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Naila Kayani

Publications and source records attributed to Naila Kayani.

At least 19 recordsLinked to original sources
PubMed2006

Painless breast lump in an elderly woman. Secretory breast carcinoma in an elderly woman.

Secretory breast carcinoma is a rare breast cancer. It occurs in all age groups, with the majority of patients being adults. It is a rare occurrence in elderly (>50 years) patients; only 5 cases have been reported in this patient group in the English literature. It is even rarer in males, with only 15 cases reported in the world literature. Ultrasonographic findings may resemble other well-circumscribed breast carcinomas as well as some benign masses, including fibroadenomas. We present a case of a 60-year-old woman who had a painless lump in her right breast. The tumor was ulcerating through the skin. Axillary lymph nodes were also palpable. Simple mastectomy was performed and the histopathologic findings revealed secretory carcinoma of the breast.

Adenocarcinoma↗
PubMed2006

Uterine perivascular epithelioid cell tumour presenting as a cervical mass.

Perivascular Epithelioid Cell Tumour (PEComa) also known as myelomelanocytic tumours are uncommon, recently described mesenchymal tumours that include angiomyolipoma, clear cell "sugar" tumour of the lung, lymphangioleiomyoma and tumours composed predominantly of epithelioid cell morphology. A predilection for uterus has been described. However up till now only 14 cases of uterine PEComas have been described. All of these were seen in adult females in the peri and post menopausal age group (from 40-75years), and almost all were located in the region of body of uterus. A single case in the upper cervical region has been reported with uterine PEComatoses. We report an unusual presentation of this rare tumour presenting as a polypoidal cervical mass in a young female. Occurrence of this tumor in a young female as seen in our case warrants inclusion of PEComa in the diferential diagnosis of all epithelioid and clear cell neoplasms of uterus irrespective of age.

Adult↗
PubMed2006

A view of HIV--infection in Karachi.

A prospective study on the prevalence of HIV-I infection in Karachi, Pakistan was conducted over a period of six years (1986-1992). Over 15,000 individual samples and more than 32,000 donor units of individuals residing in Karachi at the time of sample collection were tested for HIV-I infection by our screening test EIA which revealed a positivity rate of 0.23% and 0.003% in individual and donor units respectively by Western Blot. We divided patients into four groups A,B,C and D based on the most plausible cause of transmission. The largest number of positive patients belonged to group B, who were of either foreign origin or expatriates or Pakistanis settled abroad. They comprised approximately 67% of the total positive cases and were subjected to testing on strong clinical grounds. In individuals of other groups like group A and D, there was history of travel abroad from time to time. The only positive donor unit (group C) belonged to a person who had been living in Middle East for the last 10-12 years. The last group D comprised of samples that were directly sent to us without complete history, except for the fact that they had been traveling back and forth. The large majority of patients fell in 20-50 years age group. Despite the limitations of this study, we conclude that the prevalence of HIV is steadily increasing in our population and so far, we have not been able to find an indigenous case of AIDS in our series (JPMA 44:8, 1994).

Journal Article↗
PubMed2006

Angiokeratoma of tongue: a series of 14 cases.

Angiokeratomas (AC) are vascular lesions which are defined histologically as one or more dilated blood vessels lying directly subepidermal and showing an epidermal proliferative reaction with ectatic capillaries in the papillary dermis. Only three other cases of isolated mucosal angiokeratoma have been reported in the indexed literature. We reviewed all cases of angiokeratoma located on the tongue, diagnosed in our department during a study period of 10 years (1995-2005). Histologically all 14 cases showed dilated and congested blood vessels in the upper papillary dermis. They lack deep dermal involvement. Hyperkeratosis and acanthosis were also seen in most of the cases. No clinical data was available to assess systemic disease. A higher incidence of of AC in tongue is seen in our study.

Angiokeratoma↗
PubMed2006

Frequency and characteristics of breast lymphomas presenting to a tertiary care hospital, Pakistan.

