Pathology

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    Assessment of Malaria and Intestinal Parasites as Public Health Problems Based on Clinical Record, Parasitological Surveys and Kap in Borena District, South Wollo, Central-North Ethiopia
    (2010-07) Bereded, Fentaw; Beyene, Petros(Professor)
    The analysis of retrospective clinical records from Mekane-Selam Health Center showed high average annual malaria (25.0%) and intestinal parasite prevalence (46.3%). In the cross-sectional survey, both direct wet mount and formal-ether concentration methods were used for microscopic diagnosis of intestinal parasites; malaria diagnosis was based on microscopic diagnosis of thin and thick Giemsa stained blood film. Accordingly, an overall prevalence of 24.5% intestinal parasite infections and 0.96% malaria parasite was determined. The intestinal parasites detected were E. histolyica/dispar (10.83%), A. lumbricoides (7.6%), G. lamblia (1.81%), hookworm (1.99%), H. nana (3.6%) and 0.9% each of E. vermicularis and S. stercoralis. Malaria infections were due to P. falciparum (0.38%) and P. vivax (0.58%). Multiple intestinal parasitic infections were common (12.5%). High prevalence of intestinal parasitic infection was not in general significantly associated with the absence of toilet, source of drinking water, eating raw meat and open field disposal of household waste (P>0.05). Illiteracy and not washing hands before meal and after toilet use were shown to be associated with G. lamblia (OR=4.21, P=0.043; OR=9.06, P=0.001) and E. histolytica/dispar (OR=17.04, P=0.01; OR=5.104, P=0.001) infection. Relatively high awareness (78.1%) was detected among the heads of household about malaria and its preventive and control measures. Significant discrepancy in prevalence levels between the retrospective clinical record and the cross-sectional survey was observed for malaria. This is to be expected because the prevalence data of clinical records were obtained based on treatment seeking patients reporting to the Health Center. Furthermore, malaria control interventions such as the use of ITNs/LLINs, IRS and prompt treatment with ACT, based on RDT, appeared to have reduced malaria transmission in the study area. On the other hand, the deworming program reportedly under implementation in the study area does not seem to be effective since the prevalence of intestinal helminths remained too high. Therefore, the implementation of control intervention measures for malaria must continue as it is currently practiced and the geo-helminth control measures will require serious improvement in Borena District. Key words/phrases: Malaria, intestinal parasites, parasitic infection control, health, Borena
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    Pattern of Malignant Colorectal Tumors in Blacklion Hospital, Addis AbabaUniversity, Ethiopia, 2010-2012.
    (Addis Ababa University, 2012) T/haymanote, Alemwosen; Dr.Ergete, Wondwossen
    This study analyzed age,sex,site & histologic types of Malignant colorectal neoplasms in 203 cases during a period of January 2000 to December 2012 in the department of pathology,Addis Abeba University,Ethiopia. This cases accounted for 1.1% of total biopsies submittedto the departement during the study period.The mean age for Malignant colorectal neoplasms was 48 years. The mean age for each histologic type was analyzed.The youngest case seen was 15years of age. The male:female ratio was 1.3:1.Of all CRC 59.7% occurred in the rectum & sigmoid. The most frequent histologic type was Adenocarcinoma 83.25%.Mucinous carcinoma was the the second frequent histologic type which accounted for 6.4%.100% of lymphomas occurred in the caecum. Increasing burden of CRC is observed in the young. Frequency of Mucinous carcinoma increased with relatively young age predilection. Therefore, high index of clinical suspicion for CRC in the young recommended.
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    Sensitivity and Specificity of Fine Needle Aspiration Cytology on Breast Mass as Compared to Histology Evaluation
    (Addis Ababa University, 2014-10) Abraham, Yohannes
    Introduction: Breast cytology has been used for many years as a diagnostic tool for managing patients with breast lesions. In experienced hands, FNAB was found to be highly sensitive and specific. Objective: To evaluate the accuracy and diagnostic performance of fine needle aspiration FNA cytology in diagnoses of breast masses. Methods: FNA diagnoses and biopsy of breast masses of patients who underwent subsequent histopathologic evaluation during June2013-June2014 at Black lion Hospital pathology laboratory were evaluated. Cytological diagnoses was classified as benign, suspicious for malignancy, malignant, and inadequate or inconclusive and was compared with the histopathologic diagnoses obtained from incisional biopsy or mastectomy specimen to assess the diagnostic performance of FNA. Result and conclusion: The sensitivity and specificity of FNAc was found to be 86.7% and 90.3% respectively. FNA is still proved to be a good diagnostic modality for immediate diagnosis and patient follow up. The positive and negative predictive values are 86.7% and 90.3% respectively.
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    Pattern of Diseases of Thyroid: A Four-year Retrospective Study of Histopathologic Diagnosis Tikur Anbessa Hospital, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2014-12) Solomon, Manyahelehal
    Background: The diversity of diseases affecting the thyroid gland can be due to hormonal excess/deficiency, reactive proliferations to deficiency states, inflammation, or neoplastic conditions most of which manifest by a form of enlargement of the thyroid gland commonly called goiter. The distribution of these diseases depends on several factors, both environmental and individual. Simple (non toxic goiter is quiet common throughout the world and is more prevalent where iodine difficiency is prevalent. The reported prevalence of goiter in Ethiopia is in the range of 27% in the early 90s to 40% today. Objective: To assess the distribution of histolpathologic types of thyroid diseases over a period of four years. Setting: Tikur Anbessa Specialized Hospital, Department of Pathology, College of Medicine and Health Sciences, Addis Ababa University Methods: Retrospective analysis of biopsy diagnoses of thyroid disease. Results: one thousand two hundred cases were included in the study. nine hundred eighty six were found to be non neoplastic(82%) and two hundred eleven were found to be neoplastic(18%). Nodular colloid goiter was the commonest, appearing in 956 cases(79.6%). Adenoma, carcinoma and thyroiditis accounted for 64(5.3%), 147(12.3%) and 16(1.3%)respectively. The female to male ratio was 5.1:1. Eighty four point five percent of thyroid diseases were found in the age group between 20 and 59 years. Conclusion: Nodular colloid goiter is the commonest of all thyroid diseases. Thyroid malignancies have become more common than adenomas. Papillary carcinoma is the commonest of thyroid cancers. Efforts need to improve to tackle the problem of iodine deficiency. Proper evaluation of thyroid swellings and early seeking of health service in case of neck swelling needs to be advocated.
