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S Pervez

Publications and source records attributed to S Pervez.

At least 37 records · Page 2Linked to original sources
PubMed2001

Immunohistochemical cathepsin-D expression in breast cancer: correlation with established pathological parameters and survival.

Breast cancer is an increasingly important cause of illness and death among women. In recent years, several novel prognostic determinants of breast cancer have been identified, including Cathepsin-D (CD) protein. CD protein expression was analyzed immunohistochemically (IHC) in tumor specimens (315 patients) of infiltrating ductal breast carcinoma. These patients also had axillary lymph node sampling. Overexpression of CD was observed in 39% of the tumors. IHC results were compared with the histological grade. Seventy nine percent (n = 95; 79%) tumor positivity was seen in grade II tumors, followed by grade I (n = 13; 11%) and grade III tumors (n = 12; 10%). Axillary lymph node metastasis had no significant correlation with CD positivity (p > 0.05). Bone metastases were significantly correlated with CD positivity (p < 0.05). CD positivity showed no significant correlation with disease-free and overall survival (p > 0.05). At a median follow-up of 48 (4 years) months in CD-positive patients, overall survival was 3.17 years, and disease-free survival 2.67 years. The overall survival of CD-negative tumor patients was 3.50 years, and disease-free survival was 2.93 years. We conclude that in comparison with cytosol-based quantitative studies, CD expression is not a good prognostic marker when, as in all ICH studies, only the expression in the tumor is considered.

Adult↗
PubMed2001

Flow cytometric analysis of childhood leukemias.

OBJECTIVE: To collect demographic data for childhood (less than 15 years) leukemias in Karachi, describe the accuracy of the cell surface markers routinely used in the flow cytometric analysis of leukemic cells and arrive at an ideal panel of antibodies for analyzing leukemic samples. MATERIALS AND METHODS: Data from 62 consecutive cases of childhood leukemias referred to the Department of Pathology, Aga Khan University Hospital, (AKUH) between January 1995 and December 1998 was analyzed using Epi Info Version 6. Flow cytometry on all samples was performed using standard protocols. RESULTS: The mean age of patients was 8.2 years and 49 (79%) were males. Fifty (81%) had acute lymphoblastic leukemias of which 50% were CD10 positive and 24% CD10 negative Pre-B cell leukemias. Among all Pre B cell All 98% were positive for CD19, 96% for CD22, 89% for HLA-DR and 67% for CD10. Of the 10 AML cases, 100% were positive for CD33, 90% for CD13, 80% for CD19 and 70% for HLA-DR. CONCLUSION: The mean age in this study population was significantly higher and percentage of CD10 positive Pre-B All is lower than that in the West. Both these factors might be responsible for the poorer prognosis of these patients. It is not possible to specify a minimum or maximum panel of antibodies that should be used for phenotyping all cases of childhood leukemias. A certain degree or redundancy is essential in any panel of antibodies used for flow cytometry of leukemias.

Acute Disease↗
PubMed2001

Histological pattern of central nervous system neoplasms.

OBJECTIVE: To see in a large series of patients the histological pattern of CNS neoplasms and to provide a comprehensive data about the frequency of CNS neoplasms in Pakistani patients and to give a clearer idea about their prevalence. METHOD: Retrospective study of all consecutive cases of CNS neoplasms diagnosed at The Aga Khan University Hospital (AKUH) between 1st January, 1994 and 31st December, 1999. SETTING: The section of Histopathology, AKUH, Karachi. OBSERVATION: Our series included a large number of cases i.e., 1110. There are very few local studies on CNS tumours and none so large. Our data was correlated with published Western and Pakistani data. Glial tumours were the commonest primary CNS neoplasms followed by meningiomas. Among glial tumours, astrocytomas comprised the largest group and the majority were high grade (III and IV) astrocytomas. Percentages of anaplastic oligodendrogliomas and ependymomas were also significant. Male to female ratio was 1.6:1. However, meningiomas were more common in females. Almost half of the CNS tumours in patients 15 years or younger were in the posterior cranial fossa. Metastatic tumours were much lower as compared to the West. CONCLUSION: Except for the high percentages of anaplastic oligodendrogliomas and ependymomas and the low percentage of metastatic tumours, most of our findings roughly correspond with the published data.

Adolescent↗
PubMed2001

Morphological pattern of salivary gland tumours.

