Conflict of interest: None What's already known about this topic? Approximately one third of acra... more Conflict of interest: None What's already known about this topic? Approximately one third of acral melanomas (AM) lack a dermoscopic parallel ridge pattern (PRP), rendering their detection more troublesome. What does this study add? A scoring system composed of 6 variables achieves the highest diagnostic accuracy for AM. Application of the latter diagnostic scheme minimizes the possibility of missing AM that are not dermoscopically characterized by a PRP.
International journal of health sciences, Jun 1, 2012
Fine-needle aspiration (FNA) of the thyroid gland is a widely accepted and accurate method for tr... more Fine-needle aspiration (FNA) of the thyroid gland is a widely accepted and accurate method for triaging patients with thyroid nodules. Thyroid FNA suffers from a reporting confusion due to multiplicity of category terminologies. To address this, The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was recently introduced for unifying the terminology and morphologic criteria along with the corresponding risk of malignancy.
Indian journal of anatomy and surgery of head, neck and brain, Oct 15, 2021
Spinal epidermoid cyst is a rare entity. It may be congenital with associated spinal dysraphism s... more Spinal epidermoid cyst is a rare entity. It may be congenital with associated spinal dysraphism such asspina bifida ,dermal sinus tract and other neural tube defects or acquired due to repeated lumbar puncture and trauma. Congenital spinal epidermoid cysts without spinal dysraphism are rare. Here we are reporting a rare and interesting case of thoracic extramedullary intradural epidermoid cyst with no associated features of spinal dysraphism or history of iatrogenic trauma in a young male patient. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
medRxiv (Cold Spring Harbor Laboratory), Jan 20, 2021
doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by pee... more doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
Different cytological techniques have been successfully applied for the diagnosis of primary lung... more Different cytological techniques have been successfully applied for the diagnosis of primary lung cancers. Flexible fiberoptic bronchoscopy has served as a major breakthrough in respiratory cytology, as bronchial brushings, washings and fine needle aspiration have become more easy, accessible and cost effective.This study aims to determine the diagnostic value of bronchial wash (BW), bronchial brushing (BB) and fine needle aspiration (FNA) cytological samples in diagnosing primary lung carcinoma, among patients attending King Abdulaziz University Hospital,Jeddah Saudi Arabia. A retrospective analysis was performed to compare the diagnostic value of the three specimens' types among patients with a clinical suspicion of primary lung carcinoma. All cytology specimens of bronchial washing, bronchial brushing and fine needle aspirate of lung performed for a clinical diagnosis of primary lung carcinoma, between Jan 2000-Dec 2013, were identified and evaluated in comparison to their respective histological correlations. Combined BB + BW showed the best sensitivity (90.6%), specificity (75%), PPV (98%) and Global Accuracy (89.5%), when compared to any of the three techniques employed individually. In ROC curves analysis, combined BB + BW showed the highest diagnostic significance with an Area Under Curve (AUC)=.828 (p value = .030), followed by BB with an AUC=.774 (p value=.004) and FNA with an AUC = .767, (p value= .042). Combination of bronchial brush and bronchial wash complement each other and enhance the diagnostic efficacy of lung cytology for the diagnosis of primary lung carcinoma and are more superior when compared with bronchial brush, bronchial wash or FNA performed individually.
