Immunohistochemical expression of P53 in basal cell carcinoma of skin.

Objectives: To evaluate the immunohistochemical expression of p53 in basal cell carcinoma of skin. Study Design: It was cross sectional study. Setting: Pathology department of Pakistan Institute of Medical Sciences Hospital, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. Period: Six months after approval from the Hospital Ethical Committee. Material and Methods: In a descriptive background, 50 cases were involved in the study. Cases were selected by non-probability consecutive sampling technique. Patients of all age group (Males and Females) that was diagnosed as basal cell carcinoma of skin by Hematoxylin & Eosin were included in study. Other epithelial tumors of skin, appendageal tumors and metastatic tumors were excluded. Cases were evaluated for expression of tumor suppressor protein-p53 by immunohistochemical technique applied on formalin-fixed paraffin-embedded blocks. Results: Out of 50 cases, majority of patients were found to be male. Ratio of male to female was 2.6:1. Age range of patient was found between 21-98 years. Mainstream of the patients were between 41-60 years. Nose was found to be frequently involved site 28 (56%) cases. p53 expression was seen in 42 (84%) cases while in 8 (16%) cases p53 expression was not seen. Conclusion: It was found that p53 expression rate is very high in basal cell carcinoma of skin. This high expression of p53 immunoreactivity was explained in terms of its pathogenetic role and mutation in basal cell carcinoma

Biopsy Proven Renal Morphology Cognizance into its Four-Year Evolving Pattern; A Pakistani Perspective

Objective: To determine the pattern of Biopsy Proven Renal Diseases (BPRD) in a single tertiary care centre in Islamabad, Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: Department of Nephrology, KRL Hospital, Islamabad Pakistan, from Mar 2016 to Nov 2020. Methodology: The archival records of all native renal biopsies performed in adults (>18 years) were retrospectively analyzed.The biopsies were performed according to standard indications and evaluated by light microscopy and immunofluorescence. Results: A total of 134 renal biopsies were studied. Among these, 85(61.1 %) were males, and 49(36.5 %) were females. The mean age was 44.70±14.63 years. Primary glomerulonephritis’s were the predominant group of diseases found in 93(69.4%) cases. Membranous nephropathy (MN) was the most common lesion in 52(38.8%), followed by focal segmental Glomerulosclerosis (FSGS) in 22(16.4%) cases. Chronic tubulointerstitial nephritis (Ch. TIN) 12(9.0%) was the third most common lesion among all biopsies. Other diagnoses included lupus nephritis (LN) 10(7.5%) and IgA nephropathy (IgAN) 9(6.7%). One sample one-sided t-test was used to estimate the minimum proportion of occurrence of different biopsies in our concerned population. The estimated minimum proportion of membranous nephropathy (MN) was 0.31, with a p-value of 0.034. Conclusion: We concluded that primary Glomerulonephritis (PGN) is the most common renal disease, and membranous nephropathy is the most common biopsy-proven Glomerulopathy in our concerned population

Actinomycosis, A Rare Cause of Perianal Fistula

Perianal fistula (fistula-in-ano) is one of the most common anorectal diseases. It is an abnormal connection between the anal canal and the perianal skin and is lined with granulation tissue. Although benign, the condition can cause significant distress and embarrassment to the patient. Major causes of an anal fistula are clogged anal glands forming anal abscesses. Other, much less common, conditions are infections, trauma and tumors. The treatment of an anal fistula depends on the etiology and location of the fistula. Most fistulas are treated surgically, through a variety of different procedures. Actinomycosis which is a gram positive bacteria can rarely cause perianal fistulas which is difficult to diagnose clinically so can result in mismanagement and recurrences leading to repeated surgeries. Key words: Actinomycosis, Fistula in ano, Gram positive bacteria

Adenosquamous Carcinoma of Gallbladder – A Case Report

Gallbladder cancer is an uncommon malignancy and majority of these carcinomas are adenocarcinomas. Adenosquamous carcinoma of gallbladder is a rare histopathological subtype of gallbladder carcinoma. It usually presents with symptoms of cholelithiasis like epigastric pain, nausea and bloating. On clinical examination, tenderness is usually present. Radiologically in most of the cases, gallstones are found leading to the diagnosis of cholelithiasis for which cholecystectomy is done. Gallbladder carcinomas are found mostly as an incidental finding on microscopic examination of cholecystectomy specimen. This disease is curable if diagnosed earlier but in most of the cases they present at advanced stages when resection is not possible and prognosis is poor. As this disease is extremely rare so published information is largely based on the case reports and case series. This is a case of 60 years old female patient who underwent cholecystectomy for cholelithiasis with incidental finding of Adenosquamous carcinoma on histopathology report