OBJECTIVE: To delineate the spectrum of salivary gland tumors in our setup. SETTING: The Aga Khan University Medical Centre, Karachi. METHOD: Tumors were analysed considering histological type, age and sex of the patients and anatomic location. The diagnosis of individual tumours was based on the 1991 World Health Organisation Classification. RESULTS: During the span of eight years (1991-1998), 379 cases of salivary gland tumours were diagnosed. Of these, 205 (65.7%) were male and 174 (34.3%) were female. The median age at the time of diagnosis was 35 years. The median age for patients with malignant lesions (44 years) was 12 years older than those with benign tumours (34 years). Overall, malignant tumours were seen more frequently in males, however benign tumours were distributed equally between the two sexes. The most common site was parotid gland (82.85%). Only five cases of minor salivary gland tumours were seen. The most frequently diagnosed benign salivary gland neoplasm was pleomorphic adenoma (84.5%), followed by Warthin's tumours (6.18%), Mucoepidermoid carcinoma was the most commonly encountered malignant lesion (56.9%), followed by adenoid cystic carcinoma (19.6%). CONCLUSION: Plemorphic adenoma was the most common benign salivary gland tumour and mucoepidermoid carcinoma was the most frequent malignant neoplasm. Parotid gland was the most common site of origin in both benign and malignant tumours. The overall relative frequency of salivary gland tumours in this series correlates with that reported in the international literature.

Adenoma, Pleomorphic↗
PubMed2001

Relationship of p53 expression with clinicopathological variables and disease outcome: a prospective study on 315 consecutive breast carcinoma patients.

Breast cancer is an increasingly important cause of illness and death among women. In recent years several novel prognostic determinants of breast cancer have been identified which includes p53. Alterations of p53 are one of the most common abnormalities detected in primary breast cancer. In this study alteration of p53 in primary carcinoma breast was correlated with other pathological variables and disease outcome. In this prospective study the expression of p53 oncoprotein was analyzed immunohistochemically on 315 patient's tumour specimens of infiltrating ductal carcinoma of breast from 1992 to 1997. These patients also had axillary lymph nodes sampling. Both univariate and multivariate statistical analysis was performed to analyze results including disease outcome. Overexpression of p53 was observed in 55.23% tumours. Axillary lymph node metastasis had significant correlation with positivity of p53 (p<0.05). A significant number of p53 patients developed local recurrence and distant metastases to brain, liver, lung and bone (p< 0.05). At a median follow-up of 48 months (4 years) in p53 positive patients, the median overall survival (OS) was 3.0 years and disease free survival (DFS) was 2.5 years. p53 negative tumour patients showed a better survival. In this group the median OS was 3.8 years and the DFS was 3.3 years. The above findings have reinforced the view that p53 immunohistochemical detection is of help in detecting a subgroup of breast carcinoma patients who are at high risk. This may also be of particular relevance in decisions regarding adjuvant chemotherapy to these patients.

Antineoplastic Agents↗
PubMed2000

Incidental prostate cancer: the importance of complete prostatic removal at cystoprostatectomy for bladder cancer.

Patients with invasive bladder cancer could be at a higher risk for a second malignancy such as an unsuspec- ted prostate cancer. We report a case of muscle-invasive transitional cell carcinoma of the urinary bladder with incidental adenocarcinoma of prostate, and review the literature to highlight the importance of complete prostatic removal to prevent residual disease.

Adenocarcinoma↗
PubMed2000

Frequency of malignant solid tumors in children.

OBJECTIVE: To find out the frequency of malignant solid tumors in children (< 15 years). SETTING: All cases of pediatric malignant solid tumors which were diagnosed in the section of histopathology at the Aga Khan University Hospital, Karachi during the period of two years. METHODS: These tumors were initially evaluated on H&E stained sections and special stains were also performed whenever indicated. The undifferentiated tumors were evaluated immunohistochemically by using a panel of antibodies on sections from routinely processed, formalin fixed, paraffin embedded tissue blocks. RESULTS: Of two hundred and fifty three (253) consecutive cases of paediatric malignant solid tumors, lymphoma (26.1%) was the most common tumor followed by central nervous system tumors (16.6%), osteosarcoma (7.5%), rhabdomyosarcoma (6.7%), neuroblastoma (5.1%), Wilm's tumor (5.1%), Ewing's sarcoma (4.7%), retinoblastoma (4.7%), germ cell tumor (4.4%) and primitive neuroectodermal tumor (4%) in order of frequency. In seven cases (2.8%), the nature of lesion remained undetermined even after immunohistochemical staining. Rest of malignant tumors (12.3%) included the rare entities like synovial sarcoma, nasopharyngeal carcinoma, leiomyosarcoma, malignant schwannoma and thyroid carcinoma, etc. CONCLUSION: Lymphoma was the most frequent Paediatric tumor. The frequency of childhood central nervous system tumors was quite high as compared to the other series from different regions of Pakistan.

