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Item 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, BorenaItem 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, MengistuBackground: 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. 10Item 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.Item 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.Item 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.Item Cytopathologic Review of Breast Lesions and Correlation with Histopathologic Results at Tikur Anbessa Specialized Hospital: A Six Years and Eight Months Retrospective Study from 2015 - 2021.(Addis Ababa University, 2021-11) Belihu, Negash; Dr.Ergete, Wondwossen(MD, Associate Professor of Pathology)Background: A palpable breast lump is always a cause of concern to the patient. Hence, accurate pathological diagnosis is crucial for further management and to evaluate the outcome. Clinical examination, imaging and FNAB are implemented in the assessment of breast lesions in the Triple Test. In this regard the role of FNAB is vital in the diagnoses of breast lesions particularly in identifying malignant lesions. Objectives: The aim of this study was to determine cytopathologic patterns of breast lesions in TASH and to correlate Fine Needle Aspiration Biopsy results with the corresponding histopathologic results as to determine the validity of FNAB. Methods: A retrospective descriptive cross-sectional study of 1327 patients who underwent FNAB of whom 145 had histopathology results over six years and eight months between January 2015 and August 2021 in TASH. Descriptive statistics of the cytology reports as well as diagnostic performance analysis of malignant and benign FNAB categories made using SPSS version 23. Results: A total number of 1327 patients were included out of which 1214 (91.5%) were females and 113 (8.5%) were males. According to the IAC Yokohama system the malignant and benign categories of FNAB account 44% each of the total cases and the rest contributed by the suspicious, atypical and insufficient categories. Most of the Malignancies present in the 4 th and 5 th decades of life whereas benign cases happened a decade earlier. 145 of the cases were followed by histopathology. FNAB of benign and malignant lesions showed 96.0% accuracy, 96.3% sensitivity and 97.7% specificity. Conclusion: The burden of malignancy in this setup (TASH) is high yet, FNAB remains to be a reliable and acceptable method for the diagnosis of breast lesions.Item Evaluating Efficacy of Paraffin Oil, Isopropanol and Ethanol Mixture as Alternative for Xylene in Surgical Biopsy Tissue Processing by the Conventional Paraffin Wax Method: Comparative Study in Histopathology(Addis Ababa University, 2021-06) Berhane, Natinael; Dr.Bekuretsion, Yonas (MD, Pathologist, Asst. professor of pathology); Abite, Yeshiwas (PhD Candidate, AAU, Pathology Department)Background: Major global mortality is due to non-communicable diseases with cancer predominance. Unfortunately, Cancers diagnosed at late to end stages in Africa. Histopathology diagnosis has tremendous value in the treatment, prognosis and follow up of cancer patients. Fixation, processing, embedding, sectioning, staining and evaluation of slides are mandatory procedures in histopathology. These procedures use noxious and carcinogenic chemicals primarily xylene. However; xylene is hazardous chemical that causes muscular, neuron, ocular, reproductive, respiratory, immunological, hematological, renal, hepatic, cardiac effects. Fluid and vapors of xylene cannot be prevented with glove and masks. Hence there should be some substitution mechanism which can minimize or replace use of xylene in histopathology laboratory. Objective: This study aimed to evaluate the comparative efficacy of paraffin oil, isopropanol and ethanol mixture (PIE) as a bio friendly replacement for noxious xylene in surgical tissue processing with conventional paraffin wax method. Method: Prospective cross-sectional method and purposeful sampling technique was used at St. Paul’s hospital millennium medical college pathology department from February 2019 up to December 2020 GC. A total of 112 samples were processed using new mixture and conventional xylene method. Block sectioning simplicity and slide quality for diagnosis were evaluated by histologists and