scholarly journals A Case of Genital Tuberculosis Presenting as HSIL on Cervical Biopsy

2021 ◽  
Vol 11 (7) ◽  
pp. 168-170
Author(s):  
Apra Attri ◽  
Priyanka Sharma ◽  
Sita Thakur
Keyword(s):  
Key Words ◽  
Postmenopausal Women ◽  
Histopathological Examination ◽  
Cervical Dysplasia ◽  
High Grade ◽  
Genital Tuberculosis ◽  
Cervical Biopsy ◽  
Post Menopausal

Genital tuberculosis is a frequent cause of chronic PID and infertility. Cervical TB is rare in postmenopausal women. We present a case of a post menopausal patient, who presented with a complaint of blood mixed discharge per vaginum for six months. Her preliminary investigations were consistent with that of HSIL/ High grade cervical dysplasia. Upon further evaluation, histopathological examination confirmed the possibility of tuberculosis instead. Key words: HSIL, Genital tuberculosis, Cervical biopsy.

scholarly journals Genital tuberculosis mimic as a genital malignancy in post menopausal women

2021 ◽  
Vol 10 (3) ◽  
pp. 1195
Author(s):  
Monalisa Mahajan
Keyword(s):  
Histopathological Examination ◽  
Abdominal Mass ◽  
Pelvic Mass ◽  
Final Diagnosis ◽  
Ovarian Malignancy ◽  
Genital Tuberculosis ◽  
Menopausal Women ◽  
Post Menopausal ◽  
High Level ◽  
Palpable Abdominal Mass

Genital tuberculosis tends to be an indolent infection and the disease may not manifest for year after initial seeding. The most common presentation reported in general population are pelvic pain, postmenopausal bleeding, ascites, abdominal mass, ovarian mass. The diagnosis is made by histopathological examination. Surgery is indicated as presence of abdominal pelvic mass with severe pain. Preoperative diagnosis of genital tuberculosis is often difficult because of confusion with ovarian malignancy. A 60 years old women present with weight loss, palpable abdominal mass with ascites, prominent bilateral ovaries and increase level of CA125. Pelvic malignancy was initially suspected but a diagnosis of tuberculosis was made following postoperative peritoneal wash biopsy. Patient managed with surgical laparotomy under a provisional diagnosis of ovarian malignancy but the final diagnosis was genital tuberculosis followed by anti tubercular regimen. Genital tuberculosis with high level of CA125 mimicking ovarian carcinoma. 

Role of Ancillary Techniques in Cervical Biopsy and Endocervical Curettage Specimens as Follow-Up to Papanicolaou Test Results Indicating a Diagnosis of Atypical Squamous Cells, Cannot Exclude High-Grade Squamous Intraepithelial Lesion, or High-Grade Squamous Intraepithelial Lesion

2019 ◽  
Vol 64 (1-2) ◽  
pp. 155-165 ◽  
Author(s):  
Taylor M. Jenkins ◽  
Hadi Shojaei ◽  
Sharon J. Song ◽  
Lauren E. Schwartz
Keyword(s):  
Cervical Dysplasia ◽  
Pap Test ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Papanicolaou Test ◽  
Squamous Cells ◽  
Cervical Biopsy ◽  
Intraepithelial Lesion ◽  
Infected Cells ◽  
Tissue Specimens

The Papanicolaou (PAP) test is widely used to screen for cervical cancer. All high-grade lesions such as atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H), and high-grade squamous intraepithelial lesion, identified on a PAP test should be followed-up by a confirmatory cervical biopsy. In this review, we discuss the challenges in interpreting cervical tissue specimens and the various ancillary techniques used in the evaluation of cervical dysplasia. Ancillary studies include deeper levels, p16 immunohistochemistry (IHC), human papillomavirus (HPV) testing, and, importantly, cyto-histologic correlation. Of these, p16 IHC is consistently sensitive and specific for detecting HSIL. HPV RNA in situ hybridization (ISH) is a newer technique with excellent sensitivity and specificity for detecting virally infected cells and it may be more broadly applicable to both low- and high-grade squamous intraepithelial lesions.

