Objective: To ascertain the frequency and spectrum of histopathological findings in renal allograft rejection cases received in one year. Study Design: Cross-sectional study. Place and Duration of Study: Histopathology Department of Armed Forces Institute of Pathology, Rawalpindi Pakistan from Jun 2020 to May 2021. Methodology: Renal allograft rejection biopsy cases of 62 male and female patients between the ages of 15-60 years having undergone renal transplant with prior end-stage renal disease over one year were collected. Frequency and histopathological findings were studied after classifying them according to the Banff Classification. Results: Cellular (T-cell mediated) rejection accounted for more than half of the cases under study, making it the most common cause of transplant rejection in our demographical area. It accounted for 28 (45.2%) slides of all the biopsies studied. Antibody-mediated rejection followed next with 17 (27.4%) slides, with seven slides (11.3%) of the cases borderline for changes accounting for a T-Cell mediated rejection. About 10 (16.2%) were non-specific changes negative for transplant rejection criteria. Conclusion: Our study was instrumental in establishing rejection patterns and major rejection sub-types while classified under the Banff Classification in our demographical area. The cataloguing of the cases and the major underlying cause would help minimize rejection rates resulting in better clinical outcomes and increased patient survival.
ABSTRACT Objective: To evaluate the reproducibility of the Gleason scoring system and to compare its inter-observer variability for histological grading of prostatic adenocarcinoma. Study Design: Prospective double-blind study. Place and Duration of Study: Histopathology department of Armed Forces Institute of Pathology (Jan-Jul 2020). Methodology: A total of 128 pathology slides of prostate biopsies from patients with prostate cancer were re-evaluated. The International Society of Urological Pathology 2005 modified Gleason grading system with Epstein’s modification was used. Two pathologists, blinded to each other and to the initial pathology report, performed the pathological evaluation. To determine inter-observer concordance, the kappa coefficient test was used. Results: Concordance rates between the two observers for Gleason pattern sums were 67% (Ꝁ=0.556, 95% CI 0.40-0.59), respectively. Best concordance was at Gleason sum 7 (n=30/128). Conclusion: The agreement between observers on the Gleason sum was moderate. It can be greatly reduced if better trained uropathologists employ the Gleason scoring system resulting in less variability and more conformity.
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