scholarly journals POSTMENOPAUSAL BLEEDING

2020 ◽  
Vol 10 (02) ◽  
pp. 142-146
Author(s):  
Shakila Yasmin
Keyword(s):  
Vaginal Bleeding ◽  
Pap Smear ◽  
Routine Laboratory ◽  
Postmenopausal Bleeding ◽  
Abdominal Ultrasonography ◽  
Cervical Biopsy ◽  
Carcinoma Of Cervix ◽  
General Physical ◽  
Abnormal Vaginal Bleeding ◽  
Chronic Cervicitis

Objective : To evaluate the etiology, incidence of malignancy and interval between menopause and onset of abnormal vaginal bleeding inpostmenopausal women. Design: Prospective study. Place And Duration of Study: The study was conducted at Bahawal Victoria Hospital,Bahawalpur for a period of 14 months (February 2002 to March 2003). Subjects: Thirty five cases of postmenopausal bleeding. Methods: Adetailed history was taken followed by a detailed general physical, abdominal, pelvic and per-rectal examination. Cervical pap smear was donein all the patients except those with obvious cervical growth. Besides routine laboratory work, abdominal ultrasonography was done in all thecases. All patients were invariably subjected to fractional curretage and cervical biopsy was taken where indicated. Results: Malignancy wasfound to be the most common cause (51.42%) of postmenopausal bleeding. Carcinoma of the cervix was commonest and found in 34.28%,carcinoma of endometrium in 11.42%, atrophic endometrium in 11.42%, polyps in 8.57%, chronic cervicitis in 8.57%, endometrial hyperplasiain 5.71%, carcinoma of ovary in 2.85%, liomyosarcoma in 2.85%, senile vaginitis, trauma, and forgotten IUCD each in 2.85% of cases. Etiologyremained undetermined in 5.71 % cases. Malignancy was directly related to years of clear span and was 88.88% in cases presenting 10 yearsor more after the menopause. Conclusion: Carcinoma of cervix was the commonest cause of postmenopausal bleeding in our study. Screeningprogramme for early detection of carcinoma of cervix at a pre-invasive stage is highly recommended.

A case of alpha-fetoprotein–producing adenocarcinoma of the endometrium with a hepatoid component as a potential source for alpha-fetoprotein in a postmenopausal woman

2006 ◽  
Vol 16 (3) ◽  
pp. 1442-1445
Author(s):  
K. Takeuchi ◽  
S. Kitazawa ◽  
S. Hamanishi ◽  
M. Inagaki ◽  
K. Murata
Keyword(s):  
Postmenopausal Woman ◽  
Vaginal Bleeding ◽  
Pap Smear ◽  
Case Reports ◽  
Unknown Origin ◽  
Serum Levels ◽  
Alpha Fetoprotein ◽  
Endometrioid Adenocarcinoma ◽  
Eosinophilic Cytoplasm ◽  
Abnormal Vaginal Bleeding

Although case reports of alpha-fetoprotein (AFP)–producing adenocarcinoma other than hepatocellular carcinoma have gradually increased in number, AFP-producing adenocarcinoma of the endometrium is very rare. The patients universally complain of abnormal vaginal bleeding. The patient presented with complaints of epigastric discomfort. No vaginal bleeding was observed. Serum AFP concentration was 453 ng/mL, and lens culinaris agglutinin–reactive AFP percentage of total AFP was increased to 67%. Radiologic imaging and endoscopy did not provide evidence of any primary carcinoma in the liver and gastrointestinal tract. To investigate the unknown origin of high AFP, Pap smear of the endometrium followed by fractional curettage was performed and revealed adenocarcinoma of the endometrium. Radical hysterectomy with pelvic lymph node dissection and partial omentectomy was performed. Histologic study showed a mixture of major AFP-negative endometrioid adenocarcinoma and minor medullary proliferation of the AFP-positive hepatoid adenocarcinoma cells with eosinophilic cytoplasm and hyaline globules. After the surgery followed by four courses of weekly carboplatin and paclitaxel administration, serum levels of AFP dropped into normal range. The possible existence of AFP-producing adenocarcinoma of the endometrium should be considered in a postmenopausal woman even if there is no vaginal bleeding, when AFP-producing tumor is clinically suspected and the imaging studies fail to confirm the diagnosis.

