Critical Analysis of Cervical and Endometrial Biopsy Specimens

Introduction: This is a retrospective study done in cervical and endometrial biopsy specimens received in the pathology department of Shree Birendra Hospital over a period of one year from 14th April, 2011 to 13th April, 2012. The aims of this study were to analyze the histological findings of cervical and endometrial biopsies and to identify activities needed to critically evaluate these specimens. Methods: The histopathological diagnoses of 104 cervical and 84 endometrial biopsy specimens reported by the pathologists were retrieved. The diagnoses were categorized and correlated with age in order to work out a strategy for better patient management. Results: The majority of 104 cervical biopsies (76.0%) comprised of neoplastic lesions and 83.5% of them were low-grade squamous intraepithelial lesions. Among the nonneoplastic lesions, cervical polyps and cervicitis were in the ratio of 3:2. Of the 84 endometrial biopsies analyzed, proliferative endometrium comprised the majority (61.9%) with disordered proliferative being the most common pattern. Detailed information about the patients was minimal including the absence of age in 8.0% of cases. More than 80% of both cervical and endometrial biopsies were performed in the age group 30-59 years of age. Conclusions: Neoplastic lesions comprised the majority of the cervical biopsies while all the endometrial biopsies were nonneoplastic. Important clinical information like age of the patient has to be mentioned in the biopsy request form for useful clinical correlation of histological findings. Medical Journal of Shree Birendra Hospital; January-June 2013/vol.12/Issue1/23-28DOI: http://dx.doi.org/10.3126/mjsbh.v12i1.9088

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A clinicopathological study of dysfunctional uterine bleeding

Journal of Pathology of Nepal ◽

10.3126/jpn.v4i8.11500 ◽

2014 ◽

Vol 4 (8) ◽

pp. 635-638

Author(s):

N Katuwal ◽

G Gurung ◽

A Rana ◽

A Jha

Keyword(s):

Abnormal Uterine Bleeding ◽

Endometrial Biopsy ◽

Uterine Bleeding ◽

University Teaching ◽

Age Group ◽

Dysfunctional Uterine Bleeding ◽

Obstetrics And Gynaecology ◽

Proliferative Endometrium ◽

One Year ◽

Complete History

Background: Dysfunctional uterine bleeding is a form of abnormal uterine bleeding when there is absence of organic disease of the genital tract. The objective of this study was to find out the clinical and pathological aspect of women presenting with dysfunctional uterine bleeding.Materials and Methods: A descriptive study was conducted over a period of one year from April 14th 2010 to April 13th 2011 in the Department of Obstetrics and Gynaecology and Department of Pathology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. A complete history, clinical examination, pelvic scan, hormonal status if required and endometrial biopsy were done to diagnose dysfunctional uterine bleeding.Results: A total of 120 cases were included. The age of the patients diagnosed dysfunctional uterine bleeding were ranging from 24 -63 years. Dysfunctional uterine bleeding was most common in the age group 40-44 yrs (30%) followed by 45-49 yrs (27.5%). Menorrhagia (41.7%) was the most common presenting sign. Majority histopathology of endometrium revealed anovulatory pattern (61.7%) followed by ovulatory (38.3%). Of the cases with an anovulatory pattern 48.6% was proliferative endometrium, 33.8% disordered proliferative endometrium, 6.8%atrophic, 5.4% weakly proliferative and 2.7% each of simple hyperplasia without atypia and complex hyperplasia with atypia. All cases with ovulatory pattern showed secretory endometrium.Conclusion: Dysfunctional uterine bleeding was the most common in the perimenopausal age group and chiefly in the form of an anovulatory endometrium. . Histopathological evaluation of endometrium helps exclude the local causes and establishes the diagnosis of dysfunctional uterine bleeding, its types, and clinical correlation to histopathological findings and finally helps to determine the mode of management.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11500 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 635-638

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Histopathological Study of Endometrial Biopsy Specimens for Abnormal Uterine Bleeding

