1/14. Mitotic arrest of endometrial epithelium after paclitaxel therapy for breast cancer.We report the histopathologic findings in endometrial curettings from a 31-year-old woman with dysfunctional uterine bleeding who had received paclitaxel therapy for breast carcinoma. paclitaxel, a member of the taxane family of antineoplastic agents that is used in the treatment of breast carcinoma, ovarian carcinoma, and non-small cell lung carcinoma, acts by the simultaneous promotion of tubulin assembly into microtubules and inhibition of microtubule disassembly. The curettings in this case showed fragmented menstrual phase endometrium with striking numbers of mitotic figures. Cell divisions were arrested in metaphase. Glandular epithelial cells showed strong immunoreactivity for bcl-2 and MIB-1. We attribute this marked morphologic effect to paclitaxel-induced mitotic arrest of the endometrium.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
2/14. Treatment of life-threatening post-haemorrhagic anaemia with cell-free haemoglobin solution in an adolescent Jehovah's Witness.Severe blood loss carries an increased risk of a fatal outcome in patients who do not consent to the use of blood products. For patients who base this decision on a religious belief system, such as the jehovah's witnesses, important distinctions may exist between the appropriateness of various blood products. We describe the first successful use of purified human cell-free haemoglobin solution in a paediatric patient, in this case in the management of life-threatening anaemia in a 14-year-old female Jehovah's Witness with immune thrombocytopenia.- - - - - - - - - - ranking = 2.5keywords = cell (Clic here for more details about this article) |
3/14. Mosaic form (45X/46XX) of Turner's syndrome. A case report.BACKGROUND: Turner's syndrome (TS) is a sex chromosome disorder occurring in 1 in 2,500 female births and in approximately 50 in 100,000 adult females and is characterized by retarded growth, gonadal dysgenesis and infertility. The 45,X/46,XX chromosomal pattern is the most frequent mosaic type of this disease (36%). CASE: The mosaic form of TS was diagnosed in a 25-year-old, nulliparous woman whose major symptoms were menstrual irregularity and menorrhagia. She had normal development of secondary sexual characteristics and spontaneous menarche despite a very low amount (7%) of normal cells. CONCLUSION: Dysfunctional uterine bleeding is very uncommon in TS. Mosaic forms of TS may have very few features of TS despite a very low range of normal cells.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
4/14. Cytologic features of atypical polypoid adenomyoma of the endometrium. A case report.BACKGROUND: In 1981, Mazur reported the histologic characteristics of atypical polypoid adenomyoma (APA) of the endometrium. Although most APAs of the endometrium are considered to show benign behavior, there is a small associated risk of the development of adenocarcinoma. The histology of APA of the endometrium is well defined, but the cytologic features of the lesion have not yet been clarified. CASE: A 28-year-old nulligravida with hypermenorrhea had an exophytic, polypoid mass arising from the posterior uterine wall on ultrasonography and magnetic resonance imaging. The results of endometrial smear and biopsy were normal. Transcervical total resection of the tumor was performed with a resectoscope. frozen sections of the sample suggested APA of the endometrium, and the permanent sections confirmed the diagnosis. The tumor stump/resection plane smears revealed overlapping, highly atypical glandular cells with enlarged, hyperchromatic nuclei; squamous metaplastic cells; and abundant, spindled smooth muscle cells on a clear background, effectively reflecting the epithelial and mesenchymal cell components of the lesion. CONCLUSION: Endometrial smear and biopsy are inaccurate methods for the diagnosis of APA of the endometrium because of limited sampling. Tumor stump/resection plane cytology appears to be useful for detecting APA of the endometrium.- - - - - - - - - - ranking = 30.92591006757keywords = spindle, cell (Clic here for more details about this article) |