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    Assessment of Possible Tuberculous Lymphadenopathy by Xpert MTB/RIF Assay Compared to Non-Molecular Methods at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
    (2016-08) Fantahun, Mengistu; Gemechu, Tufa (PhD); Kebede, Abebaw; Mamuye, Yeshiwondem; Tadesse, Mengistu
    Background: There are nearly 9 million new cases and 2 million deaths from tuberculosis (TB) worldwide every year. The incidence of mycobacterial lymphadenitis has increased in parallel with the increase in the incidence of mycobacterial infection worldwide. TB lymphadenitis is seen in nearly 35 per cent of extra pulmonary TB which constituted about 15 to 20 % of all cases of TB. Extra pulmonary tuberculosis (EPTB) is a significant health problem worldwide because of difficulties in its diagnosis and in monitoring its treatment, in which Tuberculous lymphadenitis (TBLN) is high prevalent. . However, no adequate information had been made available on the tuberculous lymphadenitis in Addis Ababa. To this effect, adequate knowledge on the prevalence and better diagnosis method is required. Objective: This study was aimed to determine the prevalence of TBLN and assesse diagnostic performance of laboratory methods in diagnosis of TBLN among presumptive TBLN patients at St. Paul’s hospital millennium medical college (SPHMMC). Materials and Methods: A cross-sectional study was conducted on tuberculosis lymphadenitis presumptive patients at SPHMMC from December 2015 to May 2016. Fine needle aspiration samples were collected from all TB lymphadenitis presumptive patients. Structured questioners were used to collect socio-demographic and clinical related data. Samples were screened for TB lymphadenitis using TB culture, cytomorphology, Xpert MTB/RIF assay and other staining techniques. The data were analyzed using software packages SPSS version 20 (SPSS Inc, Chicago, Illinois, USA). Negative predictive value, positive predictive value, sensitivity and specificity were calculated. Kappa value was calculated to see the presence of agreement. Chisquare test was done along with P-value to see the presence of associations. P-value less than 0.05 were considered as statistically significant and logistic regression analyses were used to see the association of different variables. Odds ratios and 95% confidence interval were computed to determine the presence and strength of association Result: Of the 152 TBLN presumptive cases, 103(67.8%) were positive for TBLN by FNAC examinations. On the other hand, only 44.7% were positive by mycobacterial culture and 24.3% cases were detected by Fluorescent microscopy (FM). ziehl Neelsen (ZN) was detected in 14.5% cases while 49.3% cases were positive for mycobacteria by Xpert MTB/RIF assay. Pus (AOR 9 0.082, 95% CI 0.030-0.228) and caseous (AOR 0.059, 95%CI 0.020-0.169) aspirates and Previous treatment was significantly associated with TBLN (AOR 0.113, 95% CI 0.031-0.407). The sensitivity of GenXpert compared to composite LJ culture was 78% (73.7-82.3) and specificity 74% (69.4-78.6). The sensitivity was 30.9% for ZN, 47% for FM and 94.1% for cytology compared to composite LJ culture. Cytology showed the lowest specificity (53.6%) but ZN revealed highest sensitivity 98.8% compared to composite culture. Cytology had 61.3% specificity and 87.8% sensitivity compared to against bacteriological methods. Among 49 cytological non-TBL cases, 10 were positive on GeneXpert. The highest agreement was observed between ZN and FM (k=0.69) and the lowest between FNAC and ZN (k=0.199). Conclusion: The results of this study revealed a high prevalence of TBLN in the study sites. TBLN is an important public health problem that needs to be addressed in the area. Types of aspirate and previous treatment were significantly associated with tuberculosis lymphadenitis. FNA cytology showed a relatively high sensitivity but a low specificity. Combining bacteriological methods with FNA cytology in an endemic region like Ethiopia improves the overall accuracy of the diagnosis of mycobacterial lymphadenitis, which in turn may lead to better patient management. Further prospective and advanced studies are recommended to determine the specific etiologic agents and contributing factors and Pathologists should be conscious of tuberculosis cases whenever they encounter enlarged lymph node with pus and/or causous aspirates to initiates immediate treatments. 10
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    Molecular Detection of Mycobacterium leprae in Stained Slit Skin Smear from leprosy Patients and Comparison of Molecular and Histopathological Findings with Clinical Data
    (Addis Ababa University, 2017-06) Bereket, Azeb; Gemechu, Tufa (PhD)
    Background:Mycobacterium leprae is a causative agent of leprosy which is a chronic infectious disease. The disease mainly involves the skin and peripheral nerves. Leprosy is endemic in tropical countries especially in developing countries.Globally theprevalence of leprosy at the end of 2015 was 210,758 cases (3.2 cases per 100, 000 populations)and the number of new cases reported globally in the same year was 199,992. The Aim of this study was to improve the sensitivity of leprosy laboratory diagnosisusing PCR on Archival ZN Stained Slide of Skin Smear and to compare with other tests. Objective: To evaluate the diagnostic performance of PCR to detect M. leprae on stained Slit Skin Smear collected from clinically confirmed leprosy patients. Methodology:Retrospective cross sectional study was conducted on 60 clinically confirmed leprosy patients of 42MB and 18PB leprosy cases and Archival sample ZN stained slides on SSS and archival data of H&E and FF on biopsy stained slides of the sixty leprosy patients were collected from the AHRI histopathology laboratory. Results: The PCR on SSS was positive in 6 (10.00%) PB patients and in 23 (38.67%) MB patients. Among the 23 MB cases detected by PCR 3, and among PB cases detected 2 were from AFB negative slides. Histopathological findings were graded according to Ridley and Jopling scale where most common histological type was BT seen in 14(23.33%) cases followed by BL 8(13.33%) cases, LL 8(13.33%), BB 7 (11.67%), TT 5 (8.33%), and IL 3 (5%). Majority (71.67%) of the cases was MB type and the rest (28.33%) were PB. Faite-Faraco staining was positive in 37 (61.7%) cases. Conclusion: The PCR on SSS detected a total of 29 out of 60 samples indicating its potential for diagnosis. Although PCR on SSS showed low detection as compared to H&E and FF staining (staining on punch biopsy samples), it detected more positive samples than ZN staining. Therefore, by improving some technical procedures in sample collection and handling, it can be used for diagnosticswhere PCR machines are available. XIII