Journal of Lumbini Medical College ◽

10.22502/jlmc.v4i2.94 ◽

2016 ◽

Vol 4 (2) ◽

pp. 72

Author(s):

Archana Tiwari ◽

Narinder Kaur ◽

Sushila Jain ◽

Ramji Rai ◽

Surendra Kumar Jain

Keyword(s):

Light Microscopy ◽

College Teaching ◽

Abnormal Uterine Bleeding ◽

Endometrial Biopsy ◽

Uterine Bleeding ◽

Histopathological Study ◽

Medical College ◽

Biopsy Specimens ◽

Neoplastic Lesions ◽

Post Menopausal

Introduction: Endometrial specimen for abnormal uterine bleeding (AUB) is the one of the commonest specimens received in histopathology laboratory. Histopathological characteristics of endometrial tissues, as assessed by light microscopy, remains the diagnostic standard for the management of AUB. The objective of study is to find out the histopathological pattern of endometrium in AUB in the light of clinical details. Methods: This was a prospective observational study carried out in the department of Pathology, Lumbini Medical College Teaching Hospital for a period of two years from June 2014 to May 2016. Formalin fixed endometrial specimens were processed, paraffin embedded, sectioned at 3-4 µm, stained with hematoxylin and eosin, and studied under light microscopy along with their demographics. Data were collected, entered and analyzed using SPSS version 20. Results: The study included 100 cases of endometrial biopsy specimens with clinical diagnosis of AUB. Menstrual disturbances was found in wide age range between 17-75 years with the mean age of 45 (SD=13.36) years. Menorrhagia was the commonest (n=60, 60%) clinical presentation. Most (n=85; 85 %) endometrium had non-neoplastic lesions. Among them, normal endometrial patterns were commonest (n=50, 50 %). Neoplastic lesions (n=15, 15%) were distributed in all menstruation status with majority in postmenopause (n=7, 7%) and included malignant cases (n=5, 5%) among others. Conclusion: Post-menopausal bleeding was common presentation among women with malignant and premalignant disease which was present in 15% of the cases together. Timely evaluation of AUB by histopathology can be life saving with early tissue diagnosis and management.

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Downregulation of IL-2 and IL-23 in Cervical Biopsies of Cervical Intraepithelial Lesions: A Cross-Sectional Study

Acta Cytologica ◽

10.1159/000508015 ◽

2020 ◽

Vol 64 (5) ◽

pp. 442-451

Author(s):

Caetano Galvão Petrini ◽

Larissa Brito Bastos ◽

Geraldo Duarte ◽

Patricia Pereira Dos Santos Melli ◽

José Carlos Alves-Filho ◽

...

Keyword(s):

Immune Response ◽

Cross Sectional Study ◽

Low Grade ◽

Sectional Study ◽

Cross Sectional ◽

Cervical Biopsy ◽

Biopsy Specimens ◽

Cytokine Levels ◽

Intraepithelial Lesion ◽

Intraepithelial Lesions

Introduction: Persistent infection with high-risk human papillomavirus (HPV) types is associated with high-grade intraepithelial lesions (HSILs) and invasive cervical cancer. The host immune response plays a key role in whether HPV clears or persists. Most studies on local immune response to HPV collect cervical mucus in order to quantify secreted cytokines; however, cells located inside the tissue can release different cytokines associated with HPV infection. Objective: This study compared the cytokine levels in cervical biopsy specimens of women with abnormal colposcopic findings according to the histopathological results: low-grade intraepithelial lesion (LSIL), HSIL, and no intraepithelial lesion (NSIL). Methods: A cross-sectional study enrolling 141 cervical biopsy specimens examined the cytokine profile for interleukin (IL-) 2, IL-4, IL-10, IL-12, IL-17, and IL-23 and interferon-γ, using the Luminex assay/ELISA. Differences in cytokine levels among the cervical lesion groups were assessed using the Kruskal-Wallis test. Results: The 141 specimens included 90 HSILs, 22 LSILs, and 29 NSILs. IL-2 levels were significantly higher in NSIL samples than in LSIL or in HSIL samples (p = 0.0001) and IL-23 levels were significantly higher in NSIL than in HSIL samples (p = 0.003). Conclusions: Our study shows that in samples from the lesion site point, 2 important pro-inflammatory cytokines, IL-2 and IL-23, are downregulated in HPV lesions.