pathologists using standard checklist respectively. Result: According to the study, report of the three histologists revealed that 94.4% and 94.5% blocks were easy to produce good sections with paraffin oil, isopropanol and ethanol mixture and Conventional xylene methods respectively; indicating no statistical difference among methods (p=0.967). Evaluation of mounting, block storage stability and physical quality of sections confirmed adequacy in 98.2%, 99.1% and 98.3% respectively. This result showed no statistical significant difference with the conventional method (p=1.000)). The new xylene free method showed 95 % and 96.4% nuclear and cytoplasmic staining adequacy respectively.no statistical difference in both parameters recorded (p=0.602 and0.772 respectively) 95.3%, 96.8% and 95.5 % of stained slides which were processed with the new method revealed adequacy for clarity, uniformity and crispness of staining respectively indicating no statistical significant difference as p=0.073, 0.108, and 0.180 respectively. About 95.8% of total slides were adequate for diagnosis with the new method which was not statistically significant (p=0.668 & p= 0.229 by score and observant respectively). Conclusion: The new mixture has comparable ability with that of xylene to clear surgical biopsy specimens during processing in histopathology.Item Evaluating the Efficacy of Turmeric Solution as Cytoplasmic Stain in Routine Staining Procedure(Addis Ababa University, 2021-07) Zewdu, Belaynesh; Temesgen, Mulugeta(MD, Pathologist, Asst. Professor of Pathology)Background: histopathology is a gold standard method in pathology where tissue samples are grossed, processed, cut, stained, mounted and microscopically evaluated. Samples of tissue are taken from patients and then prepared using appropriate staining protocols to detect and diagnose the disease. Hematoxylin and eosin is the most pronounced technique. Eosin is a synthetic dye derived from fluorescein. Eosin is hazardous to humans and animals. With the increasing awareness of green earth it is advisable to use more of eco-friendly and biodegradable material which can be effectively achieved by the use of natural dye from plants and other natural sources. Turmeric available as curcuma longa (domestic) is believed to have staining property. Aim: This study aimed to evaluate the efficacy of turmeric solution as cytoplasmic stain in hematoxylin and eosin staining procedure for substitution of hazardous eosin. Method: prospective cross-sectional method and convenience sampling technique was used at Tikur Anbesa Specialized hospital pathology department in August 2020. Forty tissue blocks were used. From each block three sections were taken at 4µm thickness, a total of one hundred twenty sections grouped into three and stained turmeric with mordant (H&TM), turmeric without mordant (H&T) and conventional eosin (H&E) staining methods. Staining was evaluated by three histopathologists independently, using standard checklist. Slides were scored using six parameters: Nuclear, cytoplasmic, uniformity, clarity, crispness and background of staining. Slides that satisfied at least four of the aforesaid parameters were considered adequate for diagnosis. Z- test and chi-square test were used to compare the difference among the three methods, p-value < 0.05 considered significant. Result: TM stained slides were adequate for diagnosis was comparable with that of the conventional eosin method. There was no statistical significant difference among pathologist as well as the methods p- value was >0.05(0.123). On average from a total of 120 stained slides, 112(93.3%) stained slides were adequate for diagnosis and 8 (6.7%) inadequate. but adequacy and substituting capability of HT with that of eosin showed high discrepancy in adequacy. There was statistical significant difference among methods p- value was<0.05(0.00) .On average from a total of 120 stained slides 69(57.7%) were adequate for diagnosis and 51(42.5%) inadequate.Item Evaluation of Fine Needle Aspiration Cytology in Primary Soft Tissue Tumors with its Histopathological Correlation in Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia: A Five Year Retrospective Study from July 2016 to July 2021.