Background: Immunohistochemistry is an adjunct tool in Surgical Pathology. The fast growing use of immunohistochemistry in gynecologic Pathology has revolutionized the fields of tumor diagnostics & research. Objective: The objective of the study was to share & discuss the experience of utility of immunohistochemistry in Gynecologic Pathology, at a tertiary care hospital in Lahore, Pakistan. Patients & Methods: This was a retrospective, descriptive, cross sectional study, carried out at the Pathology Department of Fatima Jinnah Medical University, Lahore. All cases which were diagnosed after the application of immunohistochemistry during the study period from 1st July 2019 to 31st December 2020 were included in the study. Data included age of the patient, marital status, parity, clinical & radiological presentation, histopathological findings & differentials, list of immunohistochemical markers applied to the case with results & final histopathological diagnosis. Data was analyzed using SPSS version 17. Results: A total of 196 cases were included in the study. The age of the patients ranged from 14 years to 82 years with a mean age of 41 ± 7 years. The commonest use of immunohistochemistry was for histological classification of the tumors of the female genital tract, identifying precancerous lesions, differentiating primary from metastatic CA & predicting response to chemotherapy via proliferative index Ki67. The most commonly used immunohistochemical markers were CK, CK7, CK20, CD 3, CD20, ER, PR, VIMENTIN, WT 1, Ki67, CD 117, SMA, INHIBIN, p53 & p63. Practical implication This study shares the experience of use of common immunohistochemical markers in different cases of gynecologic pathology, highlighting & discussing different panels for use in different scenarios, from which other pathologists may benefit. Conclusion: Immunohistochemistry is an important ancillary tool in the evaluation of gynecologic pathology cases. However, it cannot replace conventional histopathology. It should always be used as an adjunct to histopathology, in the proper clinical & radiological context. Keywords: immunohistochemistry, gynecologic pathology, ovarian carcinoma, leiomyoma, dysgerminoma,

Background: Urinary bladder carcinoma is more common in elderly males than females. Urothelial (Transitional cell) carcinoma is the most common histological subtype. Objective: The purpose of present study was to describe the different histological features observed in transurethral resection of bladder tissue and to determine the association of tumor grade with stage and also of the age with grade and stage of tumor. Methods: An analytical Cross sectional study, conducted in the Department of Pathology Fatima Jinnah Medical University Lahore, Pakistan from August 2019 – April 2021. Total 80 specimens of transurethral resection of bladder tissue (TURBT) were included. All the specimens were fixed in 10% formalin and stained with Hemotoxylin Eosin stain and studied under the light microscope. urinary bladder malignancies were classified, staged and graded according to the WHO/ISUP guidelines. Results: Total n=80 cases were included in the study. Mean age of the male patients was 59± 1.13 years and 50±1.1 years in females. N=76(95%) were malignant and only 4 (5%) were benign cases. Out of 76(95%) malignant cases, 48 (63.1%) were high grade urothelial carcinoma and 28 (36.8%) were low grade carcinoma. N=33 (43.4%) were invading the lamina propria (T1) and 43 (56.5%) were invading the detrusor muscle (T2).Low grade tumors showed lamina propria invasion (T1) in 18 (64.2%) cases and muscular invasion (T2) was seen in only 10(35.7%) cases. N=33(68.7%) of high grade tumor were invading the deep muscle (T2) and 15 (31.2%) were limited to lamina propria (T1). Tumor with high grade morphology were diagnosed at advanced stage and was observed more frequent in elderly patients. Statistically significant association of tumor histological grade with stage and also of patient's age with tumor grade and stage was observed p