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Glomerular Neovascularization in Nondiabetic Renal Allograft Is Associated with Calcineurin Inhibitor Toxicity

Nephron ◽

10.1159/000511452 ◽

2020 ◽

pp. 1-6

Author(s):

Anri Sawada ◽

Masayoshi Okumi ◽

Shigeru Horita ◽

Kohei Unagami ◽

Sekiko Taneda ◽

...

Keyword(s):

Diabetic Kidney Disease ◽

Renal Allograft ◽

Calcineurin Inhibitor ◽

Clinical Information ◽

Renal Allografts ◽

Biopsy Specimens ◽

Allograft Biopsy ◽

Time Periods ◽

Medical University ◽

Trough Levels

Introduction: Extra efferent arterioles, also known as polar vasculosis (PV), are often observed in the glomerular vascular pole and are associated with glomerular hypertrophy, indicating early recurrent diabetic kidney disease (DKD) in renal allografts. However, its significance in patients without diabetes remains uncertain. Methods: A total of 9,004 renal allograft biopsy specimens obtained between January 2007 and December 2017 at Tokyo Women’s Medical University were retrospectively analyzed to examine the clinical and pathological significance of PV in renal allografts. PV was identified in 186 biopsy specimens obtained from 165 patients. The PV group comprised 46 patients; 35 patients without DKD and 11 patients with DKD as the initial cause of ESRD, whose clinical information was available and treated with the calcineurin inhibitor (CNI) tacrolimus. The non-PV group comprising patients with renal allografts matched for age and postoperative day included 93 patients without DKD and 16 patients with DKD as the initial cause of ESRD. Results: In patients with nondiabetic renal allografts, systolic blood pressure was significantly higher in the PV group than in the non-PV group. The trough tacrolimus levels during the overall study period and at 2 weeks, 1 month, and 2 years after transplantation were significantly higher in the PV group compared with the non-PV group. Glomerulomegaly was significantly more common. Moreover, ah and aah scores in Banff score were significantly higher in the PV group than in the non-PV group. In those with diabetic renal allografts, although the clinical parameters and tacrolimus trough levels in all time periods were not significantly different between the PV and non-PV groups, the ah score was significantly higher in the PV group. Conclusion: PV was associated with CNI toxicity in nondiabetic but not in diabetic renal allografts. The pathogenesis of PV in renal allografts is considered to be multifactorial.

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HGG-02. ADOLESCENT AND YOUNG ADULT (AYA) GLIOMA WITH BRAF V600E-MUTANTATION

Neuro-Oncology ◽

10.1093/neuonc/noaa222.294 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii344-iii344

Author(s):

Yui Kimura ◽

Yukitomo Ishi ◽

Yuko Watanabe ◽

Yoshiko Nakano ◽

Shigeru Yamaguchi ◽

...

Keyword(s):