Adolescent↗
PubMed2000

Childhood non-Hodgkin's lymphoma: an immunophenotypic analysis.

OBJECTIVE: To observe the frequency of histological subtypes of childhood non-Hodgkin's lymphoma and its immunohistochemical profile. SETTING: All cases of non-Hodgkin's lymphoma diagnosed in children (< 15 years) in the section of histopathology at the Aga Khan University Hospital Karachi during the period of three years. METHODS: These consecutive cases were evaluated on H&E stained sections and then immunohistochemistry analysis of these tumors was performed by employing Peroxidase Anti-Peroxidase (PAP) technique. RESULTS: The present series included 61 cases of non-Hodgkin's lymphoma. NHL was more common in males as compared to females with male to female ratio of 5.8:1. High grade NHL comprised 87% of childhood lymphoma. The mode of presentation in majority of NHL (57%) was extranodal. Burkitt's lymphoma (33%) was the most prevalent histological subtypes, followed by lymphoblastic (28%), diffuse large cell (15%), diffuse mix small and large cell (13%), small non cleaved Non-Burkitt's (7%) and immunoblastic (4%). Immunophenotypic analysis of the childhood Non-Hodgkin's lymphoma revealed that 67% of the Non-Hodgkin's lymphoma are B-cell type while 33%, are those of T-cell lineage. CONCLUSION: NHL was more common in males. Majority of NHL in children were high grade tumors. Burkitt's lymphoma was the most frequent histological subtype. T-cell NHL comprised a significant portion of childhood lymphomas.

Adolescent↗
PubMed2000

Audit of lymph node biopsies in suspected cases of lymphoproliferative malignancies: implications on tissue diagnosis and patient management.

AIMS: To carry out an audit ascertaining the importance of condition of lymph node specimen, submission of clinical history including site of biopsy and immunohistochemical studies on conclusiveness of diagnosis made. METHODOLOGY: Computer records of the Aga Khan University Hospital, Histopathology Laboratory were used to analyze all cases of lymphoproliferative malignancies presented at the hospital from 1992 to 1998. RESULTS: Out of a total of 466 cases studied, in 283 (61%) the lymph nodes were fragmented. The site of biopsy was mentioned in 361 (77.5%) cases with the cervical region forming the most common site (56.5%). A clinical history was submitted in 395 (85%) and a conclusive diagnosis was reached in 378 (81%) cases. CONCLUSION: This audit indicates a strong co-relation between the condition of lymph node biopsies received, clinical history of the patient submitted including site of biopsy, ancillary studies like IHC performed on the eventual outcome in the form of precise diagnosis and categorization of lymphoproliferative malignancies.

Adolescent↗
PubMed2000

DNA ploidy analysis of borderline epithelial ovarian tumours.

OBJECTIVE: Borderline epithelial ovarian tumours not uncommonly pose a great difficulty to surgical pathologists as morphologically they may show very similar features as those of malignant epithelial tumours except invasion. However it is important to separate these from their invasive counterparts because of their superior prognosis. Recently, attention has been focussed on the prognostic value of flow cytometric analysis of DNA ploidy in borderline epithelial ovarian tumours. The purpose of this study is to investigate whether flow cytometric analysis of cellular DNA content acts as a useful adjunct to the histopathological diagnosis of borderline malignancy. MATERIALS AND METHODS: Fifteen histologically confirmed borderline serous epithelial tumours of the ovary were selected. Samples were analyzed on a FACScan flow cytometer using the software MODFIT. A total of 10,000 nuclei were counted each time. RESULTS: The mean CV for the 15 cases was 3.67 (Range 2.4-5.0). In the DNA histograms a diploid sample was defined as one that had a single Go/Gl peak. An aneuploid tumour was defined as one that displayed an additional distinct peak. All 15 cases of borderline serous epithelial tumours showed a diploid stemline with DNA index between 0.9-1.10. CONCLUSION: This study suggests that aneuploidy if ever demonstrated in histologically confirmed borderline tumours should prompt extensive sampling of the tumour and a close follow up.

Aneuploidy↗
PubMed2000

Retinoblastoma tells the story of our health care system.

