CLINICO-PATHOLOGICAL PATTERN, CLASSIFICATION AND STAGING OF URINARY BLADDER CARCINOMAS--A FIVE YEARS EXPERIENCE AT A TERTIARY CARE HOSPITAL IN CENTRAL PUNJAB. .

BACKGROUND: In Pakistan, urinary bladder carcinoma is the 8th commonest malignancy while being the fourth commonest cancer in men. The relative occurrence of a particular histological type of bladder carcinoma depends on the clinical setting. Both grade and stage of these cancers are highly correlated with recurrence, progression and patient survival rates. METHODS: This cross- sectional study comprised of 122 patients with newly diagnosed operable primary bladder carcinomas who underwent cystoscopy associated transurethral resection of bladder tumour at the Urology Department of Punjab Employees Social Security Hospital, Lahore. All participants completed a detailed questionnaire and underwent an in-depth interview to obtain data. The surgical specimens were referred to the Pathology department. Gross observations of the tumour recorded. RESULT: A total of 114 cases, classified according to WHO/ISUP criteria, low-grade papillary lesions, comprising Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) and Papillary Low Grade carcinomas, accounted for 43% of tumours. Male to female ratio being 5.3:1 (74%). Lateral walls were involved in 44%, posterior wall in 25.3%, trigone in 10.7%, bladder neck in 7.2%, dome in 5.8%, ureteric orifice in 4.13%, anterior wall in 2% and left ureter in 0.87% cases. Tumour staging revealed an overall 11.5% of tumours with stage Ta and 31.5% with stage T3-4. About 29% tumours were non invasive. About n=13 of low-grade carcinomas and n=68 of high-grade carcinomas were invasive. For tumours classified by WHO/ISUP criteria, the percentage of women was larger for PUNLMP than for the other categories of urothelial tumours (p-value 0.006); no statistically significant difference was found by age or gender with respect to tumour stage (p-value 0.138 and 0.452). CONCLUSION: Transitional Cell Carcinoma (TCC) is the commonest among middle aged men.

A morphological study of celiac, superior mesenteric and inferior mesenteric arteries in atherosclerosis.

BACKGROUND: Depolymerisation of acid-mucopolysaccharides results in the loss of metachormasia of the ground substance followed by visible fibre crumbling, complete dissolution and replacement by lipid droplets and cholesterol. The objective of this study was to assess the distribution of different atherosclerotic lesions in celiac, superior mesenteric and inferior mesenteric arteries relation to age and sex. METHODS: A prospective descriptive observation study was conducted at Mortuary of King Edward Medical University Lahore, and Department of Pathology Allama Iqbal Medical College Lahore. A total of 30 human autopsies were carried out. Celiac, Superior mesenteric and inferior mesenteric arteries were taken out and opened length-wise. One to four areas of tissue were taken from each artery for histological examination. Slides were prepared from each paraffin block. Sections were stained with haematoxylin and eosin. Special stains were performed on sections to display each component of atherosclerosis. RESULTS: The fibrolipid plaques were seen in 6 cases. The complicated lesions were present in 5 cases. Of these, 4 showed ulceration and 1 showed thrombus formation. The calcified lesions were observed in 5 cases. The morphological changes in media and elastica were present in 4 cases. In superior mesenteric artery fatty streaks were present in 8 cases. The fibrolipid plaques were confirmed in 5 cases. Three cases showed ulceration, 1 case showed intimal vascularisation, haemorrhage, and thrombus formation. The calcified lesions were present in 2 cases. The morphological changes in media and elastica were seen in 4 cases in anterior mesenteric artery. Fatty streaks were present in 8 cases. The fibrolipid plaques were grossly observed in 6 cases. The complicated lesions were present in 4 cases; of these, 3 cases showed ulceration, and 1 showed intimal vascularisation and haemorrhage along with thrombus formation. The calcified lesions were present in 3 cases. The morphological changes in media and elastica were present in 4 cases. CONCLUSION: This data indicates the incidence of ischemic changes in abdominal viscera due to atherosclerotic narrowing.

Atherosclerosis in relation to fat penniculus (obesity) between xiphoid and umbilicus.

BACKGROUND: It has been shown that possible influence of body weight is more evident for coronary than aortic atherosclerosis; and more in men than women. Coronary heart disease due to obesity in males becomes significant when body mass index (BMI) exceeds 30 (30% overweight) and does not affect the life expectancy particularly in women. This study was conducted to asses the relation of thickness of fat penniculus (obesity) between xiphoid and umbilicus to different atherosclerotic lesions; and to collect basic data about age and sex distribution of this relation METHODS: It was prospective descriptive study and conducted at mortuary of King Edward Medical University, and Department of Pathology, Allama Iqbal Medical College. Lahore. A total of 130 human autopsies were carried out in one-and-a-half year of study duration. The ages of the deceased ranged between 8 and 85 years. Heart aorta and its major branches were included in this study. In addition, fat penniculus between xiphoid and umbilicus was measured and atherosclerosis lesions were categorised and correlated with this parameter. Haematoxylin and Eosin, and different special stains were done in Pathology Department of Allama Lqbal Medical College, Lahore to asses to severity of atherosclerosis lesions. RESULTS: The fatty streaks were present in predominantly more cases with Fat Penniculus < 20 mm than in asses with Fat Penniculus < 10 mm and < 30 mm. The fibrolipid plaques, complicated and calcified lesions were present in a dominant number of cases with Fat Penniculus < 30 mm on percentage basis. CONCLUSION: Raised lesions were seen more frequently in cases with Fat Penniculus 20 mm to < 30 mm than in cases with Fat Penniculus < 10 mm and < 20 mm thickness.