Braf Inhibitor ◽

Clinical Information ◽

Early Recurrence ◽

Pleomorphic Xanthoastrocytoma ◽

Adolescent And Young Adult ◽

Braf V600e ◽

Low Grade ◽

Diffuse Astrocytoma ◽

Genetic Features ◽

Epithelioid Glioblastoma

Abstract BACKGROUND Biological features of pediatric glioma differ significantly from those of adult glioma, and limited data are available on those of AYA patients. Here, we focused on AYA patients with glioma, especially those harboring BRAF V600E mutation, and investigated their clinical and genetic features. METHOD: We retrospectively analyzed AYA patients with brain tumors harboring BRAF V600E, who were treated in two hospitals in Japan. RESULTS Clinical information was available for 14 patients. The median age at diagnosis was 25 years (range: 15–38). Five patients were diagnosed with glioblastoma (GBM), including one epithelioid type. These patients were over 25. Although one patient with GBM died of the disease 6.9 years after initial diagnosis, the remaining patients were alive. Two patients were alive without recurrence at 38 and 51 months after the treatment. The patient with epithelioid glioblastoma experienced early recurrence. The remaining nine patients (64%) were diagnosed with low-grade glioma, including ganglioglioma, pilocytic astrocytoma, diffuse astrocytoma, oligodendroglioma, pleomorphic xanthoastrocytoma, and polymorphous low-grade neuroepithelial tumor of the young. No patients died of the disease, and four patients are alive without recurrence after initial operation without adjuvant treatment. Two patients are (epithelioid glioblastoma and ganglioglioma) currently undergoing treatment with a BRAF inhibitor for recurrent tumors. DISCUSSION Although the number of this study is limited, our study suggested that the prognosis of AYA patients with BRAF-V600E positive GBM may not be as dismal as that of children or adults.

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Histopathological pattern of endometrial samples in abnormal uterine bleeding

Journal of Pathology of Nepal ◽

10.3126/jpn.v1i1.4443 ◽

1970 ◽

Vol 1 (1) ◽

pp. 13-16 ◽

Cited By ~ 3

Author(s):

R Baral ◽

S Pudasaini

Keyword(s):

Age Groups ◽

Abnormal Uterine Bleeding ◽

Endometrial Biopsy ◽

Uterine Bleeding ◽

Age Group ◽

Physiological Changes ◽

Biopsy Material ◽

Histological Pattern ◽

Biopsy Specimens ◽

Histological Characteristics

Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of abnormal uterine bleeding is not complete without tissue diagnosis. The aim of the study was to find out the histopathological pattern of the endometrium in abnormal uterine bleeding. Materials and Methods: Endometrial biopsy specimens received from Jan 2007 to Nov 2010 were studied retrospectively in the Department of Histopathology, Helping Hands Community Hospital, Kathmandu. The specimens were routinely processed and the hematoxyllin and eosin stained slides were studied. Results: A total of 300 specimens were analyzed. In the group of patients less than 40 years of age, 73 (50%) were normal, 34(23%) had abnormal physiologic changes and 13 (9%) had pregnancy related complications and benign changes. In the age group between 40 – 55 years, abnormal physiological changes, benign conditions and normal physiological changes were 45 (32%), 41 (29%) and 37 (26%) respectively. In the age group > 55 years, there were 3(21%) malignant and 3(21%) benign conditions. There were 5(36%) unsatisfactory samples in this age group. Conclusion: It is important to know the histological pattern of the endometrium in abnormal uterine bleeding in different age groups since it will help in the management of the cases. In this study endometrial hyperplasias were seen in 55 cases (18.8%). The importance of studying the histological pattern of endometrium in abnormal uterine bleeding in different age group is to help in correctly managing the cases. Keywords: Endometrium; Simple hyperplasia; Complex hyperplasia; Endometritis; Endometrial Carcinoma. DOI: 10.3126/jpn.v1i1.4443 Journal of Pathology of Nepal (2011) Vol.1, 13-16

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Colposcopic characteristics and Lugol׳s staining differentiate anal high-grade and low-grade squamous intraepithelial lesions during high resolution anoscopy

Papillomavirus Research ◽

10.1016/j.pvr.2015.06.004 ◽

2015 ◽

Vol 1 ◽

pp. 101-108 ◽

Cited By ~ 17

Author(s):

Naomi Jay ◽

J. Michael Berry ◽

Christine Miaskowski ◽

Misha Cohen ◽

Elizabeth Holly ◽

...

