COMPARISON OF CERVICAL BIOPSY USING PUNCH BIOPSY FORCEPS  VERSUS LOOP ELECTRODE

Context: The biopsy of cervix can be obtained by various methods with availability of newer modalities like loop electrode. Objectives: To compare the histo-pathological parameters and clinical outcome of cervical biopsy obtained using punch biopsy forceps versus loop electrode. Methods: Women attending OPD were screened for cervical pathology, and colposcopy was done for those who screened positive. Patients who required cervical biopsy after colposcopy were allocated into 2 group; one undergoing LEEP biopsy and other half biopsied with Punch forceps. During procedure patients were evaluated for the intra–op pain and bleeding and their severity. The histo- pathological diagnosis was carried out and the sample was studied for its size, adequacy, and presence of any thermal or crush artefacts. Result: The two methods of biopsy were comparable in intra-op parameters, except for the increased requirement for additional haemostasis in LEEP biopsy. There was no case of bleeding from biopsy site at the follow-up visit. LEEP biopsy was associated with continued vaginal discharge more often than punch biopsy. An adequate sample for histopathological diagnosis was obtained in 91.25% of all cases. The comparative findings were reflective of comparable efficacy of both methods in providing an acceptable tissue sample for diagnosis. Conclusion: After analysing and comparing the aforementioned parameters, we opined that neither method can be deemed clearly superior to the other as a cervical biopsy procedure.Keywords: Punch biopsy forceps; Loop electrode; Cervical biopsy.

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Comparison of Keyes punch biopsy instrument with cervical punch biopsy forceps for diagnosing cervical lesions

10.1055/s-0039-1685286 ◽

2016 ◽

Author(s):

Natasha Tyagi ◽

Amita Suneja ◽

Kiran Mishra ◽

Sandhya Jain ◽

Neelam B. Vaid ◽

...

Keyword(s):

Punch Biopsy ◽

Rank Test ◽

Target Area ◽

Biopsy Forceps ◽

Cervical Lesions ◽

Surgical Specimen ◽

Transformation Zone ◽

Cervical Biopsy ◽

Signed Rank ◽

Signed Rank Test

Aims: To assess the feasibility and efficacy of Keyes punch biopsy instrument (KP) in diagnosing cervical lesions and compare it with cervical punch biopsy forceps (CP). Methods: 75 women having adequate colposcopy with abnormal transformation zone were included and paired colposcopic directed biopsies were taken using KP followed by CP from the same target area. The outcome parameters were compared using paired t-test, Wilcoxon signed rank test and McNemar test. Results: It was feasible in all cases to take cervical biopsy with KP and CP. Volume of gross specimen obtained by KP was less than CP (0.076±0.097 vs 0.101±0.156 cm3, p=0.061), however on microscopic examination, mean length and depth of tissue in KP was greater than CP by 0.06 mm (p=0.810) and 0.14 mm (p=0.634) respectively. There was an exact agreement with final surgical specimen in 42% of cases in both forceps. Agreement within 1 degree was found in 25% of cases with KP and in 17% of cases with CP. Both the forceps equally missed microinvasive lesions but KP was inferior to CP for invasive cancer. Conclusion: KP is almost at par with CP for diagnosing preinvasive cervical lesions and is a useful adjunct to the existing armamentarium of biopsy forceps.

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Primary Malignant Melanoma of Uterine Cervix

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v15i1.29352 ◽

2020 ◽

Vol 15 (1) ◽

pp. 86-88

Author(s):

Ramesh Shrestha ◽

Purbesh Adhikari ◽

Surya Prasad Rimal ◽

Pritha Basnet ◽

Pappu Rijal ◽

...

