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

Posttransplantation lymphoproliferative disorder presenting with skin involvement

Post-transplantation lymphoproliferative disorders [PTLD] are lymphoid proliferations or lymphomas that develop as a result of immunosuppression in recipients of solid organs and bone marrow allografts. Post-transplatation lymphoproliferative disorder is seen in 1-2% of renal transplant recipients with a variable time period of presentation and is usually seen within the first year following transplantation. We report a case of B-cell lymphoma [PTLD WHO class-3] presenting with skin involvement in a patient of renal transplantation, eight years after receiving the transplant