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Objective: To evaluate the NKX3.1 expression by immunohistochemistry in normal testicular parenchyma and in Sertoli cell tumours and Sertoli Leydig cell tumours of the testes and ovary. Study Design: Retrospective longitudinal study. Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore Pakistan, from 20102021. Methodology: We used immunohistochemistry to evaluate the positivity and loss of nuclear expression of NKX3.1 in the Sertoli cell tumour (11 cases), Sertoli Leydig cell tumour (31 cases) and in normal testicular parenchyma (7 cases). Results: In our study, there were 49 cases. All the cases of benign testicular parenchyma expressed positivity with nuclear staining of NKX 3.1 in Sertoli cells. Two out of 11 Sertoli cell tumours expressed positivity with nuclear positivity of NKX 3.1 in Sertoli cell component (18.18%) and 9 of the cases showed loss of staining of NKX 3.1 (81.8%). All Sertoli Leydig cell tumours showed loss of staining of NKX 3.1. Conclusion: Nuclear expression of NKX 3.1 is seen in Sertoli cells of normal testicular parenchyma. This staining is lost in Sertoli cell tumours and Sertoli Leydig cell tumours. [ABSTRACT FROM AUTHOR]

Objective: To investigate the incidence ERG fusion positive adenocarcinoma and its correlation with gleason grade and gleason group. Study Design: Cross-sectional study. Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital & Research Centre (SKMCH & RC), Lahore Pakistan, from Jan 2018 to Jan 2019. Methodology: A total of 100 cases of prostatic adenocarcinoma were retrieved and ERG immunohistochemical stain was applied on all these cases. ERG expression, extent of staining, percentage of tumor cells positive for ERG, pattern of staining was recorded. We found out relationship of ERG expression and gleason grade/gleason group. Results: ERG expression was seen in 62/100 (62%) cases. Mean patient age of ERG positive prostatic adenocarcinoma patients was 69.68 years. In GG1 (14.5%) 9 cases exhibited ERG positivity. In GG2-3, 41.93% cases and in GG4-5, 43.54% cases showed ERG expression. Conclusion: To conclude, age of presentation of ERG positive adenocarcinoma was high. ERG expression was seen in 62% of our cases which was much higher than reported in other Asian countries. In our study we found a significant correlation between ERG expression and high gleason grade group. [ABSTRACT FROM AUTHOR]

Objective: To assess the sensitivity and specificity of DOG 1 in the diagnosis of chondroblastomas. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Histopathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, from Jun 2015 to Jul 2017. Methodology: Total fifty-two patients were included in this study using simple random sampling technique including 19 chondroblastomas, 21 giant cell tumors and 12 chondromyxoid fibromas. DOG 1 antibody was applied on all the cases. Results: DOG 1 was positive in 100% of cases of chondroblastomas. However, intensity and proportion of staining pattern was variable among them. Fifteen (78%) cases showed diffuse moderate to strong expression while 4 (22%) cases showed focal weak expression. Only 2 (10%) cases of giant cell tumors and 4 (33%) cases of chondromyxoid fibromas expressed focal weak expression for DOG 1. Conclusion: This study confirms 100% expression of DOG 1 in cases of chondroblastomas but intensity and proportion of staining pattern was variable. Therefore DOG 1 may prove to be a useful immunohistochemical marker for diagnosis of chondroblastomas in the future in difficult cases in correlation with histological and radiological features. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the use of Ki67 as a surrogate marker for Mitotic Karyorrhectic Index (MKI) in Neuroblastoma. Study Design: Cross-sectional study. Place and Duration of Study: This was a retrospective study conducted at Department of Histopathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. 41 cases of neuroblastoma from 2010 to 2014 were retrieved. Methodology: Forty one cases of neuroblastoma were evaluated. Clinical and morphological features like age, gender and subtype of tumor were quantified. For each case, Mitotic Karyorrhectic Index was calculated and categorized as low, intermediate and high. This was followed by immunostaining for Ki67 on each case. Using linear regression model an equation was derived to calculate ki67 from Mitotic Karyorrhectic Index. The equation was as follows: Mitotic Karyorrhectic Index = (Ki67 x 0.115) ± 1.355. Using this equation, the cut-off values for low, intermediate and high Ki67 were <5.60%, 5.60% - 23.0% and >23.0% respectively. Results: Twenty four cases had low Mitotic Karyorrhectic Index and in 18/24 cases, Ki67 was also low. There were 5 cases with intermediate Mitotic Karyorrhectic Index with two cases showing correspondingly intermediate Ki67 index. There were 12 cases with high Mitotic Karyorrhectic Index and 10/12 cases showed a high Ki67 index as well. Conclusion: Ki67 is a useful technique and may be used as an adjunct to Mitotic Karyorrhectic Index for better evaluation of cases. [ABSTRACT FROM AUTHOR]

Objective: To stratify diffuse gliomas into subtypes including diffuse astrocytomas, oligodendrogliomas and glioblastomas based on recent molecular updates and assess their frequencies in our local subpopulation. Study Design: Cross-sectional study. Place and Duration of Study: Department of Histopathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, from Jun 2015 to Jul 2017 Methodology: Two hundred and fourteen (n=214) cases of adult diffuse gliomas were evaluated. Clinical and morphological features like age, gender and type of tumor were quantified. Molecular studies including IDH 1 by antibody and PCR, ATRX by antibody and 1p/19q co-deletion by FISH were tested. Gliomas were subcategorised based on WHO 2016 guidelines. Results: Mean age of presentation was 39 years. Overall n=146/214 (68.2%) of the cases were completely classifiable including Diffuse Astrocytomas, Oligodendrogliomas and Glioblastomas. Out of the glioblastomas (n=81), 67/81(n=82.7%) were IDH Wild type and 14/81 (17.3%) were IDH Mutant. Conclusion: In this study, glioblastomas are the most frequent gliomas as categorized by current WHO molecular guidelines followed by diffuse astrocytomas. Oligodendrogliomas are the least common. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: to determine unusual morphological features and a panel of immunohistochemical markers to diagnose Xp11 translocation carcinoma. Study Design: Retrospective longitudinal study. Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital, Lahore Pakistan, from Jun 2015 to Feb 2020. Methodoldogy: We analyzed clinicopathological features, and evaulated intensity and extent of TFE 3 immunoreactivity of 18 cases with suggested diagnosis of xp11 translocation associated renal cell carcinoma from 2015-2020. Results: Different morphological pattern includes papillary (8/18, 44%), nested (2/18, 11.1%), alveolar (3/18, 16.7%), nested and papillary (3/18, 16.7%), solid and nested (1/18, 5.6%), cystic and nested (1/18, 5.6%). Four cases show papillary architecture with a linear array of nuclei away from the basement membrane, a pattern seen in SFPQTFE3 renal cell carcinoma and NONOTFE3 renal cell carcinoma. Strong nuclear TFE3 expression was seen in 9/18 (50%) cases. Cathepsin k expression was seen in 6/11 (54%) cases, Ck7 was focal weak positive in 4/12 (25%) cases, PAX8 was positive in 8/8 (100%) cases, and CA IX was focal weak positive in 1/5 (20%) case. According to follow-up data, disease progression was seen in only one case with the lowstage disease. No death was reported due to renal cell carcinoma to date of follow-up. Conclusion: We have suggested that young patient age, unusual morphological features and an immunohistochemical panel may help reach the diagnosis in countries with limited resources. [ABSTRACT FROM AUTHOR]