5/14. Sarcomatoid variant of B-cell lymphoma of the uterine cervix.Malignant lymphomas with a prominent spindle-cell or sarcomatoid pattern are unusual tumors typically of T- or null-cell phenotypes. We encountered a case of a 32-year-old woman who presented with a 3-week history of excessive menstrual bleeding, left lower-quadrant pain, and weight loss. A mass involving the uterine cervix and right parametrium was detected on pelvic examination and imaging studies. A diagnosis of diffuse large B-cell lymphoma with a spindle-cell pattern was made with immunohistochemical and gene rearrangement studies on endocervical curettage and parametrial core biopsy specimens. After chemotherapy and radiation therapy, the patient was in clinical and radiological remission 10 months after diagnosis. To our knowledge, this is the first sarcomatoid B-cell lymphoma presenting in the uterine cervix. awareness of the spindle-cell pattern of diffuse large B-cell lymphoma and its possible presentation in extranodal sites such as the uterine cervix should prevent potential misdiagnosis.- - - - - - - - - - ranking = 92.27773020271keywords = spindle, cell (Clic here for more details about this article) |
6/14. Multiple uterine angioleiomyomas in a woman presenting with severe menorrhagia.BACKGROUND: Angioleiomyoma is a rare benign neoplasm that originates from smooth muscle cells and contains thick-walled vessels. There were only five cases of uterine angioleiomyoma reported in the available English literatures. We present here the unique computed tomography finding in a patient with multiple uterine angioleiomyomas causing severe menorrhagia. CASE: A 50-year-old, nulligravid woman consulted us with the complaint of menorrhagia for 3 years and progressively palpable lower abdominal mass for a half year. Laboratory findings were all within normal limits except lower hemoglobin concentration (6.2 g/dl). An abdomino-pelvic computed tomography (CT) showed that a huge 30-cm heterogeneously multilobulate mass with solid and laminated configuration, with cystic and multiseptal contents was found in left lower abdomen and pelvic cavity. At laparotomy, the area beneath the left broad ligament was filled with a well-encapsulated, elastic, ovoid, and lobulate mass that connected to the uterus and measured up to 20 cm in greatest diameter. The uterus was composed of a huge intramural tumor and measured 28 x 21 x 12 cm. The uterus and huge subserosal tumor were resected completely and a frozen section was obtained. The final histopathologic diagnosis was angioleiomyoma, a definitely benign soft tissue tumor. Eighteen months after surgery there was no recurrence. CONCLUSION: Uterine angioleiomyoma should be considered when prominent tortuous vascular-like enhancing structures are noted on CT examination of a well-demarcated soft tissue mass arising from the uterus in pelvis. Either angiomyomectomy with tumor-free margins or hysterectomy proved to be an effective treatment in these cases, and resulted in a good recovery and a satisfactory outcome.- - - - - - - - - - ranking = 0.5keywords = cell (Clic here for more details about this article) |
7/14. Use of a hemoglobin-based oxygen carrier in the treatment of severe anemia.BACKGROUND: Hemoglobin-based oxygen carriers hold promise for the treatment of acute anemia. CASE: We report a patient with severe dysfunctional uterine bleeding. During her hospitalization, her lowest hemoglobin level was 3.1 g/dL, with a hematocrit of 9.3%. An investigational product, o-raffinose cross-linked human hemoglobin solution (hemoglobin raffimer), was infused along with ongoing high-dose recombinant human erythropoietin and estrogen. The time until the patient's own hematopoiesis provided sufficient red blood cell mass was successfully managed by reducing oxygen demand and providing multiple hemoglobin-based oxygen carrier infusions. After hemoglobin-based oxygen carrier administration, transient pulmonary hypertension and fever were noted. She was discharged after corrective surgery 7 days after hemoglobin-based oxygen carrier administration with a hemoglobin level of 7.8 g/dL. CONCLUSION: The hemoglobin level-based oxygen carrier improved oxygen delivery and permitted uterine corrective surgery.- - - - - - - - - - ranking = 0.5keywords = cell (Clic here for more details about this article) |
8/14. Use of recombinant factor viia in the management of severe bleeding episodes in patients with bernard-soulier syndrome.bernard-soulier syndrome (BSS) is a rare congenital platelet disorder characterized by defective platelet adhesion and manifested by spontaneous and often profuse bleeding. Recombinant factor viia (rFVIIa) is a haemostatic agent licensed for the treatment of bleeding episodes in patients with haemophilia and inhibitors, which may represent a low-risk alternative to existing therapies in the management of patients with BSS. Here, we describe the use of rFVIIa for the treatment of three severe bleeding episodes in two patients with BSS. Data were extracted by automated searching of the