Objectives: In developing countries and worldwide cervical cancer is an important cause of female... more Objectives: In developing countries and worldwide cervical cancer is an important cause of female mortality. Reports describing the frequency and pattern of abnormal Pap smears in Saudi Arabia, using the revised Bethesda system (RBS) are very few. The current study was conducted to explore the changing pattern of epithelial cell abnormalities (ECA) detected in Pap smears (PS) in females of the Western region of Saudi Arabia at King Abdulaziz University Hospital, Jeddah using the RBS. Materials and methods: A retrospective study was designed to review all the PSs from the archives of Cytopathology Department at King Abdulaziz University Hospital, starting from January 2000 to October 2012 using RBS. Cytological aspects of PSs were reviewed with age distribution. Results: Of the 15805 PS, 84 (0.53%) unsatisfactory smears were excluded. There were 2295 cases (14.52%) with ECA. In the abnormal squamous cell category the distribution of lesions was as follows: Atypical squamous cells of indeterminate significance (ASC-US) were 7.1%; atypical squamous cells, cannot exclude high squamous intraepithelial lesion (ASC-H) were 1.08%; low grade squamous intraepithelial lesion (LSIL) including human papillomavirus was 2.2%, high grade squamous intraepithelial lesion (HSIL) was 0.8% and high grade squamous intraepithelial lesion with suspicious invasion was 0.06% smears. The mean age (MA) incidence was 39,43,45,46 and 45 years respectively. Conclusion: The percentage of abnormal PS is increasing (14.52%) over the last decade. This increase is evident by different studies conducted across Saudi Arabia. Under present circumstances the need for mass screening.
Primary clear cell adenocarcinomas most commonly involve the genitourinary system, including the ... more Primary clear cell adenocarcinomas most commonly involve the genitourinary system, including the vagina. Previously, primary clear cell adenocarcinomas of the vagina have been discussed within the context of prenatal exposure to diethylstilbestrol. Due to its widely proven role in the development of this carcinoma, administration of diethylstilbestrol is prohibited. We present two cases of non-diethylstilbestrol-associated primary clear cell adenocarcinoma of the vagina from the archives of the Anatomical Pathology Department at King Abdulaziz University in order to improve our understanding of its biological behavior. Our findings suggest that primary clear cell adenocarcinoma of the vagina may be unrelated to diethylstilbestrol exposure and that non-diethylstilbestrol-associated primary clear cell adenocarcinoma of the vagina, when present at a younger age, may have a worse prognosis.
Objective: To evaluate Pap smear (PS) diagnoses at a tertiary care hospital using the revised Bet... more Objective: To evaluate Pap smear (PS) diagnoses at a tertiary care hospital using the revised Bethesda system, and to compare the results with other similar studies. Methods: We designed a retrospective study to review all PS from the Cytopathology Department of King Abdulaziz University Hospital, Jeddah, Saudi Arabia from January 2005 to December 2009. Results: Of the 7297 cases reviewed, 1254 cases (17.3%) had epithelial cell abnormalities. The categories included: atypical squamous cell of undetermined significance (ASC-US) found in 9.3%, atypical squamous cell, cannot exclude high squamous intraepithelial lesion (ASC-H) in 0.8%, low grade squamous intraepithelial lesion (LSIL) in 2.7%, and high grade squamous cell lesion (HSIL) in 0.9%. The mean age incidence (MAI) was 40 years for ASC-US, 42 years for ASC-H, 47 years for LSIL, and 45 years for MAI. Squamous cell carcinoma (SCC) was found in 0.06% with mean age incidence of 46 years. In the atypical glandular cell category, there was 3.2% atypical glandular cell of undetermined clinical significance not otherwise specified, 0.1% atypical glandular cells favoring neoplasm, and 0.08% atypical endometrial cells favoring neoplasm. Conclusion: The incidence of abnormal PS has increased from previously 4.7%, to 17.3% in the present study. The ASC-US among total PS examined has also significantly increased. The increase in the number of positive PS raises concerns of whether the new BS results are an artificial increase in the prevalence and the predictive value of cytology to some extent.
Low grade appendiceal mucinous neoplasms are a challenging entity not just due to their innocent ... more Low grade appendiceal mucinous neoplasms are a challenging entity not just due to their innocent appearance and aggressive extension but also due to their origin dilemmas. We present one such interesting case in a 35-year-old Saudi female who presented to King Abdulaziz University Hospital with acute abdominal pain. Th e patient presented with the main bulk of the mucinous tumor in the left ovary with extensive pseudomyxoma peritonei. Incidentally there was also a mature cystic teratoma in the same ovary. Appendiceal origin was confi rmed on histology and immunohistochemistry. In conclusion our case scenario of low grade appendiceal mucinous neoplasms with concomitant ovarian mucinous tumor, mature cystic teratoma and pseudomyxoma peritonei suggests appendiceal origin both on morphology and immunohistochemistry. As such routine excision of appendix in these case scenarios remains a valid consideration.