Keyword(s):

Malignant Melanoma ◽

Uterine Cervix ◽

Radical Hysterectomy ◽

Vaginal Discharge ◽

Post Treatment ◽

Primary Malignant Melanoma ◽

Histopathological Diagnosis ◽

Figo Staging ◽

Aggressive Cancer

Primary malignant melanoma of cervix (PMMC) is rare and aggressive cancer of uterine cervix. It presented as vaginal discharge, post coital bleding and blackish cervical growth that was biopsied and radical hysterectomy performed immediately after getting the histopathological diagnosis at stage-1B2 (FIGO staging, 2018). Post-treatment, she was recurrence free at nine months of regular follow up visit. Keywords: cervix, malignant, melanoma, primary

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Is jumbo biopsy forceps comparable to cold snare for diminutive colorectal polyps? – a meta-analysis

Endoscopy International Open ◽

10.1055/a-1293-6965 ◽

2021 ◽

Vol 09 (01) ◽

pp. E9-E13

Author(s):

Sachin Srinivasan ◽

Peter D. Siersema ◽

Madhav Desai

Keyword(s):

Meta Analysis ◽

Complete Removal ◽

Colorectal Polyps ◽

Comparable Efficacy ◽

Incomplete Resection ◽

Complication Rates ◽

Biopsy Forceps ◽

Significant Difference ◽

Leave One Out ◽

Endoscopic Assessment

Abstract Background and study aims Diminutive colorectal polyps are increasingly being detected and it is not clear whether jumbo biopsy forceps (JBF) has comparable efficacy to that of cold snare polypectomy (CSP) for management of these lesions. Methods An electronic literature search was performed for studies comparing resection rates of JBF and CSP for diminutive polyps (≤ 5 mm). The primary outcome was incomplete resection rate (IRR). Secondary outcomes included failure of tissue retrieval and complication rates (post-polypectomy bleeding, perforation etc.). Leave-one-out analysis was performed to examine the disproportionate role of any of the studies. Meta-analysis outcomes and heterogeneity (I2) were computed using Comprehensive meta-analysis software. Results A total of 4 studies (3 randomized controlled trials and 1 retrospective study) with 407 patients and 569 total polyps (mean size of 3.62 mm) was included for analysis. IRR of JBF was slightly higher than that of CSP (10.2 % vs 7.2 %) but this was not statistically significantly different (Pooled OR 1.76; 95 % CI 0.94–3.28; I2 = 0). Leave-one-out analysis showed no significant difference in the pooled OR comparison either. Two of the 4 studies reported 0 % failure of tissue retrieval for JBF and 1 % and 4.3 % for CSP. There were no complications for either group from the 2 studies that reported this outcome. The quality of the included studies was moderate to high. Conclusions This systematic review with only limited data shows that JBF and CSP are not statistically different in completely removing diminutive polyps, although careful endoscopic assessment is needed to ensure complete removal of all polyp tissue.

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Squamous cell carcinoma of the scrotum in HIV: two case reports

African Journal of Urology ◽

10.1186/s12301-021-00177-3 ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Jeff John ◽

Ken Kesner ◽

John Lazarus

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Case Reports ◽

Treatment Options ◽

Punch Biopsy ◽

Delayed Treatment ◽

Clinical Presentations ◽

T1 N0 M0

Abstract Background Squamous cell carcinoma (SCC) of the scrotum was the first malignancy known to be associated with exposure to an occupational carcinogen—in this case, soot trapped in the breeches of chimney sweeps. Better civil rules and regulations and the replacement of hearths with other forms of heating have rendered SCC of the scrotum a rarity. We report two cases of scrotal SCC with vastly differing clinical presentations and management. Case presentation Case 1 had T1 N0 M0 disease and presented with a small (< 2 cm), innocuous-looking, non-healing ulcer of eight years duration. A punch biopsy revealed a superficially invasive SCC confirmed on immunohistochemical profiling. A wide local excision of the lesion was subsequently performed. Follow-up at three years showed no signs of recurrence. Case 2 presented with T4 N1 M1 disease and rapidly progressing locally destructive mass. A punch biopsy of the scrotal lesion confirmed invasive moderately differentiated focally keratinising SCC. The metastatic evaluation confirmed the presence of metastatic, extensive para-aortic lymphadenopathy. He was managed with cisplatin-based chemoradiotherapy. Conclusion Early detection and management of patients with SCC of the scrotum are essential. If the diagnosis is delayed, treatment options become limited, and the prognosis is poor. Notwithstanding the rarity of this disease, multicentre trials are needed to provide more precise guidelines as to the optimal management of these patients.

