1/55. Exfoliative cytology of a lymphoepithelioma-like carcinoma in a cervical smear. A case report.BACKGROUND: Lymphoepithelioma-like carcinoma of the cervix (LELC) is cytologically identical to its counterparts at other sites, such as the nasopharynx. LELC can be suspected on a cervical cytologic smear. The differential diagnosis includes nonkeratinizing squamous cell carcinoma with prominent stromal inflammation, carcinoma with intense stromal eosinophilia, glassy cell carcinoma, malignant lymphoma (especially lymphoepitheloid-Lennerts lymphoma) and metastatic Schmincke-Regaud tumor. CASE: A 55-year-old female presented with an ulcerated endophytic tumor in the cervix. Exfoliative cytology showed uniform, large tumor cells, often associated with inflammatory cells, with round or oval nuclei and one or more prominent nucleoli. The cytoplasm was finely granular to flocculent, and the nuclei were uniformly vesicular. The chromatin was peripherally marginated. The cell borders were indistinct. There was no evidence of dyskeratotic or keratinized cells, koilocytes or glandlike formations. These findings were highly suspicious for LELC and were confirmed by biopsy. flow cytometry showed dna aneuploidy, with a dna index of 1.08. in situ hybridization was negative for human papillomavirus 16 and 18. CONCLUSION: LELC of the uterine cervix has cytologic features that are sufficiently characteristic for a specific cytologic diagnosis. The diagnosis, nevertheless, has to be proven by histology.- - - - - - - - - - ranking = 1keywords = index (Clic here for more details about this article) |
2/55. Invasive cervical cancer after laser vaporization for cervical intraepithelial neoplasia: a 10-year experience.The treatment of cervical intraepithelial neoplasia by laser vaporization has been in progress at the Birmingham and Midland Hospital for women since September 1977. In this interval, 3182 patients have been treated. Seven women have developed invasive cancer at intervals 4-34 months postlaser. The lesions diagnosed were stage Ia (3), Ib (1), IIb (1), IIIa (1), and IV (1). These case histories are presented. On retrospective assessment, there were contraindications to local destructive treatment in six of seven cases. This series emphasizes the need for thorough evaluation of patients before embarking on local destructive treatments and emphasizes the need for careful follow-up of treated patients.- - - - - - - - - - ranking = 2.1391549817206keywords = assessment (Clic here for more details about this article) |
3/55. Diagnostic dilemma in high intracanalar carcinoma of the cervix.The use of colposcopy for follow up of patients with abnormal cervical smears has considerably increased the rate of detection of cervical malignancies and intraepithelial lesions in recent years. In case the lesion is situated high up in the cervical canal however, the chances of missing out the lesion are considerable. In our case the malignancy was detected only on endocervical sampling, but was missed on scrape as well as on colposcopically directed biopsy. The patient who was in perimenopausal age group, had complaints of post coital bleeding. The initial cervical scrape smear showed only squamous metaplasia. Colposcopically directed biopsy also showed the same findings. On a high index of suspicion clinically, the endocervical sampling was done with a cytobrush, which showed squamous cell carcinoma (SCC) of the cervix. Subsequent hysterectomy of the patient confirmed the diagnosis. Simultaneous endocervical sampling considerably increases the chances of finding an intracanalar lesion, particularly in older women, in whom the transitional zone (TZ) is situated high up in the cervical canal. In such a situation, even a colposcopically directed biopsy may prove inadequate. This was amply proved in our case.- - - - - - - - - - ranking = 1keywords = index (Clic here for more details about this article) |
4/55. Cervical verrucous carcinoma involving endometrium. Case report.A case report of verrucous carcinoma of the cervix is presented. Verrucous carcinoma is a rare variant of squamous cell carcinoma with distinct clinical and histopathologic features, with a favorable prognosis. A 32-year-old woman had an abdominal hysterectomy with bilateral ovary transposition. Intravaginal brachytherapy using cesium 137 in a total dose of 60 Gy 0.5 cm from the vaginal layer was performed. Five year disease-free follow-up was observed. Macro- and microscopic examination of the tissue after hysterectomy was performed. The full thickness of the tumor is necessary for histopathological assessment. The cytology or superficial and simple biopsy may be misdiagnosed. The differentiating diagnosis among condyloma acuminata, verrucous carcinoma and invasive squamous cell carcinoma was analysed.- - - - - - - - - - ranking = 2.1391549817206keywords = assessment (Clic here for more details about this article) |
5/55. Squamous cell carcinoma of the cervix simulating an advanced malignancy of the ovaries.A 40-year-old woman was diagnosed as having stage II squamous cell cervical carcinoma and managed with radiotherapy. Three months after treatment, she presented with features suggestive of an advanced ovarian tumour including gross abdominal swelling, bilateral ovarian tumours, multiple tumour seedlings in the abdominal cavity and ascites. There was also pleural effusion. Operative findings revealed widespread intra-abdominal metastases whose histology, contrary to expectations, showed squamous cell carcinoma of cervical origin. Distant metastases from squamous cell carcinoma of the cervix are rare. A high index of suspicion is necessary to detect this unusual mode of presentation.- - - - - - - - - - ranking = 1keywords = index (Clic here for more details about this article) |