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    Investigating the Role of Liquid Dish Washing Soap as a Substitute for Xylene in Routine Hematoxylin and Eosin Staining: Comparative Study
    (Addis Ababa University, 2018-01) Nureddin, Dollar; Gemechu, Tufa (MD, Associate professor)
    Background: One of the most important chemical in histopathology laboratory but potentially hazardous to the technologists is xylene. Histotechnologists and other workers in the histology laboratory are exposed to xylene during various procedures, especially during deparaffinizing tissue sections. Lack of proper disposal system of xylene and the laboratory workers poor preventive mechanism towards the chemical in daily activities are some of the reasons that make the impact of the exposure worse. Objective: To investigate the role of liquid dish washing soap as a substitute for xylene in routine Hematoxylin and Eosin (H&E) staining procedure for biopsy sections. Materials and Methods: One hundred forty one tissue blocks were used. Two sections from each paraffin block, a total of two hundred eighty two sections with 4μm thickness were included. From each pair of section, one was stained with conventional (routine) H&E staining procedure and the other with xylene-alcohol free (XAF) H&E staining procedure. Slides were scored using five parameters: Nuclear, cytoplasmic, clarity, uniformity, and crispness of staining. Slides that fulfilled at least three of the aforementioned parameters were considered adequate for diagnosis. Three different pathologists evaluated the slides independently. Z test and McNemar’s test were used to compare the difference between the two methods, p-value < 0.05 considered significant. Result: From the three, one pathologist reported that there is no difference between the paired sections on nuclear staining (Z=0.5, p>0.05). As reported by pathologists II(Z =0.6& 0, p >0.05) and III(Z =0.9 & 0.3, p >0.05), there is no significant difference between the paired sections on cytoplasmic and uniformity of staining. Pathologist III reported all slides stained by both methods as “clear”, indicated no difference between conventional and XAF H&E stained slides. Pathologist I(Z =1.7, p >0.05) and III(Z =0, p >0.05) noted that both staining methods showed a crisp staining and there is no significant difference. Finally pathologists II(Z =1, p>0.05) and III (Z =0.6, p >0.05) showed that there is no difference between the two methods stained sections for diagnosis. All the above results are shown by “Z” test because both “Z” test’s and McNemar’s test p value lead to similar statistical conclusion. However, the result of pathologist I for XII crispiness of staining showed discrepancy, while “Z” test showed no significant difference, McNemar’s test indicated agreement between the methods. Conclusion: Removing xylene from the routine staining procedure has many advantages. Replacing it with safer, cheaper and easily disposable reagent is ideal. Therefore, considering the advantages of the new method with regard to the pathologists report in this study, it is possible to say that XAF H&E staining procedure has the potentiality of being the new routine procedure in histology laboratory.
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    Correlation Between Morphology, Cytochemistry, and Flow Cytometry in the Diagnosis of Acute Leukemia at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2018: a Prospective Cross-Sectional Study
    (Addis Ababa University, 2018-03) Dessalegn, Kiyya; Ergete, Wondwossen (MD, Pathologist)
    Background: Leukemia is a group of disorders characterized by the accumulation of abnormal white cells in the bone marrow. The main classification of leukemia is into acute and chronic leukemia. The diagnosis of leukemia has moved from evaluation of morphology and cytochemistry to assessment by modern methods such as immunophenotyping, cytogenetics, and molecular characterization. Objective: To analyze the correlation between morphology, cytochemistry, and flow cytometry in the diagnosis of acute leukemia. Method: This prospective cross-sectional study was conducted from May 2017 to March 2018 in Tikur Anbessa Specialized Hospital and convenient sampling method was used. A total of 40 study participants were diagnosed with acute leukemia based on morphology. Cytochemistry was performed using Sudan Black B and Periodic Acid Schiff. Flow cytometry employing primary and secondary antibodies was performed using FACS Calibur (Becton Dickinson). Data were entered and analyzed using SPSS 20.0. Frequencies were calculated for socio-demographic data and for the morphologic and flow cytometry results. Cross tab was used to measure the association between morphology and cytochemistry and between morphology and flow cytometry and between cytochemistry and flow cytometry. Kappa value was calculated to show the measure of agreement between flow cytometry and morphology. The significant level was based on the p-value of less than 0.05. Results: Based on BM morphology, 15(37.5%) of the 40 cases were classified as ALL and 21 (52.5%) as AML while 4(10%) cases remained unclassified. Based on Flow cytometry, 14(35%) were classified as ALL, 25(62.5%) as AML and 1(2.5%) case was classified as Bi-lineage. Out of 15 ALL cases which were detected by morphology, 2(13.3%) cases showed PAS reactivity and 8(53.3%) showed SBB positivity. Out of 21 AML confirmed cases based on morphology, 19(90.5%) were positive for SBB. Out of four unclassified cases, three cases (75%) were SBB positive. Conclusion: FCA and cytochemistry helped in classifying the unclassifiable cases based on morphology. FCA helped in lineage assignment particularly in ALLs. It is important to use morphology, cytochemistry, and FCA together in classifying acute leukemia as it greatly influences the treatment and the prognosis.
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    A Retrospective Study of Histopathologic Patterns of Odontogenic Tumors ,CYSTS and Maxillofacial Bone Tumors Submitted to Department of Pathology,A5Year Experience at Tikur Anbessa Specialized Hospital From September 2013to August of 2018.
