Histopathological Features of Colorectal Cancer in Al-Madinah Region of Saudi Arabia: 8 Years Experience

Albasri, Abdulkader,Yosef, Hala,Hussainy, Akbar Shah,Sultan, Saud Ahmad,Alhujaily, Ahmed Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.7

Background: To determine the histopathological pattern of colorectal cancer (CRC) among Saudi patients with a view to determine various epidemiological and histopathological features of the disease. Materials and Methods: We retrospectively collected and analyzed the demographic and histopathological data of all the patients with CRC diagnosed at King Fahad Hospital, Madinah, Saudi Arabia over a period of 8 years from January 2006 to December 2013. Results: Of 324 cases of CRC reviewed, 200 cases (61.7%) were males while 124 cases (38.3%) were females giving a male to female ratio of 1.6: 1. Age of the patients ranged from 20 to 100 years with a mean age 57.9 years. The rectosigmoid region was the most frequent anatomical site (13.6%) involved and adenocarcinoma (88.6%) was the most common histopathological type. The majority of adenocarcinomas (87.3%) were moderately differentiated. A total of 47.8% of patients were in stage B and 43.5% of patients were in stage C of the Aster-Coller classification. Most patients (75.7%) presented with large size tumors. Lymphovascular invasion and lymph node metastasis were recorded in 67.9% and 43.6% of cases, respectively. Conclusions: Colorectal cancer is common in our environment and the majority of patients present late with an advanced stage. Screening programs regarding CRC should be enhanced to improve the outcome of the patients.

Histopathological Patterns of Thyroid Disease in Al-Madinah Region of Saudi Arabia

Albasri, Abdulkader,Sawaf, Zeinab,Hussainy, Akbar Shah,Alhujaily, Ahmed Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.14

Objectives: This study aimed to characterize the histopathological pattern of thyroid lesions among Saudi patients and to highlight the age and gender variations of these lesions as base line data. Materials and Methods: We retrospectively analyzed the data from thyroid specimens received at the Department of Pathology, King Fahad Hospital, Madinah, Saudi Arabia from January 2006 to December 2013. Results: The 292 thyroidectomy specimens received during the study period came from 230 (78.8%) females and 62 (21.2%) males giving a female: male ratio of 3.7:1. Age of the patients ranged from 14 to 95 years with a mean age 39.7 years. Two hundred and eleven (72.3%) cases were found to be non-neoplastic and 81 (27.7%) cases were neoplastic. The non-neoplastic group included: colloid goiter, including both diffuse and nodular goiter (170 cases; 58.2%), nodular hyperplasia (28 cases; 9.6%), Hashimoto/chronic lymphocytic thyroiditis (12 cases; 4.1%), and Grave's disease (1 case; 0.3%). In neoplastic lesions, there were 7 benign tumors and 74 malignant tumors. Among the benign tumors, 5 were follicular adenomas and 2 were Hurthle cell adenomas. Papillary carcinoma was the commonest malignant tumor accounting for 87.8% of all thyroid malignancies, followed by lymphoma, follicular carcinoma and medullary carcinoma. The size of papillary carcinoma was more than 2 cm in 40 cases (76.9%). Conclusions: Non-neoplastic thyroid lesions were more common than neoplastic ones. Colloid goiter was the most common lesion. Follicular adenoma was the commonest benign tumor and papillary carcinoma was the commonest malignant lesion. There appears to be a slightly increased trend of papillary carcinoma diagnosis, most being diagnosed at an advanced stage.

Profile of Colorectal Polyps: a Retrospective Study from King Fahad Hospital, Madinah, Saudi Arabia

Albasri, Abdulkader,Yosef, Hala,Hussainy, Akbar,Bukhari, Saud,Alhujaily, Ahmed Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.6

Aim: To evaluate the predominant colorectal polyps in the Almadinah region of Saudi Arabia. Materials and Methods: In this iretrospective study, we analyzed pathology reports of colonoscopies performed in King Fahad Hospital, Madinah, Saudi Arabia during the period 2006 to 2013. Data based on patient age, gender, size, site and type of polyps and the degree of dysplasia were analyzed by software SPSS 17 and compared with other published studies from different geographic regions of the world. Results: During these years, 224 patients had colonic polyps, of whom 149 (66.5%) were men and 75 (33.5%) were women. The most common types of polyps were adenomatous (166), followed by hyperplastic polyps (24), juvenile (18), inflammatory (13), lipomatous (2) and one patient with Peutz-Jegher polyps. Tubulovillous adenoma was the commonest adenomatous polyp (102), followed by tubular (41) and villous (23) types. The sigmoid colon was the most commonly involved region (36.6%). Dysplasia was significantly associated with female patients who had large size tubulovillous polyps located in the left colon. Conclusions: The type and distribution of colorectal polyps in Saudi Arabia is very similar to Western countries. Patient gender, and size, histological type and location of polyps are closely related to dysplastic change in colonic polyps.