(Addis Ababa University, 2021-10) Birhanu, Tadele; Dr.Girma, Yonas(MD, Assistant Professor of Pathology)Soft tissue tumors constitute a large and heterogeneous group of neoplasms. Benign tumors out number their malignant counterparts by a ratio of about 100:1 in hospital population. FNAC has emerged as a major outpatient procedure for the diagnosis of soft tissue tumors due to low cost of the procedure, less complications, feasibility, quick results and high therapeutic efficiency with specificity and sensitivity of approximately 95%. The diagnostic accuracy of FNAC of soft tissue tumors in distinguishing benign and malignant lesion is also very high. The objectives of this study will be to study the role of FNAC in the diagnosis of soft tissue tumors and its correlation with histopathology. Also, this study aimed at studying various cytomorphological patterns of soft tissue tumors and correlating cytological grading with histopathological grading. The aim of this study is to determine the role of fine needle aspiration cytology in soft tissue tumors and its histopathological correlation in Tikur Anbessa Specialized Hospital. The study applies retrospective cross-sectional descriptive method to review the role of fine needle aspiration cytology in soft tissue tumors and its histopathological correlation in the five years period (July 2016 to July 2021).The data is collected from the pathology data archives and data analysis will be done by Using IBM SPSS 25.0.Both FNAC and biopsy done for soft tissue tumors are more common in males than females and for malignant tumors than benign tumors. The most common age at which both FNAC and biopsy done is from 2nd to 4th decade for benign soft tissue tumors and from 2nd to 6th decade for malignant soft tissue tumors. The commonest site for both benign and malignant soft tissue tumors were lower extremities followed by trunk and upper extremities. The commonest soft tissue tumors for which both FNAC and biopsy done were under spindle cell, adipocytic and small round blue cell tumor categories. Out of total of 34 sarcomas majority are grade 3 followed by 1 and most are under the group of small round blue cell sarcoma and spindle cell sarcomas. The diagnostic accuracy of FNAC of soft tissue tumors is about 81.08%. Majority of discordant rate was found to be under a group of spindle cell tumor. Excisional biopsy was recommended for majority of soft tissue tumors after FNAC especially for malignant soft tissue tumors.In this study soft tissue tumors are more common in males than females and the peak age at presentation was from 10 to 29 years. The top three commonest location of soft tissue tumors were lower extremities, trunk and head and neck regions. Malignant tumors outnumbered benign tumors and the commonest soft tissue tumors were grouped under spindle cell, adipocytic and small round blue cell tumors. The majority of soft tissue tumor cytological diagnosis was a group diagnosis not specific diagnosis for which excisional biopsy was recommended. The majority of soft tissue sarcomas were high grade which has high concordance rate with histopathological grading. In general FNA cytology was found to be fairly reliable diagnostic procedure for early diagnosis of soft tissue tumorsItem Histomorphologic Patterns of Primary Mediastinal Masses at Tikur Anbessa Hospital: A Retrospective Cross-Sectional Study(Addis Ababa University, 2020-12) Alamineh, Amanuel; Dr. BekureTsion, Yonas (MD, Assoc. Professor of Pathology)Background: The mediastinum is a complex anatomic division of the thorax, housing numerous organs and harboring many histologically diverse tumors and cysts affecting people of all ages. Data regarding to their true incidence, symptomatology, age distribution and incidence trends of particular histologic types is lacking due to their heterogeneity and rarity. Aims: The aim of this study is to assess epidemiologic profile and histomorphologic patterns of primary mediastinal masses in Tikur Anbessa Specialized Hospital, Addis Ababa University over a five years’ period from August, 2015 to 2020. Methods: This is a retrospective cross-sectional study in which we collected, compiled and analyzed documents of patients with biopsy diagnosis of primary mediastinal tumor from the archives of Department of pathology, Addis Ababa University from August 2015 to 2020. Data were entered, cleared, and analyzed using SPSS statistical software package. Result: Among 102 