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Classification of Male Breast Lesions According to the IAC Yokohama System for Reporting Breast Cytopathology

Acta Cytologica ◽

10.1159/000512041 ◽

2020 ◽

pp. 1-8

Author(s):

Melissa Oosthuizen ◽

Rubina Razack ◽

Jenny Edge ◽

Pawel Tomasz Schubert

Keyword(s):

Predictive Value ◽

Best Practice ◽

Internal Audit ◽

Needle Aspiration ◽

Male Breast ◽

Histopathological Diagnosis ◽

Breast Lesions ◽

Risk Of Malignancy ◽

Sensitivity Specificity

Objective: This study aims to determine the diagnostic utility of the International Academy of Cytology (IAC) Yokohama System for reporting breast cytopathology in lesions of the male breast. Study Design: Fine-needle aspiration biopsy (FNAB) reports between 2015 and 2019 were retrospectively recategorized according to the 5-tiered IAC Yokohama Reporting System. Our database yielded a total of 1,532 FNAB reports from breast lesions, obtained from 1,350 male patients. The risk of malignancy (ROM) and diagnostic performance of FNAB were determined using follow-up histopathological diagnosis and/or clinical follow-up, where available, for each category. Results: The category distribution were as follows: inadequate, 40%; benign, 57%; atypical, 0.6%; suspicious for malignancy, 0.7%; and malignant, 1.6%. The ROM in each category was nondiagnostic, 11%; benign, 3%; atypical, 28%; suspicious for malignancy, 56%; and malignant, 100%. The sensitivity, specificity, positive predictive value, and negative predictive value were recorded as 63, 100, 100, and 84.6% respectively, when only malignant cases were considered as positive tests. Conclusion: This study validates the IAC Yokohama System for reporting male breast cytopathology. In accordance with the aim of the Yokohama System to establish best practice guidelines for reporting breast cytopathology, this comprehensive scheme facilitates comparisons between local and international institutions. The ROM acts as an internal audit for quality assurance within one’s own laboratory and provides guidance for clinical management. It highlights inefficiencies such as high inadequacy rates for category 1 and also features strengths with impressive specificity for categories 4 and 5.

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Is clear cell sarcoma a malignant form of psammomatous melanotic schwannoma?

Neurosurgical FOCUS ◽

10.3171/foc.2006.21.6.3 ◽

2006 ◽

Vol 21 (6) ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Ahmet Şengöz ◽

Erol Taşdemiroğlu ◽

Halit Togay

Keyword(s):

Malignant Melanoma ◽

Nerve Root ◽

Clear Cell ◽

Clear Cell Sarcoma ◽

Histopathological Diagnosis ◽

Total Resection ◽

Cell Sarcoma ◽

Melanotic Schwannoma ◽

Psammomatous Melanotic Schwannoma

✓The authors present a case of clear cell sarcoma (CCS) in which the tumor originated in the S-1 nerve root and had been previously diagnosed as psammomatous melanotic schwannoma (PMS). This is the third case of a spinal nerve root origin for CCS reported in the English-language literature. The similar histogenesis of CCS and malignant melanoma supports the hypothesis that biological agents or immunotherapy are potentially important areas of investigation. The patient underwent S1–3 laminectomy and gross-total resection of the mass lesion. The border of the resection was extended 1 cm distal to the tumor margin. The postoperative period was uneventful. The new histopathological diagnosis was CCS (malignant melanoma of soft tissue). Despite total resection, the patient returned with disseminated disease at the 18-month follow-up visit. His follow-up magnetic resonance image of the lumbar spine revealed sacral L5–S3 involvement of the vertebral bodies along with disseminated cauda equina seeding. A CCS originating from peripheral nerves is quite rare. The histopathological and immunohistochemical appearance of CCSs resembles those of PMSs. Surgery should be the first choice of treatment.

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Do patients with atypical parathyroid adenoma need a close follow-up?

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab452 ◽

2021 ◽

Author(s):

Federica Saponaro ◽

Elena Pardi ◽

Laura Mazoni ◽

Simona Borsari ◽

Liborio Torregrossa ◽

...

