scholarly journals Histologic Findings in Gynecologic Tissue From Transmasculine Individuals Undergoing Gender-Affirming Surgery

2021 ◽  
Author(s):  
Lawrence Hsu Lin ◽  
Andrea Hernandez ◽  
Alan Marcus ◽  
Fang-Ming Deng ◽  
Esther Adler
Keyword(s):  
Multidisciplinary Approach ◽  
Comprehensive Evaluation ◽  
Transitional Cell ◽  
Cervical Cytology ◽  
Common Finding ◽  
Gynecologic Surgery ◽  
Squamous Cells ◽  
Follicular Maturation ◽  
Institutional Review ◽  
Raising Awareness

Context.— Gender-affirming surgery is part of a multidisciplinary approach in gender transitioning. Deeper histologic examination may strengthen care for transmasculine individuals and increase the understanding of the influence of hormonal therapy in specific organs. Objective.— To evaluate and catalogue histologic findings of tissue obtained from gender-affirming gynecologic surgery and cervical cytology specimens. Design.— This is an institutional review board–approved retrospective study that included transmasculine individuals who underwent gender-affirming gynecologic surgery from January 2015 to June 2020. All surgical gynecologic pathology and cervical cytology slides were reviewed by 2 pathologists. Results.— Fifty-five patients were included, which represented 40 uteri, 35 bilateral ovaries, 15 vaginectomy specimens, and 24 cervical cytology results. The median age was 27 years (range, 18–56) and 94% (50 of 53) of patients were receiving testosterone for at least 1 year. Seventy-five percent (30 of 40) of endometria were inactive, while 25% (10 of 40) showed evidence of cycling. Transitional cell metaplasia was the most common finding in the cervix (17 of 40) and vagina (15 of 15), reflecting a high percentage (4 of 24) of unsatisfactory or ASC-US (atypical squamous cells of undetermined significance) cervical cytologies. Prostatic-type glands were identified in 20% (8 of 40) of cervices and 67% (10 of 15) of vaginectomy specimens. Multiple bilateral cystic follicles and evidence of follicular maturation were present in 57% (20 of 35) of cases. Four cases showed paratubal epididymis-like mesonephric remnant hypertrophy. Conclusions.— A comprehensive evaluation of tissue from gender-affirming surgery increases knowledge of the changes following androgen therapy in transmasculine individuals and may contribute to optimal patient care by raising awareness of normal histologic variations in this population.

Cardiovascular Oncology: The Need for a Multidisciplinary Approach

2021 ◽  
Author(s):  
Rodrigo Ortega Pérez ◽  
Ana Pardo Sanz ◽  
Valentín García Gutiérrez ◽  
José Luis Zamorano Gómez
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
General Population ◽  
Early Detection ◽  
Multidisciplinary Approach ◽  
Ventricular Dysfunction ◽  
Care Process ◽  
Scientific Journals ◽  
Raising Awareness ◽  
Low Rate

AbstractImproved cancer survivorship has led to an increase in cardiovascular (CV) complications in the oncologic population, mainly associated with therapeutic regimens. Hence, cardio-oncology has grown toward unifying the cancer care process in which the best prevention, early detection, treatment, and CV surveillance are offered to patients. This multidisciplinary approach allows us to optimize and agree upon clinical decisions to enhance clinical outcomes. Atrial fibrillation is one of the hot topics in the field because it is still challenging in cancer patients. The optimal antithrombotic therapy remains unclear. Nevertheless, evidence supports that specific recommendations are needed due to a hemorrhagic/thrombotic disbalance present within this subgroup of patients and a low rate of anticoagulation treatments compared with the general population. Further, cardiotoxicity management is currently transforming. Increasingly, early detection of subclinical alterations is raising awareness. When medical therapy is initiated early, fewer patients progress to ventricular dysfunction and the rate of patients completing cancer therapy gradually increases. New approaches are demonstrating better outcomes and these strategies will expectedly be established in clinical practice. Cardio-oncology enables us to find the best balance between cancer treatment and CV health protection. Nowadays, more and more physicians are being instructed in this discipline, which gradually exhibits a greater presence in conferences and scientific journals. However, given the need for physicians thoroughly trained in cardio-oncology, this subspecialty must be promoted further.

scholarly journals p16 immunostaining can avoid overdiagnosis in postmenopausal cervical cytology