OBJECTIVE: To review cases of retinoblastoma. SETTING: Department of Pathology Aga Khan University Hospital Karachi. METHOD: Twenty-three specimens from cases of retinoblastoma received over a period of eight years were routinely processes and stained with haematoxylin and Eosin stain. Other stains were used for tuberculoses and melanin. Immunochemistry was resorted to in undifferentiated tumors. RESULTS: Over 60% cases of retinoblastoma were diagnosed after 5 years and nine cases showed involvement of optinerve. CONCLUSION: Late diagnosis of retinoblastoma effects the stage of the tumors and the prognosis.

Child, Preschool↗
PubMed2000

Central nervous system lymphomas: a histologic and immunophenotypic analysis.

OBJECTIVE: To observe the spectrum of non-Hodgkin's lymphomas involving the central nervous system including morphological subtypes and immunophenotypic status. SETTING: Retrospective analysis of eleven years (1986 to 1996) data from surgical pathology files of Department of Pathology. RESULTS: Forty-three cases of non-Hodgkin's lymphomas were diagnosed during the period of eleven years (from 1986 to 1996), all of which were diffuse types. A total of 1177 Central Nervous CNS biopsies were examined, out of which 937 cases were diagnosed as CNS neoplasms, the remaining were non-neoplastic in nature. Among 937 CNS neoplasms, 43 cases (4.6%) were reported as non-Hodgkin's lymphomas. As most of the cases were outside referrals, the primary or secondary nature of the lymphomatous process could not be assessed. Seventeen cases were intracranial, while 26 cases were spinal in location. Majority of the intracranial lymphomas were biopsied from the cerebrum (12 cases). Male to female ratio was 1:2. The median age for intracranial lymphomas was 50 years and for spinal lymphomas 29 years. There were 16 cases (37%) of diffuse large cell lymphomas; 7 cases (16%) of diffuse mixed small and large cell lymphomas; 3 cases (7%) of diffuse large cell immunoblastic lymphomas; 2 cases (4.6%) of lymphoblastic lymphomas and diffuse small non-cleaved cell lymphomas and one case of small lymphocytic lymphoma and diffuse small cleaved cell lymphoma. One case of T cell rich B cell lymphoma was also diagnosed in the thoracic spine as primary extranodal lymphoma. Eight cases were unclassifiable and in 2 cases the features were suggestive of lymphoma. Immunophenotypic analysis was performed in 20 cases, however, in 2 cases the results were inconclusive. Fifteen cases (83%) showed immunoreactivity for B cell markers and 3 cases showed T cell phenotype out of which one case was lymphoblastic lymphoma. CONCLUSION: CNS lymphomas were uncommon tumors and comprised 4.6% of the total CNS neoplasms in our study. Moreover, these CNS lymphomas accounted for 2.2% of the total non-Hodgkin's lymphomas, including both nodal and extranodal. There was a higher incidence of location of these lymphomas within the spinal cord than brain. Most of the lymphomas were of intermediate or high grade (75%) according to the working formulation. Immunophenotypical status revealed B-cell phenotype in 84% of the lymphomas, in which it was tested (JPMA 50:141, 2000).

Central Nervous System Neoplasms↗
PubMed1999

T cell rich B cell lymphoma (TCRBCL): study of sixteen cases with review of literature.

T cell rich B cell lymphoma (TCRBCL) is a recently described variant of diffuse non Hodgkin's lymphoma (NHL), the acronym of which has gained wide acceptance among hematopathologists in a relatively shorter period of time. The recognition of this entity requires immunohistochemical facilities especially on paraffin embedded tissues. TCRBCL is one of the many examples in the diagnostic anatomic pathology which emphasizes the need of immunocytochemistry and availability of this technique at least in referral laboratories. One of the differential diagnosis in this case includes lymphocyte predominance Hodgkin's disease (LPHD) which is the most favorable prognostic histologic subtype of Hodgkin's disease (HD) while TCRBCL is an aggressive B Cell NHL and should be treated as high grade large cell lymphoma. The other close differential includes peripheral T cell non-Hodgkin's lymphoma (PTCL). We reported sixteen (16) cases of TcRBCL diagnosed during a period of two and a half years (January 1995 to June 1997). HD and PTCL were the main differential diagnoses in most of these cases. The median age at diagnosis was 39 years and male to female ratio was equal. TCRBCL was nodal in location in 15 cases and a single case in extranodal site presenting as spinal tumor. The mean neoplastic B cell population was 12%, while that of reactive T cells was 82%. A significant polymorphous inflammatory cellular background was noted in 5 cases. Reed-Stenberg like cells were observed in 3 cases. Immunoglobulin light chain restriction studies were performed in fourteen cases and revealed lambda light chains in ten cases while in four cases kappa light chains were present.

