic and clinical features of idiopathic granulomatous lobular mastitis among Saudi females in Asir Region and to increase awareness of this disease among pathologists and surgeons practicing in the Kingdom of Saudi Arabia. A review of 312 breast biopsies at the histopathology laboratory of Asir Central Hospital, over an eight and a half year period [January 1987 to June 1995] revealed a total of 8 cases of granulomatous mastitis. Only one case proved to be tuberculous mastitis and is excluded from the current study. The remaining 7 cases fitted the diagnosis of idiopathic granulomatous lobular mastitis. The latter diagnosis was made based on the classic histological features and absence of microorganisms using special stains and cultures. The mean age of the 7 patients was 28.8 years [range 22-23 years]. Right and left sides of the breast were equally affected and all patients gave a history of delivery within 3 years before the biopsy was taken [mean no. of years since last delivery = 1.6 years; range =0.4-3 years]. Malignancy was clinically suspected in 4 patients, chronic inflammation was only suspected in one patient and no prebiopsy clinical impression was given for the two remaining cases. Treatment and follow-up of the 7 cases is not well documented as complete excision was carried out in 4 cases with lesion free follow-up period of only 1.5 years, whereas in the remaining 3 cases an incisional biopsy was carried out and patients were lost to follow-up. The current study showed that histological and clinical feature idiopathic granulomatous lobular mastitis among Saudi female patients is similar to that reported in other countries and that this disease is not uncommon in Saudi Arabia. Therefore, the awareness of this entity should be increased among pathologists and surgeons in Saudi Arabia

Effect of schistosomiasis on histopathologic pattern of urothelium in 262 bladder biopsies

Schistoscmiasis is a known endemic disease in the Asir region of the Kingdom of Saudi Arabia. Primary urinary carcinoma is the fourth ranked cancer in the Asir region. The current study aims at reviewing the histopathologic pattern of 262 cystoscopic biopsies to evaluate the impact of schistosomiasis on the urothelial lining of the urinary bladder among patients from Asir region. Schistosomiasis was diagnosed in 91 cases [37.7%], non-neoplastic urothelial lesions were seen in 75 cases [29%] and primary bladder cancer was diagnosed in 61 cases [23.3%]. Schistosomiasis was seen in association with 67% of patients with squamous cell carcinoma, 50% of patients with non-neoplastic proliferative urothelial lesions, 20% of patients with adenocarcinoma and only 2.3% of patients with transitional cell carcinoma. Of the 91 patients with schistosomiasis 47 [51.5%] showed associated urothelial lesions of one type or the other while the remaining 44 [48.5%] did not show associated urothelial lesions. The conclusion of the study is that schistosomiasis has an impact on bladder cancer through a series of pre-neoplastic mucosal changes

Gastric cancer in southern Saudi Arabia

A total of 84 cases of primary gastric cancer were diagnosed in the histopathology laboratory of Asir Central Hospital over a five year period [1987 to 1991]. Seventy-two patients [86%] were Saudis and 12 cases [14%] were non-Saudis. The mean age of the patients included in this study was 60 years with a range of 22 to 85 years and a male:female ratio of 4.6:1. Intestinal adenocarcinoma occurred in 63 patients [75%] followed by malignant lymphomas in 12 cases [14%] and diffuse adenocarcinoma in nine cases [11%]. The gastric antrum was the most common site affected [47%], followed by gastric corpus [27%], cardia [14%], and fundus [12%]. Comparisons of our findings to similar reports from other provinces of Saudi Arabia and other countries are discussed