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Background: Lung cancer is the most common cause of cancer-related death worldwide and unfortunately up to 80% of patients amongst newly diagnosed are inoperable therefore the cytological sample is often the only material available for diagnosis and assessment of molecular characteristics driving the treatment. Recently immunotherapy has shown promising results in tumors expressing Program Death Ligand 1 (PD-L1). The expression of PDL1 can routinely be detected by immunohistochemistry. However, the presence of several antibodies with different cut-off and the expression of this marker by normal immune cells are generating confusion in interpretation and the need for harmonization amongst pathologists. Materials and methods: We assessed the suitability of 74 consecutive cell blocks from cytology samples for PDL1 testing and evaluate the concordance between two different antibodies (Ventana assay SP263 and Dako 223C pharmDx assay) and amongst different pathologists from two different tertiary referral center for thoracic pathology. The degree of agreement was measured by Fleiss K statistic (FKS) for categorical scores after dichotomization based on specified cutoffs. A review of discordant cases was also performed. Results: Review of the slides stained with both antibodies showed substantial agreement within our department and moderate agreement with results from the other institution. Overall less than 10% of cases were deemed inadequate. Discordant cases showed a decreased amount of tumor cells, therefore, tumor heterogeneity could be responsible for the variation in the reading. Conclusions: Our results show overall concordance between the two antibodies and the suitability of cytology material for PDL-1 testing.

Eighteen patients with chronic hepatitis C virus infection (CHCV) were treated with three million units of interferon (IFN) three times a week for a minimum of six months. Four (22.2%) had completely responded, two (11.1%) had partial response and the rest (eight or 44.4%) did not show any evidence of response. After stopping treatment, patients who had a complete or partial response developed a relapse during the follow-up period. Few reversible adverse effects of treatment were reported in more than half of the patients. So, we conclude that three million units of IFN three times weekly is not recommended for treating patients with CHCV. Perhaps a larger dose of five to six million units should be tried and for a longer duration.

At the Riyadh Armed Forces Hospital (RAFH), 352 patients had gastroscopy and from each, antral gastric biopsies were taken for identification of Helicobacter pylori, by urease test and histopathology. In 217 (61.64%) of these 352 patients, the histology specimens showed Helicobacter pylori in 73.68% of patients with duodenal ulcer, 70% of patients with gastric ulcers and gastric erosions, 61% of patients with duodenitis and 52% of patients with gastritis. The urease test was positive at six hours in 164 (49.59%) of these 352 patients. The urease test was positive in 60% of each group of patients with endoscopic findings of gastric erosions, gastric ulcers and duodenal erosions.