OBJECTIVE: To assess the relative frequency of (primary and secondary) mammary lymphomas presenting to a tertiary care hospital, Pakistan and its categorization according to WHO classification of lymphoid neoplasms. METHODS: All NHLs (nodal and extra nodal) diagnosed in the section of histopathology during 1992-2004 were retrieved and reviewed. All patients (n=30) diagnosed with lymphomatous involvement of the breast were selected. Distinction between primary and secondary breast lymphomas was not made owing to lack of availability of clinical information. RESULTS: A total of 5637 breast malignancies were diagnosed in our department during the study period of 10 years and the total number of NHLs (Nodal and extra Nodal) was 2632. Thirty (n=30) patients accounting for 1.13% were diagnosed to have lymphomatous involvement of the breast. The Female to Male ratio was 13.5:1; age range was 12-92 years with a median age of 43 years (Mean age 46.5 years and Standard deviation of age was 16.88 years). The sites of the lesions were the right breast in 11 cases (37.93%), left breast in 9 cases (31.03%) and both breasts in 2 cases (6.89%), while the location of 8 masses (27.58%) was unknown. Immunohistochemical studies were negative for cytokeratins (MNF and Cam 5.2) in all cases. All cases of DLBCL expressed B cell lineage antigens and were positive for LCA and Pan B (CD20 and 79a). CONCLUSION: We concluded that breast lymphomas represent 1.13% of all NHL and 0.5% of all breast malignancies in this study. The most frequent morphologic type was diffuse large B-cell lymphoma. As patients with primary breast lymphoma have a better prognosis than those with carcinoma of the breast or patients with extranodal lymphomas, a multidisciplinary approach including surgery, radiotherapy, and chemotherapy when needed would result in a more favourable outcome.

Adolescent↗
PubMed2005

Prognostic value of proliferating cell nuclear antigen (PCNA) in infiltrating ductal carcinoma breast.

OBJECTIVE: To assess the independent and interdependent prognostic value of proliferating cell nuclear antigen (PCNA) in carcinoma of breast in our female population and its association with pathologic variables and disease outcome. DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: Section of Histopathology, Department of Pathology and Microbiology, The Aga Khan University, Karachi from January 1992 to December 1997. PATIENTS AND METHODS: All cases diagnosed with invasive ductal carcinomas (IDC) of breast with lymph nodes sampling were included. The expression of PCNA was analyzed on tumor specimens of IDC breast. These patients also had axillary lymph node sampling. The expression of PCNA protein was analyzed immunohistochemically by PAP technique. Patients were followed for a median duration of 48 months. RESULTS: The percentage of PCNA positive tumor cells was estimated semi-quantitatively. Positivity was seen in every case, mean PCNA positivity was 27% (range 10-80) with a median of 28%. The <25% positivity was seen in 149 (47%) cases, and >25% positivity seen in 166 (53%) cases. According to the pathological grading lowest mean PCNA was seen in grade-I i.e., 26% tumor cells showed nuclear reactivity to PCNA followed by grade-II 30% and grade-III 33%. PCNA categorical expression was significantly correlated with histological differentiation, (p<0.05) and tumor size (p<0.01). Distant metastases were seen in>25% positive cases (p<0.05). PCNA expression when correlated with overall survival, showed significant correlation between categorical PCNA (p<0.05). At a median follow-up of 48 months, 66% of <25 PCNA positive patients died with an overall survival of 3.16 years and disease-free survival of 2.5 years, among >25% PCNA positive patients 77% died with an overall survival of 2.7 years and a disease-free survival of 2.2 years. CONCLUSION: In this study PCNA proved to be an independent prognostic indicator in predicting disease-free and overall survival in breast carcinoma patients.

Biomarkers, Tumor↗
PubMed2005

Ovarian primary neuroendocrine carcinoma of non-small cell type: report of an extremely rare neoplasm.

Paraffin block sections of a uterus and ovarian mass from a 31 year old female were sent for second opinion to the Pathology Laboratory of Aga Khan University. Histologic examination and immunohistochemical features gave a diagnosis of primary neuroendocrine carcinoma of non-small cell type admixed with benign mucinous cystadenoma. This is a rare tumour with only eight being reported in literature.

Adult↗
PubMed2005

Ductal carcinoma in situ (DCIS) in Karachi.