    (Addis Ababa University, 2018-08) Nigussie, Bethelehem; Gemechu, Tufa(MD , Associate Professor of Pathology)
    Introduction: The objectives of this study were to analyse, compare and contrast the demographic, clinical and pathological data of odontogenic tumours , cysts and maxillofacial bone tumors seen at Tikur Anbesa Hospital, Pathology department and compare with other international data as an aid to clinicians in diagnosing odontogenic and maxillofacial bone lesions. Materials and Methods: This was a descriptive, retrospective study of odontogenic tumours and cysts and bone lesions diagnosed from Sep 2013 - Oct 2018 at this centre. These were analyzed for age, gender, site of tumor and histopathologic typing. The odontogenic tumours were classified using the 2005 World Health Organization classification system. Results: From a total of 132 patient cases reviewed , only 107 were having complete records suitable for the study. Of the remaining 107 cases, 59 (55.1%) of the study subjects were males while remaining 48(44.9%) were female. M:F ratio of 1:1.2. Mean age of patients was 27.8years . The commonest age group for both neoplastic and non-neoplastic lesions were in the first and second decades. 60(56.1%) of cases were Benign, 16(15.0%) were Malignant and the rest 31(29%) were nonneoplastic. Most (94.4%) of the biopsy specimen were received from Maxillofacial surgery unit of Yekatit 12 Hospital. Out of the 31 Non-neoplastic cases, 27(87%) of the cases were Odontogenic cysts. Of these, 17(63%) occurred in males and 10(37%) in females. The mean age of occurrence of Odontogenic cysts was 31.56 years. The most frequently recognized Odontogenic cysts were Benign Odontogenic cyst 9(33.3%), followed by Dentigerous cyst 8(29.6%), Odontogenic keratocyst 5(18.5%)and Radicular cyst 5(18.5%). The most commonly affected location by Odontogenic cysts were Maxilla 17(63%) followed by Mandible 9(33.3%). From the 60 benign cases, the commonest benign Odontogenic tumor was Ameloblastoma 15(25%). The mean age of occurrence being 28.8years and M:F ratio of 1.14:1. The commonest site of occurrence was the mandible 14(93.3%). The second commonest benign lesion found was Ossifying fibroma 12(20%). The mean age of occurrence was 22.9years . It occurred in 7(58.3%) of males and 5(41.7%) of females & both mandible 6(50%) and maxilla 6(50%) were equally involved Malignant lesions were 16(15%) of the total cases. 12(75%) were males and 4(25%) were females. The mean age was 29.6% .7 cases(43.8%)occurred in the maxilla, 6 (37.5% in the mandible and the rest 3(18.8%) occurred in Jaw(site not specified). Of the total 16 cases, there were 4 cases(25%) of Osteosarcoma and 4 cases (25%) of Primary intraosseous squamous cell carcinoma Conclusion: Odontogenic tumors, cysts and maxillofacial bone lesions show a definite geographic variation. In our study, ameloblastomas were the most frequent odontogenic tumor similar to other African studies,but significant variation form studies done in Canada and Brazil. Benign fibroosseous lesions were the second commonest lesion which was in contrary to most literatures. Dentigerous cyst was the commonest cyst followed by Odontogenic Keratocyst and Radicular cysts. Adefinitive diagnosis can be made on the basis of clinical radiological, and histological findings. Knowledge of the biological and histological behavior of these lesions is required for their early detection and effective treatment.
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    Performance Evaluation of Conventional Formalin Fixation and Rapid Microwave, Formalin Free Fixation of Large Biopsy Specimens
    (Addis Ababa University, 2018-10) Abite, Yeshwas; Gemechu, Tufa (MD, Pathologist, Associate professor)
    Background: Fixation is the first most important preparative technique. Formaldehyde causes a burning sensation to the eyes, nose, and lungs at high concentrations and also has possible associations with cancers of various organs in occupationally exposed populations. It takes about 24 hours for complete fixation. Microwave fixation method is an alternative tissue fixation technique which can decrease formalin exposure and fixation time. Objective: The objective of this study was to compare the quality of slides prepared by formalin and microwave fixation methods and to compare the time duration of the two methods. Materials and Methods: A prospective cross sectional study was conducted in Tikur Anbessa Specialized Hospital (TASH) from January 2017 to August 2018. A total of 120 paired tissue samples were collected by convenient type of sampling method. Domestic type of microwave and ten percent formalin were used for microwave and conventional fixation respectively. Chi square and kappa statistics were computed for association and agreement tests respectively. Results: Microwave fixation method reduced the time of fixation to 11 minutes while it was 24 hours in formalin fixation. According to observer I, 89.2% and 45% of slides prepared by formalin and microwave fixation methods respectively, gave at least satisfactory result. While as per observer II, 97.5% and 91.2% of the slides prepared by the two fixation methods respectively, gave the same result. The agreement between the two fixation methods on slide qualities was positive except for some parameters. The slide grade of 33 % and 17% of all types of tissue was significantly associated (p< 0.05) with fixation method according to observers I and II respectively. While the slide grades of the rest (67% and 83%) of slides were not dependent on methods of fixation according to these observers respectively.. Conclusion: Microwave irradiation under controlled conditions can reduce fixation time to 11 minutes without significant loss of specimen quality. It can also reduce staffs exposure to formalin. Further assessment need to be done before implementing these methods in various settings.
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    Comparison of Modified Papanicolaou and Dane-Herman Stain with Routine Hematoxylin and Eosin Stain for Demonstration of Keratin in Tissue Sections
    (Addis Ababa University, 2019-04) Sori, Moti; Bekuretsion, Yonas(MD, Associate Professor); Girma, Yonas(MD, Assistant Professor)
    Background: Keratins are intermediate filament forming proteins with specific physicochemical properties produced in any vertebrate epithelia. Having characteristic findings in many epithelial pathologies made them diagnostically important marker. Hematoxylin and Eosin(HE) stain, the routine dye, does not distinguish different eosinophilic components of connective tissue distinctly. On the other hand, special stains like modified Papanicolaou( Mod Pap) and Dane-Herman(D-H) stain can prove to be a simple solution to detect the presence and pattern of keratin histologically. Objectives: To compare modified Papanicolaou stain and Dane Herman stain with routine Hematoxylin and Eosin Stain for demonstration of keratin and also there basic staining characteristics on paraffin blocks tissue sections. Methodology: A total of 116 Formalin-Fixed Paraffin-Embedded(FFPE) tissue blocks were taken of known keratin containing tissue which included Squamous Cell Carcinoma(SCC), Squamous Papilloma, Verrucous Carcinoma and Odontogenic Keratocyst. The tissue blocks were retrieved from the archive of Tikur Anbessa Specialized Hospital(TASH), Department of Pathology. Three sections of 4µm thick tissue from each paraffin block were made and stained with HE, Mod PAP and D-H stains. Then the three stains were evaluated for Nuclear stain(NS), Cytoplasmic stain(CS), Uniformity of staining(US), Background stain(BS) and Keratin pattern(KP) by two pathologists. Finally, the third Senior pathologist was used as a tie breaker. Result: Mod PAP showed agreement with HE by showing Mc Nemar’s P value of 0.219 for NS, 0.727 for CS, 0.851 for US, 0.824 for BS and 1.00 for KP. Whereas D-H showed disagreement with HE for the first four parameters(P=0.000). But D-H showed agreement for KP. Thus, these results show that keratin was stained by D-H, Mod PAP and HE stains distinctly. Mod PAP stain showed similar result when compared with HE stain with parameters-NS, CS, US and BS. However, D-H stain showed statistically significant difference when crosschecked with HE stains. Special stains agreement were analyzed using McNemar as a statistical data tool, P< 0.05 were considered statistically significant. Conclusion: Mod PAP and D-H stains showed similar result for staining of keratin compared to HE stain. For the other four parameters Mod PAP showed an excellent result but not D-H.
