Power doppler ultrasonography guided and random prostate biopsy in prostate cancer diagnosis - a comparative study

To compare the diagnostic accuracy of power Doppler-guided targeted prostate biopsy and random sextant biopsy in the diagnosis of prostate cancer. The prospective study was carried out at the Allama Iqbal Medical College and Jinnah Hospital, Lahore, Pakistan, from January to December, 2012, and comprised clinically suspected cases of carcinoma prostate. Power Doppler-guided biopsies using automatic biopsy gun were obtained from the suspected targeted site. One to three cores per suspected site were obtained. Subsequently random sextant biopsies were performed in the same sitting. Six cores were obtained from 6 random sites using the same gun. Biopsies from both sources were processed for routine haematoxylin and eosin stainstained sections for histopathological examination. Of the 50 patients in the study, 30[60%] were diagnosed with power Doppler-guided biopsy as malignant, whereas random sextant biopsy could pick up 22[44%] cases. For benign prostatic hyperplasia, random sextant biopsy labelled 28[56%] as benign, whereas only 20 [40%] were labelled as benign with power Doppler-guided biopsy. Discrepancy in the results between the two procedures was observed in 14[28%] cases, and of them, 11[22%] were labelled as malignant on power Doppler-guided biopsy while histopathology of sextant biopsies labelled these as benign. The sextant biopsies rendered a specificity, sensitivity, negative predictive value, positive predictive value and diagnostic accuracy of 60.71%, 86.36%, 85%, 63.33% and 72% respectively. Random sextant biopsy in combination with power Doppler-guided targeted biopsy increases the rate of detection of prostate cancer whereas both procedures in isolation have low sensitivity and specificity for cancer detection

Spectrum of pathologies in cases of intestinal obstruction and perforation based on histopathological examination of resected intestine - Report from a third world country

Cases presenting with intestinal perforation and obstruction constitute a substantial work load on our surgical service. Etiologies vary in underdeveloped and developed countries. Histopathological examination of resected intestine is expected to provide the definite evidence of the underlying etiology- guiding a better health care planning for preventive measures. Our objective was to study the spectrum of histopathological findings in resected intestines from cases of intestinal obstruction and perforation in our local population to document the underlying etiology. A total of 120 cases of intestinal resection were included. Detailed gross and microscopic examination with routine stains was performed. Definite evidence of any specific etiology on the basis of morphology was documented. A total of 95 cases with clinical/radiological diagnosis of obstruction [79.2%] and 25 of intestinal, perforation [20.8%] were included. Tuberculous enteritis was the commonest etiology [n=41; 43.1%] in cases of intestinal obstruction followed by malignant tumours [n=30; 31.5%]. Ischemic infarct/gangrene, post op illeal adhesions, polyps and ulcerative colitis followed. In cases of perforation, Typhoid enteritis [n=15; 60%], was the commonest pathology followed by idiopathic perforation [n=5; 20%], tuberculous enteritis [n=3;12%], carcinoma [4%] and ulcerative coliti [4%]. In developing countries infective etiology remains a dominant cause of intestinal obstruction and perforation. Its presentation in younger age leading to intestinal resection demands effective preventive measures in this part of the world to prevent morbidity and mortality

Benign lesions in abdominal hysterectomies in women presenting with menorrhagia

Menorrhagia is a common and debilitating problem. It is one of the major causes leading to hysterectomy in women all over the world. Menorrhagia is most commonly associated with benign pathologies like uterine fibroids, adenomyosis and pelvic infection. Rarely it is secondary to malignant pathology like endometrial carcinoma. Hysterectomy specimens form a major component of histopathological work in Pathology laboratories. The present study was undertaken in Pathology department, Allama Iqbal Medical College, Lahore to find out the morphology and frequency of different benign histopathological lesions in total abdominal hysterectomy specimens in patients presenting with menorrhagia. A descriptive case series study of one hundred total abdominal hysterectomies of patients presenting with menorrhagia carried out. Patients' data and detailed gross examination of specimens were recorded on a proforma. Representative sections were taken for microscopic examination and findings were recorded. The ages of the patients ranged from 30- 59 years with maximum number [73%] of cases in 40 - 49 years age group. Macroscopically fibroids were seen in 69% cases in myometrium. Microscopic examination of cervix revealed features of chronic cystic cervicitis in 100% cases. Endometrial histology showed disordered proliferation [41%] followed by hyperplasia [25%] as the commonest finding. Myometrium revealed foci of adenomyosis in 49% cases. The commonest neoplastic lesion was leiomyoma [69%]. In patients with menorrhagia the commonest neoplastic lesion was leiomyoma [69%], and commonest histopathological cervical lesion as chronic cervicitis [100%]. Endometrial hyperplasia was the most common lesion [41%] on endometrial histology. Myometrium revealed foci of adenomyosis in 49% cases

Pattern of benign morphological myometrial lesions in total abdominal hysterectomy specimens

Hysterectomy is one of the most common major surgical procedure performed all over the world. Indications for total abdominal hysterectomy include dysfunctional uterine bleeding, leiomyoma, adenomyosis, chronic pelvic pain and pelvic inflammatory disease. Other causes include endometrial hyperplasia, cervical intraepithelial neoplasia. invasive cancer and endo-metrial malignancy. Hysterectomy specimens contribute a major component of histopathological work in Pathology laboratories. The present study was undertaken in Pathology department, Allama Iqbal Medical College, Lahore to find out the morphology and frequency of different benign histopathological lesions in myometrium of uterus in total abdominal hysterectomy specimens. A descriptive case series study of one hundred total abdominal hysterec-tomy specimens was carried out in Allama Iqbal Medical College, Lahore. One hundred total abdominal hysterectomy specimens were studied. The ages of the patients ranged from 30 - 69 years with maximum [73%] cases in 40 - 49 years age group. The commonest presenting complaint was menorrhagia [68%]. The two benign histopathological lesions in myometrium were leiomyoma and adenomyosis. Myometrium revealed leiomyoma in 6g% cases and foci of adenomyosis in 47% cases. The commonest benign histopathological lesion in myometrium was leiomyoma [69%] followed by adenomyosis [47%]