scholarly journals Ovarian thecoma- an incidental finding in a patient with UVprolapse

1970 ◽  
Vol 1 (2) ◽  
pp. 69-70
Author(s):  
Suniti Rawal ◽  
Kesang D Bista ◽  
Geeta Gurung ◽  
Ashma Rana
Keyword(s):  
Key Words ◽  
Ovarian Tumor ◽  
Histopathological Examination ◽  
Incidental Finding ◽  
Preoperative Evaluation ◽  
Abdominal Hysterectomy ◽  
Uterovaginal Prolapse ◽  
Solid Mass ◽  
Post Menopausal

A seventy two year old postmenopausal multiparous lady who presented with III° uterovaginal prolapse was found to have a solid mass palpable through the vaginal fornices for which the vaginal procedure was deferred for abdominal hysterectomy. A solid mass resembling fibrothecoma was discovered which after histopathological examination was reported to be thecoma pointing out the importance of preoperative evaluation. Key words: post menopausal ovarian tumor, thecoma, uterovaginal prolapse with ovarian tumor doi:10.3126/njog.v1i2.2404 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 69-70 Nov-Dec 2006

Low Utility in Colposcopy-directed Biopsies for Non-high Grade Cytological Abnormalities on PAP Smear

2020 ◽  
Vol 16 (1) ◽  
pp. 18-22
Author(s):  
Eronmwon E. Gbinigie ◽  
Joshua Fogel ◽  
Maggie Tetrokalashvili
Keyword(s):  
Pap Smear ◽  
Multinomial Logistic Regression ◽  
Cervical Dysplasia ◽  
Outcome Variable ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion ◽  
Cytologic Abnormalities ◽  
Cytology Screening

Background: Clinicians commonly perform colposcopy directed biopsies on patients with low grade squamous intraepithelial lesion (LSIL) on PAP cytology even when not consistent with clinical guidelines. Objective: We study the association of PAP cytology screening results with cervical intra-epithelia neoplasia (CIN) 2-3 high-grade dysplasia, as confirmed by colposcopy-directed biopsy. Methods: A retrospective study of 263 women with an abnormality on the PAP smear. Multinomial logistic regression was performed with predictors of PAP cytology screening results with the outcome variable of colposcopy-directed biopsy. Results: High grade squamous intraepithelial lesion (HSIL) had significantly increased relative risk for CIN 2-3 (RR: 9.85, 95% CI: 1.84, 52.79, p=0.008). LSIL was not significantly associated with CIN 2-3. In the comparisons of negative with CIN-1, both HSIL and LSIL were not significantly associated with a negative biopsy. Conclusion: HSIL is associated with cervical dysplasia of CIN 2-3 while LSIL is not associated with cervical dysplasia of CIN 2-3. We do not recommend routine biopsies in patients with LSIL cytologic abnormalities unless additional compelling factors exist.

scholarly journals Diffuse leptomeningeal glioneuronal tumor with high-grade features masquerading as tubercular meningitis—a case report

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Sameer Peer ◽  
Vivek Murumkar ◽  
Karthik Kulanthaivelu ◽  
Chandrajit Prasad ◽  
Shilpa Rao ◽  
...  
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Histopathological Examination ◽  
Glioneuronal Tumor ◽  
Communicating Hydrocephalus ◽  
High Grade ◽  
Endemic Region ◽  
Tubercular Meningitis ◽  
Leptomeningeal Enhancement ◽  
Diffuse Leptomeningeal Glioneuronal Tumor