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    Cytopathologic Patterns of Thyroid Lesions and Correlation of FNAC Reports with the Corresponding Bstopathologic Results at a Tertiary Hospital in Ethiopia, a five-year Retrospective Study Between January 2015 and August 2019.
    (Addis Ababa University, 2019-06) Jember, Woldie; Dr.Gemechu, Tufa(MD, Associate professor of pathology)
    Background Thyroid diseases are among the most common endocrine disorders worldwide including in Ethiopia and Patients with thyroid diseases can present with diffuse or nodular thyroid enlargement. Determining the type of the lesions in a given setup has paramount importance to design effective therapeutic strategy. As a result, the aim of this study was to find out the cytological patterns of thyroid lesions and compare these cytopathologic reports with their corresponding histopathologic diagnosis at Black Lion Hospital. Methods This was a retrospective cross sectional descriptive study conducted on 687 patients having cytopathologic evaluation for thyroid lesions at Black Lion Hospital between January 2015 and August 2019. Results: Most of the patients were in the age range of 20-60 years, accounting for 521/663(77.3%) cases with Mean age of 41.98 and F:M ratio of 4.69:1. Non- diagnostic(Inconclusive), Benign (Non-neoplastic lesions), Follicular neoplasm, Hurthle Cell neoplasm, Suspicious for malignancy and malignant cytopathologic diagnosis accounted for 33(4.8%), 504(73.4%), 51 (7.4%), 11(1.6%),3(0.4%) and 85(12.4%) of the cases respectively. Among the Benign (Non-neoplastic lesions), Colloid Goitre was the most common diagnosis occurring in 458(90.9%) of the cases. The minimum and maximum age for the occurrence of malignancy in the study was 21 and 80 years old respectively and Papillary Carcinoma was the leading type of malignancy accounting 43(48.9%) of all malignant cases followed by Anaplastic(Undifferentiated) Carcinoma constituted 20(23.6%) of the malignant vi cases. From all 687 patients with cytopathologic evaluation, only for 19 of them were histopathologic reports available for comparison. Eleven of the 19 cases were diagnosed benign(non-neoplastic) lesions by FNAC and 2 ended up with malignant diagnosis histologically. Six of the 19 cases had malignant diagnosis by FNAC and 2 became adenoma up on histologic examination. Conclusion: FNAC is an important tool for the management of thyroid lesions. It is simple, cost-effective technique without any major complications and with minimal discomfort to the patient.
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    Histopathological Pattern of Central Nervous System Tumors:A 5-Year Retrospective Study, at a Tertiary Hospital in Ethiopia.
    (Addis Ababa University, 2019-10) Assefa, Meseret; Girma, Yonas(MD), Associate Professor of Pathology.
    Introduction: Central nervous system tumors are a heterogeneous group of neoplasms, they differ not only in their histomorphological features but also have a distinct biological background and disease course. CNS tumors are confined to the brain, spinal cord, meninges, cranial and Para spinal nerves, with each tumor having its own features, location, morphology, prognosis and treatment. Objective:The purpose of this study is to provide the histopathological pattern of CNS tumors in a tertiary care center in Ethiopia. Material and method: A retrospective descriptive histopathological analysis of central nervous system tumors carried out in the Postgraduate Department of Pathology in Tikur Anbessa Specialized Referral Hospital (TAH), Addis Ababa, Ethiopia. Patients data were retrieved from the archives of the department of Pathology for a period of 5 years from January 01, 2015 to August 31, 2019. Result:A total of 565 cases were analyzed and a wide range of histopathological diagnosis of CNS tumors was observed. Patients ages ranged from 2minths-80 years with a mean age of 36.9 years and a male to female ratio of 1:1.11. Majority of tumors had intracranial location (499 cases, 88.3%).Most of CNS tumors were low grade belonged to Grade I 70% followed by grade II 14. 8%. Tumors of meningeal tissue were most common 51.9% followed by neuroepithelial 24.2 %. When examining the data pertaining to specific types of tumors, most frequent type of CNS tumors was meningioma(272 cases, 48.1%) followed by astrocytoma (86 cases, 15.2%) Conclusion: The present study thus reflects the histopathological patterns of CNS tumors from our center. Although there is availability of advanced imaging techniques at present, still histopathological examination is gold standard in their diagnosis.The conventional H & E staining is the mainstay for pathologic diagnosis, and IHC also plays a major role in differential diagnosis and improving diagnostic accuracy.
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    Histopathologic Pattern of Neoplastic Colorectal Lesions in Resection Specimens at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, over a 5 Year Period, 2016-2020
    (Addis Ababa University, 2020) Yitbarek, Zekarias; Dr.Temesgen, Mullugeta(MD, Assistant professor of pathology)
    Background: Adenocarcinoma of the colon is the most common malignancy of the gastrointestinal tract and is a major contributor to morbidity and mortality worldwide. By contrast, the small intestine, which accounts for 75% of the overall length of the gastrointestinal tract, is an uncommon site for benign and malignant tumors [1] Over 1.8 million new colorectal cancer cases and 881000 deaths are estimated to occur in 2018 accounting for about 1 in 10 cancer cases and deaths. Overall colorectal cancer ranks third in terms of incidence but 2nd in terms of mortality. During 2018, according to Globocan report on Ethiopia 2878 and 1671 new cases of colon and rectal cancers were diagnosed making colon and rectal cancers 5th and 11th in overall cancer incidence .In the same year 2371 and 1067 cases of colon and rectal cancer patients died which makes them 5th and 12th commonest causes of cancer related death. [2] Objectives: The aim of this study is to determine Histopathologic patterns of Neoplastic Colorectal Lesions in resection specimens in Tikur Anbessa Specialized Hospital. Methods and materials: The study applies retrospective cross-sectional descriptive method to review Histopathologic reports of patients with Neoplastic Colorectal Lesions at resection specimens in the five years period (January 2016 to August 2020).The reports are collected from the pathology data archives and data analysis is done by Using IBM SPSS 23.0. Result: A total of 208 colorectal resections fulfil the study criteria in the study period. From this 117 were males and 91 were females. Majority of the cases are in the 5th decade of life (41-50 years), 25%. The age of the study subjects ranges from the minimum of 19 to the maximum age of 87 forming the range of 68 and mean of 52.13. The Rectum is most common location (29.5%) of the lesions followed by the Sigmoid Colon (24.4%). Adenocarcinoma (194, 93.3%) is the most common Histopathologic pattern followed by Neuroendocrine Tumors (7, 3.4%) and 2 cases (1%) of High risk GIST. From the 194 cases of Adenocarcinoma 111 (57.2%) are Males and 83(42.8%) are Females, male to female ratio 1.34:1. The mean age patients with Adenocarcinoma is 51.73 and age range is 19-87.The Rectum 56(30.9%) followed by Sigmoid Colon 47 (26 %) are most common locations. From the total cases of adenocarcinoma 41 of them (21.1%) are aged below 40 while 153(78.9%) are aged above 40. Adenocarcinoma NOS is most common histologic subtype of Adenocarcinoma 165(85.1%) followed by mucinous Adenocarcinoma 26(13.4%) and Signet Ring Cell Carcinoma 3(1.5%). Conclusion: This study reveals that majority of the colorectal cancers occur in the Recto Sigmoid area, in the 5th to 7th decades and more common in males. Adenocarcinoma is by far the most common Histopathologic pattern.