OBJECTIVE: To study the frequency of ductal carcinoma in situ (DCIS) in a large pathology series. DCIS is a proliferation of non-invasive, malignant epithelial cells within the ductolobular system of the breast. It is a heterogeneous entity with several morphologic variants that differ in gross appearance, growth pattern, cytologic features, mammography, and malignant potential. METHODS: The data of The Aga Khan University' Pathology Department, diagnosed on the basis of histopathology, during a 6-year period (1st January 1998 to 31st December 2003) was reviewed, all cases of DCIS studied, and data was analyzed with the help of analytical software SPSS. RESULTS: Thirty-eight cases of DCIS were reported to the Aga Khan University Pathology Department, during a 6-year period (1998 to 2003), comprising approximately 1% of all breast cancers reported to the unit in the same period. The mean age of the patients at diagnosis was 48.95 years (CI 95% 44.6; 53.3). Approximately half the cases occurred in the 45-54 year age group (figure 1). Two cases (5.3%) were recurrences with previous lumpectomy scars. Comedo necrosis was observed in five (13.2%) cases, whereas 33 (86.8%) cases were non-comedo type. The clinical presentation was a palpable mass (92.1%), nipple discharge (5.3%) or clinically occult lesions diagnosed on mammography (2.6%). Approximately half the patients presented with a grade 2 disease. Atypical ductal hyperplasia was observed in a third of the cases, predominantly associated with a grade 1 and 2 disease. The estrogen and, progesterone receptor status was studied in 12 (31.6%) cases. Estrogen positivity was observed in 11 (91.7%) cases and progesterone positivity in 7 (58.3%) cases. Microcalcification was observed in four (10.6%) cases. CONCLUSION: The cases reported in this study are the indolent grade 1 or 2 cases with a non-comedo pattern, and a positive estrogen and progesterone receptor status. If untreated, only 40% of these innocuous forms of DCIS become invasive over a time span of approximately 25-30 years. In Pakistan we are missing the more aggressive forms of DCIS which have a shorter transition to invasive carcinoma.

Adult↗
PubMed2005

Lymphoepithelioma-like carcinoma of urinary bladder: (LELCA).

Lymphoepithelioma-like carcinoma of the bladder (LELCA) is an uncommon neoplasm of the urinary bladder and up till now only 49 cases have been reported in the English literature. It is imperative to distinguish between lymphoepithelioma-like carcinoma and malignant lymphoma as primary bladder lymphoma is extremely rare. We report a case of a 55 year old lady who presented with the complaint of burning micturition and gross hematuria for the past 5 months. There were no other known comorbids. Pelvic ultrasound was normal. Cystoscopy showed a 4x4 cm sessile mass in the bladder. Histopathological examination was consistent with the diagnosis of lymphoepithelioma like carcinoma of the urinary bladder.

Carcinoma, Squamous Cell↗
PubMed2005

Colorectal carcinoma, extent and spread in our population. Resection specimens give valuable information.

OBJECTIVE: To acquire information about the extent and spread of colorectal carcinomas in our population by examining colon and colorectum resection specimens received. METHODS: All colon and colorectum resection specimens received in the section of Histopathology, Aga Khan University Hospital, Karachi from January 1, 2003 to July 31, 2003 were included in the study. RESULTS: Eighty five resection specimens were received during the study period, 69.41% patients were males, and 30.59% were females. The mean age for males was 49 years and for females 48 years. Tumor location was in left colon (58.82%), and in right colon (41.18%). The average size of the lesions in largest dimension was 5.5cms. Majority (83.53%) were colorectal adenocarcinomas, 71.76% cases were grade 11, 16.47% were grade I, and 11.76% were grade III. Most cases (85.88%) infiltrated full thickness of the bowel wall extending into the pericolonic fat. Vascular invasion was seen in 16.47% cases. Radial margin was positive in 23.08% of rectal carcinomas and 57.65% cases showed lymph node metastases. CONCLUSION: The findings in our study demonstrate that the disease is usually very advanced with extension into pericolonic fat and positive lymph nodes. Thus, the early detection and resection (while the disease is still in an early stage) are essential in our population using better surgical techniques, for proper staging of these tumors.

Adolescent↗
PubMed2005

Metanephric adenoma: a rare benign renal tumour.

Metanephric adenoma is a rare benign renal tumour. We are reporting one histologically proven such case in a 23 year old male from Afghanistan. He presented with severe right flank pain since 3 weeks. Nephrectomy was done and histopathology was consistent with the diagnosis of metanephric adenoma. This novel renal mass has been reported to have benign clinical course despite its symptomatic presentation and large tumour size. There is no distinguishing radiological feature with can differentiate it from malignant tumours. So far, a uniformly benign clinical course has been associated with Metanephric adenoma, but given its relatively recent identification and rarity and the lack of clinical, radiographic, or cytologic means to establish a definite diagnosis, Metanephric adenoma remains primarily a pathologic diagnosis.

