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Introduction: Gastrointestinal polyps may be non-neoplastic or neoplastic lesions They are mostly asymptomatic and are common in the colon but may occur anywhere in the gastrointestinal tract Some polyps have an increased risk for malignancy so it is important to determine the histologic type and characteristics for treatment This study was undertaken to determine the histomorphological spectrum of polyps, their potential risk for malignancy and frequency in our center. Methods: This is a descriptive study which was carried out at Kathmandu Medical Colege Teaching Hospital for a period of three years from 1st January 2011 to 31st December 2013 A Total of 67 polypectomy specimens were received and processed in the Pathology Department Hematoxylin and Eosin stained slides were examined. Results: 47(701%) gastrointestinal polyps were non-neoplastic, 19(283%) were neoplastic and 1(16%) was an infracted polyp Most of the patients presented with rectal bleeding The age of patients for non-neoplastic and neoplastic polyps ranged from 3- 74 and 23- 78 years, respectively Amongst the non-neoplastic polyps, 21 (447%) were retention polyps, 14(2 98%) were inflammatory polyps, 10(21.3%) hyperplastic polyps, 1(2.1%) benign gastric polyp and 1(21%) non-categorized polyp The neoplastic polyps had 16(841%) adenomatous polyps, 1(53%) mixed polyp, 1(53%) fundic gland polyp and 1(53%) moderately differentiated adenocarcinoma 11(688%) adenomatous polyps had mild dysplasia, 2 (125%) moderate dysplasia and 3(187%) severe dysplasia Size of the non-neoplastic polyps ranged from 02-50cm and size of neoplastic polyps ranged from 03-60cm in diameter For patients presented with more than one polyps. Conclusion: Polyps have a diverse histomorphology and there is risk of malignancy in the adeomatous polyps so it is important to screen patients for treatment and cancer prevention. [ABSTRACT FROM AUTHOR]

Introduction: Megaloblastic anaemia is one of the important causes of anaemias It is a macrocytic anaemia resulting from abnormal maturation of hematopoietic cels due to faulty DNA synthesis Two vitamins, cyanocobalamin (vitaminB12) and folic acid are essential for DNA biosynthesis. Deficiency of either vitamin results in abnormal nuclear maturation with normal cytoplasmic maturation, apoptosis, ineffective erythropoiesis, intramedulary haemolysis, pancytopenia and typical morphological abnormalities in blood and marrow cels. Methods: This descriptive study was carried out for two and a half years (July 2011 to December 2013) in the department of Pathology, Star hospital, Kathmandu Nepal Out of 885 anaemic patients 55 diagnosed as megaloblastic anaemia were included in the study Complete blood count, reticulocyte count peripheral smear and bone marrow examination were performed Serum vitamin B12 and folic acid estimation was done in 32 cases. Results: Out of 55 cases of megaloblastic anaemia, 31 were female and 24 were male with a female to male ratio of 13:1 Age range was 18 to 80years Palor was the predominant clinical finding in these cases. Twenty cases (36.36%) presented with only anaemia while others presented with pancytopenia or bicytopenia Of the 55 cases of megaloblastic anaemia 32 had assays done for cobalamin and folate, of which 15 (46.88%) had cobalamin deficiency, 4 (12.5%) had folate deficiency and 13 (40.62%) had combined deficiency. Conclusion: Megaloblastic anaemia can present with varied clinical manifestations Strong suspicion of megaloblastic anaemia should be entertained by clinicians to improve clinical outcome Prompt diagnosis is important as it is a completely curable condition. [ABSTRACT FROM AUTHOR]