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    Histopathologic Finding of Esophageal Lesions a Five-year Retrospective Descriptive Study at Tikur Anbesa Specialized Hospital from 2016 up to 2020.
    (Addis Ababa University, 2020-01) Nuredin, Fadil; Dr.Gemechu, Tufa (MD, Associate Professor of Pathology)
    Background: According to Globocan 2018 estimate esophageal cancer ranks the eighth and ninth as the leading cause of cancer mortality and morbidity respectively in Ethiopia. Although esophageal lesions particularly cancer is a public health problem in Ethiopia, there are limited data on the margin status, gross description of carcinoma, and proportion of nonneoplastic disease in the country. Objectives: This study aims to assess the histologic type and anatomic location of esophageal lesions overall, and gross description, length of the involved segment, radial margin status, and pathologic stage group of esophageal carcinoma at Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia. Methods: The study was carried out at Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia. The record of 518 patients who had histopathological diagnosis of esophageal lesions over a period of 4 years and 8 months between January 01, 2016, and August 30, 2020, were retrospectively analyzed. A structured data extraction tool was used to collect important variables. Descriptive statistics such as mean, median, frequency, and percentages, etc... were computed using SPSS computer software version 26.0. Result: Out of 518 esophageal endoscopic and resection specimens studied 294(56.8%) were females and 224(43.2%) were males. An age range of 35 days up to 86 years was observed. There Were 475 (91.7%) malignant Cases, 34(6.56%) nonneoplastic cases, and 9(1.73%) precancerous cases. From malignant cases, 46.9% occurs in the distal third of the esophagus followed by 25.1% in the middle third. The mean and median tumor lengths were 4.23 and 4 cm respectively. The most common macroscopic (gross) finding was diffusely infiltrative or constricting 46(48.4%) followed by Fungating or ulcerative38(40.0%). There were 374(78.7%) squamous cell carcinoma and its variants, 94(19.8%) adenocarcinoma and its variants, 6(1.3%) adeno squamous cell carcinoma, and 1(0.2%) undifferentiated carcinoma. 42(44.7%) had positive radial margin status. The commonest histologic grade is G1 29 (48.3%) followed by G3 17 (28.3%) and G2 14 (23.3%). The most common pathologic stage group was stage III 49(54.5%) followed by stage II 27(30%), and stage I and IV each account for 7(7.8%). Half of premalignant cases occur in the middle third and the other half in the distal third. The most common histologic type was high-grade squamous dysplasia 5(55.6%) followed by Barrett's esophagus with low-grade dysplasia 2(22.2%). 56.3% nonneoplastic cases occur in the distal third followed by two or more segments in 21.9%. Barrettes esophagus, Nonspecific esophagitis, and benign ulcers account for more than 60 % of the cases Conclusion: The majority of esophageal lesions were malignant and are squamous cell carcinoma. Overall cancer of the esophagus mainly affects the distal 1/3 of the esophagus including GEJ. Most carcinomas are well-differentiated, in pathologic stage III, and have positive radial margin status.
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    Tuberculosis Lymphadenitis Among HIV-Positive Individuals and its Correlation to CD4 Count, Cytomorphological Pattern and Clinical Diagnosis in Mekell University Ayder Comprehensive Specialized Referral Hospital
    (Addis Ababa University, 2020-05) Alemseged, Kesete; Dr.Girma, Yonas(MD, Pathologist)
    Background: Tuberculosis is the second leading cause of death from infectious disease globally with its impact more dramatic in resource limited settings. Individuals with human immunodeficiency virus infection who also develop tuberculosis represent a significant challenge to TB control. HIV not only increases the number of TB cases, but also alters the clinical course of TB disease. As HIV related immunosuppression increases, the clinical pattern of TB changes, with increasing numbers of smear-negative and extrapulmonary cases. Lymphadenopathy is one of the most common manifestations at any stage of HIV/AIDS with different underlying pathogenesis. Tuberculous Lymphadenitis is the most common form of extrapulmonary TB and typically presents with asymmetric involvement of multiple nodes 1 cm or larger in size. Cervical and axillary nodes are most frequently affected.CD4 T cells play central roles in the function of the immune system and are important mediators of immunologic memory, Objective: the objective of this study is to determine the prevalence of tuberculosis lymphadenitis infection among HIV/AIDS positive patients and its correlation to CD4-count, morphological patterns and clinical Diagnosis. Method: A cross sectional study design was conducted from January 10/2019 to July 10/2019. A total of 90 HIV positive patients who develop lymph node were enrolled into the study by contacting the patients during their visit to the ART clinic. Socio -demographic characteristics and other variables were collected using a pretested semi-structured questionnaire. Detailed clinical history and laboratory investigations were considered in all patients. The statistical software and methods including the level of statistical significance were explained and employed for data analysis and interpretation. The results were then analyzed statistically using the statistical package for social sciences (SPSS) version 23 for Windows. Result: Maximum number of tuberculosis lymphadenitis is seen in the age group of 21-30 years followed by age group of 31-42 and with a decreasing trend in elderly. There was a female preponderance of cases. Most cases of Tuberculosis lymphadenitis emerged as the 2nd most frequent Cytomorphological pattern of diagnosis next to reactive lymphoid hyperplasia to be associated with HIV infection With the typical caseous necrosis and Epitheloid granuloma.CD4 count <200/mm3 and WHO Severe clinical stage of the disease were found to be predictors of tuberculosis lymphadenitis and cervical and axillary group of lymph node were found to be the most involved site. Finally Tuberculosis lymphadenitis is over diagnosed clinically compared to Cyto-morphological Diagnosis. Conclusion; Caseous necrosis and Epitheloid granuloma were leading causes of Tuberculosis lymphadenitis .CD4 count <200/mm3 and Sever clinical stage (stage IV) of the disease were found to be predictors of tuberculosis lymphadenitis. So initiation of Anti-retroviral treatment before the CD4 count drops below 350 /mm3 should be encouraged and intervention aimed at preventing and treating HIV Associated tuberculosis lymphadenitis is crucial. The cervical and auxiliary region was found to be the most involved site respectively and Tuberculosis lymphadenitis is over diagnosed in clinical Diagnosis compare to Cytomorphological Diagnosis suggesting the need of diagnostic test(s) like cytomorphological examination to supplement the clinical examinations. Recommendation: cytologic examination of fine needle aspirates should be included in the diagnostic work-up of any patient suspected for TBLN in health institutions with limited laboratory capacity like regional or district Hospitals. Intervention aimed at preventing and treating HIV associated Tuberculosis lymphadenitis are crucial. High quality services should provide by incorporating an efficient quality control system and a molecular technique that detects DNA sequences specific for Mycobacterium tuberculosis by polymerase chain reaction can be used as screening test. In addition since culture is considered as golden standard emphasis should be given in detection of mycobacterium tuberculosis from lymph node aspiration.
