SUMMARY Two hundred and thirty six patients with amoebic liver abscess were investigated for cholestasis, its mechanism and the natural course of the disease. Cholestasis was seen in 29% of cases and it presented with some unusual features: it was frequently seen in young men (mean age 38-6±6-3 years) (87%) with acute onset (69%) and was associated with signs of peritonism, or peritonitis (28%), splenomegaly (12%) and hepatic encephalopathy (coma 13%). Raised diaphragm was seen only in 37% of cases. Alcoholism may have contributed to the cholestasis in 37% of cases. Multiple (43%) and single (32%) large liver abscesses, especially on the inferior surface of the liver (25%), were common in jaundiced patients with amoebic liver abscess, while size and number of abscesses were directly related to the raised serum bilirubin concentrations. Bromsulphalein excretion (BSP) was found to be significantly reduced (p<001) in patients with jaundice (60%). Retrograde injection of contrast media into the common bile duct during six necropsies showed compression by amoebic liver abscess on the hepatic ducts. The mortality (43%) and the complications were significantly higher (p<0.001) in patients with jaundice. The aspiration/surgical drainage of amoebic liver abscess together with a combination of metronidazole and di-iodohydroxyquinoline was more effective than either metronidazole alone, or dehydroemetine with chloroquine.

Background: Urinary bladder cancer is an important cause of morbidity and mortality due to urological conditions. It is tenth most common cancer overall in both sexes. It is seventh most common cancer overall and second most common cancer of genitourinary tract in males. Ninety five percent of bladder tumors are epithelial and the rest are mesenchymal, of which majority are primary urothelial tumors. Urothelial tumors are classified into infiltrating urothelial carcinoma with its variants and non-invasive urothelial neoplasias. Tumor stage is the strongest prognostic parameter.Aims and Objectives: The current study was designed with an aim to elucidate the histologic pattern of bladder tumors and observe whether any association between histologic grade and muscle invasion exists.Materials and Methods: This descriptive study was carried out on 84 cases of urinary bladder tumors received in Department of Pathology, College of Medical Sciences and Teaching Hospital during a time period of 5 years from January 2012 to December 2016.Results: The mean ± SD of age of presentation was 63±13 years with a male female ratio 3.2:1. Ninety-five percent cases were primary epithelial tumors and 93% cases were of urothelial origin. Low grade papillary urothelial carcinoma was the most common urothelial tumor (40.5%) followed by high grade papillary urothelial carcinoma (34.5%). Some rare types like primary adenocarcinoma and small cell carcinoma were also seen in this study (1.2% each). Muscle invasion was significantly higher in high grade (66%) as compared to low grade papillary urothelial carcinoma (3%). Muscle tissue was absent in 8 (9.5%) cases.Conclusion: There is relationship of histologic grade with aggressiveness of tumor. Most of the high grade tumors are muscle invasive at presentation. Submission of muscle tissue is important for optimal patient management.Asian Journal of Medical Sciences Vol.9(6) 2018 45-50