2021 ◽  
Vol 9 (1) ◽  
pp. 1-8
Author(s):  
Yutaka Tsutsumi ◽  
◽  
Kazuya Shiogama ◽  
Ken Sakurai ◽  
Toru Arase ◽  
...  
Keyword(s):  
Cervical Cytology ◽  
Sampling Errors ◽  
Squamous Intraepithelial Lesion ◽  
Squamous Cells ◽  
Glass Slides ◽  
Intraepithelial Lesion ◽  
P16 Ink4a ◽  
Age Range ◽  
Chronic Cervicitis ◽  
P16 Expression

Senile (atrophic) colpitis is microscopically characterized by the predominance of parabasal squamous cells and the paucity of superficial cells. The activated parabasal cells or dyskeratotic superficial cells may be confused with squamous intraepithelial lesion (SIL) in the routine cytology practice. A total of 29 cervical cytology specimens diagnosed as atypical squamous cells (ASC) or SIL were retrospectively sampled from 24 postmenopausal women (age range: 56–84 years, mean: 65.5, median: 65). Cytological diagnoses in the routine services included ASC-US 20, ASC-H 2, LSIL 4 and HSIL 3. All the specimens showed an atrophic background (senile colpitis). There were two microscopic patterns of senile colpitis with atypia: 1) parabasal cells were clustered (n = 23) and 2) dyskeratotic superficial cells were seen in a highly inflamed background (n = 6). Immunostaining for p16-INK4a (p16 in short) was performed, after the cells were transferred to trimethoxy[3-(phenylamino)propyl]silane-coated glass slides. Only three of the 29 cytology specimens (two of the 24 cases) judged as HSIL cytologically revealed p16 positivity in clustered atypical parabasal cells. Biopsy was performed in 11 cases, and chronic cervicitis without p16 expression was seen in nine. Two lesions showed p16-positive dysplasia (one mild dysplasia and another moderate dysplasia). In one lesion in an 84 year-old female, both cytology and histology specimens showed p16 positivity (HSIL). Discrepancy of p16 expression between the cytology and histology specimens was encountered in two lesions, representing sampling errors. It is of note that the overcytodiagnosis is avoidable with the aid of p16 immunostaining. Keywords: Atypical squamous cells (ASC), cell transfer technique, p16-INK4a, senile colpitis, squamous intraepithelial lesion (SIL).

Clinical significance of atypical squamous cells (ASC; Bethesda System 2001) in uterine cervical cytology

2007 ◽  
Vol 46 (4) ◽  
pp. 211-215 ◽  
Author(s):  
Miyuki SHIBATA ◽  
Yuji ARAI ◽  
Noriyuki FURUTA ◽  
Masafumi TSUZUKU ◽  
Ken TAKIZAWA ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Cervical Cytology ◽  
Squamous Cells ◽  
Bethesda System

The significance of endocervical cells and metaplastic squamous cells in liquid-based cervical cytology

2009 ◽  
Vol 37 (4) ◽  
pp. 241-243 ◽  
Author(s):  
Kai M. Leung ◽  
Manbo Lam ◽  
Joyce W. Y. Lee ◽  
Gary P. S. Yeoh ◽  
Keeng W. Chan
Keyword(s):  
Cervical Cytology ◽  
Squamous Cells

scholarly journals Experience of Initial Symptoms of Breast Cancer and Triggers for Action in Ethiopia

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Timothy D. Dye ◽  
Solomon Bogale ◽  
Claire Hobden ◽  
Yared Tilahun ◽  
Teshome Deressa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Addis Ababa ◽  
Medical Advice ◽  
First Year ◽  
Qualitative And Quantitative ◽  
Institutional Review ◽  
Raising Awareness ◽  
Initial Symptoms ◽  
Addis Ababa University ◽  
Cancer Experience

Objective. This study assessed the initial experiences, symptoms, and actions of patients in Ethiopia ultimately determined to have breast cancer.Methods. 69 participants in a comprehensive breast cancer treatment program at the main national cancer hospital in Ethiopia were interviewed using mixed qualitative and quantitative approaches. Participants’ narratives of their initial cancer experience were coded and analyzed for themes around their symptoms, time to seeking advice, triggers for action, and contextual factors. The assessment was approved by the Addis Ababa University Faculty of Medicine Institutional Review Board.Results. Nearly all women first noticed lumps, though few sought medical advice within the first year (average time to action: 1.5 years). Eventually, changes in their symptoms motivated most participants to seek advice. Most participants did not think the initial lump would be cancer, nor was a lump of any particular concern until symptoms changed.Conclusion. Given the frequency with which lumps are the first symptom noticed, raising awareness among participants that lumps should trigger medical consultation could contribute significantly to more rapid medical advice-seeking among women in Ethiopia. Primary care sites should be trained and equipped to offer evaluation of lumps so that women can be referred appropriately for assessment if needed.

