Aim-To determine interobserver and intra-observer agreement in the assessment of cytological grade and intraduct necrosis in pure duct carcinoma in situ (DCIS) of the breast. Methods-Sixty unselected cases with illustrated diagnostic criteria were circulated to 19 practising histopathologists. Results-Overall agreement was moderate for cytological grade in three categories: 71% agreement; weighted ( w), 0.36; intraduct necrosis in three categories (absent, present, extensive): 76% agreement; w, 0.57; and the Van Nuys classification system: 73% agreement; w, 0.48. Agreement was no better among observers participating in the National External Quality Assurance Programme. Intraobserver agreement for cytological assessment (69.6% agreement; w, 0.52) and intraduct necrosis (68.3% agreement; w, 0.48) was moderate, suggesting that individual variation rather than precision of criteria contributes to the lack of agreement. Conclusions-Moderate agreement on observations can be achieved by nonspecialist pathologists, with better agreement on necrosis than cytological grade. There was evidence of consistent individual bias towards over or under scoring cytological grade, which could be corrected with adequate and prompt feedback. (J Clin Pathol 2000;53:596-602)
Hysterectomy is one of the most frequently performed gynecological procedure all over the globe undertaken for varying indications, to effectively cure many gynaecological conditions. Histopathological analysis of the hysterectomy specimens should be undertaken for justification of procedure and diagnostic purposes. Objectives: To determine the frequency and morphology of different benign histopathological lesions in total abdominal hysterectomy specimens. Study Design: Descriptive cross-sectional study. Setting: Department of Pathology Fatima Jinnah Medical College. Period: From Jan 2015 to June 2015. Material & Methods: The gross and histopathological findings of uterus and cervix in one hundred Total Abdominal hysterectomy specimens were studied. Non-probability, purposive sampling was done. Total abdominal hysterectomy specimens with or without salpingoophorectomy of patients aged between 20 to 70 years were included. While Total abdominal hysterectomy done in mentally retarded patients and for malignancies were excluded. Patient’s data, presenting complaints and preoperative diagnosis was recorded on predesigned proforma. SPSS version 17 was used as an analytical tool. Results: Age of the patients ranged from 30-55 years with 72% between 41-50 years. The microscopic examination of the cervix revealed features of chronic cervicitis in 75% cases. The commonest neoplastic lesion was leiomyoma present in 66% of cases. Myometrium revealed foci of adenomyosis in 21% cases. Endometrial histology showed hyperplasia in 25% of cases(simple hyperplasia 20%, cystic hyperplasia 4% and complex hyperplasia 1%), hormonal imbalance in 21%, pressure atrophy in 11%, atrophic endometrium in 6% , cystic atrophy in 2% while acute and chronic endometritis in 1% and 2% of cases respectively. Conclusion: The commonest cervical lesion was chronic cervicitis (75%). The commonest benign neoplastic lesion was leiomyoma, present in 66% of cases. Other common pathologies on histology were hyperplasia in 25% of cases, adenomyosis and hormonal imbalance in 21 % of cases each, pressure atrophy in 11%, atrophic endometrium in 6% while endometritis (acute & chronic ) in 3% of cases mainly. Histopathological examination of hysterectomy specimens helps to detect the exact cause and underlined pathology.
SUMMARYSpontaneous expulsion of a small portion of the intestinal mucosa per rectum, in an infant, associated with ileocolic intussusception is an extremely rare condition. This appears to be the first report of such a clinical presentation. The initial diagnosis was raised by the histopathologist following examination of the eliminated piece of tissue. Subsequent barium enema and laparotomy confirmed the diagnosis and the ileocolic intussusception was successfully reduced.This unusual presentation, together with a review of the pertinent literature, is discussed. Our findings indicate that both the clinicians and histopathologists should be aware of this phenomenon and stress the importance of the histological examination of any unusual faecal matter. This may prove to be a simple, quick and cheap method of investigation of this condition.
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