Perinatal outcome and near-miss morbidity between placenta previa versus abruptio placentae

To compare perinatal outcome and near-miss morbidities between placenta previa versus abruptio placentae in patients of antepartum haemorrhage [APH]. Cross-sectional, analytical study. Gynaecology Unit II, Civil Hospital, Karachi, from August 2007 to July 2009. Patients with APH diagnosed as placenta previa and abruptio placentae who delivered after 24 weeks of pregnancy were selected from labour room. Outcome measures were birth weight, neonatal intensive care admission, stillbirth, perinatal mortality rates, near-miss, surgical intensive care admission, postpartum haemorrhage, hysterectomy, massive transfusion, renal failure, coagulopathy and maternal death. Stillbirth was defined as a fetus weighing >/= 500 gm showing no sign of life after birth. Near-miss was defined as severe organ dysfunction which if not treated appropriately, could result in death. Descriptive statistics were calculated and chi-square was applied with significance level < 0.05. Stillbirths and perinatal mortality rates were significantly higher in abruptio placentae, 52.97% versus 18.18% and 534/1000 versus 230/1000 [p < 0.01]. Near-miss cases were also significantly higher in abruptio placentae, 22.27% verus 11.18% [p < 0.01]. Hypovolemic shock and coagulation failure were also significantly higher in abruptio placentae [p < 0.05]. Abruptio placentae carry significantly higher perinatal mortality and near-miss morbidity than placenta previa

Malignant peripheral nerve sheath tumour of maxilla

Malignant peripheral nerve sheath tumour [MPNST] is a very rare entity in head and neck with high rate of recurrences and local invasiveness. This tumour is usually found in lower extremities and only 10-12% occur in head and neck region. The diagnosis is considered as the most elusive and difficult among soft tissue sarcomas because of its non specific presentation, both clinically as well as pathologically. This difficulty has now been overcome by immunohistochemistry. We report here a case of MPNST in a 50 years old male with a localized right maxillary growth

Nipple adenoma of breast: a masquerader of malignancy

Nipple adenoma is a benign condition simulating malignancy such as breast carcinoma and/or Paget's disease clinically. In this study 19 cases diagnosed as nipple adenoma over a period of 14 years are described. The diagnosis was confirmed by histology alone. All patients were females with age ranging from 23 to 63 years. Most of the cases presented clinically with in duration and ulceration accompanied by pain and itching. The diagnosis was clinically suspected in only 3 cases. This highlights the importance of histological diagnosis in all suspicious breast lesions. In one case, the clinical and histological diagnosis was incorrect leading to mastectomy. Complete local excision with clear margins is curative

Small B cell Non-Hodgkins Lymphoma in Pakistan

To study the pattern of small B cell lymphomas in Pakistan. This descriptive study was carried out at the Aga Khan University Hospital pathology department including 1721 cases of Non-Hodgkins Lymphoma [NHL] diagnosed during a period of five years [1998-2002] and classified according to REAL/WHO classification. The antibodies used included Leukocyte Common Antigen [LCA], Pan B [CD20, CD79a], Pan T [UCHL-1], Bcl 2, Mib 1[Ki 67] and Cyclin D1 [Dako, Denmark]. Out of the 1721 NHL cases, only 140 [8.1%] could be categorized as small B-cell NHL. The study group comprised small lymphocytic lymphoma/chronic lymphocytic leukemia [58 cases; 41.4%] followed by follicular lymphoma [46 cases; 32.9%], mantle cell lymphoma [15 cases; 10.7%], extra nodal marginal zone B cell lymphoma of MALT type [15 cases; 10.7%], lymphoplasmacytic lymphoma [5 cases; 3.6%] and splenic marginal zone B-cell lymphoma [1 case; 0.7%]. No case of nodal marginal zone lymphoma was diagnosed. The age ranged from 18 to 98 years with a mean and median of 54.64 and 58.50 years respectively. Small B-cell NHL was more common in males; with male to female ratio of 2.1. Majority of the small B-cell NHL were nodal at presentation with a nodal to extranodal ratio of 3.4. It is concluded that the frequency of these small B-cell NHL is very low in our population in contrast to the western literature. Further studies based on epidemiologic and etiological factors are required to look into this marked difference of occurrence of these indolent lymphomas

Ovarian primary neuroendocrine carcinoma of non - small cell type: Report of an exremely rare Neoplasm

Paraffin block sections of a uterus and ovarian mass from a 31 year old female were sent for second opinion to the Pathology Laboratory of Aga Khan University. Histologic examination and immunohistochemical features gave a diagnosis of primary neuroendocrine carcinoma of non-small cell type admixed with benign mucinous cystadenoma. This is a rare tumour with only eight being reported in literature