Do Deeper Levels of Cervical Biopsies Preceded by a Pap Smear Diagnosis of LSIL, ASCUS, or NILM/HPV+ Increase the Yield of Identifying Clinically Significant Lesions?

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S163-S164
Author(s):  
K G Manjee ◽  
W G Watkin
Keyword(s):  
Pap Smear ◽  
Past History ◽  
Prior History ◽  
Cervical Biopsy ◽  
P16 Immunohistochemistry ◽  
Hpv Status ◽  
Significant Difference ◽  
History Of ◽  
Clinically Significant ◽  
Almost All

Abstract Introduction/Objective Cervical biopsy is performed following an abnormal pap smear or positive HPV testing in an attempt to uncover clinically significant lesions [HSIL/invasive carcinoma (HSIL+)]. An excisional procedure is considered if biopsy confirms HSIL+. When preceded by pap smear of LSIL, ASCUS, NILM/HPV+ or persistent HPV, continued surveillance is recommended for biopsies showing no SIL or LSIL. In our laboratory, cervical biopsies are routinely sectioned at 3 levels. Deeper levels are often ordered when initial sections are non-diagnostic. p16 immunohistochemistry, with or without deeper levels, is often ordered to confirm HSIL, or to differentiate HSIL from mimics. In this study, we examine whether and in what clinical situations does obtaining additional levels uncover clinically significant lesions. Methods 430 cervical biopsies between January-May 2018, with recent cytology of LSIL, ASCUS or NILM/HPV+ were identified in the pathology database. HPV status (if known), final biopsy diagnosis and past history of LSIL/HSIL were recorded. For each biopsy, orders for additional levels and/or p16 immunohistochemistry were recorded resulting in 4 categories: C1-no additional levels or p16, C2-deeper only, C3-deeper+p16 and C4-p16 only. Final diagnoses were divided into HSIL+, LSIL and no SIL. Results There was no significant difference in prior history of LSIL/HSIL and HPV status between all categories. Biopsy results were as follows: HSIL+: 11/222 (5%) C1; 1/78 (1%) C2; 7/43 (16%) C3; 15/87 (17%) C4 LSIL: 91/222 (41%) C1; 7/78 (9%) C2; 16/43 (37%) C3; 35/87 (40%) C4 No SIL: 120/222 (54%) C1; 70/78 (90%) C2; 20/43 (46%) C3; 37/87 (42%) C4 The average number of additional levels in C2 and C3 was 3.8 and 1.8, respectively. Conclusion Deeper levels alone did not enhance the detection of HSIL+. Almost all LSIL/HSIL were detected when initial levels were diagnostic or suspicious and supported by p16 immunohistochemistry. 3 levels are adequate to detect clinically significant lesions.

scholarly journals Angiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Ryo Takaji ◽  
Hiro Kiyosue ◽  
Miyuki Maruno ◽  
Norio Hongo ◽  
Ryuichi Shimada ◽  
...  
Keyword(s):  
Vaginal Bleeding ◽  
Transarterial Embolization ◽  
Recurrent Bleeding ◽  
Study Cohort ◽  
Technical Success ◽  
Retained Placenta ◽  
Vascular Channel ◽  
Abnormal Bleeding ◽  
Abnormal Vaginal Bleeding