Adenoma↗
PubMed2005

Validity of frozen section in the diagnosis of breast lumps: 5 years experience at the Aga Khan University Hospital.

OBJECTIVE: To determine the accuracy of frozen section in the diagnosis of breast lump. METHODS: Frozen section diagnosis given in consecutive breast biopsies performed in 5 years in our laboratory was evaluated against the final pathology report of permanent sections. RESULTS: The Aga Khan University Hospital Lab receives more than 400 cases per year for frozen section. Three hundred and nineteen consecutive frozen sections of breast lumps examined from 1999-2003 were considered for analysis. Age of patients ranged between 22 and 90 years (mean age 49 years). In 316 cases (99%) there was no difference between the frozen section diagnosis and the final diagnosis. Three cases (0.94%) were incorrect; 2 cases (0.62%) were false positive. One case was false negative (0.31%). In 7 cases (2.19%), frozen section diagnosis was deferred to permanent sections. Frozen section diagnostic accuracy was 99%. Sensitivity and specificity was 99.3% and 93% respectively. Positive predictive value and negative predictive values of frozen section were 96.6% and 99.3% respectively. CONCLUSION: High accuracy of the frozen-section diagnosis in the breast lumps was confirmed in our study

Adult↗
PubMed2003

Case control study of novel prognostic markers and disease outcome in pregnancy/lactation-associated breast carcinoma.

A case control study of pregnancy/lactation associated breast carcinoma (PAC) was conducted on 24 test cases with two controls per case, matching age, tumor grade, tumor size and axillary lymph nodes status. During seven years of this study, 6% of all patients with breast cancer had PAC. In this study, 67% of the test cases showed positive axillary lymph nodes compared to 49% in our series of 315 cases of non-pregnancy/non-lactating women with breast carcinoma (p < 0.05). The expression of nine prognostic markers, i.e. ER, PR, p53, C-erbB-2, EGFR, Cathepsin-D, PCNA, DNA ploidy and S-phase fraction, were studied by immunohistochemistry and flow cytometry. Hormone receptor status showed a statistically significant difference between the two groups, i.e. 29% immunoreactivity in test cases compared to 58% in controls with a p value of 0.007. Among p53, C-erbB-2, EGFR and Cathepsin-D in the test group, only EGFR showed a significant correlation, i.e. 33% immunoreactivity in test cases and 19% immunoreactivity in controls (p < 0.05). Higher PCNA positivity was seen in the test group compared to controls, i.e. 35% in test patients and 28% in controls (p < 0.05). Metastasis to bone and liver was a common feature of test patients as compared to controls (p < 0.05). After a median follow-up of 72 months, there was no significant difference in the overall survival (OS) of test cases and controls as 54% deaths were recorded in test patients and 44% in controls at the end of this study (p > 0.05). In summary, in spite of some significant differences in the expression of few prognostic markers, i.e. ER/PR, EGFR, PCNA and metastatic potential, there was no significant difference in the OS of PAC vs. control group if compared stage for stage.

Biomarkers, Tumor↗
PubMed2002

Large-scale pathology-based cancer data--a reflection of population-based cancer data.

Pathology-based cancer data is a high quality reflection of the patterns of cancer in the population it represents, provided the demographic details of the patients are carefully recorded. Relative frequency data is neither a replacement for population-based data nor a suggested alternative; it simply enhances the quality of population data and in very large data sets reflects the cancer patterns observed in the representative populations. Aware of the standard shortfalls of pathology-based data, the department of pathology, The Aga Khan University Hospital (AKUH) standardized its data, representing 53.4% of the cancer data of Karachi Division (Pakistan) and also reflecting the cancer pattern of other provinces of Pakistan. This data was compared with 4 different population and institutional-based data sets. The findings substantiate the observation that despite the problems of interpretation of data from pathology laboratories, they are an invaluable source of information on cancer patterns in much of the world where incidence data are unavailable . If developing countries, unable to organize National Population- Based Registry should as an alternate develop National Pathology-based Registers a well targeted and monitored, a Cancer Control Program would be possible. A good quality, large-scale pathology data with demographic details of the patient recorded can also be extended to give coverage to the population.

Female↗