Hirschsprung disease is one of the most common and problematic infancy and childhood maladies. Early and accurate diagnosis is a fundamental step in proper management and prevention of complications. The most reliable method for diagnosis is the histopathological analysis of colorectal biopsies and the typical finding of Hirschsprung disease is the absence of ganglion cells. Toluidine blue stain can act as a double check along with conventional H&E stain for ganglion cell detection. Neuron-specific enolase is an immune-histochemical marker that can also aid in better identifying ganglion cells, especially for small and immature ones. This study aimed to evaluate Toluidine blue stain and Neuron specific enolase immunostain along with conventional H&E stain as a panel for the diagnosis of Hirschsprung disease. This cross-sectional study was conducted from September 2019 to August 2021, involving 55 clinically suspected Hirschsprung disease cases. Paraffin blocks of colorectal biopsy samples were collected from the Department of Pathology, BSMMU. Hematoxylin & Eosin, Toluidine blue stain, and Neuron specific enolase immunohistochemical stain for Hirschsprung disease detection were performed on the sections from the paraffin blocks. Then the sections were examined and an evaluation of the stains was done. Statistical analysis was performed on the tabulated data by chi-square test. Among 55 cases, conventional H&E stain detected ganglion cells in 31 cases, that is 56.4%. Later, Toluidine blue stain and Neuron specific enolase immu- nohistochemical stain detected ganglion cells in 35 cases, that is 63.6%. So, these two addition- al stains were able to detect ganglion cells in four more cases compared to conventional H&E stain. In conclusion, conventional H&E stain, Toluidine blue stain, and NSE immunohisto- chemical stain can improve the diagnostic accuracy of Hirschsprung disease. BSMMU J 2022; 15(2): 102-106

Urothelial carcinoma is the most common neoplasm of urinary bladder. Antigen Ki-67 is a nuclear protein that is necessary for cellular proliferation. The aim of this study was to determine the association of expression of Ki-67 with histopathological parameters in radical cystectomy specimens of histologically diagnosed cases of infiltrating urothelial carcinoma. This is a cross-sectional study conducted among 36 cases of infiltrating urothelial carcinoma collected from Department of Pathology, Bangabandhu Sheikh Mujib Medical University. Histopathological parameters i.e. morphologic variants, stage (pT), lympho-vascular invasion, perineural invasion and lymph node metastasis were assessed. Ki-67 immunohistochemistry were performed. Mean ±SD age of the patients was 58.9±13.8 years. Among the morphological variants, 64% cases were microscopically arranged in papillary pattern. Eighteen (50%) patients underwent surgical intervention at stage pT2. Lympho-vascular invasion, perineural invasion and lymph node metastasis were identified in 12 (33.3%), 9 (25%) and 13 (48.1%) of the cases, respectively. Among the morphological parameters, Ki-67 shows association with pathological stages and lymph node metastasis. The use of Ki-67 immunomarker along with grading and staging may provide significant prognostic information in urothelial carcinoma of the urinary bladder. BSMMU J 2022; 15(3): 186-191

Background: Primary and secondary myelofibrosis has become a global burden due to its increased mortality and morbidity. Angiogenesis is a significant driving force in the development of fibrogenesis in the bone marrow, which leads to myelofibrosis. The microvascular density (MVD) with immunomarker CD34 can be used to assess the degree of angiogenesis. The objective of this study was to examine the association between degree of myelofibrosis and angiogenesis in hematological malignancies. Methods: Forty-six trephine biopsy specimens of various hematological malignancies with myelofibrosis were studied at the Department of Pathology of Bangabandhu Sheikh Mujib Medical University. Extent of myelofibrosis in each case was assessed by examining the reticulin and Masson’s trichrome stained sections using a semiquantitative grading system of bone marrow fibrosis (MF) within a scale of MF-0 to MF-3. Angiogenesis was measured by counting MVD in the ‘hotspots’ after immunostaining with CD34 antibody. Results: The trephine biopsy cases were grouped into early fibrotic (MF-1) and advanced fibrotic (MF-2,3) consisting of 16 (34.8%) and 30 (65.2%) patients, respectively. Angiogenesis was estimated as mean MVD count which revealed 16.7 ± 5.4 and 32.0 ± 11.5 in these groups, respectively.  Significant difference of mean MVD values     (P<0.001) between the early and advanced fibrotic groups revealed the association of angiogenesis and degree of myelofibrosis. Conclusion: MVD may be used to measure angiogenesis in myelofibrotic marrow along with other clinical and laboratory indices as a marker of disease activity in hematological malignancies, thus aiding disease prognosis. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(1): 26-34