Introduction: Ovarian cysts are commonly encountered lesions. They are amongst the most frequent cause of hospitalization and surgery in gynecologic practice. One cannot confidently distinguish a benign lesion from a malignant one on the basis of clinical, radiological or gross characteristics alone so a histopathology examination is a must as it guides therapy. The study was undertaken to determine the morphologic spectrum of the cystic lesions of the ovary. Methods: This is a descriptive study which was carried out at Kathmandu Medical College Teaching Hospital for a period of two years from 1st January 2011 to 31st December 2012. A Total of 135 cases of ovarian cysts were received and processed in the Pathology Department. Hematoxylin and Eosin stained slides were examined. Results: Among the 135 ovarian cystic lesions, 119 cases (88.15%) were unilateral and 16 cases (11.85%) were bilateral. There were 59 cases (43.7%) of benign cysts, 69 cases (51.1%) of benign tumors, 5 cases (3.7%) of malignant tumors and 2 cases (1.5%) of borderline epithelial tumors. The age of patients ranged from 13 years to 73 years with mean age of presentation of 43 years. Among the ovarian cystic lesions the incidence of mature cystic teratoma was the highest (30%). The most common non-neoplastic cyst was endometriotic cyst (39%), while the most common benign tumor was mature cystic teratoma (58%). The malignant tumor encountered in the study was serous cystadenocarcinoma. Two cases of borderline epithelial tumors (1.5%) were also observed in the study. Conclusion: The most common cystic lesion that were encountered in the study was benign tumor followed by benign cyst. Of the benign tumors, mature cystic teratoma was the most frequently observed lesion. Among the non-neoplastic cysts, endometriotic cyst was the most frequently observed lesion. [ABSTRACT FROM AUTHOR]

Introduction: Skin tumors are not uncommon in the Nepalese community. Accurate diagnosis and categorization of these into different types is important because of its effect on prognosis and management. We conducted this study to find out the frequency of different histological types of skin tumors, correlate with their clinicopathologic profile and to determine the stage of malignant tumors., Methods: This is a descriptive cross-sectional study of skin tumors during the period February 2015 to January 2017. All the patients who were subjected to skin biopsy for skin tumors were included in this study. The biopsies taken were fixed in 10% formalin and then processed. Four microns thick sections were taken and stained with Haematoxylin and Eosin stain (H&E)., Results: Total of 108 cases of skin tumors were included of which 68 (62.97%) cases were histologically diagnosed as benign and 40 (37.03%) cases were diagnosed as malignant tumors. Keratinocytic tumors were predominant among both benign and malignant skin tumors., Conclusions: Histopathological examination is the gold standard for accurate diagnosis and prognostic assessment of the patient. Staging of the malignant tumors in excision biopsy specimen needs to be emphasized since it is a predictor of prognosis.

Introduction: Cancer of uterine cervix is a leading cause of mortality and morbidity among women worldwide. In developing countries it is the most common gynaecological cancer and one of the leading causes of cancer death among women. Pap smears are commonly used as cytological screening test for successful eradication of precancerous lesions, which has made it a routine procedure worldwide., Methods: This descriptive study was conducted at Kathmandu Medical College Teaching Hospital, Kathmandu within a period of two years from January 2011 to December 2012. A total of 1369 cases were screened., Results: In this study, cytological examination of the smears showed 944 (68.95%) inflammatory smears, 301(21.99%) normal smears, 101(7.38%) atrophic smears, seven (0.51%) ASCUS, two (0.15%) LSIL, four (0.29%) HSIL and two (0.15%) squamous cell carcinoma. Radiation changes were seen in three (0.22%) cases. Of all the smears studied five (0.36%) cases were inadequate. Regarding ethnicity, incidence of epithelial cell abnormalities was high in Tamang (5 cases). Eleven cases (73.33%) of epithelial cell abnormalities were seen in patients from urban areas., Conclusions: In country like Nepal with predominant rural population, screening and awareness programs with co-operation of media, non-government organizations and government should be formulated for early detection of cervical cancer.