Keyword(s):

Parathyroid Adenoma ◽

Serum Calcium ◽

Good Prognosis ◽

Histopathological Diagnosis ◽

Symptomatic Disease ◽

Asymptomatic Patients ◽

Parathyroid Adenomas ◽

Relevant Role ◽

Atypical Parathyroid Adenoma

Abstract Context Atypical parathyroid adenomas (APAs) are neoplasms with uncertain malignant potential but lack unequivocal histological signs of malignancy. Objective To retrospectively evaluate the clinical and biochemical profiles of patients with APA, the outcome after parathyroidectomy (PTX), and the presence of CDC73 germline and somatic mutations. Design Monocentric study on consecutive patients undergoing PTX for primary hyperparathyroidism (PHPT) between June 2000 and December 2020. Patients Fifty-eight patients with a confirmed histopathological diagnosis of APA. Age and sex-matched controls with parathyroid adenoma (PA) were also included. Results Fifty-four patients had sporadic PHPT and four familial isolated hyperparathyroidism (FIHP). Thirty-four patients (59%) had a symptomatic disease. Serum calcium and PTH levels were significantly higher in symptomatic compared to asymptomatic patients (P=0.048 and 0.008, respectively). FIHP patients were younger than the sporadic counterpart (30±17yr vs. 55±13 yrs). APA patients had significantly higher serum calcium and PTH levels and lower 25(OH)D concentration, BMD and T-score at 1/3 distal radius compared to those with PA. Four of 56 APA patients displayed a CDC73 germline mutation. No somatic CDC73 mutation was identified in 24 tumor specimens. The mean follow-up after surgery was of 60±56.4 months. All but six patients (90%), five with apparently sporadic PHPT and one with FIHP, were cured after surgery. Conclusions The large majority of patients with APA, despite a moderate/severe phenotype, have a good prognosis. Germline CDC73 mutation-positive patients had a higher rate of persistent/recurrent disease. CDC73 gene alterations do not seem to have a relevant role in the tumorigenesis of sporadic APA.

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Dedicated clinical trial tissue tracking database to improve turn-around time at high-volume center.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.1543 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 1543-1543

Author(s):

Peter Blankenship ◽

David DeLaRosa ◽

Marc Burris ◽

Steven Cusson ◽

Kayla Hendricks ◽

...

Keyword(s):

Clinical Trial ◽

Clinical Trials ◽

Tissue Sample ◽

High Volume ◽

Trial Participation ◽

Fresh Tissue ◽

Oncology Clinical Trials ◽

The Status ◽

Unique Source

1543 Background: Tissue requirements in oncology clinical trials are increasingly complex due to prescreening protocols for patient selection and serial biopsies to understand molecular-level treatment effects. Novel solutions for tissue processing are necessary for timely tissue procurement. Based on these needs, we developed a Tissue Tracker (TT), a comprehensive database for study-related tissue tasks at our high-volume clinical trial center. Methods: In this Microsoft Access database, patients are assigned an ID within the TT that is associated with their name, medical record number, and study that follows their request to external users: pathology departments, clinical trial coordinators and data team members. To complete tasks in the TT, relevant information is required to update the status. Due to the high number of archival tissue requests from unique pathology labs, the TT has a “Follow-Up Dashboard” that organizes information needed to conduct follow-up on all archival samples with the status “Requested”. This results in an autogenerated email and pdf report sent to necessary teams. The TT also includes a kit inventory system and a real-time read only version formatted for interdepartmental communication, metric reporting, and other data-driven efforts. The primary outcome in this study was to evaluate our average turnaround time (ATAT: average time from request to shipment) for archival and fresh tissue samples before and after TT development. Results: Before implementing the TT, between March 2016 and March 2018, we processed 2676 archival requests from 235 unique source labs resulting in 2040 shipments with an ATAT of 19.29 days. We also processed 1099 fresh biopsies resulting in 944 shipments with an ATAT of 7.72 days. After TT implementation, between April 2018 and April 2020, we processed 2664 archival requests from 204 unique source labs resulting in 2506 shipments (+28.0%) with an ATAT of 14.78 days (-23.4%). During that same period, we processed 1795 fresh biopsies (+63.3%) resulting in 2006 shipments (+112.5%) with an ATAT of 6.85 days (-11.3%). Conclusions: Oncology clinical trials continue to evolve toward more extensive tissue requirements for prescreening and scientific exploration of on-treatment molecular profiling. Timely results are required to optimize patient trial participation. During the intervention period, our tissue sample volume and shipments increased, but the development and implementation of an automated tracking system allowed improvement in ATAT of both archival and fresh tissue. This automation not only improves end-user expectations and experiences for patients and trial sponsors but this allows our team to adapt to the increasing interest in tissue exploration.

