Histopathological correlation of endometrial curettage with abnormal uterine bleeding pattern

Objective: To determine the histopathological pattern of lesions associated with abnormal uterine bleeding in different age groups

Design: A cross sectional study of 500 randomly selected specimens

Place: Department of Pathology, Basic Medical Sciences Institute, Jinnah Post Graduate Medical Center, Karachi

Duration: January 2002 to December 2003

Methods: 500 formalin fixed paraffin embedded blocks were retrieved and 5mm thick sections were cut and stained with haemotoxylin and eosin, periodic acid-schiff, trichrome and reticulin. The other additional information collected was age, pattern of bleeding, and clinical findings

Results: Of 500 specimens' examined, endometrial pathology was detected in 164 cases. The most frequent histopathological change was endometrial hyperplasia observed in 103 patients [62.8%]. 26 [15.8%] out of 164 were associated with malignant changes and the maximum number of cases Le. 64 were found in 31-40 years age group

Conclusion: The current study emphasizes the necessity ofD and C before the age of 40 years in patients presenting with abnormal uterine bleeding

Immunohistochemical determination of HER-2 / new overexpression in invasive ductal carcinoma of breast with cervical nodal metastasis

This study was designed to determine the frequency of HER-2/neu overexpression, in invasive ductal carcinoma of breast and correlate it with various standard prognostic parameters. This study was performed on formalin fixed paraf n embedded blocks of 72 diagnosed cases of invasive ductal carcinoma of breast. The blocks were retrieved and the staining was done to see the HER-2/neu overexpression. Sections containing > 50% of tumour cells showing intense circumferential cell membrane staining scored as positive. The HER-2/neu overexpression was seen in 31% of cases. A significant relationship [P<0.05] was found between HER-2/neu overexpression and lymphnode status and size of the tumour. The overexpressivity of HER-2/neu oncoprotein suggests that Herceptin can be used as therapeutic measure on these cases

Histology of upper gastrointestinal lesions in chronic renal failure [CRF] patients

One hundred and sixty-eight endoscopic biopsies from the oesophagus, stomach and duodenum in patients with chronic renal failure were examined under light microscope for histologic changes. Patients with histologic alterations were picked up in 81% cases compared to 44.6% on endoscopy alone. Both on endoscopy and on histology, stomach was the commonest site involved followed by duodenum and oesophagus. Oesophagitis was seen in 45% of the cases, reflux oesophagitis constituted the majority of these. In stomach, but not in duodenum, 20% cases showed helicobacter like organisms whereas in duodenum blocked glands were seen in 40% of the biopsies. The results were compared in the normal endoscnpic biopsies obtained from G. I. clinic and these served as controls. The correlation between histology and endoscopy was poor when no lesion was detected on endoscopy

Basement membrane pattern in hyperplastic and neoplastic lesions of the endometrium the value of immunoperoxidase stain in the identification of borderline lesions

Atypical adenomatous hyperplasia and well-differentiated endometrial adenocarcinoma are sometimes difficult to diagnose on histology alone. It was therefore decided to study the basement membrane pattern of the hyperplastic and neoplastic endometrium, with the help of immunoper-oxidase stain, using specific antibody against the laminin component of the basement membrane. For this purpose 25 blocks each of normal endometrium in various phases of menstrual cycle, cystic hyperplasia, adenomatous hyperplasia and adenocarcinoma were selected for study. The staining was done with Histoset immunoperoxidase staining kit from E.Y. Laboratories. The procedure recommended by the suppliers was adopted. It was based on the methodology described by Sternberger. The stain demonstrated small breaks in a few glands in 4 cases of atypical adenomatous hyperplasia, well-defined breaks in 10 cases of non-invasive or micro-invasive carcinomas, gland breaks and fragmentation in 15 cases of frankly invasive adenocarcinoma. An intact basement membrane was seen in the normal endometrium during the various phases of the menstrual cycle and benign hyperplastic endometrium. Thus this technique helped in the differentiation of benign hyperplastic lesions, atypical adenomatous hyperplasia, and well-differentiated non-invasive or micro-invasive adenocarcinoma