Middle Ear Embryonal Rhabdomyosarcoma in a Five Years Old Child - A Rare Case Report

Rhabdomyosarcoma is the most common pediatric malignancy with a predilection for head and neck region. Embryonal Rhabdomyosarcoma is a variant of rhabdomyosarcoma which is extremely rare in middle ear. We present a case of middle year embryonal rhabdomyosarcoma in a five-year-old child who was treated as otitis media on first presentation and later misdiagnosed as a vascular aural polyp on histopathology

Intraparotid Facial Nerve Schwannoma in a 40-Year-Old Male with Hearing Loss – A Case Report

Schwannoma is a benign tumor of axonal nerve sheath. Head and neck area, particularly parotid gland is an uncommon site for Schwannoma, however it can rarely arise from the intraparotid part of facial nerve and present as either a symptomless mass or facial paresis. Its diagnosis before surgical intervention is important for the conservation of parotid gland and facial nerve. On clinical examination and imaging studies, it can be misdiagnosed easily. FNAC is a helpful tool for its diagnosis. This entity should not be ignored while dealing with parotid masses. We present a case of a patient who came with the complaint of a parotid mass. Magnetic resonance imaging (MRI) scan suggested a parotid tumor which proved to be a spindle cell neoplasm on Fine Needle Aspiration Cytology (FNAC). A definite diagnosis of schwannoma of intraparotid facial nerve was made on histopathological examination of the excision sample

Utility of Cell Block with p53 Immunostain in Diagnosing Urothelial Carcinoma

Background: Urine cytology is an initial noninvasive screening test done in patients with suspected urothelial carcinoma. The objective of this study was to compare the sensitivity of conventional smear cytology with cell block technique for the diagnosis of malignant cells in urine and to assess the efficacy of p53 immuno-marker in the diagnosis and prognosis of urinary bladder cancer. Methodology:   The study was carried out in the department of Histopathology, Pakistan Institute of Medical Sciences(PIMS), Islamabad. Cell blocks and cytology smears and were prepared from urine samples of 80 patients of urothelial carcinoma and p53 stain was applied. Data was analyzed using version 21. Sensitivity of conventional smear and cell block techniques were calculated for both low and high grade urothelial carcinomas. Results:The sensitivity of detecting atypical cells using conventional smear was 31% and 70.6% for low grade and high grade urothelial tumors respectively. The sensitivity increased to 41.4% and 84.3% for low and high grade urothelial carcinomas respectively with cell block technique. Positive p53 stain was seen in 13.8% of cases with low grade tumors and 66.7% cases with high grade tumors. Chi-square test was used to find the association of cytology findings with the histologic grade. Conclusion: Sensitivity of urine cell blocks is higher than the conventional smear method for detecting high grade lesions. It can be used as an efficient non-invasive technique and an adjunct tool for the determination of disease relapse and overall survival in patients. Keywords: Carcinoma, Cytology, P53 Protein, Urin

The Stromal Expression of CD-10 in Breast Carcinoma and its Association with Estrogen, Progesterone receptors, Her2Neu and Tumor Grade

Introduction: In previous studies, role of stromal component in epithelial malignancies has been highlighted. CD10 is a member of metalloproteinase family that breaks down the protein components of extracellular matrix and epithelial tissue remodeling thus playing an important role in carcinogenesis and metastasis. To evaluate CD 10 expression in breast carcinoma and assess its association with grade of the tumor, ER, PR and Her 2 Neu status. Methodology: The study was carried in Federal Government Polyclinic Hospital (FGPH) and Pakistan Institute of Medical Sciences (PIMS), Islamabadԁ. Immunohistochemical panel of CD 10, ER, PR and Her 2 was applied to 171 cases of invasive breast carcinoma. The association of CD 10 anԁ ER/PR status was evaluated. Results: Among 171 cases of breast carcinoma, 77.8% cases were CD-10 positive. A total of 65.5% of ER negative cases expressed strongly positive CD-10 in the stroma as compared to 37.2% of ER positive cases (P=0.001).  In 64.4% of PR negative cases expressed strong positivity of CD-10 in the stroma compareԁ with 37.5% (42/112) PR positive cases (P=0.001). The association of CD-10 with HER-2-NEU was not significant (P=0.749).  Association of high-grade tumor with CD 10 was not statistically significant (P=0.258). Conclusion: It was observed that CD10 expression is associated with negative ER, PR status and with higher grades of the tumors, showing its prognostic significance. Key Words: Breast cancer, CD 10, Estrogen receptors, HER2neu, Progesterone receptors &nbsp