Aim: To evaluate the course, origin and termination of coronary artery anomalies in subjects demonstrating various symptoms and undergoing multidetector CT coronary angiography for evaluation of coronary disease. Study Design: Retrospective study Place and duration: Ch.Pervaiz Elahi Institute of Cardiology Multan from January 2021 to January 2022. Methodology: The study included patients who were referred to the radiology department because of suspicion of coronary artery disease. The data of these patients were reviewed for the course and origin of coronary artery anomalies. A 64-slice scanner was used for MDCT coronary angiography. At the start of acquisition contrast arriving coronary arteries were synchronised using the bolus tracking technique. The whole heart was imaged during apnea using 80-90ml iodinated contrast material administered intravenously. Coronary arteries were evaluated using 3-D and multiplanar reformatted images Results: Total of 600 patients who were referred for MDCT coronary angiography. The subjects underwent screening because of various risk factors, chest pain, or similar symptoms. Coronary artery anomalies were diagnosed in 21 out of 600 (3.5%) patients, whose mean age was 52.6±10.8 years and 504 (84%) were male. 3(14%) patients had high take-off of RCA (right coronary right) and 4(19%) of LMCA (left main coronary artery). In 5(24%) patients left circumflex artery (LCx) and left anterior descending artery (LAD) originated separately from the left sinus of Valsalva (LSV). In 3(14%) patients RCA originated from the opposite sinus of Valsalva.RCA anomaly in 1 patient had a malignant course. Conclusion: The study shows that evaluation of coronary artery anomalies can viably be done using CT. Right diagnosis and treatment planning are based upon an understanding of the clinical significance and CT characteristics of different CAAs. Keywords: Coronary artery angiography, MDCT, prevalence

The spectrum of ovarian pathologies embraces wide age range among females because the risk of developing ovarian lesion starts from birth and follows diverse patterns through-out the life.1,2 The rate of development of complications, recurrence, progression to malignancy, morbidity and mortality, also varies according to the age of presentation of various ovarian pathologies.3,4,5 The prevalence of cystic lesions of ovary is more in reproductive age group as compared to post-menopausal women.6,7 Malignant neoplasms have more been observed in an advanced age group.8,9,10 The current study is aimed to observe the distribution of various histopathological patterns of ovarian lesions in different age groups. This study may be beneficial in stratifying patients, into different risk based groups and prognosis associated groups, depending upon the age of patient at the time of presentation. Methods: Total 150 cases of ovarian lesions were selected by convenient sampling in current descriptive study, carried out at Pathology department of Fatima Jinnah Medical University, Lahore from May, 2019 till June, 2020. Routine H & E stained sections, from specimens of total abdominal hysterectomy with unilateral or bilateral salpingo-oophorectomy, unilateral or bilateral oophorectomy and salpingo-oophorectomy procedures, done either for primary ovarian lesion or other than primary ovarian pathology, in all age groups, were included. Results: A majority of ovarian lesions 123 (82%) were observed in the reproductive age group, mostly being non-neoplastic (89.5%). Out of 19 post-menopausal patients, 12 presented with malignant neoplasms. All patients belonging to pre-pubertal age group had non-neoplastic pathologies. Conclusion: The malignant ovarian tumors are prevalent in post-menopausal patients while reproductive age group predominantly exhibits non-neoplastic and benign ovarian lesions. The pre-pubertal age group commonly present with non-neoplastic ovarian pathologies. Keywords: Histopathological patterns of ovarian lesion, Malignant ovarian tumors, Reproductive age group.

Background: Prostatic cancer is the 2nd most common malignancy in men. The understanding of incidence of malignancy along with Gleason grading of tumor is significant that led the development of investigations for early detection and prompt treatment of patients Aims: The aim of this study is to determine the incidence of malignancies with Gleason grade in patients with clinically enlarge prostate glands. Materials and Methods: This is a descriptive cross sectional study conducted in Rahbar medical and dental college from 100 patients with clinically enlarge prostate glands from January 2018 to December 2020. Results: A total 100 prostatic biopsies were examined histologically from January 2018 to December 2020. Out of 100 biopsies 12(12%) cases were diagnosed as adenocarcinoma and 88 (88%) were benign lesions. The age of patients ranges from 52 to 95 years with mean age of patients was 73.5 years. Majority (41.66 %) of adenocarcinomas reported as Gleason grade group 5. In 16.66 % cases the malignancy was incidental as clinically there was no any suspicion of carcinoma. Perineural invasion was noted in 66.66% of adenocarcinomas, and in 16.66% of cases lymphovascular invasion was reported, that correlates with higher grade of tumor. Conclusion: Majority of the tumor diagnosed were in grade group 4 that shows increased death rate. Prostate cancer is continue to rise and screening of every patient with enlarge prostate should be done for early detection of malignancy. Keywords: prostate gland, adenocarcinoma, Gleason grade