patients with primary diagnosis of mediastinal tumors, 52 (51.0 %) were males. The mean age of the patients was 33.6 ± 18.9 years. Seventy-two (70.6%) of the masses were in the anterior, 5 (4.9%) were in the middle, and 20 (19.6%) were in the posterior mediastinum. The most common neoplasms seen most frequently were thymomas (37.3%), neurogenic tumors (12.7%) and lymphomas (10.8%). Sixty-five (63.7%) of cases were malignant, benign tumors accounted for thirty-seven cases (36.3%). Compartment localization and age group (pediatric (<15) vs adult) had significant association with the presence of malignancy (P < 0.01). Chest pain (58.5%) and shortness of breath (52.8%) were the two most common symptoms. Conclusion: In our study malignant tumors were more common than benign tumors. Thymomas and neurogenic tumors were the most common mediastinal tumors. The anterior mediastinum was the most common location of tumors. The frequency of malignancy was significantly higher in male population as compared to females. Compartment localization and age group (pediatric (<15) vs adult) had significant association with the presence of malignancy (P< 0.01).Item 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.Item Histopathologic Pattern of Neoplastic and Nonneoplastic Lung lesions in Resected Specimens with Their Clinicoradiologic Features in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2016-2020.(Addis Ababa University, 2020-12) Kassa, Amanuel; Dr.Ergete, Wondwossen (MD), Associate Professor of Pathology:Background: List of disease entities affect the lung, with surgically removed masses accounting a large share in proportion. A variety of neoplastic and non-neoplastic lesions are under this category. Results of several studies show neoplastic lesions account for the largest share among resected specimens. From the neoplastic lesions, malignancies are the most common ones; from these primary tumors (carcinomas) are the leading. Benign tumors are very rare compared to the malignant ones, hamartoma being the most common among the benign category. According to the 2018 WHO report, lung cancer is the most cancer (2.09 million cases) and the leading cause of death (1.76 million). According to the Globocan report on the incidence and prevalence of cancer in Ethiopia by 2018, Lung cancer ranks the 7 most common malignancy in Ethiopia. Addis Ababa population-based pattern of cancer therapy, found out that lung cancer ranking as the 5th most common malignant tumor. Objectives: The aim of this study was to determine the frequency and histopathologic patterns of lung lesions with clinicoradiological features in resected specimens diagnosed in Tikur Anbessa Hospital. Methods and materials: Retrospective study was conducted on five years biopsy reports of neoplastic and non-neoplastic resected lung lesions submitted from January 01, 2016 to August 30, 2020. Data had been retrieved from the archive of the department of pathology. Clinical presentation and gross description of the lesions was collected from the patient’s original biopsy request. Final data analysis was done using latest SPSS version 25. Results: From a total of 170 cases reviewed 159 cases fulfilled the study criteria and included in the study. From these, 99 (62.3%) of the study subjects were males while the remaining 60 (37.7%) were female. M:F ratio of 1.65:1. The minimum age was 2 month and the maximum age was 73 year. Mean age of patients was 36.8 year. There were 92 (57.9%) non-neoplastic cases and 67 (42.1%) neoplastic cases. The commonest age group for both neoplastic and nonneoplastic lesions were 3rd and 4th decades. Cough and hemoptysis were the commonest clinical presentation (n = 39, 24.5%). The commonest radiologic finding was mass 37 (23.3%). Lobectomy was the most common surgical procedure performed (n=97, 61 %) followed by pneumonectomy 38 (23.9%). Bronchiectasis was the most common non-neoplastic histopathologic entity 18 (11.3%) cases, followed by aspergillosis 16 (10.1%) cases. Out of the 67 neoplastic cases, only 5 (7.5%) cases were benign the rest 62 (92.5%) were malignant. All the benign tumors were hamartoma. The malignant cases had a M:F ratio of 1.06:1. Typical carcinoid was the most common histopathologic type reported (45.2%), followed by adenocarcinoma (25.8%), SCC (9.7%). Majority of the malignant