Abstract Background Diffuse leptomeningeal glioneuronal tumor (DLGNT) has been recently described in the literature. The complete neuroimaging spectrum and histopathological characteristics of this entity are yet to be elucidated. In an endemic region, diffuse leptomeningeal enhancement on neuroimaging with associated communicating hydrocephalus is usually suggestive of infective meningitis and the patients are started on empirical anti-microbial therapy. However, it is important to consider other differential diagnosis of leptomeningeal enhancement in such cases, particularly if the clinical condition does not improve on anti-microbial therapy. An early diagnosis of a neoplastic etiology may be of particular importance as the treatment regimens vary considerably depending on the underlying disease condition. Case presentation In this case report, we describe a case of DLGNT with high-grade histopathological features which was initially managed as tubercular meningitis based on the initial neuroimaging findings. Due to worsening of the clinical course and subsequent imaging findings at follow-up, a diagnosis of DLGNT was considered and subsequently proven to be DLGNT with features of anaplasia on histopathological examination of leptomeningeal biopsy specimen. Conclusion This case highlights the importance of recognizing certain subtle finding on MRI which may help in an early diagnosis of DLGNT which is crucial for appropriate treatment.

High-risk HPV-positive and -negative high-grade cervical dysplasia: Analysis of 5-year outcomes

2021 ◽  
Author(s):  
Giorgio Bogani ◽  
Francesco Sopracordevole ◽  
Violante Di Donato ◽  
Andrea Ciavattini ◽  
Alessandro Ghelardi ◽  
...  
Keyword(s):  
High Risk ◽  
Cervical Dysplasia ◽  
High Grade ◽  
High Risk Hpv

Su.98. Mechanisms of Immune Privilege in High Grade Cervical Dysplasia

2008 ◽  
Vol 127 ◽  
pp. S156
Author(s):  
Cornelia Trimble ◽  
Christopher Thoburn ◽  
Ferdynand Kos ◽  
Shiwen Peng ◽  
Raphael Viscidi ◽  
...  
Keyword(s):  
Cervical Dysplasia ◽  
Immune Privilege ◽  
High Grade

scholarly journals High-risk HPV genotypes and cervical lesions association in postmenopausal women

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Ana Rita Fernandes Miranda da Costa ◽  
Cláudia Sousa ◽  
Erica Isidoro ◽  
Regina Silva ◽  
Cristiana Mourato
Keyword(s):  
Cervical Cancer ◽  
High Risk ◽  
Postmenopausal Women ◽  
Age Groups ◽  
Low Grade ◽  
High Grade ◽  
Cervical Lesions ◽  
Intraepithelial Lesion ◽  
The Bethesda System ◽  
High Risk Hpv

Abstract Background Persistent infection by high-risk Human Papillomavirus (hrHPV) are the major cause of cervical cancer. Studies report disparities in the incidence of infection and the various genotypes of this virus in different age groups, suggesting a higher frequency of hrHPV in young women and low-risk subtypes being predominant in older women. This study aimed to investigate the incidence and distribution of hrHPV genotypes in postmenopausal women as well as the correlation with the cytological findings. Methods 16 859 women, aged 50–64 years, performed cervical cancer screening test in Friuri Venezia Giulia region, Italy. The infection was evaluated by the Polymerase Chain Reaction methodology and the positive samples were evaluated by Liquid Based Cytology according to the Bethesda System from 2014. A statistical analysis was performed to study the molecular and cytological data of this population. Results hrHPV infection were found in 5.8% of the women and 78.3% of these were caused by hrHPV other than HPV16 and HPV18 (). Also, 65.7% of the positive samples were negative for intraepithelial lesion or malignancy while low grade squamous intraepithelial lesion was the most frequent (22.4%). There was an increase in the number of high-grade intraepithelial lesions in the presence of HPV16 compared to that recorded when this genotype was absent (20.8% vs. 8.5%). No cervical cancers were detected. Conclusions Infection with hrHPV is uncommon in postmenopausal women and it is mostly caused by subtypes less associated with the development of cervical cancer. Yet, HPV16 infection triggers the development of high-grade lesions.

scholarly journals Evaluation of cervicovaginal smear results at postmenopausal period

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Sefa Kelekci ◽  
Emre Destegül ◽  
Servet Gençdal ◽  
Emre Ekmekçi ◽  
Hüseyin Aydoğmuş ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Pap Smear ◽  
Premalignant Lesions ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Screening Programs ◽  
Postmenopausal Period ◽  
Pap Smear Screening ◽  
Intraepithelial Lesion

