A prospective study was conducted to see the sensitivity, specificity, and accuracy of fine needle aspiration cytology (FNAC) for 100 salivary gland swellings in comparison with biopsy. These randomized samples were submitted and reported at the department of pathology, Allama Iqbal Medical College, Lahore. The male to female ratio was 1:1.5. Ages of the patients ranged from 8.5 to 58 years with mean age 33.39 +/- 12.37 years. Maximum number of lesions was found in age group between 21 and 40 years. Parotid gland was involved in 68%, submandibular gland in 30%, and minor salivary glands in 2% patients. Sublingual gland was not involved in any of our subjects. There were 14% cases of non-neoplastic lesions and 86% cases of neoplastic lesions on biopsy. Non-neoplastic lesions included 12 cases of inflammations (three cases of granulomatous inflammation and nine cases of nonspecific chronic inflammation) and two cases of inclusion cysts. Among neoplastic lesions, biopsy revealed 68 cases of benign neoplasia and 18 cases of malignant neoplasia. Non-neoplastic lesions did not show any difference in diagnosis by both techniques. FNAC misdiagnosed four malignant and one benign lesion. Sensitivity, specificity, positive predictive value, and negative predictive value of FNAC for benign neoplastic lesions were 98.52, 87.05, 94.36, and 96.55%, respectively, whereas for malignant neoplastic lesions they were 77.77, 98.78, 93.33, and 95.29%, respectively. In conclusion, FNAC is found to be a highly sensitive and specific technique for diagnosis of most of salivary gland swellings, except for malignant neoplastic lesions where its sensitivity is intermediate. We strongly recommend that FNAC should be adopted as an initial investigation for all salivary gland swellings.

Summary A case of combined intrauterine and extrauterine pregnancy is reported. The initial diagnosis was that of threatened abortion at the eighth week of pregnancy. Signs of an acute surgical disturbance in the pelvis necessitated laparotomy 3 weeks later. A right tubal ectopic pregnancy was excised and the intrauterine pregnancy was terminated at the 37th week by Caesarean section for placenta praevia.

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

Background: Breast carcinoma is the most common malignancy in females associated with high mortality rate. Objective: The purpose of present study was to describe the histological grade and histopathological stage of invasive ductal carcinoma of breast among female patients and to determine the association of tumor size and histological grade withnodal metastasis. Methods: This is an analytical cross sectional study, conducted in the Department of Pathology Fatima Jinnah Medical University Lahore, Pakistan from September, 2019 till February, 2020. Female patients of all age groups who were diagnosedwith invasive ductal carcinoma and underwent modified radical mastectomy were included in the study. Tissue processed and Hematoxylin and Eosin staining was performed. All the sections were examined under the light microscope by myself and two other consultant pathologists independently. Histological grading of invasive ductal carcinoma was done by following Modified Scarff Bloom Richardson grading system and histopathological staging was done according to CAP protocols. Results: Total of 60 female patients diagnosed with invasive ductal carcinoma were included in the present study. Mean age of the patient calculated was 48.17± 13.12 years with age range from 26 to 90 years. Size of the tumor ranged from 1cm to 10cm. On microscopy, histological grade III was the most frequent grade (36, 60%). Out of total 60 cases n=43(71.6%) were diagnosed with regional lymph node metastasis and T2N1Mx( 17,38.3%) was the most frequent stage of the tumor. Statistically no significant association of tumor size and histological grade was observed with regional lymph node metastasis (p >0.05).