Pattern of Lymph Node Pathology in Western Saudi Arabia

Albasri, Abdulkader Mohammed,El-Siddig, Abeer Abdalla,Hussainy, Akbar Shah,Alhujaily, Ahmed Safar Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.11

Background: This study aimed to characterize the histopathological pattern of lymph node pathology among Saudi patients and to highlight the age and gender variations of these lesions as base line data. Materials and Methods: We retrospectively analyzed the data from lymph node biopsy specimens received at the Department of Pathology, King Fahad Hospital, Madinah, Saudi Arabia from January 2006 to December 2013. Results: Of the 289 lymph node biopsy specimens received, 154 (53.3%) were from males and 135 (46.7%) from females giving a male: female ratio of 1.14:1. Age of the patients ranged from 2.5 to 96 years with a mean age 33.9 years. The commonest lymph node group affected was the cervical (30.4%) followed by axillary (9.7%) and inguinal (8.7%). Malignant lymphoma [71 Hodgkin's disease (HD), 57 non Hodgkin's lymphoma (NHL)] 128 (44.3%), reactive hyperplasia 68 (23.5%), and tuberculosis 41 (14.2%) were the common causes of lymph node enlargement. While HD, reactive hyperplasia and tuberculosis were commonest in young adult patients (10-29 years old) and rare above the age of 50 years; NHL was the predominant cause of lymph node enlargement above 50 years. Conclusions: Lymph node biopsy plays an important role in establishing the cause of lymphadenopathy. Among the biopsied nodes, lymphomas were the most common (44.3%) followed by non-specific reactive hyperplasia (23.5%) and tuberculous lymphadenitis (14.2%).

Histopathological Profile of Benign Colorectal Diseases in Al-Madinah Region of Saudi Arabia

Albasri, Abdulkader Mohammed Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.18

Background: Patients with long-standing inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer (CRC). Colon cancer risk in IBD increases with longer duration and greater anatomic extent of colitis, the presence of primary sclerosing cholangitis, family history of CRC and degree of inflammation of the bowel. This study aimed to characterize the histopathological pattern of benign colorectal diseases among Saudi patients and to highlight age and gender variations of lesions as base line data for future studies to investigate the link between benign/IBD and colorectal cancers in the local population. Materials and Methods: The materials consisted of 684 biopsies, reported as benign (excluding malignancies and polyps) at the Department of Pathology, King Fahad Hospital, Madinah, Saudi Arabia from January 2006 to December 2013. Data collected and entered in MS-Excel and were analyzed using SPSS-20. Results: Of 684 colorectal tissues reviewed, 408 specimens (59.6%) were from male patients and 276 specimens (40.4%) were from females giving a male: female ratio of 1.5:1. Age of the patients ranged from 4 to 75 years with a mean of 39.6 years. The most frequent histologic diagnosis was a chronic non specific proctocolitis followed by ulcerative colitis, accounting respectively for 52.6% and 31.7% of all cases. These were followed by Crohn's disease 22 (3.2%), ischemic bowel disease 20 (2.9%), diverticular disease 14 (2%), eosinophilic colitis 12 (1.7%) and solitary rectal ulcer 12 (1.7%). A minority of 21 patients (3.1%) were cases of acute nonspecific proctocolitis, schistosomiasis, tuberculosis, volvulus and pseudomembranous colitis. Conclusions: These data show that although chronic non specific proctocolitis and ulcerative colitis were the dominant diagnoses, Crohn's disease, ischemic bowel disease and diverticular disease also existed to a lesser extent and should be considered in the differential diagnosis of benign colorectal diseases. This study provides a base line data for future studies which would be taken up to investigate the link between benign/IBD and colorectal cancers in the local population.

Histopathologic Characterization of Prostate Diseases in Madinah, Saudi Arabia

Albasri, Abdulkader,El-Siddig, Abeer,Hussainy, Akbar,Mahrous, Mervat,Alhosaini, Abdulaziz Abdullah,Alhujaily, Ahmed Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.10

Aims: To delineate the histopathological pattern of prostate diseases and to highlight age variations in prostate specific antigen (PSA) values and histopathological features. Materials and Methods: A retrospective review was made of all prostate biopsy reports seen between January 2006 and December 2013 at the King Fahad Hospital, Madinah, Saudi Arabia. Prostate lesions were tabulated and classified into benign and malignant groups. Histological scoring of adenocarcinomas was accomplished using the Gleason system. PSA values were correlated with Gleason scores. Results: Of 417 prostate lesions reviewed, 343 (82.3%) were benign and 74 (17.7%) were malignant, giving a benign to malignant ratio of 4.6:1. Benign prostatic hyperplasia (both with and without inflammation) was the commonest prostatic lesion and accounted for 80.3% of all cases and 97.6% of all benign cases. The age range was 20 to 97 years with a mean of 69.2 years and a peak age group at 70-79 years. Seventy one cases of adenocarcinoma accounted for 95.9% of the total of 74 malignant tumors. It showed an age range of 44 to 95 years, a mean age of 70.9 years and peak prevalence in the 80-89 year age group. Gleason score seven was the most frequent (39.4%) in occurrence. Most adenocarcinomas, 41 cases (57.7%), were moderately differentiated (Gleason score of 5-7). PSA values ranged widely between 16-1,865ng/ml with a mean of 363.4ng/ml. Elevated PSA (>100ng/ml) levels were found in 53 (81.6%) patients. There was a statistically significant positive correlation between serum PSA level and Gleason score (p=0.0304). Conclusions: Prostatic lesions constitute a significant source of morbidity among adult males in Madinah. Benign prostatic hyperplasia was the commonest benign prostatic lesion and adenocarcinoma was the commonest histological subtype of prostatic cancer.

