Background: The management of breast carcinoma depends on several molecular markers and tumor stages. In the last decades, estrogen receptors (ER), progesterone receptors (PR), and HER-2/neu have shown good therapeutic responses. Among other molecular markers, vascular endothelial growth factor (VEGF) is becoming more widely used as a prognostic indicator in patients with breast carcinoma. Anti-VEGF therapy already has been proven as an effective chemotherapeutic agent in some other carcinomas. The study aimed to find out the immunohistochemical expression of Vascular Endothelial Growth Factor (VEGF) in breast carcinoma and its possible correlation with the expression of ER, PR, and HER-2/neu and molecular subtypes to evaluate its prognostic value. Material & Methods: This study was conducted in the Department of Pathology, BIRDEM General Hospital, Dhaka, from March 2018 to January 2020. In this study, 45 diagnosed cases of breast carcinoma were enrolled. Slides of all cases were stained with ER, PR, HER-2/neu, and VEGF antibodies following the avidin-biotin-peroxidase staining method. Results: Among 45 cases, 60% showed positive immunohistochemical expression of VEGF. Most of these cases (71.1%) were ER/PR positive. VEGF did not show a significant association with other molecular markers or molecular subtypes. Conclusion: Although, the potential prognostic value of VEGF has not been confirmed. Based on the findings of the current study, it can be assumed that VEGF plays an important role in the pathogenesis of breast cancer. So, it may serve as a useful biomarker for immuno-targeting therapy in patients with breast cancer.
Background: Among various immunological markers of colorectal carcinoma, the human epidermal growth factor receptor 2 (HER2/neu) is a significant one. Overexpression of HER2/neu in breast cancer has already been established as a poor prognostic marker and trastuzumab (a monoclonal antibody against HER2/neu) has been shown to increase the patient survival. The success of anti-HER2 (Herceptin) therapy in breast cancer has led to the evaluation of HER2/neu expression in colorectal and other cancers. The aim of the study was to determine the expression of HER2/neu in colorectal carcinoma. Methods: This cross-sectional study included 97 diagnosed cases of colorectal carcinoma and was conducted in the Department of Pathology, BIRDEM General Hospital, Dhaka from September 2018 to August 2020. Sections were taken from paraffin blocks for routine hematoxylin and eosin (H&E) stain and immunohistochemical stain with HER2/neu antibody. Relevant clinical and microscopic data including age, sex, tumor site and tumor size were collected and recorded. Results: HER2/neu expression was observed in 47.4% (46) cases in this study. Among which 28.9% cases were found strongly positive (Score 3+) and 18.6% cases were found weakly positive (Score 2+). The mean age of colorectal carcinoma patient was 50.54±14.32 years and the highest expression of HER2/neu was found in 21- 30 years age group. The tumor was mostly (66.0%) located in the colon whereas HER2/neu expression was more in rectum (54.5%). The tumor size was ³5 cm in 64.9% cases while positive expression of HER2/neu was more in tumors <5 cm in size (50.0%). No statistically significant correlation of HER2/neu expression was found with age, sex, tumor site and size. Conclusion: Expression of HER2/neu has been observed in nearly half of colorectal carcinoma patients with strongly positive in almost 29% cases. BIRDEM Med J 2023; 13(2): 81-87
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
There are many well-known causes of acute or sub-acute intestinal obstruction. But Pneumatosis cystoides intestinalis (PCI) is a rare cause and can easily be misdiagnosed. PCI refers to presence of air within the wall of small or large intestine. This benign disease having both idiopathic and secondary causes with different contributing pathogenic factors that confuses many doctors. In most of the time it is asymptomatic, but clinical signs and imaging impressions may mimic true abdominal visceral perforation or soft tissue stranding leads to mechanical obstruction. PCI is sometimes incidentally found during radiological evaluation, endoscopic procedure or laparotomy. Surgery is not recommended for PCI if there was no intestinal obstruction, because of high operative risk. So correct diagnosis is imperative as treatment of PCI is generally conservative. We are presenting a case of intestinal obstruction who underwent to laparotomy followed by the histopathological diagnosis as a case of PCI. KYAMC Journal Vol. 13, No. 03, October 2022: 177-180
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