international, internet-based registry http://www.haemostasis.com . Patient 1, a 24-year-old woman, was admitted with severe epistaxis and hypotension. The diagnosis of BSS was confirmed by macrothrombocytopenia, absence of ristocetin-induced platelet agglutination (RIPA) and absence of glycoprotein (GP) Ibalpha and IX on the platelet surface. Epsilon aminocaproic acid (EACA; two 50-mg/kg doses), packed red blood cells (PRBCs, 2 U) and platelets (30 U) failed to control the bleeding and, after 13 h, three bolus doses of rFVIIa (90 microg/kg body weight) and a third dose of EACA were administered; bleeding stopped after the third dose of rFVIIa. Patient 2, a 15-year-old girl, initially presented with severe menorrhagia. A lack of RIPA and severe deficiency of GPIbalpha on the platelet surface confirmed the diagnosis of BSS. EACA and fresh-frozen plasma did not control the haemorrhage, but two bolus doses of rFVIIa (98 microg/kg body weight) resulted in a marked decrease in bleeding. On second admission, patient 2 had severe epistaxis and mild menorrhagia. Two rFVIIa doses (98 and 122.5 microg/kg body weight) were given, and the bleeding stopped. No adverse events were reported in these cases. These three admissions highlight the potential of rFVIIa for the treatment of severe bleeds in patients with BSS.- - - - - - - - - - ranking = 0.5keywords = cell (Clic here for more details about this article) |
9/14. pathology of the NovaSure (radio-frequency) impedance-controlled endometrial ablation system.The widespread use of increasingly novel diagnostic and neoadjuvant therapeutic modalities necessitates that contemporary pathologists familiarize themselves with the spectrum of tissue derangements that may be seen in the eventual surgical specimens. In the management of endometrial lesions, for example, a variety of endometrial ablation technologies, such as cryosurgery, balloon therapy, microwave, hot circulating saline, and bipolar impedance technology, have been introduced in the past decade and are being utilized with increasing frequency. We describe herein pathologic changes associated with one such technology, the NovaSure impedance-controlled endometrial ablation system. The US food and Drug Administration approved NovaSure in 2001 for ablation of the endometrial lining in premenopausal women with menorrhagia. The ablation is accomplished by the delivery of radio-frequency energy for a period of approximately 90 seconds through a device inserted transcervically into the endometrial cavity. Our patient, a 54-year-old with menorrhagia, had undergone the NovaSure ablative treatment 38 days prior to her eventual hysterectomy. The resultant changes were quite distinctive: in a uterine wall that was 20 to 30 mm thick, a 3- to 6-mm-thick, hyalinized, subendometrial bandlike zone was apparent throughout the uterus even on macroscopic examination of the slides. This zone was sharply demarcated from the subjacent myometrium and from the endometrium; the latter displayed severe stromal fibrosis, some myxoid change, and sparse glands that were largely confined to the basalis. Paradoxically, scattered aggregates of stromal cells in the endometrium remained relatively viable. Adenomyotic aggregates and leiomyomata in the myometrium beneath the hyalinized zone were unaffected by this treatment. Practitioners evaluating hysterectomy specimens should be aware of changes such as those described herein, not only to better understand the specimens they evaluate but to avoid potentially misinterpreting grotesque alterations caused by benign processes.- - - - - - - - - - ranking = 0.5keywords = cell (Clic here for more details about this article) |
10/14. Granulocytic sarcoma of the uterine cervix--literature review of granulocytic sarcoma of the female genital tract.Granulocytic sarcoma is an extramedullary tumor of malignant granulocytic progenitor cells that accompanies, heralds, or signals relapse of acute myelogenous leukemia (AML), or indicates blastic transformation of a chronic myeloproliferative disorder. We describe a case involving the uterine cervix of a 51-year-old woman that led to the diagnosis of AML. Granulocytic sarcoma can occur in the female genital tract and may be the first clinically significant manifestation of a hematologic malignancy. The salient findings in 28 reported cases from 12 different countries are reviewed. awareness of this lesion is important for all medical personnel involved in the health care of women.- - - - - - - - - - ranking = 0.5keywords = cell (Clic here for more details about this article) |
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