This study was conducted to confirm which of these modalities [mammography (MG), fine-needle aspiration cytology (FNAC), core-needle biopsy (CNB), or intraoperative touch imprint cytology (IOTIC)] is useful to detect breast cancer and to compare the accuracy of these modalities for the diagnostic setting. One hundred seventy-five, 85, 78, and 25 patients were selected who underwent FNAC, MG, IOTIC, and CNB, respectively. Histopathology was used as a gold standard for comparison of the results of all diagnostic modalities. Twenty-five patients with combinations of three preoperative tests (MG, FNAC, CNB) showed 100% accurate results when compared with histopathology, while the overall accuracy for MG, FNAC, and CNB was 91.7%, 91.5%, and 96%, respectively. Both touch and scrape imprints' sensitivity, specificity, positive predictive value, negative predictive value (NPV), and accuracy were 100% for class V and class II smears, while sensitivity, accuracy, and NPV were 87, 95, and 83% for IOTIC and 94%, 96%, and 89% for IOSC for class III and IV smears. On comparison of the results of all these procedures, the difference was nonspecific (P = 0.2, 0.3, 0.5, 0.55, and 0.6 for MG, FNAC, IOTI, IOSC, and CNB, respectively). Combinations of preoperative tests (MG, FNAC, CNB) were more accurate, reliable, and acceptable when compared with individual diagnostic procedure, but these have their own technical limitations. The accuracy of CNB was much higher than that of MG and FNAC. IOTP and IOSC are simple and cost effective diagnostic tests with better accuracy that can be used as an alternate to frozen section in diagnostic settings and margin assessments.
Background: Thyroid gland is notorious for carrying commonest endocrine pathologies and also for commonest endocrine malignancy. It is the 5th most common cancer in human beings. This makes to carry out current study to get insight of frequency of thyroid lesions at tertiary care level. Methods: This was a descriptive cross-sectional study. The study was done at the Department of Pathology, King Edward Medical University Lahore with the collaboration of four surgical units of Mayo Hospital Lahore from 2010 to 2019. Total 1601 cases were included. Information about age, sex and diagnosis was entered in the pre designed proforma. SPSS version 22 was used for data analysis. Descriptive analysis was done and the results were presented as frequencies, percentages and ratios. The results were then studied against local and international data. Results: This study revealed non neoplastic and neoplastic lesions as 1323 (82.63%) and 278 (17.37%) respectively. Bulk of the lesions 61.6% were between the age bracket of 20-39 years. Mean±SD for age was 34.22±11.42 years. Female to male ratio(F:M) was in favour of females as 9.81:1. Among the non neoplastic lesions, MNG 1151(87%) was a dominant lesion followed by TH 82(6%). LT 29(2.19%) and HT 26(1.96%) were other important lesions. F:M ratio was 10.80:1. Neoplastic lesions were divided into benign 178(64%) and malignant tumors 100(36%). FA was the leading benign neoplasm 164(59%). Rest of the benign tumors shared a minor fraction except HCA 12(4.31%). Among the malignant category, Papillary carcinoma 69(24.82%) dominated over MC 12(4.31%). FC 7(2.51%) and AC 6(2.15%) were other significant findings. F:M ratio in malignancy was 3.16:1 which was significantly lower than 13.83:1 in benign tumors. Conclusion: MNG is the dominant lesion among the non neoplastic lesions while in the neoplastic category FA was leading as benign neoplasm. Papillary carcinoma turned out to be the commonest malignant tumor. Major share of all the lesions were seen between 20-39 years. Keywords: MNG, Papillary carcinoma, Follicular adenoma, neoplastic lesions
Objective: To examine and to compare c-kit expression in benign and malignant endometrial lesions. Study Design: Comparative, Cross Sectional Study Place and Duration of Study: Department of Pathology, King Edward Medical University Lahore. Methodology: Patients undergoing Gynecological procedures (diagnostic dilatation and curettage or hysterectomies due to dysfunctional uterine bleeding). They were further sub classified into benign and malignant lesions. Patients age and histopathological diagnosis were recorded and described. Conclusion: This study showed, c-kit over expression was seen in 31/68 (45.6%) in endometrial carcinoma and 21/68 (30.9%) in benign endometrial lesions
Background: Breast cancer (BC) is the commonest malignancy in the female and it is gaining its significance due to worldwide rising incidence. It is also important due to 2.5% higher incidence in Pakistan as compared to neighbouring countries. Nottingham prognostic index (NPI) is an important prognostic factor of BC. It provides information about survival and morbidity. There are significant variations in different studies. Aim: To carry out current study relating NPI with various histopathological parameters of BC. Methods: This was a descriptive cross-sectional study. The study was done at the Department of Pathology, King Edward Medical University Lahore with the collaboration of four surgical units of Mayo Hospital Lahore from 2010 to 2019. Total 137 cases of breast carcinoma were included. Information about age, grade, primary tumor size, axillary lymph node status and stage was entered in the pre designed proforma. NPI was calculated as 0.2xtumor size(cm)+lymph node grade. NPI was scored as excellent, good, moderate and poor and its correlation was calculated against primary tumor size, lymph node grade, tumor grade and stage. Results: We studied 137 cases of breast carcinoma with mean age 49.32±11.64 years. Mean NPI was 5.4±1.4 with range of 2.4 to 9.4. NPI scores in poor 65(47.4%) and moderate 61(44.5%) groups were significantly high as compared to good 10(7.3%) and excellent scores 1(0.7%). Most of the cases of poor NPI were in p T3 and p T4 whereas this was p T2 with moderate score. Poor score of NPI was significant in grade 3 which is in contrast to moderate score where grade 2 dominated the picture. Correlation of NPI with LNG was in favor of LNG 1 with good and moderate scores while LNG3 dominated in the poor group. In stage III, 49 cases (35.8%) were seen with poor score of NPI. Conclusion: NPI is an important prognostic parameter and it can be studied with different histopathological parameters to see correlation between them. In the current study majority of the cases of NPI scored at poor and moderate levels. Correlation coefficient was linear, strong and positive especially with LNG. Mean NPI has ascending correlation with these parameters. Thus NPI can be used as a prognostic indicator when comparing with histopathological parameters of BC. Keywords: Breast cancer, NPI, tumor grade, tumor stage, LNG
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