Adolescent↗
PubMed1999

Immunohistochemical evaluation of small round cell tumors of childhood.

OBJECTIVE: This study was done to evaluate the pediatric undifferentiated small round cell tumors with immunohistochemical staining. SETTING: The present study included consecutive cases of small round cell tumors which were diagnosed in children (< 15 years) in the section of Histopathology at the Aga Khan University Hospital, Karachi during the period of two years. METHODS: The group of undifferentiated small round cell tumors were evaluated immunohistochemically by using a panel of antibodies on sections from routinely processed, formalin fixed, paraffin embedded tissue blocks. RESULTS: The category of undifferentiated small round cell tumors included rhabdomyosarcoma (23.2%), primitive neuroectodermal tumor (17.9%), non-Hodgkin's lymphoma (16.1%), neuroblastoma (14.2%), Ewing's sarcoma (10.7%) in order of frequency. Osteosarcoma (Small cell variant), retinoblastoma and medulloblastoma comprised 1.8% each. In seven cases (12.5%), the immunohistochemical analysis was inconclusive. CONCLUSION: Immunohistochemistry is a very valuable diagnostic tool which helps in distinguishing the undifferentiated tumors especially small round cell tumors. The immunohistochemical staining needs to be performed routinely for undifferentiated tumors in diagnostic histopathology.

Adolescent↗
PubMed1999

Clinico-morphological pattern and frequency of bone cancer.

OBJECTIVE: The present study was done to find out the frequency of malignant tumors of bone and to categorize the prevalence of various histological types of osseous malignancies with respect to age, sex and site of origin. SETTING: This study included consecutive cases of malignant bone tumors, which were diagnosed in the department of pathology at the Aga Khan University Hospital, Karachi during the period of three years (1995-1997). METHODS: These tumors were initially evaluated on H & E stained section from paraffin embedded tissue blocks. Special stains and immunohistochemical analysis was performed whenever required. RESULTS: A total of 169 malignant bone tumors were diagnosed during the study period. Metastatic tumors accounted for 28.4% of all malignant tumors of bone. Osteogenic sarcoma (27.2%) was the most frequent primary tumor of bone followed by Ewing's sarcoma (12.4%), Non-Hodgkin's lymphoma (10.6%), Chondrosarcoma (8.3%), Plasma Cell Myeloma (8.3%) and other rare entities (4.8%) in order of frequency. CONCLUSION: The most common malignant neoplasm diagnosed in osseous biopsies was metastatic tumors. Osteogenic sarcoma was the most frequent primary bone tumor in this series. The bone tumors were relatively more prevalent in males. The frequency of malignant bone tumor was relatively high as compared to developed countries.

Adolescent↗
PubMed1999

Spectrum of Hodgkin's disease in children and adults: impact of combined morphologic and phenotypic approach for exclusion of "look-alikes".

OBJECTIVE: To determine the prevalence of Hodgkin's disease (HD) and its various subtypes in children and adults and assess the use of immunohistochemical (IHC) studies in confirming HD cases and excluding its close mimicries/look-alikes. MATERIAL AND METHODS: All 265 Hodgkin's disease cases diagnosed at The Aga Khan University Hospital, Karachi over the last 6 years (July 1991-July 1997) were included. Of these 219 were diagnosed on routine H&E examination while in the remaining 46 cases, diagnosis was made after a thorough IHC workup. (This group initially included 161 cases labelled as lymphoproliferative disorder with HD as one of the differentials). RESULTS: Out of a total of 265 HD cases (206) 78% were males and (59) 22% were females in a ratio of 3.5:1.26% (69) cases were < 15 years while 74% (196) were > 15 years old. In both age groups, the commonest subtype proved to be Mixed Cellularity (MC) (60% of < 15 years old and 40% of > 15 years old) followed by Nodular Sclerosing (NS) (20% of < 15 years old and 27% of > 15 years old). Lymphocyte Predominant (LP) and Lymphocyte Depleted (LD) were seen less frequently. With the help of IHC studies performed on 161 cases in which HD was part of the differential diagnosis, 46 were conclusively diagnosed as HD. In the rest of the cases the main different was Non-Hodgkin's Lymphoma (NHL) that accounted for 72 of the cases. CONCLUSION: This study shows that the most common sub-type of HD in our series in MC followed by NS. This study also suggests reasons why the more aggressive sub-type MC is predominant in Third world countries like ours compared to the better prognostic NS seen more in developed countries and why LP and LD are less and less commonly diagnosed.

Adolescent↗