Rarity of ICGCTs limits our knowledge about them, making preoperative diagnosis difficult. To the... more Rarity of ICGCTs limits our knowledge about them, making preoperative diagnosis difficult. To the knowledge of authors, only one case of ICGCT has been reported so far from Saudi Arabia. [7] As such, the present study was performed to enhance our understanding regarding these tumors in our population. Objective The purpose of this retrospective study was to present the clinicopathological and immunohistochemical findings in three cases of primary intracranial germ-cell tumor along with the review of literature.
The spectrum of GB disorders in the paediatric population has changed over the past three decades... more The spectrum of GB disorders in the paediatric population has changed over the past three decades [1]. Cholecystitis is defined as inflammation of the GB traditionally divided into acute and chronic subtypes. These subtypes are considered to be separate entities but are closely related in the paediatric age group. Both acute and chronic cholecystitis may also be considered calculous or acalculous, but the inflammatory process remains the same. Most LCs performed for acute cholecystitis show evidence of chronic inflammation, supporting the concept that acute cholecystitis may actually be an exacerbation of chronic distension and GB tissue damage. Although both acute and chronic cholecystitis can be related to cholelithiasis, however in childhood acalculous cholecystitis may be the most frequent form [2]. The exact frequency of acute and chronic cholecystitis among children in India or United State remains unknown [2]. The prevalence of chronic cholecystitis in paediatric age group ranges from 0.13-1.9% including both calculous and acalculous forms [3]. Recent epidemiological studies and case reports have suggested an increase in acalculous form of chronic cholecystitis in the paediatric population [4]. While cholecystitis was previously attributable mainly to haemolytic disease, the frequency of paediatric cholecystitis due to cholelithiasis has proportionally increased with the childhood obesity epidemic suggesting a strong correlation [5]. There however, seems to be more than one factor of concern at play which may include rapid change to urban style feeding habits and fatty food intolerance. As LC is the standard of care for cholecystitis in children, it is also resulting in increased number of LCs performed in paediatric age group [6,7]. Despite the increased frequency of chronic cholecystitis in children and adolescents there is paucity of literature in this regard which results in under estimation of the burden. Most paediatric studies focus on cholelithiasis and biliary dyskinesia rather than inflammatory GB disease [8]. The aim of this study was to present the clinicopathological concordance of LCs performed among children at a single centre. MAterIAls And MethOds This was a single centre retrospective study performed on GB specimens, at
Renal cell carcinoma (RCC) is the most common renal tumour. RCC with Xp11.2 translocation/TFE3 (t... more Renal cell carcinoma (RCC) is the most common renal tumour. RCC with Xp11.2 translocation/TFE3 (transcription factor E3) gene fusions (Xp11.2 RCC) is positive for immunostain labelling by TFE3 antibody. This tumour is rarely described in adults. This study aims to evaluate the frequency of RCC with Xp11.2 in a subset of Saudi adult patients with RCC.
Background: Atypical prostatic hyperplasia (APH) is a pseudoneoplastic lesion that can mimic pros... more Background: Atypical prostatic hyperplasia (APH) is a pseudoneoplastic lesion that can mimic prostate adenocarcinoma because of its cytologic and architectural features. Suspension of date palm pollen (DPP) is an herbal mixture that is widely used in folk medicine for male infertility. The aim of the present study was to evaluate the effect of DPP suspension and extract on APH-induced rats. Methods: APH was induced in adult castrated Wistar rats by both s.c. injection of testosterone (0.5 mg/rat/day) and smearing citral on shaved skin once every 3 days for 30 days. Saw palmetto (100mg/kg), DPP suspension (250, 500 and 1000 mg/kg), and lyophilized DPP extract (150,300 and 600 mg/kg) were given orally daily for 30 days. All medications were started 7 days after castration and along with testosterone and citral. Results: The histopathological feature in APH-induced prostate rats showed evidence of hyperplasia and inflammation. Immunohistochemical examination revealed that the expressions of IL-6, IL-8, TNF-α, IGF-1 and clusterin were increased, while the expression of TGF-β1 was decreased that correlates with presence of inflammation. Moreover, histopathological examination revealed increased cellular proliferation and reduced apoptosis in ventral prostate. Both saw palmetto and DPP treatment has ameliorated these histopathological and immunohistochemical changes in APH-induced rats. These improvements were not associated with reduction in the prostatic weight that may be attributed to the persistence of edema. Conclusion: DPP may have a potential protective effect in APH-induced Wistar rats through modulation of cytokine expression and/or upregulation of their autocrine/paracrine receptors.
