1/10. Limited polyarteritis nodosa of the male and female reproductive systems: diagnostic and therapeutic approach.BACKGROUND: polyarteritis nodosa (PAN) is a multisystem necrotising small and medium sized vasculitis that when left untreated carries a grave prognosis, with a five year survival of 10-15%. Prolonged immunosuppressive treatment with cyclophosphamide and steroids leads to high remission rates while carrying the risk of life threatening complications. The diagnostic and therapeutic approach for patients with isolated genital tract PAN is not well defined. OBJECTIVE: To present the management and follow up of two patients with limited PAN localised to the male and female reproductive system. case reports: A 26 year old man presented with an "acute scrotum". He was afebrile and had no other sign or symptom. Laboratory tests, including complete blood count, erythrocyte sedimentation rate, liver and renal function tests, C reactive protein, antinuclear antibody, cryoglobulins, complement levels, antineutrophil cytoplasmic antibodies, and hepatitis b surface antigen, were all normal. His left testis was excised. Histopathology disclosed PAN of medium sized arteries with testicular infarction but no signs of torsion or infection. The other patient was a 51 year old woman who had had a total hysterectomy for a uterine myoma; incidentally PAN of the uterus and fallopian tubes was discovered. Neither patient received any immunosuppressive treatment after surgical removal of the affected organ. On prolonged follow up (clinical and laboratory evaluation) both patients are healthy with no sign of local recurrence or systemic PAN.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
2/10. Unsuspected involvement of the female genitalia in pemphigus vulgaris.A 56-year-old woman had erosions due to pemphigus vulgaris in the inner thighs and perineum. The cutaneous lesions cleared following intramuscular gold therapy. However, because of complaints of dyspareunia, a colposcopic examination was performed and involvement of the cervix was demonstrated. The need for a vaginal examination in the monitoring of pemphigus vulgaris is emphasized.- - - - - - - - - - ranking = 0.5keywords = size (Clic here for more details about this article) |
3/10. Multiplex dna short tandem repeat analysis. A useful method for determining the provenance of minute fragments of formalin-fixed, paraffin-embedded tissue.A tiny fragment of high-grade carcinoma was found in histologic sections and in the paraffin block of a benign cervical polyp from a patient with no clinical evidence of malignancy. Thus, it raised the suspicion of block contamination. No malignant tumor was processed the same day as the polyp; however, a similar tumor had been processed 6 days earlier. Multiplex dna short tandem repeat analysis was applied to paraffin-extracted tissue samples obtained from the polyp, the suspected contaminant, the patient's additional cervical biopsy specimen, and the putative source of contamination. The results demonstrated that the suspected contaminant and the patient's cervical tissue could not have come from the same patient and that the suspected contaminant derived from the tumor processed earlier, without reasonable doubt. We hypothesize that this friable tumor escaped from cassettes into the processor and contaminated the polyp specimen. Multiplex dna short tandem repeat analysis can be applied to determine the provenance of minute tissue samples in surgical pathology.- - - - - - - - - - ranking = 0.5keywords = size (Clic here for more details about this article) |
4/10. Primary fallopian tube carcinoma presenting with a sinus in the posterior portion of cervix.Primary fallopian tube carcinoma is an aggressive but rare tumor. This is an unusual presentation of papilliferous tubal carcinoma presenting with vaginal discharge through a large sinus approximately 2-3 cm in size, located posterior to the neck of cervix. Surgery was undertaken with the initial diagnosis of primary ovarian carcinoma and the fistula was left to heal spontaneously. Surgical resection was followed by adjuvant chemotherapy. The patient is doing well after the therapy.- - - - - - - - - - ranking = 0.5keywords = size (Clic here for more details about this article) |
5/10. An unusual cervical adenosis.A 57-year-old woman with a mass on the uterine cervix was presented. Her complaint was persistent leukorrhea and treated by hysterectomy because of cervical mass. The histologic diagnosis was adenosis of the cervix. It is believed that this is the first report of benign adenosis of cervix in this size in woman who was not exposed to diethylstilbestrol in utero.- - - - - - - - - - ranking = 0.5keywords = size (Clic here for more details about this article) |
