Happenings in Pathology:
Aga Khan University Shines at HAEMCON 2025
Dr Hareem Alam, Hematology
The 27th Annual Conference of the Pakistan Society of Hematology was held at the Marriott Hotel, Karachi, from April 17th to 20th, 2025 under the supervision of Professor Dr Bushra Moiz [AKU] (Chair Scientific Committee HeamCon 2025) and Dr Saba Jamal [IHHN] (Chair Organizing Committee HeamCon 2025). Five successful pre-conference workshops were conducted, covering topics such as diagnostic challenges in molecular hematopathology, case-based learning and hands-on practice in coagulation, integrated diagnostic hematology, immunohematology in transfusion medicine, and a case-based and hands-on workshop on hemoglobin disorders.
The conference commenced with an inaugural session, moderated by Dr. Sana Brohi (AKU) and Dr. Hareem Alam (AKU). The Ibne Sina Lecture was delivered by Maj. Gen (R) Dr. Pervez Ahmed, who spoke on bone marrow transplantation and cellular therapies in Pakistan. The keynote address was given by Dr. Flora Peyvandi, Professor of Internal Medicine at the University of Milan, Italy. The Lifetime Achievement Award was presented to Maj. Gen (R) Suhaib Ahmed, and a posthumous award was given to Dr. Tahir Shamsi (late). The session concluded with the opening of the exhibition by the conference patrons i.e. Distinguished University Professor Dr Mohammad Khurshid (AKU) and Dr Khalid Zafar Hashmi (SIUT).
Over the following three days, eight scientific sessions were held. Each session featured three free research paper presentations, followed by three invited talks by national and international speakers, and concluded with a panel discussion.
Aga Khan University's significant participation in HAEMCON 2025 included:
Professor Dr. Bushra Moiz chaired the Scientific Committee of the conference.
Dr. Shariq Shaikh, Dr. Muhammad Hasan, and Dr. Zeeshan Ansar served as facilitators for the workshops.
Professor Dr. Salman Adil chaired the session on acute leukemia and bone marrow failure.
The session on challenges in transfusion was chaired by Professor Dr. Muhammad Khurshid, with the panel discussion led by Dr. Muhammad Hasan.
Professor Dr. Usman Shaikh chaired the session on myeloproliferative neoplasms, moderated by Dr. Nabiha Saeed.
Professor Dr. Bushra Moiz co-chaired the session on advancing hematology.
Dr. Zeeshan Ansar delivered a talk on molecular screening for alpha and beta thalassemia.
Professor Dr. Zehra Fadoo spoke on pediatric acute myeloid leukemia.
Professor Dr. Natasha Ali gave an outstanding talk on transplant viral infections, focusing on CMV.
Dr. Afsar Ali Mian discussed gene editing technologies for hemoglobinopathies.
Posters were presented by Dr. Haleema Urooj (R-V), Dr. Fatima Farhan (R-IV), Dr Muhammad Shayan Ashfaq (R-III), Dr. Wajeeha Iftikhar (R-II), Ms. Anila Zafar (Senior Technologist Hematology) & Muhammad Salman (Charge Technologist Blood Bank).
Dr. Fatima Farhan (Hematology R-IV) served as the overall moderator of the conference.
The conference concluded with an award ceremony highlighting the achievements of our residents and staff:
Dr. Muhammad Umer Naeem Effendi (Chemical Pathology R-V) received the first prize in oral presentation for his research paper on the 'Prevalence and clinical utility of anti-β2 Glycoprotein-1 antibodies in Pakistani patients suspected of Antiphospholipid syndrome'. (Co-Authors: Dr Hafsa Majid, Dr Bushra Moiz, Dr Lena Jafri & Dr Aysha Habib Khan)
The first prize for poster presentation was jointly awarded to Hematology Residents Dr. Haleema Urooj (R-V) [Co-Author: Dr Bushra Moiz], Dr. Fatima Farhan (R-IV) [Co-Author: Dr Sana Brohi], and Dr. Wajeeha Iftikhar (R-II) [Co-Authors: Dr Zehra Fadoo, Dr Bushra Moiz, Dr Salman Kirmani, Dr Ali Hussain & Dr Fizza Akbar].
A complimentary prize was presented to Ms. Anila Zafar, Senior Technologist Hematology, for her poster on the 'Significance of white cell ratio as biomarker in mosquito borne infections' [Co-Author: Dr Bushra Moiz].
These accomplishments marked a proud and memorable conclusion to the conference for our department.
x----------------------------x-------------------------x
An Undifferentiated Neoplasm-A case
Dr Hajrah Syndeed Pal, Hematology
Introduction: Integrated reporting exemplifies the collaborative efforts of multiple departments, all working together for the benefit of patient care. The pathology department often serves as a hub for such integration, combining diverse findings into a unified, comprehensive report. In this case report, we present a neoplasm that underwent extensive evaluation and multidisciplinary review by consultants from various specialties.