Outcome of “Atypical squamous cells” in a cervical cytology screening program: Implications for follow up in resource limited settings

2007 ◽  
Vol 35 (11) ◽  
pp. 677-680 ◽  
Author(s):  
Sanjay Gupta ◽  
Pushpa Sodhani ◽  
Krishan Lal Chachra ◽  
Veena Singh ◽  
Ashok Sehgal
Keyword(s):  
Screening Program ◽  
Cervical Cytology ◽  
Resource Limited Settings ◽  
Squamous Cells ◽  
Resource Limited ◽  
Cytology Screening

scholarly journals p16INK4a immunocytochemistry on cell blocks as an adjunct to cervical cytology: Potential reflex testing on specially prepared cell blocks from residual liquid-based cytology specimens

CytoJournal ◽  
2011 ◽  
Vol 8 ◽  
pp. 1 ◽  
Author(s):  
Vinod B. Shidham ◽  
Ravi Mehrotra ◽  
George Varsegi ◽  
Krista L. D'Amore ◽  
Bryan Hunt ◽  
...  
Keyword(s):  
Intraepithelial Neoplasia ◽  
Cervical Cytology ◽  
Low Grade ◽  
Cell Block ◽  
Squamous Intraepithelial Lesion ◽  
Squamous Cells ◽  
Cytology Specimen ◽  
Under Sampling ◽  
Reflex Testing ◽  
Intraepithelial Lesion

Background: p16 INK4a (p16) is a well-recognized surrogate molecular marker for human papilloma virus (HPV) related squamous dysplasia. Our hypothesis is that the invasive interventions and related morbidities could be avoided by objective stratification of positive cytologic interpretations by p16 immunostaining of cell block sections of cytology specimens. Materials and Methods: Nuclear immunoreactivity for p16 was evaluated in cell block sections in 133 adequate cases [20 negative for intraepithelial lesion or malignancy, 28 high-grade squamous intraepithelial lesion (HSIL), 50 low-grade squamous intraepithelial lesion (LSIL), 21 atypical squamous cells, cannot exclude HSIL (ASC-H), and 14 atypical squamous cells of undetermined significance (ASCUS)] and analyzed with cervical biopsy results. Results: (a) HSIL cytology (28): 21 (75%) were p16 positive (11 biopsies available — 92% were positive for cervical intraepithelial neoplasia (CIN) 1 and above) and 7 (25%) were p16 negative (3 biopsies available — all showed only HPV with small atypical parakeratotic cells). (b) LSIL cytology (50): 13 (26%) cases were p16 positive (12 biopsies available — all were CIN1 or above) and 37 (74%) were p16 negative (12 biopsies available — all negative for dysplasia. However, 9 (75%) of these biopsies showed HPV). (c) ASC-H cytology (21): 14 (67%) were p16 positive (6 biopsies available — 5 showed CIN 3/Carcinoma in situ/Ca and 1 showed CIN 1 with possibility of under-sampling. Cytomorphologic re-review favored HSIL) and 7 (33%) were p16 negative (5 biopsies available — 3 negative for dysplasia. Remaining 2 cases — 1 positive for CIN 3 and 1 showed CIN 1 with scant ASC-H cells on cytomorphologic re-review with possibility under-sampling in cytology specimen). (d) ASCUS cytology (14): All (100%) were p16 negative on cell block sections of cervical cytology specimen. HPV testing performed in last 6 months in 7 cases was positive in 3 (43%) cases. Conclusion: p16 immunostaining on cell block sections of cervical cytology specimens showed distinct correlation patterns with biopsy results. Reflex p16 immunostaining of cell blocks based on the algorithmic approach to be evaluated by a multiinstitutional comprehensive prospective study is proposed.

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