6/55. Villoglandular papillary adenocarcinoma of the cervix. Beware of a wolf in sheep's clothing.Villoglandular papillary adenocarcinoma of the cervix is a well differentiated form of cervical adenocarcinoma with a favourable prognosis and a conservative procedure is suggested. We present three cases of villoglandular papillary adenocarcinoma of the cervix. Histological examination of a biopsy of each cervix showed well differentiated villoglandular papillary adenocarcinoma, stage Ib according to FIGO classification. In all cases the disease was limited to the cervix. Nevertheless, histopathological examination of the surgical specimen revealed an infiltrating component with squamous differentiation in one case, while in a second case histopathological examination revealed a moderately differentiated papillary adenocarcinoma with a superficially infiltrating growth-pattern besides the villoglandular papillary adenocarcinoma. Before conservative therapy is considered, careful evaluation of the presence of poor prognostic features must be made. One should consider whether conservative therapy is sufficient because of the predominance of concomitance of other carcinoma besides the villoglandular papillary adenocarcinoma.- - - - - - - - - - ranking = 59.993982137073keywords = prognostic (Clic here for more details about this article) |
7/55. Stage IIa cervix carcinoma with metastasis to the heart: report of a case with immunohistochemistry, flow cytometry, and virology findings.OBJECTIVE: The aim of this study was to report a stage IIa squamous cell cervix carcinoma with intraperitoneal carcinomatosis and metastasis to the heart in a 50-year-old woman and to study the original tumor for expression of oncogenes and tumor suppressor gene proteins, for dna ploidy, and for human papillomavirus (HPV) infection. methods: Clinical course, histopathology of the original tumor, and autopsy record were rewieved. The original tumor was analyzed for expression of CD44 variant 6, p16, p21, p53, retinoblastoma (Rb), and c-erb-2. dna flow cytometry was performed on tissue samples from the original tumor and from the heart. Sequences of the HPV genome on cervical and cardiac tissue samples were amplified by polymerase chain reaction. RESULTS: Immunohistochemical analysis showed expression of CD44v6 and p16. No expression of p21, Rb, c-erb-B2, and p53 was seen. dna flow cytometry of the original cervical tumor showed a dna index (DI) of 1.0. dna flow cytometry of tissue samples from the posterior wall and from the right ventricle of the heart showed two different aneuploid cell populations with DI of 1.6 and 2.2, respectively. HPV gene sequences were identified neither in the original tumor nor in the heart. CONCLUSIONS: To our knowledge, this is the first case of cervix carcinoma with metastasis to the heart with immunohistochemistry, flow cytometry, and virology findings.- - - - - - - - - - ranking = 1keywords = index (Clic here for more details about this article) |
8/55. Hematogenous skin metastases from cervical cancer at primary presentation.OBJECTIVE: Cutaneous metastasis from carcinoma of the uterine cervix is an uncommon occurrence. The majority of cases are diagnosed as recurrent carcinoma. This is believed to be the first report of hematogenous skin metastases present at the diagnosis of cervical carcinoma. methods: A case of a patient with cutaneous manifestations at the time of cervical carcinoma diagnosis is presented. RESULTS: Two lesions on the patient's hand occurred at points of recent skin puncture. These were biopsy-proven metastases from her primary cervical carcinoma. CONCLUSION: skin metastases from cervical carcinoma are rare and represent a poor prognostic sign.- - - - - - - - - - ranking = 59.993982137073keywords = prognostic (Clic here for more details about this article) |
9/55. Exfoliative cytology of lymphoepitheliomalike carcinoma of the uterine cervix. A report of two cases.BACKGROUND: Lymphoepitheliomalike carcinomas (LECs) are morphologically similar to undifferentiated nasopharyngeal carcinoma but occur at sites other than the nasopharynx. They rarely occur in the uterine cervix. Sixty-five cases of LEC of the cervix have been published to date, and the pitfalls of histopathologic interpretation have been discussed. This undifferentiated carcinoma with a prominent lymphocytic infiltrate represents a challenge for the pathologist examining a scant cervical biopsy or Pap smear. Distinguishing LEC as a separate entity is important. Despite the fact that the epithelial component is poorly differentiated, this neoplasm is associated with a lower frequency of lymph node metastases, is potentially radiosensitive and has a better prognosis. Although mentioned in passing in several papers, the exfoliative cytology of this cervical neoplasm has not been adequately discussed. We report the cytologic features of LEC in cervical smears obtained from two patients. CASES: The first patient presented with menometrorrhagia and postcoital bleeding. The cervical smear taken at the time of presentation was reported as unsatisfactory for evaluation. ASCUS was diagnosed on a vaginal smear obtained one year earlier. The second patient presented with a complaint of postcoital bleeding. A cervical smear and the cervical biopsy taken at the time of presentation were reported as ASCUS and high grade dysplasia versus carcinoma, respectively. A retrospective review of the cervical smears revealed rare malignant cells occurring singly or in small groups. The tumor cells had a high nuclear/cytoplasmic ratio, irregular nuclear membrane and hyperchromatic nuclei with coarse chromatin and were obscured by heavy inflammation and blood. The background resembled that of a menstrual smear. CONCLUSION: The diagnosis of LEC of the cervix is often made on a loop electrical excision procedure or on a hysterectomy specimen. The presence of heavy inflammation and blood, which can obscure the malignant nature of the cells, presents the cytopathologist with a challenging diagnosis of LEC in cervical smears. In view of the prognostic implications, it is desirable for the pathologist to classify LEC as a distinct entity.- - - - - - - - - - ranking = 59.993982137073keywords = prognostic (Clic here for more details about this article) |
10/55. Primary non-Hodgkin's lymphoma of the uterine cervix.We present a patient with primary malignant lymphoma of the uterine cervix, which is extremely rare. She had a complete remission with a combination of chemotherapy and radiotherapy. Measurement of the serum soluble interleukin-2 receptor level was a useful index of the effectiveness of treatment.- - - - - - - - - - ranking = 1keywords = index (Clic here for more details about this article) |
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