neoplasms were in pathologic stage II (55.2 %). There were 31 (53.4%) cases with known lymph node status. From these, 58.1 % had up to 3 LNs and 25.8 % had up to 4-6 LNs examined with majority had N0 (34.5%) cases and N1 (15.5%) cases. Conclusion: In this study a higher proportion of non-neoplastic lesions were identified in resection specimens than neoplastic cases. Carcinoid tumor was the most frequent histopathologic subtype. thItem 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.Item Histopathologic Patterns of Neoplastic and Non-neoplastic Kidney Lesions in Nephretcomy Specimen in Tikur Anbesa Specialized Hospital, Addis Abeba, Ethiopia, Over a Five Year Period, 2017-2021(Addis Ababa University, 2022-01) Wolde, Kasahun; Dr.Gemechu, Tufachu (MD, Associate professor of pathology)Background : The kidney is one of the major organs that have essential functions such as maintaining electrolyte balance and ph as well removing waste products among other things. Various neoplastic and non-neoplastic lesions affect the kidneys for which nephrectomy are the standard procedure performed. The indications, however, differ by geographic location , age groups and time periods .Therefore ,the aim of this study is to determine the patterns of neoplastic and non neoplastic lesions in nephrectomy specimens in TASH. Methods and Materials This was a retrospective cross sectional descriptive study conducted on 174 patients having Histopathologic evaluation of their nephrectomy specimens at Tikur Anbesa Specialized Hospital from September 2017 and August 2021. Result : 92 (52.9%) of the study subjects were females while remaining 82(47.1%) were male with male to female ratio of 0.9;1 . Neoplastic diseases accounted for 75.2 percent, nonneoplastic 22.4 and multicystic renal dysplasia 2.3 percent . The mean age of patients was 31.95 with SD 22.127 with minimum and maximum age of 6 month and 75 years respectively. The most common neoplatsic indication for nephrectomy was renal cell carcinoma [N=69] constituting 39.7 percent followed by nephroblastoma 26.4 percent [N=46]. The most common non-neoplastic lesion was CPN with HN accounting for 35.5 percent. Conclusion : A wide Histopathologic spectrum of neoplastic and non neoplastic diseases were found in the present study. There is a decline in non-neoplastic lesions which may be due to early diagnosis and treatment.Item 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.Item Histopathologic Patters of liver Diseases: a Five Year Retrospective Study in Tertiary Level Teaching Hospital, Tikur Anbessa Specialized Hospital, Ethiopia.(Addis Ababa University, 2020-12) Shitahun, Mengistu; Dr.Girma, Yonas(MD, Associate Professor of Pathology)Introduction: Liver diseases account for a significant number of morbidity and mortality worldwide being affected by a wide spectrum of various primary and secondary diseases. The major primary diseases of the liver are viral hepatitis, nonalcoholic fatty liver disease (NAFLD), alcoholic liver disease, and hepatocellular carcinoma (HCC). Distinguishing among them can be challenging, but the distinction is critically important given the differing prognostic and therapeutic implications. These diseases can be diagnosed with the help of clinical, biochemical or radiological examinations. However, liver histopathology remains the mainstay in diagnosis as well as management of various liver diseases. Objectives: The aim of this study was to assess histopathologic patterns of liver diseases Methods and Materials: A retrospective descriptive histopathological analysis of histopathological pattern of liver disease was carried out in the Postgraduate Department of Pathology, college of health sciences, Tikur Anbessa Specialized Referral Hospital (TAH), Addis Ababa, Ethiopia. Patients data was retrieved from the archives of the department of Pathology for a period of 4 years and 8 months from January 2016 to August 2020). Result : In this study a total of 116 cases were included. Of the total cases 60(51.7%) were females and 56(48.3%) were males with female to male ratio of 1.1:1. Most of the ages ranges from 30 to 79 years, which accounts for 86.2% of cases and with mean, standard deviation, lowest and highest age range of 49, 17.97, 6 months and 79 years respectively. The peak age was the 7 decade. Malignant lesions were the