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M S Fernando

Publications and source records attributed to M S Fernando.

15 recordsLinked to original sources

Comparison of the pathology of cerebral white matter with post-mortem magnetic resonance imaging (MRI) in the elderly brain.

White matter lesions (WML) on magnetic resonance imaging (MRI) brain scans are associated with ageing. They are unrelated to specific disorders, and their impact on cognitive and other brain functions is poorly characterized. Pathological studies often omit systematic survey of WML because of the need to study multiple full coronal tissue blocks, and uncertainty over the significance of lesions identified in periventricular and deep subcortical regions. Post-mortem MRI provides a means of mapping WML but the sensitivity and specificity of the method are unresolved. In this study post-mortem MRI of WML in fixed brain slices was compared with pathology in 33 brains donated to the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS). This study shows that MRI detection of WML was less sensitive than pathology: periventricaular lesions (PVL) sensitivity = 95% (87-99%), specificity = 71% (44-90%); deep subcortical lesions (DSCL) sensitivity = 86% (79-93%), specificity = 80% (72-88%). False negative MRI was associated with milder pathology, but lesions detected by myelin attenuation alone showed both microglial and endothelial activation. Therefore post-mortem MRI of formalin-fixed brain slices is a reliable method to obtain systematic data on the severity and distribution of cerebral white matter disease, and appears to detect those WML most likely to have clinical impact.

Aged↗

Cytohistologic features of invasive micropapillary carcinoma in a young female.

Invasive micropapillary carcinoma (IMPC) is a recently reported variant of breast carcinoma in women. There has been only a single report describing the cytologic features of IMPC in the literature. We report on the cytohistologic features of IMPC with diffuse involvement of two quadrants of the breast and axillary lymph node metastases in a 32-yr-old female. The cytologic appearance of IMPC was characterized by high cellularity, marked cell discohesion, and epithelial cells forming aggregates, morules, and angular and papillary clusters without fibrovascular cores and showing high nuclear/cytoplasmic ratio, irregular nuclear contours, and finely stippled chromatin. Occasional psammoma bodies were noted. Histologic examination showed a pure IMPC composed of clusters, morules, and aggregates of malignant epithelial cells surrounded by distinctly clear spaces separated by thin fibrovascular septa. The tumor involved both inner quadrants and axillary lymph nodes. A primary tumor elsewhere, particularly in the ovaries, was excluded. The patient has been disease-free 38 mo after the initial diagnosis.

Adult↗

Comparison of some clinical and histological features of colorectal carcinoma occurring in patients below and above 40 years.

OBJECTIVE: To determine the clinicopathological features of colorectal malignancies in Sri Lankan patients aged 40 years or younger, and to compare them with those of older patients. METHODS: The clinicopathological features of 60 colorectal malignancies which occurred in patients aged 40 years or younger were compared with 245 malignant colorectal tumours in older patients. These tumours had been diagnosed at a University Department of Pathology over 15 years. RESULTS: 19.7% of colorectal malignancies occurred in patients aged 40 years or younger. (Male:Female ratio = 1.6:1). The mean duration from onset of symptoms to diagnosis was 4.2 months. There was no statistically significant difference between young and old patients in the presenting symptoms, site of tumour and Dukes' staging of colorectal malignancies. A statistically significant proportion of tumours in young patients was mucoid (13.3%) or signet ring cell (5%) type. 3.3% of young patients with colorectal carcinoma gave a family history of similar malignancy. A history of predisposing conditions (ulcerative colitis) was present in 3.3% of young patients. CONCLUSIONS: The clinical presentation of colorectal malignancies in Sri Lankan patients below 40 years of age does not differ from that in older patients. Mucoid and signet ring cell carcinomas are commoner in the young.

Adult↗

Breast cancer: do histopathology reports provide adequate information for patient care?

INTRODUCTION: Many studies have shown that certain pathologic features correlate with risk of recurrence, development of nodal and distant metastases, long term survival and multicentricity of breast carcinoma. Such information is useful in selection of appropriate therapy and prognostication. OBJECTIVE: To determine the proportion of histopathology reports of breast carcinoma that provide essential pathologic prognostic information. METHOD: All (110 mastectomy and 25 lumpectomy) cases of breast carcinoma reported during 79-month period from January 1992 were assessed for inclusion of tumour size, information on excision margins and 8 microscopic features. Mastectomy reports were evaluated for information on axillary lymph node status. RESULTS: 9.6% of reports assessed included all relevant features. All 110 mastectomy reports gave information on axillary lymph node status. Tumour size was included in 91.1% of reports. Excision margins were commented on in 36% of lumpectomy reports. Of the microscopic features assessed, tumour type was included in 98.5% and histologic grade in 66.7%. In formation on other features ranged from 28.1% for inflammatory infiltrate at the tumour-host interface to 69.1% for nipple invasion. CONCLUSION: Reporting on basic prognostic information falls short of the ideal. Provision of guidelines will help to ensure the inclusion of relevant histopathologic prognostic information.

Breast Neoplasms↗

Prevalence of prostatic intraepithelial (PIN) in surgical resections.

OBJECTIVES: To determine the prevalence of prostatic intraepithelial neoplasia (PIN) in surgical specimens and assess its relationship to adenocarcinoma. METHOD: 205 surgical specimens (191) transurethral resections, 6 open prostatectomies, 8 needle biopsies) reported at the University Department of Pathology, Colombo over 64 months were reviewed. RESULTS: There were 170 benign hyperplasias and 35 adenocarcinomas. PIN I was present in 22.92% PIN II in 5.36% and PIN III in 7.32% of the specimens. 8.51%, 27.27% and 93.3% PIN I, PIN II and III were associated with invasive adenocarcinoma. Nine cases (4.39%) had high grade PIN (PIN II & III) in the absence of adenocarcinoma. CONCLUSION: PIN II & III were strongly associated with coexistent carcinoma but PIN I was not. The finding of high grade PIN in surgical biopsies with no obvious adenocarcinoma warrants examination of all available tissue and deep sections.

Adenocarcinoma↗

Necrotising lymphadenitis of Kikuchi and Fijimoto in Sri Lanka.

We present the clinicopathological features of 10 patients with Kikuchi's lymphadenitis. It is important to distinguish this unusual form of necrotising lymphadenitis, both clinically and histologically, from lymphoma and infective lymphadenitis, including mycobacterial infection. The 10 lymph node biopsies studied were from young adults (9 women) with fever, cervical lymphadenopathy and elevated ESR. This is the first documentation of this condition in Sri Lanka. This benign self-limiting condition can be mistaken for lymphoma or infective lymphadenitis.

Adolescent↗