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Evaluation of effectiveness of combined use of COC and topical preparation containing azelaic acid for acne

Medical alphabet ◽

10.33667/2078-5631-2021-34-24-28 ◽

2021 ◽

pp. 24-28

Author(s):

L. S. Kruglova ◽

N. V. Gryazeva

Keyword(s):

Azelaic Acid ◽

Comparable Efficacy ◽

Antibacterial Drug ◽

Global Assessment Scale ◽

Efficiency Assessment ◽

Combined Use ◽

Comparison Groups ◽

Group 2 ◽

Group 1

The article presents the results of evaluating the effectiveness of the combined use of combined oral contraceptives (COC) and Skinoren cream in severe papular-pustular and moderate nodular-cystic acne.Material and methods. Patients of the first group (n = 11) used COC and an external antibacterial drug two times a day for the treatment of acne. Patients of the second group (n = 12) used COC and an external drug containing azelaic acid (Skinoren) for the treatment of acne two times a day. The duration of follow-up was 6 months. The efficiency assessment was carried out taking into account the dynamics of the indicators of the IGA (Investors Global Assessment) scale. The Manchester Scar Scale (MSS) was used to assess the effectiveness of post-acne correction. In addition, the effectiveness was evaluated based on the results of the mexametry.Results. When evaluating IGA in the comparison groups in patients with severe papulopustular acne and moderate nodular cystic acne, comparable efficacy was noted, but the best results were recorded in the COC + Skinoren group (p < 0.05). No effect and deterioration of the condition were observed in any group. When assessing MSS, the most pronounced changes were observed in patients of group 2, where the combination of COC + Skinoren was used. So, in group 1, the severity of scars decreased by 42.3 %, in group 2 by 48.2 % (p < 0.05). The evaluation of the results of the mexametry showed a more pronounced decrease in the amount of pigment in patients from group 2. When studying the results of the severity of erythema, the dynamics similar to the severity of the pigment was obtained. The best result was registered in group 2 (COC + Skinoren) (p < 0.05).Conclusions. The combined use of COC and Skinoren cream for severe papular-pustular and moderate nodular-cystic acne has proven to be an effective method both in relation to the number of inflammatory and retention elements, and in relation to hyperpigmentation.

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Comparable Efficacy of Terbinafine and Itraconazole in the Treatment of Tinea Pedis

Bangladesh Journal of Medicine ◽

10.3329/bjmed.v21i2.13615 ◽

2013 ◽

Vol 21 (2) ◽

pp. 74-79

Author(s):

Md Abdul Wahab ◽

Mohammad Jamal Uddin ◽

Biswas Shahen Hassan ◽

Md Zafrul Islam ◽

Ishrat Bhuiyan ◽

...

Keyword(s):

Fungal Infection ◽

Tinea Pedis ◽

Comparable Efficacy ◽

P Value ◽

Mycological Cure ◽

Efficacy Analysis ◽

Group A ◽

Group B

Background: Tinea pedis (athlets foot) is the most common fungal infection. Relapse is common in tinea pedis and may be result of recurrence following inadequate treatment or reinfection. Objective: To evaluate the comparable efficacy of terbinafine and itraconazole in the treatment of tinea pedis. Methods: 120 patients of tinea pedis confirmed by KOH microscopy were included in the study. The study was carried out in three different Hospitals and Private Chambers for a period of 3 years from July 2006 to June 2009. Mean age of the patients was 40.28±10.23. The patients were devided into 2 equal group:A & B. Group- A was given terbinafine 250 mg/day and group-B was given intraconazole 200 mg/day for 2 weeks. Results: Follow up 2 weeks after cessation of therapy revealed clinical and mycological cure of 93.3% in terbinafine group and 86.6% in itraconazole group. Conclusion: Efficacy analysis revealed that terbinafine is superior than itraconazole in the treatment of tinea pedis (P value 0.224). DOI: http://dx.doi.org/10.3329/bjmed.v21i2.13615 Bangladesh J Medicine 2010; 21: 74-79

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