Background: Ovarian tumors are histogenetically varied and complex tumors spanning all age groups. They account for 30% of all gynaecologic cancers. Malignant tumors carry a high mortality due to its late detection and ineffective screening programs. Current study aims at finding association between age at presentation and size of tumor with behavior of tumors and also association between category of tumor and age at presentation. Methods: This Hospital record based cross-sectional (historical) study was carried out on 158 cases of ovarian tumors received in Department of Pathology, College of Medical Sciences and Teaching Hospital during a time period of five and a half years from January 2012 to June 2017. Results: Age of the patients ranged from 12 to 88 years with maximum cases 96 (60.8%) in 20 – 40 years age group. The mean ±SD of age was 36.6±14.4 years. Majority of the cases 137 (86.7%) were benign. Sixteen (10.1%) cases were malignant and 5 (3.2%) cases were borderline. Majority of both benign and malignant cases were seen in 20 – 40 years age group. Size of the tumors ranged from 2 – 30 cm with mean±SD of 9.9±5.0 cm and maximum 93 (58.9%) cases in the size range of 5 – 10 cm. Majority of both benign and malignant tumors were in the size range of 5 – 10 cm. There was no association of age at presentation and size of tumor with behavior of tumor (p > 0.05). Sevety five (47.5%) cases were germ cell tumors, 72 (45.6%) cases were surface epithelial-stromal tumors, 9 (5.7%) cases were sex cord-stromal tumors, 1 (0.6%) was bilateral with surface epithelial tumor in right ovary and germ cell tumor in left ovary and 1 (0.6%) case was soft tissue tumor not specific to ovary. Majority of cases of germ cell tumors were seen below 40 years age whereas significant proportion of surface epithelial-stromal tumors was seen after 40 years with significant association between category and age at presentation (p < 0.05). Most common histopathological diagnosis overall was dermoid cyst in 43.7% cases. Conclusions: Benign ovarian tumors were more common than  malignant ones. Malignancy was seen in all age groups and in any size tumor. Surface epithelial-stromal   tumors and germ cell tumors were roughly equal in frequency with slight predominance of latter. Germ cell tumors were common in younger whereas surface epithelial-stromal tumors were more common in older   individuals. Histopathological examination in any ovarian tumor at any age with any size is mandatory.

Introduction: Neoplastic lesions of gallbladder are less well defined than other lesions in gastrointestinal tract due to rarity of lesions and also poor accessibility of this site. More than fifty percent cases of cancer are clinically missed. This study was aimed to see the histopathologic spectrum of premalignant and malignant lesions, compare clinical diagnosis with histopathological diagnosis and see association between gross morphology and missed clinical diagnosis. Methods: This study was conducted on 56 consecutive cases of premalignant and malignant lesions of gallbladder received in study period of 10 years from January 2011 to December 2020. Results: Age of the patients ranged from 13 – 84 years with a mean±SD of 56.8±13.7 years with maximum 17 (30.4%) cases in 41 – 50 years age group. There were 14 (25.0%) males and 42 (75.0%) females with a male female ratio of 1:3. 10 (17.9%) cases were premalignant lesions and 46 (82.1%) cases were malignant lesions. 93.5% malignant cases were adenocarcinoma. 41.3% cases were clinically not suspected to be malignant. There was no association between gross morphology and missed clinical diagnosis (p > 0.05). Conclusions: Routine histopathologic examination of all the resected gallbladder specimens is manadatory as important diagnosis can be missed.

Introduction and objectives: Polyps and colorectal cancer have overlapping clinical presentation and may be difficult to diagnose on clinical grounds alone and close clinicopathological correlation is required for correct diagnosis and management. This study was aimed to see the spectrum of polyps and cancer in colorectum, see the percentage of colorectal cancer in younger individuals, see association between histologic grade and pathologic stage at presentation and compare site of tumor and pathologic stage at presentation in younger and older age group. Methods: This study was carried out on 138 consecutive cases of polyps and malignant lesions of colorectum during a time period of 10 years from January 2011 to December 2020. Results: Age of the patients ranged from 2 – 90 years with mean 45.1 years and a male female ratio 2:1. There were 58 (42.0%) cases of polyps and 80 (58.0%) cases of malignancies. 37 (46.3%) malignancy cases were seen in individuals ≤ 50 years of age. Most common site of involvement was rectum in 80 (58.0%) cases. Most common non-neoplastic polyp was retention polyp comprising 25 (67.6%) and most common neoplastic polyp was adenoma comprising of 18 (85.7%) cases. Most common malignancy was adenocarcinoma comprising 75 (93.8%) cases. Conclusion: Significant number of malignancies is seen in younger individuals stressing the need for suspicion and surveillance in this age group. Histologic grade is an important prognostic parameter and there is no difference in site of tumor and stage at presentation between younger and older age group.