Introduction: Bladder tumours constitute one of the most common urological conditions. Urothelial (transitional cell) carcinoma accounts for 90% of all primary tumours of the bladder. These tumours are an important cause of morbidity and mortality. The objective of this study was to present the histopathological patterns of urothelial tumours and to determine the grade and stage of these tumours., Methods: This is a 3 year descriptive study of urothelial tumours carried out in the Department of Pathology, Patan Academy of Health Sciences (PAHS), Lalitpur, Nepal. Data of all cystoscopic biopsies collected during this period were analyzed., Results: Of the 83 urinary bladder tumours, 81 (97.59%) cases were urothelial (transitional cell) tumours. Transitional cell carcinoma (TCC) was the most common bladder tumour which was seen in 67 (80.72%) cases. Thirty two (47.76%) cases of TCC were low grade while 35 (52.24%) were high grade. Forty three (64.18%) cases of TCC were superficial or in early stage (pTa and pT1) while 24 (35.82%) showed muscle invasion., Conclusions: Transitional cell carcinoma was the most common bladder cancer. Most of these tumours were high grade. A large percentage of high grade carcinomas presented with muscle invasion. Pathological grade and muscle invasion are the most valuable prognostic predictors of survival. The importance of including smooth muscle in the biopsy specimens needs to be emphasized.

Abnormal uterine bleeding is a common presenting complaint in gyanecology out patient department. Histopathological evaluation of the endometrial samples plays a significant role in the diagnosis of abnormal uterine bleeding. This study was carried out to determine the histopathological pattern of the endometrium in women of various age groups presenting with abnormal uterine bleeding. Endometrial biopsies and curettings of patients presenting with abnormal uterine bleeding was retrospectively studied. A total of 403 endometrial biopsies and curettings were analyzed. The age of the patients ranged from 18 to 70 years. Normal cyclical endometrium was seen in 165 (40.94%) cases, followed by 54 (13.40%) cases of disordered proliferative endometrium and 44 (10.92%) cases of hyperplasia. Malignancy was seen in 10 (2.48%) cases. Hyperplasia and malignancy were more common in the perimenopausal and postmenopausal age groups. Histopathological examination of endometrial biopsies and curettings in patients presenting with abnormal uterine bleeding showed a wide spectrum of changes ranging from normal endometrium to malignancy. Endometrial evaluation is specially recommended in women of perimenopausal and postmenopausal age groups presenting with AUB, to rule out a possibility of any preneoplastic condition or malignancy.

Ovarian cysts are an extremely common gynecological problem. Majority of ovarian cysts are benign with few cases being malignant. This is a retrospective study of all the cases of ovarian cysts operated in a tertiary hospital (Kathmandu Medical College, KMC) from January 2006 to December 2008. In this 3 years duration, 102 cases (2.0%) were of ovarian cyst out of the total histopathological specimen processed in pathology department. The mean age of presentation was 38years. Ovarian cysts (27.5%) were more commonly seen in the age group 21- 30 years. Bilateral ovaries were involved in 19 cases (18.6%). Among these ovarian cysts, 89 cases (87.3%) were benign and 13 cases (12.7%) were malignant. The most common type of ovarian cyst was serous cystadenoma (40.2%) followed by mature cystic teratoma (15.7%). Metastasis to ovary was seen in 6.9% (7 cases). The most common metastasis was adeno carcinoma from gastro intestinal tract (4 cases). Other metastases to ovary were 2 cases from endometrioid adeno carcinoma of endometrium and 1 case from Non Hodgkin's Lymphoma of small intestine.