Although melanocytic skin lesions have been recognized since antiquity, their literature was limi... more Although melanocytic skin lesions have been recognized since antiquity, their literature was limited to Caucasians. To date, the clinicopathologic features of these lesions in Egyptians are still unknown. To define these features, diagnostic records of the melanocytic skin lesions received at the Pathology Department, Assuit University Hospitals (1989-2004) were reviewed. The lesions examined included 12 benign naevi (BN), 10 dysplastic naevi (DN), and 21 cutaneous malignant melanomas (CMMs). The DN and CMMs were more common in men than in women (2 : 1 and 1.5 : 1, respectively) while BN were more common in women (2 : 1). The average age incidence was 33 ± 5, 38 ± 7 and 54 ± 3 years, for BN, DN and CMM, respectively. The lower limb (13/21, 62%), head and neck (7/21, 33%) were the most common sites for CMMs. The average size (mm) was 2 ± 0.3, 4 ± 0.6 and 21 ± 0.3 for BN, DN and CMMs, respectively. Recurrence occurred in 10% of CMMs. Histologically, CMMs were of nodular type and composed of epithelioid (7/21, 33%), spindle cells (1/21, 5%), or mixed cells (13/21, 62%). The mean tumour thickness (Breslow) was 6 ± 0.5 mm. CMMs included two of 21(9%), three of 21(14%), six of 21(38%), and 10 of 21(38%) with Clark level II, III, IV and V. In Egypt, CMM is the third most common cutaneous neoplasm following squamous and basal cell carcinomas. Compared with Western societies, melanoma has a male sex predilection, similar histological features but different topographical distribution and rare incidence. The striking difference from Western series is the incidence of nodular melanoma-in the West this represents 15-30% of melanomas, with superficial spreading being the majority. Another key difference from the West is the 'sun-bed' culture of the West and the desire to have suntans. This is the first study that reports the clinicopathologic features of melanocytic skin lesions in Egypt.
Organization (WHO) classification of lymphomas, primary diffuse large B-cell lymphoma (DLBCL) of ... more Organization (WHO) classification of lymphomas, primary diffuse large B-cell lymphoma (DLBCL) of the CNS is recognized as a separate entity under "Aggressive lymphoma/leukemia". [1,2] The incidence of CNS lymphoma has been increasing over the past two decades [3] and according to the most recent central brain tumor registry of united states (CBTRUS) [4] statistical reports it now represents 2.3% of all primary brain and central nervous system tumors in USA. The age-adjusted incidence is 0.46/100,000 and appears to be increasing over time. Approximately 1,000 new cases are diagnosed annually in the United States. [4] The study of PCNSL is important for several reasons. Firstly because nothing is known about how lymphoma arises in an organ, which is immunologically privileged and gives sanctuary to the malignant lymphocytes among immune competent individuals. [5] Secondly once a rare tumor and the subject of individual case reports, PCNSL now afflicts approximately 1,000 people in the United States each year [6] and has shown a trend towards an increase in incidence over the past three decades [3,7] contributing to an increasingly important differential diagnosis of intracranial mass lesions.