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    Morphological Patterns of Neoplastic and Non-neoplastic Salivary Gland lesions in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, over a 5 year period, July 2015 to June 2020
    (Addis Ababa University, 2020-07) Abate, Demis; Dr.Arayaselassie, Mahlet (MD, Assistant professor of pathology)
    Introduction: Salivary gland tumors account for < 1% of all tumors and about 4% of all epithelial neoplasms in head and neck region, and can display a remarkable range of morphological diversity between different tumor types. The objectives of this study were to analyze, compare and contrast the demographic and morphological data of neoplastic and nonneoplastic salivary gland lesions seen at Tikur Anbessa Hospital, Pathology department. Materials and Method: This was a descriptive, retrospective study of the salivary gland lesions diagnosed from July 2015 up to June 2020 from the Tikur Anbessa Hospital, Department of Pathology archive. These were analyzed for age, gender, anatomical location of the tumors and morphological typing. The salivary gland tumors were classified according to the 2017 WHO classification system. Results: From a total of 378 cases reviewed, 339 files had complete medical records fulfilling the study criteria. Of the 339 cases, 180 (53.1%) of the study subjects were females with an F: M ratio of 1.13:1. The commonest age group for both neoplastic and non-neoplastic salivary gland lesions was in the 3rd and 4th decades but spans a broad age range (2nd to 6th decades of life). 143 (42.2%) of the cases were non-neoplastic while the remaining 185 (54.6%) cases were neoplastic. Eleven (3.2%) cases were diagnosed as normal glands. Majority of the salivary gland neoplasms were benign tumors, accounting for 111 (60%). Among from the 143 non-neoplastic 76 (53.1%) were sialadenitis. More than half of the sialadenitis, 47 cases (61.8%) were constituted by chronic non-specific sialadenitis followed by obstructive sialadenitis with sialolithiasis and lymphoepithelial sialadenitis, 7 cases (9.2%) each. The most frequently affected anatomic location was the submandibular glands (62%) followed by the parotids (23.4%). Out of the 111benign tumors, PA was the most frequently occurring benign neoplasm with 99 cases (89.2%). The mean age of occurrence being 36.9 years and an F:M ratio of 1.4:1. The commonest site of occurrence was the parotids 36 (32.4%). The second most common benign tumor were myoepithelioma and basal cell adenoma containing 3 cases (2.7%) each, both located in the major salivary glands, mainly the parotids and the submandibular glands. Of the malignant tumors, 40 (58.8%) were females and 30 (44.2%) were males with an F:M ratio of 1.33:1. The mean age was 42.5 years. Mucoepidermoid carcinoma 23 (33.3%) cases was the commonest salivary gland cancer followed by 21 cases of adenoid cystic carcinoma (30.4%), 6 cases of acinic cell carcinoma (8.8%) and 3 cases of adenocarcinoma, NOS (4.4%). 78 (42.4%) cases occurred in the parotid, 40 (21.7%) cases arose from the palate and 25 (13.6%) of the cases originated from the submandibular glands. Four cases of lymphomas, 3 cases of primary squamous cell carcinomas and a single case of high grade sarcoma were reported. Conclusion: Non-neoplastic lesions and tumors of the salivary glands show a slight geographic variation. In our study, pleomorphic adenomas were the most frequent salivary gland tumors similar to other African, Brazilian and Asian studies, but significant variation form studies done in Croatia. Sialadenitis was the second commonest lesion obtained which was in agreement to most literatures in African and Caribbean nations. In our study, Warthin tumor was the fourth most frequently identified benign salivary gland tumor which was in contradictory to most of the literatures.
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    A Retrospective Study of Cytopathologic Patterns of Lymphnode Lesions at a Tertiary Hospital in Ethiopia, Between January, 2018 to August ,2020.