Keyword(s):

High Resolution ◽

Low Grade ◽

High Grade ◽

Squamous Intraepithelial Lesions ◽

Intraepithelial Lesions

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Routine Syndecan-1 Immunohistochemistry Aids in the Diagnosis of Chronic Endometritis

Archives of Pathology & Laboratory Medicine ◽

10.5858/2004-128-1000-rsiait ◽

2004 ◽

Vol 128 (9) ◽

pp. 1000-1003 ◽

Cited By ~ 11

Author(s):

Ilene B. Bayer-Garner ◽

Jennifer A. Nickell ◽

Soheila Korourian

Keyword(s):

Plasma Cells ◽

Abnormal Uterine Bleeding ◽

Endometrial Biopsy ◽

Uterine Bleeding ◽

Endometrial Polyp ◽

Chronic Endometritis ◽

Underlying Malignancy ◽

Proliferative Endometrium ◽

Exogenous Progesterone ◽

Secretory Endometrium

Abstract Context.—Chronic endometritis is reportedly observed in 3% to 10% of women undergoing endometrial biopsy for abnormal uterine bleeding. The diagnosis of chronic endometritis rests on the identification of the plasma cells. Their identification may be obscured by a mononuclear cell infiltrate, plasmacytoid stromal cells, abundant stromal mitoses, a pronounced predecidual reaction in late secretory endometrium, menstrual features, or secondary changes due to exogenous progesterone treatment prior to the biopsy. Syndecan-1 is a proteoglycan that is found on the cell surface of plasma cells and keratinocytes. Immunohistochemistry stains for this antibody may facilitate diagnosis of chronic endometritis. Objective.—To determine whether or not routine syndecan-1 immunohistochemistry will aid in the diagnosis of chronic endometritis. Design.—Immunohistochemistry stains for syndecan-1 were performed on 3 levels of 47 endometrial biopsies from patients with abnormal uterine bleeding. None of the patients had endometrial hyperplasia or an underlying malignancy. Clinical correlation and follow-up was attempted in 20 cases that showed evidence of plasma cells by syndecan-1 by immunohistochemistry. Results.—Plasma cells were identified in 20 cases, 7 of which were initially diagnosed as chronic endometritis. The remaining 13 positive cases were diagnosed as tubal metaplasia (1), secretory endometrium (4), proliferative endometrium (4), menstrual endometrium (1), endometrial polyp (1), secretory endometrium with endometrial polyp (1), and endometrial polyp with exogenous hormone effect (1) based on the original hematoxylin-eosin section. Conclusions.—Syndecan-1 may be a useful adjunct in the diagnosis of chronic endometritis. Approximately half of the cases of chronic endometritis responded to an antibiotic regime; thus, this diagnosis is important and may potentially obviate the need for surgical intervention.

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Controversies in the Diagnosis of Barrett Esophagus and Barrett-Related Dysplasia: One Pathologist's Perspective

Archives of Pathology & Laboratory Medicine ◽

10.5858/2010-0249-ra.1 ◽

2010 ◽

Vol 134 (10) ◽

pp. 1479-1484 ◽

Cited By ~ 4

Author(s):

John R. Goldblum

Keyword(s):

English Literature ◽

Goblet Cells ◽

High Grade Dysplasia ◽

Barrett Esophagus ◽

Low Grade ◽

High Grade ◽

Biopsy Specimens ◽

Columnar Lined Esophagus ◽

Intramucosal Adenocarcinoma ◽

Rule Out

Abstract Context.—Pathologists frequently assess esophageal biopsy specimens to “rule out Barrett esophagus,” as well as to assess for the presence or absence of dysplasia. Objective.—To review some of the recent controversies in the diagnosis of Barrett esophagus and Barrett-related dysplasia. Data Sources.—Sources were the author's experience and review of the English literature from 1978 to 2009. Conclusions.—Although goblet cells are required by the American College of Gastroenterology to confirm a diagnosis of Barrett esophagus, this definition might expand to include columnar-lined esophagus without goblet cells. The recognition of dysplasia in Barrett esophagus remains a difficult task for the surgical pathologist, with difficulties in distinguishing reactive epithelium from dysplasia, low-grade dysplasia from high-grade dysplasia, and even high-grade dysplasia from intramucosal adenocarcinoma.

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