Case details: A 57-year-old male presented with painless right testicular swelling for three-four months. There was no history of cryptorchidism, abnormal sexual development, trauma in the inguino-scrotal region, or primary tumor in other sites. On examination the testis was firm and painful on palpation. The overlying skin was without any visible changes. There was no associated weight loss, hepatosplenomegaly or palpable lymphadenopathy. Testicular biopsy performed outside AKUH and reported with the possibility of mast cell sarcoma.
Workup for the case: A complete workup of the patient was performed at AKUH inclusive of baseline testing. CBC showed bicytopenia and leucoerythroblastic blood picture. Bone marrow trephine biopsy and cytogenetic studies were proceeded as well.
Bone marrow aspirate showed infiltration with large atypical mononuclear cells showing hyperchromatic nuclei, condensed chromatin and moderate basophilic cytoplasm (as shown in Fig: 1). Bone trephine showed altered marrow architecture, presence of necrosis and infiltration with large atypical mononuclear cells (as shown in Fig: 1).
Review of testicular block showed effacement of testicular parenchyma by back-to-back closely packed nests and aggregates of neoplastic cells which are mildly pleomorphic, have hyperchromatic nuclei, inconspicuous nucleoli and moderate to abundant eosinophilic cytoplasm (as shown in Fig: 1).
Immuno-histochemical panel performed on bone marrow and testicular block included SALL-4, CD117, OCT3/4, CD30, Synaptophysin, Chromogranin-A, CD56, LCA, CD20, CD3, DOG-1, Desmin, CD34, TDT, MUM1, PAX5, MPO, Ki-67, Cytokeratin CAM5.2, CD138, PLAP, HMB-45, Melan-A, Glypican-3.Out of all these stains, CD117 was diffuse positive, Synaptophysin patchy positive and Cytokeratin CAM 5.2 focal positive (as shown in Fig: 1).
The cytogenetic studies showed 47, XY, del (3) (p26), del (5) (q31) x 2, -10, add (20) (q13.3), +21 [20] (as shown in Fig:2).
Conclusion:
The case was reviewed in the multidisciplinary team (MDT) meeting and concluded to represent a malignant undifferentiated neoplasm, based on the correlation of the available investigative findings.
Discussion:
A malignant undifferentiated neoplasm, often called an undifferentiated cancer, is a tumor in which the cells lack the typical characteristics of the tissue they originated from, making it difficult to determine their origin. These tumors are usually aggressive and high-grade and pose diagnostic as well as therapeutic challenge.
Treatment options vary depending on the location and type of undifferentiated neoplasm, but may include surgery, radiation, and chemotherapy. Additionally, immunotherapies have been proven to have better outcomes in some studies. In patients with undifferentiated neoplasms, treatment response varies and depends upon the combination offered. Those who don't respond to induction chemotherapy generally have a poor outcome.
x----------------------------x-------------------------x
Connecting with Pathology: Exploring our Facebook Page and Website
Dr Sana Brohi, Hematology
In today's digitally driven healthcare landscape, maintaining a strong online presence is crucial for pathology labs to connect with patients, share services, and establish trust. To strengthen its outreach and accessibility, the Department of Pathology & Laboratory Medicine at AKU has launched a dedicated Facebook page and is in the process of enhancing its existing website.
AKU's Facebook page (link: https://www.facebook.com/profile.php?id= 61574240963703) will serve as an effective platform to directly engage with patients, caregivers and students. It will feature high-quality visuals, including images of the facility, advanced equipment, and staff, along with detailed information about available tests to enhance trust and credibility. Consistent updates—such as announcements on test availability, health tips, promotional packages, and patient feedback—will help keep the page dynamic and informative.
The website (link: https://www.aku.edu/mcpk/pathology/Pages/home.aspx) for the Department of Pathology and Laboratory Medicine at Aga Khan University serves as a comprehensive resource, showcasing the department's key functions in diagnostics, education, research, and clinical services. It offers detailed information about the various branches of pathology, faculty, and laboratory networks across Pakistan. The site also highlights available pathology services, quality standards, and professional development opportunities, making it valuable for students, healthcare professionals, and patients. Furthermore, the website features regular updates through Lablog posts, a Memory Book, and a "Meet Our Team" section, providing a thorough overview of the department's vibrant academic and clinical landscape.
We kindly request LabRad readers to click on the links below, like our Facebook page, and explore our website.
Links:
Facebook link: https://www.facebook.com/profile.php?id= 61574240963703
Website link: https://www.aku.edu/mcpk/pathology/Pages/home.aspx