Anti-inflammatory and antiproliferative activities of date palm pollen (Phoenix dactylifera) on e... more Anti-inflammatory and antiproliferative activities of date palm pollen (Phoenix dactylifera) on experimentally-induced atypical prostatic hyperplasia in rats
Conflict of interest: None What's already known about this topic? Approximately one third of acra... more Conflict of interest: None What's already known about this topic? Approximately one third of acral melanomas (AM) lack a dermoscopic parallel ridge pattern (PRP), rendering their detection more troublesome. What does this study add? A scoring system composed of 6 variables achieves the highest diagnostic accuracy for AM. Application of the latter diagnostic scheme minimizes the possibility of missing AM that are not dermoscopically characterized by a PRP.
International journal of health sciences, Jun 1, 2012
Fine-needle aspiration (FNA) of the thyroid gland is a widely accepted and accurate method for tr... more Fine-needle aspiration (FNA) of the thyroid gland is a widely accepted and accurate method for triaging patients with thyroid nodules. Thyroid FNA suffers from a reporting confusion due to multiplicity of category terminologies. To address this, The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was recently introduced for unifying the terminology and morphologic criteria along with the corresponding risk of malignancy.
Indian journal of anatomy and surgery of head, neck and brain, Oct 15, 2021
Spinal epidermoid cyst is a rare entity. It may be congenital with associated spinal dysraphism s... more Spinal epidermoid cyst is a rare entity. It may be congenital with associated spinal dysraphism such asspina bifida ,dermal sinus tract and other neural tube defects or acquired due to repeated lumbar puncture and trauma. Congenital spinal epidermoid cysts without spinal dysraphism are rare. Here we are reporting a rare and interesting case of thoracic extramedullary intradural epidermoid cyst with no associated features of spinal dysraphism or history of iatrogenic trauma in a young male patient. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
medRxiv (Cold Spring Harbor Laboratory), Jan 20, 2021
doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by pee... more doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
Different cytological techniques have been successfully applied for the diagnosis of primary lung... more Different cytological techniques have been successfully applied for the diagnosis of primary lung cancers. Flexible fiberoptic bronchoscopy has served as a major breakthrough in respiratory cytology, as bronchial brushings, washings and fine needle aspiration have become more easy, accessible and cost effective.This study aims to determine the diagnostic value of bronchial wash (BW), bronchial brushing (BB) and fine needle aspiration (FNA) cytological samples in diagnosing primary lung carcinoma, among patients attending King Abdulaziz University Hospital,Jeddah Saudi Arabia. A retrospective analysis was performed to compare the diagnostic value of the three specimens' types among patients with a clinical suspicion of primary lung carcinoma. All cytology specimens of bronchial washing, bronchial brushing and fine needle aspirate of lung performed for a clinical diagnosis of primary lung carcinoma, between Jan 2000-Dec 2013, were identified and evaluated in comparison to their respective histological correlations. Combined BB + BW showed the best sensitivity (90.6%), specificity (75%), PPV (98%) and Global Accuracy (89.5%), when compared to any of the three techniques employed individually. In ROC curves analysis, combined BB + BW showed the highest diagnostic significance with an Area Under Curve (AUC)=.828 (p value = .030), followed by BB with an AUC=.774 (p value=.004) and FNA with an AUC = .767, (p value= .042). Combination of bronchial brush and bronchial wash complement each other and enhance the diagnostic efficacy of lung cytology for the diagnosis of primary lung carcinoma and are more superior when compared with bronchial brush, bronchial wash or FNA performed individually.