most common diagnoses accounted for 56.9%, HCC being the most frequent malignant lesion 19.8% of all cases followed by secondary carcinoma 17.2%, cholangiocarcinoma 6.9%, neuroendocrine tumor 3.4%, secondary high grade sarcoma 2.6%, adenocarcinoma with neuroendocrine differentiation 1.7%, hepatoblastoma 1.7%, malignant undifferentiated tumor 0.9 %, lymphoma 0.9%, secondary epitheloid GIST 0.9% and suspicious for malignancy 0.9% in decreasing frequency. HCC was more common in males with male to female ratio of 2.8 : 1. Almost all benign liver lesions were found in females with female to male ratio of 12 : 1. Hemangioma was the most common benign neoplastic lesion accounting for 7.8% followed by benign liver cyst 1.7% and FNH 0.95%. TB was most common non neoplastic lesion 3.4%. And the remaining histologic patterns included hydatid cyst 3(2.6%), abscess 2(1.7%), seatosis/fatty change 2(1.7%), cirrhosis 1(0.9%), biliary atresia with cirrhosis 1(0.9 %), chronic active hepatitis 1(0.9%), acute alcoholic hepatitis 1(0.9%), acute complete intrahepatic cholestasis with ascending cholangitis + stage 3 fibrosis 1(0.9%), chronic nonspecific inflammation of the cyst wall 1(0.9%), non diagnostic 1( 0.9%) and 3(2.6%) of cases were reported as normal histology. 13.8% of cases were descriptive reports. Conclusion : HCC is the most common liver lesion and most common malignant histopathologic diagnosis in this study which agrees to some studies in India. In most African studies infectious and inflammatory lesions are the most common. The diagnoses of malignant lesions in this study were at later ages than most of other studies. Hemangioma was significant in amount.Item Histopathologic study of Bladder lesions: A Hospital Based Retrospective Study, From January 01, 2016 to August 30, 2020.(Addis Ababa University, 2020-12) Belachew, Anteneh; Dr.Temesgen, Mulugeta (MD), Assistant professor of pathologyBackground: Urinary bladder lesions, non-neoplastic and neoplastic, are collectively responsible for significant morbidity and mortality throughout the world. Bladder cancer is the 7th most common cancer worldwide, with an estimated 260,000 new cases occurring each year in men and 76,000 in women. Cancer of the urinary bladder accounts for about 3.2% of all cancers worldwide and is considerably more common in males than in females. According to Globocan, there were 1455 newly diagnosed bladder cancer cases in Ethiopia in 2018 and accounts for 2.2% of cancer death in the same year. According to Addis Ababa Cancer registry, there were a total of 4139 newly diagnosed cancer cases over the period of two years (2012– 2013) and bladder cancer accounts for 5.6% of cases. Objectives: The aim of this study is to determine histopathologic patterns of neoplastic and nonneoplastic bladder lesions in Tikur Anbessa Specialized Hospital. Methods: This was a retrospective cross sectional descriptive study conducted on 625 patients having histopathologic evaluation for bladder lesions at Tikur Anbessa Specialized Hospital from January 01, 2016 to August 30, 2020. Results: From a total of 700 cases reviewed, 625 cases fulfilled the study criteria and included in this study. Out of 625 cases, 597 cases were of TURBT, 27 cases were cystectomy specimens and 1 case was true cut biopsy. The majority of the cases were seen in the age group of 51-60 y(28.5) with a male predominance (76.8%).Hematuria was the most common presenting symptom(59%).non neoplastic lesions accounted for 111 cases (17.8%) ,benign tumors accounted for 16 cases (2.6%) and malignant tumors accounted for 498 cases (79.6%).Urothelial carcinoma (96.4%) were the predominant lesions observed under malignant category, of which low gradenon invasive papillary urothelial carcinoma (51.8%) was the most common subtype. urothelial papilloma was the commonest benign tumor accounting for 7 cases(43.8%).Among nonneoplastic lesions, chronic nonspecific cystitis (20.7%) was the commonest lesion noted. Conclusions: This study demonstrates that majority of the cases were malignant bladder neoplasms of urothelial origin, large number of which was low grade non-invasive papillary urothelial carcinoma.Item 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.Item 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.Item 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.