Dermatomyositis Following BNT162b2 mRNA COVID-19 Vaccination

Wesam Gouda,Anwar Albasri,Faisal Alsaqabi,Humoud Y. Al Sabah,Marwan Alkandari,Hassan Abdelnaby 대한의학회 2022 Journal of Korean medical science Vol.37 No.5

Dermatomyositis (DM) is one of the uncommon multi-organ idiopathic inflammatory myopathies that has been reported following the hepatitis B, Influenza, tetanus toxoid, H1N1, and BCG vaccines. However, an association with the coronavirus disease 2019 (COVID-19) vaccine is yet to be reported. In this case, we present the case of a 43-year-old Asian Indian female who was diagnosed with DM 10 days after receiving the second dosage of BNT162b2 mRNA COVID-19 vaccination, in the absence of any additional triggering factors. The diagnosis was established based on physical examination, serological antibodies, magnetic resonance imaging of the muscles, skin biopsy, and electromyography. She received standard treatment for DM, including oral high doses of prednisolone, hydroxychloroquine, mycophenolate, and physiotherapy. The treatment successfully reversed skin changes and muscle weakness. This is the first reported case of classic DM complicated by interstitial lung disease following COVID-19 vaccination. More clinical and functional studies are needed to elucidate this association. Clinicians should be aware of this unexpected adverse event following COVID-19 vaccination and arrange for appropriate management.

High Quality Tissue Miniarray Technique Using a Conventional TV/Radio Telescopic Antenna

Elkablawy, Mohamed A.,Albasri, Abdulkader M. Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.3

Background: The tissue microarray (TMA) is widely accepted as a fast and cost-effective research tool for in situ tissue analysis in modern pathology. However, the current automated and manual TMA techniques have some drawbacks restricting their productivity. Our study aimed to introduce an improved manual tissue miniarray (TmA) technique that is simple and readily applicable to a broad range of tissue samples. Materials and Methods: In this study, a conventional TV/radio telescopic antenna was used to punch tissue cores manually from donor paraffin embedded tissue blocks which were pre-incubated at $40^{\circ}C$. The cores were manually transferred, organized and attached to a standard block mould, and filled with liquid paraffin to construct TmA blocks without any use of recipient paraffin blocks. Results: By using a conventional TV/radio antenna, it was possible to construct TmA paraffin blocks with variable formats of array size and number ($2-mm{\times}42$, $2.5-mm{\times}30$, $3-mm{\times}24$, $4-mm{\times}20$ and $5-mm{\times}12$ cores). Up to $2-mm{\times}84$ cores could be mounted and stained on a standard microscopic slide by cutting two sections from two different blocks and mounting them beside each other. The technique was simple and caused minimal damage to the donor blocks. H&E and immunostained slides showed well-defined tissue morphology and array configuration. Conclusions: This technique is easy to reproduce, quick, inexpensive and creates uniform blocks with abundant tissues without specialized equipment. It was found to improve the stability of the cores within the paraffin block and facilitated no losses during cutting and immunostaining.

Molecular Profiling of Breast Carcinoma in Almadinah, KSA: Immunophenotyping and Clinicopathological Correlation

Elkablawy, Mohamed A,Albasry, Abdelkader M,Hussainy, Akbar S,Nouh, Magdy M,Alhujaily, Ahmed Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.17

Purpose: To subtype breast cancer (BC) in Saudi women according to the recent molecular classification and to correlate these subtypes with available clinicopathological parameters. Materials and Methods: Estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (Her2/neu) immunostaining was semi-quantitatively assessed to define molecular subtypes of luminal A and B, HER-2 and triple negative (basal-like) in BC paraffin embedded sections from 115 Saudi female patients diagnosed between 2005 to 2015 at the Department of Pathology, King Fahd Hospital, Almadinah, Saudi Arabia. Results: The most common subtypes were luminal A (47%), followed by luminal B (27.8%) and basal like subtypes (18.3%), whereas HER-2 was the least common subtype (6.9%). Luminal A was predominantly found in the old age group, with low tumor grade (p<0.001) and small tumor size, whereas HER-2 and basal-like subtypes were significantly associated with young age, high tumor grade, lymph node metastasis and lymphovascular invasion (p<0.03, 0.004, 0.05 and 0.04 respectively). All subtypes showed advanced clinical stage at the time of presentation. Conclusions: Molecular subtypes of Saudi BC patients in Almadinah region are consistent with most of the worldwide subtyping. The biological behaviour of each molecular subtype could be expected based on its characteristic clinicopathological features. Along with other prognostic indicators, molecular subtyping would be helpful in predicting prognosis and management of our BC patients. We recommend screening and early diagnosis of BC in our population.