Objectives: In developing countries and worldwide cervical cancer is an important cause of female... more Objectives: In developing countries and worldwide cervical cancer is an important cause of female mortality. Reports describing the frequency and pattern of abnormal Pap smears in Saudi Arabia, using the revised Bethesda system (RBS) are very few. The current study was conducted to explore the changing pattern of epithelial cell abnormalities (ECA) detected in Pap smears (PS) in females of the Western region of Saudi Arabia at King Abdulaziz University Hospital, Jeddah using the RBS. Materials and methods: A retrospective study was designed to review all the PSs from the archives of Cytopathology Department at King Abdulaziz University Hospital, starting from January 2000 to October 2012 using RBS. Cytological aspects of PSs were reviewed with age distribution. Results: Of the 15805 PS, 84 (0.53%) unsatisfactory smears were excluded. There were 2295 cases (14.52%) with ECA. In the abnormal squamous cell category the distribution of lesions was as follows: Atypical squamous cells of indeterminate significance (ASC-US) were 7.1%; atypical squamous cells, cannot exclude high squamous intraepithelial lesion (ASC-H) were 1.08%; low grade squamous intraepithelial lesion (LSIL) including human papillomavirus was 2.2%, high grade squamous intraepithelial lesion (HSIL) was 0.8% and high grade squamous intraepithelial lesion with suspicious invasion was 0.06% smears. The mean age (MA) incidence was 39,43,45,46 and 45 years respectively. Conclusion: The percentage of abnormal PS is increasing (14.52%) over the last decade. This increase is evident by different studies conducted across Saudi Arabia. Under present circumstances the need for mass screening.
Primary clear cell adenocarcinomas most commonly involve the genitourinary system, including the ... more Primary clear cell adenocarcinomas most commonly involve the genitourinary system, including the vagina. Previously, primary clear cell adenocarcinomas of the vagina have been discussed within the context of prenatal exposure to diethylstilbestrol. Due to its widely proven role in the development of this carcinoma, administration of diethylstilbestrol is prohibited. We present two cases of non-diethylstilbestrol-associated primary clear cell adenocarcinoma of the vagina from the archives of the Anatomical Pathology Department at King Abdulaziz University in order to improve our understanding of its biological behavior. Our findings suggest that primary clear cell adenocarcinoma of the vagina may be unrelated to diethylstilbestrol exposure and that non-diethylstilbestrol-associated primary clear cell adenocarcinoma of the vagina, when present at a younger age, may have a worse prognosis.
Objective: To evaluate Pap smear (PS) diagnoses at a tertiary care hospital using the revised Bet... more Objective: To evaluate Pap smear (PS) diagnoses at a tertiary care hospital using the revised Bethesda system, and to compare the results with other similar studies. Methods: We designed a retrospective study to review all PS from the Cytopathology Department of King Abdulaziz University Hospital, Jeddah, Saudi Arabia from January 2005 to December 2009. Results: Of the 7297 cases reviewed, 1254 cases (17.3%) had epithelial cell abnormalities. The categories included: atypical squamous cell of undetermined significance (ASC-US) found in 9.3%, atypical squamous cell, cannot exclude high squamous intraepithelial lesion (ASC-H) in 0.8%, low grade squamous intraepithelial lesion (LSIL) in 2.7%, and high grade squamous cell lesion (HSIL) in 0.9%. The mean age incidence (MAI) was 40 years for ASC-US, 42 years for ASC-H, 47 years for LSIL, and 45 years for MAI. Squamous cell carcinoma (SCC) was found in 0.06% with mean age incidence of 46 years. In the atypical glandular cell category, there was 3.2% atypical glandular cell of undetermined clinical significance not otherwise specified, 0.1% atypical glandular cells favoring neoplasm, and 0.08% atypical endometrial cells favoring neoplasm. Conclusion: The incidence of abnormal PS has increased from previously 4.7%, to 17.3% in the present study. The ASC-US among total PS examined has also significantly increased. The increase in the number of positive PS raises concerns of whether the new BS results are an artificial increase in the prevalence and the predictive value of cytology to some extent.
Low grade appendiceal mucinous neoplasms are a challenging entity not just due to their innocent ... more Low grade appendiceal mucinous neoplasms are a challenging entity not just due to their innocent appearance and aggressive extension but also due to their origin dilemmas. We present one such interesting case in a 35-year-old Saudi female who presented to King Abdulaziz University Hospital with acute abdominal pain. Th e patient presented with the main bulk of the mucinous tumor in the left ovary with extensive pseudomyxoma peritonei. Incidentally there was also a mature cystic teratoma in the same ovary. Appendiceal origin was confi rmed on histology and immunohistochemistry. In conclusion our case scenario of low grade appendiceal mucinous neoplasms with concomitant ovarian mucinous tumor, mature cystic teratoma and pseudomyxoma peritonei suggests appendiceal origin both on morphology and immunohistochemistry. As such routine excision of appendix in these case scenarios remains a valid consideration.