<p>This study evaluates the statistical analysis of cervicovaginal smear results at postmenopausal period accompanied by literature. Cervicovaginal smear results of 894 postmenopausal women were evaluated retrospectively according to the 2001 Bethesda system (BS) in Adana Numune Training and Research Hospital of Obstetrics and Gynecology Clinic from 2007–2010. The study found, normal results on 287 patients (32.1%), benign findings on 556 patients (62.2%), abnormal epithelial cell changes on 48 patients (5.36%) and malignant changes on 3 patients (0.33%). The abnormal epithelial changes were observed to be atypical cells of undetermined significance (ASC-US) for 22 patients (2.46%), <a href="http://medical-dictionary.thefreedictionary.com/high-grade+squamous+intraepithelial+lesion">low-grade squamous intraepithelial lesion</a> (LSIL) for 11 patients (1.23%), <a href="http://medical-dictionary.thefreedictionary.com/high-grade+squamous+intraepithelial+lesion">high-grade squamous intraepithelial lesion</a> (HSIL) for 7 patients (0.78%), findings that cannot exclude a high-grade squamous intraepithelial lesion (ASC-H) for 6 patients (0.55%) and atypical glandular cells-not otherwise specified (AGC-NOS) for 2 patients (0.22%). Malignant results were 2 squamous cell carcinomas (SCC) (0.22%) and 1 adenocarcinoma (ACC) (0.11%). Cervical cancer screening programs should be expanded and Pap smear screening should be applied to all postmenopausal women. The longer time span involved from premalignant lesions to cancer improves our chance for the diagnosis and treatment. As the incidence of invasive cancer increases in menopausal period, gynecological smear examination and regular check-up are crucial. A high rate of abnormalities of epithelial cells was detected in this study.</p><p> </p>

scholarly journals Significance of survivin immunoreactivity and morphometric analysis of HPV-induced cervical dysplasia

2014 ◽  
Vol 66 (1) ◽  
pp. 429-436
Author(s):  
Biserka Vukomanovic-Djurdjevic ◽  
Gordana Basta-Jovanovic ◽  
N. Baletic ◽  
Milica Berisavac ◽  
D. Nenadic ◽  
...  
Keyword(s):  
High Risk ◽  
Human Papilloma Virus ◽  
Morphometric Analysis ◽  
Cervical Dysplasia ◽  
Epithelial Dysplasia ◽  
Control Group ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Papilloma Virus ◽  
Intraepithelial Lesion

Genomic integration of high-risk human papilloma virus in the nucleus of cervical epithelial mucosal cells leads to epithelial dysplasia. The aim of this study was to determine the relevance of correlation between epithelial survivin expression and the degree of human papilloma virus (HPV)-induced cervical epithelial dysplasia, and to establish the significance of morphometric analysis of the nuclear area in the assessment of the degree of cervical dysplasia. This retrospective study included 99 women with primary, previously untreated lesions, and colposcopic findings indicating dysplasia, in whom a cytological test by Papanicolaou method was interpreted according to the Bethesda criteria as lowgrade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), and atypical squamous cells of undetermined significance (ASCUS). We performed human papilloma virus (HPV) typing by PCR for evidence of viruse types 16, 18, 31, 33. After biopsy of the cervical mucosa, we performed hematoxylin-eosin (H-E) and Periodic Acid Schiff (PAS) staining, and immunohistochemical and morphometric analysis of tissue samples. The control group consisted of 12 women without dysplasia and without a verified infection of cervical high-risk HPV. A high statistical correlation between the degree of dysplasia and expression of survivin was found in patients with different types of cervical dysplasia (p = 0.003). We observed a high statistical difference between the area of nuclei at different degrees of cervical dysplasias (p = 0.000). The high-grade cervical dysplasia had a more than 2-fold higher level of ranking in comparison to low-grade dysplasia, and a more than 10-fold higher ranking than the control group without cervical dysplasia.

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