Histopathological outcome of pancytopenia cases on bone marrow trephine biopsy

Objective: To determine the histological outcome of pancytopenia cases on bone marrow trephine biopsy and to see the frequency of various causes of pancytopenia in our population

Study Design: Descriptive study

Place and Duration of Study: Pathology department, Combined Military Hospital [CMH], Kharian [Pakistan]. One year [Jan 2015-Dec 2015]

Material and Methods: Two hundred bone marrow trephine biopsies were done in one year [2015], out of which 40 were done for evaluation of pancytopenia. The criteria for diagnosis of pancytopenia were; haemoglobin less than 10 g/dl, total leukocyte count [TLC] less than 4.0 x 109/1 and platelet count less than 100,000 x 109/1. Patients with pancytopenia secondary to drugs, chemotherapy and radiotherapy were excluded from the study

Trephine biopsies showing marked crushing and having inadequate material were also excluded from the study. Biopsies were processed, slides made and examined under light microscope by haematologist and histopathologist. Frequencies of various causes of pancytopenia diagnosed on histopathology were calculated. The findings were analyzed by using SPSS version 10.0

Result: Out of 40 cases of pancytopenia, male to female ratio was 3:2. The age range was between 1 year to 75 years. Histopathological analysis of bone marrow trephine biopsies revealed megaloblastic anaemia as the most common cause of pancytopenia [30%], followed by aplastic anaemia [25%] and hypersplenism [15%]

Conclusion: Megaloblastic anaemia is the most common cause of pancytopenia in our population as compared to aplastic anaemia mentioned in most of the international studies. This indicates prevalence of nutritional deficiency in our population and megaloblastic anaemia must be kept at top of list while evaluating pancytopenia cases. Early diagnosis and treatment of megaloblastic anaemia will prevent any further complication of this disease

Histopathological analysis of gastric mucosal biopsies in non ulcer dyspepsia

Objective: To find out the pattern of gastric mucosal histopathological findings in gastric biopsies of patients with non ulcer dyspepsia

Study Design: Prospective descriptive study

Place and Duration of Study: Histopathology department Combined Military Hospital [CMH] Kharian Pakistan from Jan to Dec 2015

Material and Methods: One hundred patients presenting at outpatient gastroenterology department with dyspepsia having no endoscopic lesion were included in the study. Two gastric mucosal biopsies from antrum and two from corpus were taken. The specimens were processed and examined histologically to see the changes

Results: Gastric biopsies of 100 patients including 65 males and 35 females presenting with non ulcer dyspepsia were studied. Most of the patients were between the age group of 31-50 years. Histological examination of gastric biopsies revealed 70% of patients having histological features of gastritis, while 30% having no significant histological finding. Chronic inflammation was seen in 70 cases [70%], activity in 15 cases [15%], glandular atrophy in 2 cases [2%] and intestinal metaplasia in 2 cases [2%]. H.Pylori were identified in 25 cases [25%] based on haematoxylin and eosin [H and E] staining and modified giemsa staining

Conclusion: Most the cases of non ulcer dyspepsia show histological evidence of gastritis, however a significant number of patients showed no gastric mucosal histological abnormality. A significantly low frequency of H. Pylori in gastric biopsies noted in non ulcer dyspepsia cases may be due to more frequent use of antibiotics and acid suppressant drugs used by general practitioners at some stage of disease

Evaluation of HER-2/NEU expression by immunohistochemistry in urothelial carcinoma of urinary bladder

The objective of this study is to determine the HER-2/NEU expression by imrnunohistochemistry in Urothelial carcinoma of urinary bladder. Cross sectional study. Department of Histopathology, Armed Forces Institute of Pathology [AFIP], Rawalpindi, from 15[th] August 2011 to 14[th] August 2012. Bladder cancer tissue specimens from 70 patients were selected in one year as per the inclusion criterion. Immunohistochemistry results were interpreted on light microscope using high power field objective and Her 2/ neu expression was recorded. Mean and standard deviation were calculated for quantitative variables. Frequencies and percentages were calculated for qualitative variables. Out of 70 cases of urothelial carcinoma, Her 2/ neu expression was found to be positive in 24 cases, out of which 5 were of low grade and 19 were of high grade while 16 were invasive and 8 were non invasive. The expression of Her 2/neu was detected in 16 out of 33 cases of invasive carcinoma [48.4%] and in 8 out of 37 cases of non invasive carcinoma [21.6%]. As far as grade is concerned, Her 2/ neu was found to be positive in 5 out of 30 cases of low grade carcinoma [16.6%] and 19 out of 40 cases of high grade carcinoma [47.5%]. The expression of Her 2/neu has been shown to be related to the stage and grade of urothelial carcinoma. Her 2/neu expression is increased in high grade and invasive urothelial carcinoma. Molecular targeted therapy targeting Her 2/neu can be beneficial in patients after assessment of Her 2/neu expression

CD 10 expression intensity in various grades and stages of urothelial carcinoma of urinary bladder

To evaluate CD 10 expression in urothelial carcinoma of the urinary bladder and the association of immunohistochemical [IHC] CD10 expression intensity with grade and stage. Study Design: Descriptive cross-sectional analytical study. Armed Forces Institute of Pathology, Rawalpindi, from January to December 2011. Methodology: Fifty consecutive cases of urothelial bladder carcinomas, obtained through transurethral resections, were included in this study. Hematoxylin-eosin [HE] stained sections from each case were re-evaluated histopathologically according to WHO 2004 grading system. The TNM system was used for pathologic staging. On selected slides IHC CD10 marker was applied and a semiquantitative scoring for its expression based on the percentage of positive cells and intensity was performed. Data was entered and analysed on SPSS version 17. Fisher's exact test was used to compare grades, stages of urothelial carcinoma with CD 10 expression and age groups. P < 0.05 was taken as level of significance. Results: Urothelial carcinoma was more common in males. The male to female ratio was 9:1. The older patients > 50 years had higher grade and stage as compared to the younger patients. All cases of high grade urothelial carcinoma showed higher positivity for CD 10. Twenty cases [86.95%] of high grade urothelial carcinoma were positive with +2 immunostaining while 3 cases [13.04%] were positive with +1 staining. None of the tumors of stage pTa was positive for CD 10 expression. Of all patients with stage pT 1 tumor, 1 case [5.3%] was CD 10 negative and 17 cases [89.9%] were CD 10 positive having +1 staining with 5 - 50% staining and 1 case [5.3%] had +2 staining with more then 50% expression. Out of all patients with stage pT 2, no tumor was CD 10 negative, 3 [13.6%] patients were CD 10 positive with +1 staining and 19 [86.4%] with stage pT 2 tumor had stained positive with +2 staining. CD 10 expression was greater in high grade and invasive urothelial carcinomas; it may be associated with tumor progression in bladder cancer pathogenesis