Rarity of ICGCTs limits our knowledge about them, making preoperative diagnosis difficult. To the... more Rarity of ICGCTs limits our knowledge about them, making preoperative diagnosis difficult. To the knowledge of authors, only one case of ICGCT has been reported so far from Saudi Arabia. [7] As such, the present study was performed to enhance our understanding regarding these tumors in our population. Objective The purpose of this retrospective study was to present the clinicopathological and immunohistochemical findings in three cases of primary intracranial germ-cell tumor along with the review of literature.
The spectrum of GB disorders in the paediatric population has changed over the past three decades... more The spectrum of GB disorders in the paediatric population has changed over the past three decades [1]. Cholecystitis is defined as inflammation of the GB traditionally divided into acute and chronic subtypes. These subtypes are considered to be separate entities but are closely related in the paediatric age group. Both acute and chronic cholecystitis may also be considered calculous or acalculous, but the inflammatory process remains the same. Most LCs performed for acute cholecystitis show evidence of chronic inflammation, supporting the concept that acute cholecystitis may actually be an exacerbation of chronic distension and GB tissue damage. Although both acute and chronic cholecystitis can be related to cholelithiasis, however in childhood acalculous cholecystitis may be the most frequent form [2]. The exact frequency of acute and chronic cholecystitis among children in India or United State remains unknown [2]. The prevalence of chronic cholecystitis in paediatric age group ranges from 0.13-1.9% including both calculous and acalculous forms [3]. Recent epidemiological studies and case reports have suggested an increase in acalculous form of chronic cholecystitis in the paediatric population [4]. While cholecystitis was previously attributable mainly to haemolytic disease, the frequency of paediatric cholecystitis due to cholelithiasis has proportionally increased with the childhood obesity epidemic suggesting a strong correlation [5]. There however, seems to be more than one factor of concern at play which may include rapid change to urban style feeding habits and fatty food intolerance. As LC is the standard of care for cholecystitis in children, it is also resulting in increased number of LCs performed in paediatric age group [6,7]. Despite the increased frequency of chronic cholecystitis in children and adolescents there is paucity of literature in this regard which results in under estimation of the burden. Most paediatric studies focus on cholelithiasis and biliary dyskinesia rather than inflammatory GB disease [8]. The aim of this study was to present the clinicopathological concordance of LCs performed among children at a single centre. MAterIAls And MethOds This was a single centre retrospective study performed on GB specimens, at
Renal cell carcinoma (RCC) is the most common renal tumour. RCC with Xp11.2 translocation/TFE3 (t... more Renal cell carcinoma (RCC) is the most common renal tumour. RCC with Xp11.2 translocation/TFE3 (transcription factor E3) gene fusions (Xp11.2 RCC) is positive for immunostain labelling by TFE3 antibody. This tumour is rarely described in adults. This study aims to evaluate the frequency of RCC with Xp11.2 in a subset of Saudi adult patients with RCC.
Background: Atypical prostatic hyperplasia (APH) is a pseudoneoplastic lesion that can mimic pros... more Background: Atypical prostatic hyperplasia (APH) is a pseudoneoplastic lesion that can mimic prostate adenocarcinoma because of its cytologic and architectural features. Suspension of date palm pollen (DPP) is an herbal mixture that is widely used in folk medicine for male infertility. The aim of the present study was to evaluate the effect of DPP suspension and extract on APH-induced rats. Methods: APH was induced in adult castrated Wistar rats by both s.c. injection of testosterone (0.5 mg/rat/day) and smearing citral on shaved skin once every 3 days for 30 days. Saw palmetto (100mg/kg), DPP suspension (250, 500 and 1000 mg/kg), and lyophilized DPP extract (150,300 and 600 mg/kg) were given orally daily for 30 days. All medications were started 7 days after castration and along with testosterone and citral. Results: The histopathological feature in APH-induced prostate rats showed evidence of hyperplasia and inflammation. Immunohistochemical examination revealed that the expressions of IL-6, IL-8, TNF-α, IGF-1 and clusterin were increased, while the expression of TGF-β1 was decreased that correlates with presence of inflammation. Moreover, histopathological examination revealed increased cellular proliferation and reduced apoptosis in ventral prostate. Both saw palmetto and DPP treatment has ameliorated these histopathological and immunohistochemical changes in APH-induced rats. These improvements were not associated with reduction in the prostatic weight that may be attributed to the persistence of edema. Conclusion: DPP may have a potential protective effect in APH-induced Wistar rats through modulation of cytokine expression and/or upregulation of their autocrine/paracrine receptors.