6/10. Protracted pneumonitis in young infants associated with perinatally acquired cytomegaloviral infection.Two infants developed a protracted pneumonitis with lower respiratory obstruction beginning at one month of age. lung biopsy in one suggested a viral etiology which prompted an extensive investigation of each infant for specific etiology. Virologic, serologic, immunologic, and electronmicroscopic studies indicated that cytomegalovirus was a major causative factor. The infections were apparently acquired at birth from infected maternal genital tracts and have persisted for prolonged periods of time. Evidence for gross immunologic defect as a precipitating cause was lacking. These infants serve to emphasize the possible pathologic potential of CMV when acquired in early life even in the absence of iatrogenic immunosuppression.- - - - - - - - - - ranking = 0.5keywords = size (Clic here for more details about this article) |
7/10. Development of melanosis of uterine cervix after cryotherapy for epithelial dysplasia. A case report and brief review of the literature on pigmented lesions of the cervix.A case of melanosis of the exocervix, which developed within eight months after cryotherapy for epithelial dysplasia, is reported. The literature on pigmented lesions of the cervix is briefly summarized and the importance of biopsy and histologic examination for diagnosis and classification of these lesions is emphasized.- - - - - - - - - - ranking = 0.5keywords = size (Clic here for more details about this article) |
8/10. Sonography of Nabothian cysts.Retention cysts of the cervix (nabothian cysts) are common gynecologic findings that have not been previously reported in the sonographic literature. Experience with 25 cases is presented. Cyst size varied from 6 to 20 mm. Most cysts (14/25) were multiple and most (17/25) were eccentric in relation to the cervical canal. cysts within 1 cm of the external os were classified as "low" (10/25); those cranial to this level were "high" (15/25). Six patients had both high and low cysts. Many of the cysts (9/25) caused enlargement of the cervix. Representative cases are presented with a discussion of the pathogenesis of nabothian cysts and their clinical significance.- - - - - - - - - - ranking = 0.5keywords = size (Clic here for more details about this article) |
9/10. Florid deep glands of the uterine cervix. Another mimic of adenoma malignum.Two cases of florid deep glands of the uterine cervix, a lesion which mimics adenoma malignum are reported. One case was misdiagnosed as adenoma malignum, and the patient was treated with adjuvant radiotherapy. In contrast to the majority of cases of adenoma malignum in which there is preoperative evidence of a cervical abnormality, the lesion described in both cases was an incidental microscopic finding in hysterectomy specimens. The architectural pattern in both these cases was strikingly similar, showing diffusely scattered endocervical glands within the endocervical stroma extending to the outer third of the cervical wall. However, the variability in size and shape of the glands, which were typically round to oval, was less than observed in adenoma malignum. Additionally, there was no cytologic atypia, which is observed focally in most cases of deeply invasive adenoma malignum. The lack of a desmoplastic stromal reaction, vascular and perineural invasion also may help distinguish florid deep glands from adenoma malignum. Finally, in both cases of florid deep glands, there was no cytoplasmic immunoreactivity for carcinoembryonic antigen, which is in contrast to what is seen in adenoma malignum.- - - - - - - - - - ranking = 0.5keywords = size (Clic here for more details about this article) |
10/10. Microglandular endocervical hyperplasia and tubal metaplasia: pitfalls in the diagnosis of adenocarcinoma on cervical smears.The detection of atypical glandular cells of undetermined significance (AGUS) has risen recently due to the use of new endocervical canal sampling devices, in particular the cytobrush. From April 1993-June 1994, a diagnosis of AGUS ranging from adenocarcinoma in situ (AIS) to invasive adenocarcinoma was initially made on cervical smears from 6 women for whom histologic follow-up data were available. The purpose of this study was to determine if benign cervical glandular lesions can be reliably distinguished from adenocarcinoma on cytology. review of the smears and histologic slides from 3 patients showed microglandular endocervical hyperplasia on cervical cone specimens. Cervical smears from 2 of these patients showed clusters of small-to-medium-sized cells with nuclei containing coarse, granular chromatin and prominent nucleoli. Cytoplasmic vacuoles and engulfment of neutrophils were present, findings suggestive of endometrial adenocarcinoma. The third patient's smear showed clusters of large cells with ample, vacuolated cytoplasm and vesicular nuclei containing prominent nucleoli, findings suggestive of endocervical adenocarcinoma. In 3 cases evaluated by cervical conization, histologic slides showed tubal metaplasia. The cervical smears showed clusters and sheets of cells with round-to-oval-shaped nuclei containing evenly distributed, finely granular chromatin and inconspicuous nucleoli. Pseudoglandular formation was present in 2 cases, a finding suggestive of AIS. Since the cytologic features of microglandular endocervical hyperplasia and tubal metaplasia overlap those of adenocarcinoma, a differential diagnosis is prudent on cytologic smears of AGUS.- - - - - - - - - - ranking = 0.5keywords = size (Clic here for more details about this article) |
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