Background: Breast carcinoma is a heterogenous disease that represent a major health problem in Bangladeshi population. Several molecular markers have been detected over the past several decades, that are important in clinical aspects of breast carcinoma. Most recently, Vascular Endothelial Growth Factor (VEGF) is emerging as a prognostic marker in patients with several types of carcinoma including breast carcinoma. Many anti-angiogenic therapies targeting VEGF has been proven effective in many carcinomas. Objectives:This study was aimed to determine the expression of VEGF in different histomorphological types of breast carcinoma in an attempt to clarify its potential clinical outcome. Materials and Methods: This study was conducted in the Department of Pathology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka from March 2018 to January 2020. In this study, 45 diagnosed cases of breast carcinoma were enrolled. Histopathological slides of all cases were re-evaluated. Thin sections were taken on coated slides from each paraffin block and immunohistochemical staining was done with VEGF antibody. Results: Among 45 cases, 73.3% cases were invasive ductal carcinoma and 13.3% cases were invasive lobular carcinoma. The immunohistochemical expression of VEGF was positive in 60% cases. In this study, 100% cases of in-situ ductal carcinoma, 83.3% cases of invasive lobular carcinoma and 57.6% cases of invasive ductal carcinoma showed overexpression of VEGF. However VEGF expression did not show significant association with histomorphological types. Conclusion: VEGF expression was found in 60% of breast carcinoma cases. It may serve as a potential therapeutic target for the management of breast carcinoma. KYAMC Journal Vol. 13, No. 01, April 2022: 9-12
A 34-years-old married middle-class housewife without diabetes, hypertension or betel-nut- chewing hailing from Manikganj, Dhaka; came with the outside diagnosis as neuroendocrine tumor of the gallbladder to the Oncology Department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). She was admitted in the hospital with complaints of upper abdominal pain, abdominal bloating, weakness, anorexia, nausea and heartburn while taking fatty food. According to her Ultrasonography (USG) of the abdomen, a soft tissue mass was found in the gallbladder with unremarkable routine blood examination including tumor markers. She underwent open cholecystectomy with the suspicion of cancer. Grossly, gallbladder was measures 7.0x 5.0 cm with 0.3 cm wall thickness and on opening a polypoid nodule is found. Before treatment on request from the Oncology Department of KYAMCH, all slides were reviewed and a histopathological diagnosis of paraganglioma was made on the basis of organoid, nested or lobules (Zellballen pattern) of tumor cells in the lamina propria surrounded by a prominent fibrovascular stroma. Atypical mitoses, tumor necrosis, lymphovascular or perineural invasion was not found. The IHC reveals diffuse and strong positive reactions to NSE and CD56 for chief cells and strong positive reaction to S-100 protein for sustentacular cells. The epithelial tumor was ruled out by CK negative reaction. Therefore, the diagnosis of paraganglioma of the gallbladder was established. Because of the positive reaction to sustentacular cells, the neuroendocrine tumor has been excluded. To our knowledge, this type of case has not been reported in our country. On clinical follow-up the patient was found healthy. KYAMC Journal Vol. 14, No. 01, April 2023: 57-61
Renal primitive neuroectodermal tumor (renal PNET) or renal Ewing sarcoma (renal ES) is a rare, rapidly growing malignant small round cell tumor with poor prognosis. A 32-years-old Bangladeshi male patient presented with right loin pain, fever and anemia. On CT imaging a large (18x10.5x10.0 cm) renal mass was discovered. On suspicion of malignancy, a biopsy was taken from the mass. Microscopic evaluation showed features consistent with malignant small round blue cell tumor. Immunohistochemical stains showed diffuse and strong positive reaction to CD-99 and negative for WT-1, CD-3 and CD-20, which confirmed the diagnosis of renal PNET. After 6 cycles of combined chemotherapy, the patient was relatively well and at 6 months follow-up he showed no evidence of metastasis or recurrence. KYAMC Journal Vol. 13, No. 04, January 2023: 257-260
Background: The diagnosis of Hirschsprung’s disease (HD) is dependent on the histological study of rectal ganglion cells. Open rectal biopsy is the mainstay that requires general anesthesia (GA) and carries risk of many complications. Rectal punch biopsy has gained wide acceptance and has become the choice as it is simple, safe, having no need of anesthesia, done bedside with a simple biopsy forcep with high degree of accuracy and virtual absence of any complications. Objective: To find out the efficacy of rectal punch biopsy in the diagnosis of Hirschsprung’s disease. Materials and Methods: A cross sectional descriptive observational study was carried out with the histological findings of 60 rectal punch biopsies with corresponding 60 full thickness rectal biopsies from 60 suspected HD patients from March 2018 to February 2020. Sections made from the paraffin blocks were stained with H&E and were examined for the presence or absence of ganglion cells and hypertrophic nerve fibers in the submucosa. Then the relations were studied. These findings were compared with full thickness rectal biopsy. Result: There were 40(66.7%) cases of male and 20(33.3%) cases of female including 26 (43.3%) cases of infants. Out of 60 cases, 10 cases (seven inadequate and three suspicious) of punch biopsy were not compared with full thickness rectal biopsy. Out of 50 cases, 38(63.3%) cases were HD in punch biopsy; among these 36(92.3%) cases were HD and 2(18.2%) cases were Non-HD in full thickness rectal tissue biopsy. The accuracy of punch biopsy was measured by sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and efficiency of the test which were 92.3%, 81.8%, 94.7%, 75.0% and 90.0% respectively. Conclusion: The rectal punch biopsy is simple, safe, no need of anesthesia and can be done with a simple biopsy forcep with high degree of accuracy. KYAMC Journal Vol. 13, No. 01, April 2022: 37-40
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