Although melanocytic skin lesions have been recognized since antiquity, their literature was limi... more Although melanocytic skin lesions have been recognized since antiquity, their literature was limited to Caucasians. To date, the clinicopathologic features of these lesions in Egyptians are still unknown. To define these features, diagnostic records of the melanocytic skin lesions received at the Pathology Department, Assuit University Hospitals (1989-2004) were reviewed. The lesions examined included 12 benign naevi (BN), 10 dysplastic naevi (DN), and 21 cutaneous malignant melanomas (CMMs). The DN and CMMs were more common in men than in women (2 : 1 and 1.5 : 1, respectively) while BN were more common in women (2 : 1). The average age incidence was 33 ± 5, 38 ± 7 and 54 ± 3 years, for BN, DN and CMM, respectively. The lower limb (13/21, 62%), head and neck (7/21, 33%) were the most common sites for CMMs. The average size (mm) was 2 ± 0.3, 4 ± 0.6 and 21 ± 0.3 for BN, DN and CMMs, respectively. Recurrence occurred in 10% of CMMs. Histologically, CMMs were of nodular type and composed of epithelioid (7/21, 33%), spindle cells (1/21, 5%), or mixed cells (13/21, 62%). The mean tumour thickness (Breslow) was 6 ± 0.5 mm. CMMs included two of 21(9%), three of 21(14%), six of 21(38%), and 10 of 21(38%) with Clark level II, III, IV and V. In Egypt, CMM is the third most common cutaneous neoplasm following squamous and basal cell carcinomas. Compared with Western societies, melanoma has a male sex predilection, similar histological features but different topographical distribution and rare incidence. The striking difference from Western series is the incidence of nodular melanoma-in the West this represents 15-30% of melanomas, with superficial spreading being the majority. Another key difference from the West is the 'sun-bed' culture of the West and the desire to have suntans. This is the first study that reports the clinicopathologic features of melanocytic skin lesions in Egypt.
Organization (WHO) classification of lymphomas, primary diffuse large B-cell lymphoma (DLBCL) of ... more Organization (WHO) classification of lymphomas, primary diffuse large B-cell lymphoma (DLBCL) of the CNS is recognized as a separate entity under "Aggressive lymphoma/leukemia". [1,2] The incidence of CNS lymphoma has been increasing over the past two decades [3] and according to the most recent central brain tumor registry of united states (CBTRUS) [4] statistical reports it now represents 2.3% of all primary brain and central nervous system tumors in USA. The age-adjusted incidence is 0.46/100,000 and appears to be increasing over time. Approximately 1,000 new cases are diagnosed annually in the United States. [4] The study of PCNSL is important for several reasons. Firstly because nothing is known about how lymphoma arises in an organ, which is immunologically privileged and gives sanctuary to the malignant lymphocytes among immune competent individuals. [5] Secondly once a rare tumor and the subject of individual case reports, PCNSL now afflicts approximately 1,000 people in the United States each year [6] and has shown a trend towards an increase in incidence over the past three decades [3,7] contributing to an increasingly important differential diagnosis of intracranial mass lesions.
Anti-inflammatory and antiproliferative activities of date palm pollen (Phoenix dactylifera) on e... more Anti-inflammatory and antiproliferative activities of date palm pollen (Phoenix dactylifera) on experimentally-induced atypical prostatic hyperplasia in rats
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