Introduction: Cysticercosis is the larval manifestation of the cestode T. solium. It commonly presents as subcutaneous and intramuscular nodules which is often clinically misinterpreted as benign mesenchymal lesions and lymph nodes. Cysticerci in subcutaneous nodules can be diagnosed rapidly and with considerable accuracy by FNAC. This study highlights the cytomorphological features of subcutaneous cysticercosis diagnosed by FNAC., Methods: Forty three patients with palpable nodules diagnosed as cysticercosis or suspected as cysticercosis by FNAC between August 2005 to July 2008 were included in the study. Excision biopsy was done in 12 cases where definitive evidence of parasite was not found., Results: Solitary nodules were present in 36 (83%) patients and multiple nodules were present in seven (17%). In 31 cases (72.09%) definite evidence of cysticercus was found. In 12 cases (27.9%) a suggestion of parasitic inflammation was made based on other cytomorphological features which was confirmed by biopsy in eight cases., Conclusions: Human cysticercosis commonly presents as subcutaneous nodules which can be diagnosed with considerable accuracy by FNAC. Definite evidence and suggestion of parasitic inflammation on cytology obviates the need for subsequent histopathological examination.

Background: Fine Needle Aspiration Cytology (FNAC) is a simple and rapid diagnostic technique. Because of early availability of results, simplicity, minimal trauma and complications, the aspiration cytology is now considered a valuable diagnostic aid and is part and parcel of a pathologist's repertoire., Objectives: The aim of the study was to evaluate the results of fine needle aspiration cytology (FNAC) of lymph nodes in our institution in comparison to result of histopathology., Materials and Methods: The present study on 130 patients of lymphadenopathy was conducted in the Department of Pathology Kathmandu Medical College Teaching hospital, Kathmandu from June 2006 to May 2008 (2 years)., Results: In this series of FNAC cervical lymph nodes were 66 (50.76%), and axillary lymph nodes were 20 (15.38%). Male to female ratio of the patients was 1: 0.9. The age of patients ranged from 3 to 85 years. FNAC diagnosis was found to be as follows : reactive hyperplasia 54( 41.55%), tubercular lymphadenitis 36 (28 %), metastatic carcinoma 16 (12.3%), granulomatous lymphadenitis 12 ( 9.2 % ), lymphoma 8 (6%) and suppurative lymphadenitis 4(3%) . Out of 28 cases of FNAC 26 (92.85%) were consistent with histopathological diagnosis of tubercular lymphadenitis. In metastatic carcinoma to lymph nodes sensitivity and specificity of FNAC were 100% each., Conclusion: FNAC is useful and reliable in diagnosing neoplastic and non- neoplastic lesions of lymph nodes. It helps in planning surgery for malignant cases, where definitive operative intervention can be performed in one session.

Objectives: The aim of this study was to evaluate the diagnostic accuracy and efficacy of Fine needle aspiration cytology (FNAC) in various salivary gland swellings., Materials and Methods: This retrospective study was performed at Kathmandu Medical College Teaching Hospital (KMCTH) from January 2004- December 2006.During this period a total of 978 FNAC's were done out of which 40 FNAC's were on salivary gland swellings. Correlation was done between cytological smear slides and biopsy slides., Results: In this series of FNAC, 16 cases (40%) were benign neoplasms, 5 cases (12.5%) malignant neoplasms, non-neoplastic cysts 3 cases (7.5%) and inflammatory lesions 16 cases (40%).Histopathology was available in 24 cases out of which 22 cases correlated with cytology. There were no false positive reports but false negative result was seen in 4 cases. Sensitivity and specificity were 90% and 100% respectively., Conclusion: FNAC is useful in the diagnosis of salivary gland swellings especially in benign conditions with a sensitivity of 90% and specificity of 100%.

Objectives: The cytological findings of 50 ST Ts were evaluated aiming to determine the role of FNA in diagnosis of STTs, Methods: Fifty patients with soft tissue tumours underwent FNA in the preoperative investigation during a one year period. The smears were stained with Papanicolaou and May-Graunvald Giemsa stains., Results: Forty-four cases were reported as benign, whereas 2 were malignant. Four cases revealed insufficient material. The malignant STTs were small round cell tumour and malignant spindle cell tumour. Cytological and histological correlation could be achieved in 40 cases. The overall sensitivity and specificity were 25% and 100% respectively with overall accuracy of 80%., Conclusion: A reliable diagnosis of STTs can be made with FNA when supported by other clinical and other diagnostic data.