Abstract Objectives To clarify characteristic angiographic features and clinical efficacy of selective transarterial embolization (TAE) of retained placenta with abnormal vaginal bleeding. Methods The study cohort comprised 22 patients (mean age, 33.5 years; range, 22–24 years) who underwent selective TAE for retained placenta with abnormal bleeding between January 2018 and December 2020 at our institution. Angiographic images were reviewed by two certified radiologists with consensus. Medical records were reviewed to evaluate the efficacy of TAE. Angiographic features of retained placenta, technical success (disappearance of abnormal findings on angiography), complications, clinical outcomes (hemostatic effects and recurrent bleeding) were evaluated. Results Pelvic angiography showed a dilated vascular channel mimicking arteriovenous fistulas or an aneurysm contiguous with dilated uterine arteries in the mid-arterial–capillary phase in 20 patients; it showed contrast brush in the remaining two patients. TAE technical success was achieved in all patients. No major complications were observed in any patients. Fifteen patients were followed up with expectant management after TAE; all but one patient showed no re-bleeding during the follow-up period (mean follow-up interval, 3.4 months; range, 1–17 months). One patient showed minor rebleeding, which resolved spontaneously. Seven patients underwent scheduled hysteroscopic resection within 1 week after TAE, and no excessive bleeding was observed during or after the surgical procedure in all seven patients. Conclusions The characteristic angiographic feature of retained placenta is “dilated vascular channel that mimic low flow AVM.” TAE is a safe and effective treatment to manage retained placenta with abnormal bleeding.

scholarly journals Adenoid Basal Carcinoma of Cervix: A Rare Case Report

2020 ◽  
Vol 3 (2) ◽  
pp. 392-394
Author(s):  
Alina Karna ◽  
Nisha Sharma
Keyword(s):  
Pap Smear ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Adenoid Cystic ◽  
Carcinoma Of Cervix ◽  
Rare Case Report ◽  
Intraepithelial Lesion

Adenoid basal carcinoma of the uterine cervix is a rare low-grade tumor and its cell origin is still obscure. Adenoid basal carcinoma can be confused with adenoid basal hyperplasia, adenoid cystic carcinoma, and basaloid squamous cell carcinoma of the cervix. We present here a case of a 59 year-old-female who initially presented with a high-grade squamous intraepithelial lesion on Pap smear. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Histopathology revealed focal invasive adenoid basal carcinoma with extensive areas of a high-grade squamous intraepithelial lesion involving the endocervical gland. The immunohistochemical stain was positive for p16.

scholarly journals Five Years’ Experience on Hysteroscopy in Abnormal Vaginal Bleeding

2013 ◽  
Vol 2 (1) ◽  
Author(s):  
Mansoureh Vahdat ◽  
Elaheh Sariri ◽  
Maryam Kashanian ◽  
Zahra Najmi ◽  
Mahjabin Marashi ◽  
...  
Keyword(s):  
Vaginal Bleeding ◽  
Abnormal Vaginal Bleeding

scholarly journals The Cervical pap smear cytological changes with clinicopathological correlation in a sample of Iraqi patients

2021 ◽  
Vol 5 (3) ◽  
Keyword(s):  
Vaginal Discharge ◽  
Pap Smear ◽  
Histopathological Examination ◽  
Pap Test ◽  
Pap Smears ◽  
Postmenopausal Bleeding ◽  
Parity Number ◽  
Medical City ◽  
Chief Complaints ◽  
Iraqi Women

Objectives: This study aimed to evaluate the role of Pap test in detecting pre-cancerous lesions in Iraqi women aged 45 years to 85 years, correlate the pap result with patient’s age, parity, number of births, number of abortions, chief complaint, and clinical cervical exam, and to evaluate the diagnostic accuracy of the pap test in correlation to histopathological examination. Methods: Women who attended the outpatient gynaecological clinic of the Department of Obstetrics and Gynaecology at Baghdad medical city, Baghdad, Iraq, from January 2019 to January 2020 who had different chief complaints were selected for the study. Women who are 45 years to 85 years old were included in the study. A Pap smear was used for all women to screen for cervical cancer and the results were reported according to the 2014 Bethesda system. The data analysis was done utilizing statistical package for social sciences version 24 (SPSS v24). Results: Total number of pap smears analyzed were 510, NILM (negative for intraepithelial lesions or malignancy) constituted major group 464/510 (91%) and epithelial cell abnormality were 46/510 (9%), age is significantly correlated with increasing rate of pre-neoplastic and neoplastic lesions in women and the significance of vaginal discharge & postmenopausal bleeding and its association with premalignant changes in the cervix. The sensitivity of Pap test is 94%, the Specificity was 60% and accuracy rate 74%. Conclusion: There is significant correlation between Pap smear abnormality and increasing age, vaginal discharge and postmenopausal bleeding, were evident in this study.

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