    (Addis Ababa University, 2020-08) Terefe, Lemlem; Dr.Ergete, Wondwossen (MD, Associate professor of pathology)
    Background: Lymph node comprises an important part of defense system in the human body as it traps or filters foreign particles. Lymphadenopathy refers to lymph nodes with abnormal size, number or consistency (1). The cause of lymphadenopathy is varied and may be inflammatory or neoplastic process. There is a wide variation in pattern of disease in different age groups, gender and in various countries. The main aim of FNAC is for rapid diagnosis of lymphadenopathy with simple, accurate procedure and with minimum trauma and low cost. It identifies lymph node enlargements with malignant potential that requires treatment and those benign conditions that can be observed clinically. Methods and Materials: Retrospective cross-sectional descriptive study was conducted on 771 lymphadenopathies cases in which FNAC was performed in patients referred to pathology laboratory of black lion hospital in the three years period (from January 01, 2018 to August 30, 2020). Results: Of the 771 lymph node FNAC biopsy specimens received, 409 (53%) were females and 362 (47%) were from males making F: M ratio of 1.13:1. with mean, lowest and highest age limits of 33.6 years, 3 month and 84 years respectively. Most of the patients were in the age range of 21-30 years accounting for 152(19.7%). Localized lymphadenopathy was observed in 638 (82.7%)cases. Cervical lymphadenopathy predominated, comprising 211 (27.4%)cases. Metastatic disease and reactive lymphadenitis were the major causes of lymphadenopathies constituting 256 (33.2%) and 176(22.83%) respectively. Metastatic tumor was commonest in adult females above 30 years and reactive lymphadenitis was the predominant cause of lymph node enlargement in age groups (0-30 years ) and rare above the age of 40 years. 166 (21.5%)lymphoma cases were seen out of these 132 (79.5%) of the cases were Non-Hodgkin’s lymphoma of these 67.4% occurred in males and 32.6% in females followed by Hodgkin’s lymphoma accounting 27(16.3%) and 63% cases were seen in males and 37% cases in females. 7 (4.2%) cases diagnosed as lymphoma only. Other benign lesions identified were; tuberculosis lymphadenitis constituting 83 (10.8%). Suppurative lymphadenitis 10 (1.3%)and other benign diseases 2(0.3%)were seen. Other malignant lesion identified in this study were non-specified malignant tumor, leukemic infiltration, myeloid sarcoma and plasmacytoma accounting 11 (2.5%), 4(0.9%), 2(0.5%) and 1(0.2%) respectively. Conclusion: In this study the majority of patients with lymphadenopathy had metastatic deposits commonly ductal carcinoma. Reactive lymphadenitis was the second most common pathology Followed by lymphoma.
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    Histopathologic Study of Sinonasal Lesions: A Hospital Based Retrospective Study, From January 2016 to August 2020
    (Addis Ababa University, 2020-09) Alemayehu, Ruth Abera; Dr.Gemechu, Tufa (MD, Associate Professor of Pathology)
    Background: Sinonasal area is a host to various neoplastic and non- neoplastic lesions. The presenting symptoms of sinonasal lesions are similar and pose difficulty for diagnosis based on clinical features and advanced imaging modalities, which makes histopathology the principal diagnostic tool approach for these lesions. The aim of this study is to determine the various histopathologic types of Sinonasal lesions, their classification and relative distribution with regards to age and sex in our setting. Materials and Methods: A retrospective cross-sectional descriptive study conducted on 306 cases of sinonasal lesions over the period from January 2016 to August 2020. All the sinonasal tissues were received and diagnosed at histopathology section of Department of Pathology in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. The Pathology reports were collected from the pathology data archives; and the variables of study were extracted by using a data extraction sheet, and data analysis was done using SPSS version 26.0. Results: Most affected age group was 21-30 years 81(26.5%). Male predominance was observed with M: F ratio of 1.4:1.Nasal cavity was the commonest anatomical site involved 237(77.5%).There were 137(44.8%) Non-neoplastic lesions and 169(55.2%) Neoplastic lesions. Inflammatory Sinonasal Polyps 100(73.0%) were the most common among non-neoplastic lesions; inverted Sinonasal Papilloma 34(41%) the most common among the benign neoplastic and squamous cell carcinoma and nasopharyngeal carcinoma accounting for 21(25.6%) cases each, were the commonest malignant lesions. Conclusion: clinical findings and advanced image modalities can reach to a presumptive diagnosis for the sinonasal lesions but histopathology remains the gold standard for categorizing and diagnosis of non-neoplastic and neoplastic lesions of sinonasal tract.
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    Histopathologic Patterns of Uterine Corpus Neoplasms in in a Tertiary Level Teaching Hospital,CHS,Tikur Anbessa Specialized Hospital, AAU, Addis Ababa, Ethiopia, a Retrospective Study over a 5 year period, August ,2016-2020.
    (Addis Ababa University, 2020-10) Teshome, Hiwot; Dr.Girma, Yonas(MD, Associate professor of pathology)
    Background: Malignant Uterine corpus tumors (UCT ) are increasing in alarming rate throughout the word. Even if most common of this endometrial carcinoma; is prevalent in western & high income countries ,due to change in life style, increasing obesity, metabolic syndrome and exogenous hormone use its incidence is raising in middle income & developing nations. Many studies of large series has been conducted worldwide on uterine corpus tumors. However, in Ethiopia, epidemiological analysis of these tumors are very scarce. The present paper is a retrospective study of 1126 cases of uterine corpus lesions from a single institution, in Addis Ababa University, TASH. According to global cancer observatory estimate in2018 there were total 67,573 new cancer cases, and 47,954 deaths in Ethiopia. Out of this corpus uterine contributes 762 new cases (1.13%) and 404 deaths( 0.08) And Addis Ababa Cancer Registry 2015 report had estimated 961 new cases of uterine cancer ranked 9th commonest cancer among women; with ASIR OF 3.2% and CIR 1.9 %. Objectives: The aim of this study is to determine histopathologic patterns of uterine corpus lesions and their frequency .in Tikur Anbessa Specialized Hospital. Methods and materials: A retrospective analysis of histopathological pattern of Uterine corpus tumors was carried out in the Department of Pathology, college of health sciences, Tikur Anbessa Specialized Referral Hospital (TAH), Addis Ababa university , Addis Ababa, Ethiopia. Patients data was retrieved from the archives of the department of Pathology for a period of 5 years from August 2016-2020 and analyzed using spss version 26. Result: Out of 1126 cases ,benign lesions accounted 88.4% and the rest 11.6% are malignant lesion .Leiomyoma is most frequent benign lesions. with peak age b/n 31-40yrs.and cellular leiomyoma is commonest histologic type. From malignant lesions ,epithelial origin is the most frequent accounting 55% followed by MMMT (13%), Leiomyosarcoma (9.2%), ESS ,choriocarcinoma, Invasive mole each contribute ( 6.9%).other sarcoma’s group; one rhabdomyosarcoma & two undifferentiated pleomorphic sarcoma total 3 cases (2.3%) is found. Endometroid carcinoma is most common endometrial carcinoma type. Mean age of occurrence for endometrial carcinoma is younger than endometrial sarcomas. Conclusion: In this study benign neoplasms are way more prevalent than malignant lesions,but for age above 50 yr malignancy appeared to be a common cause of uterine bleeding. Both benign & malignant lesions have common clinical presentation majority having AUB ,b/s of this histopathology remains the mainstay of final and definitive diagnosis.