Histopathological study of cervical lesions in a tertiary health care centre in south India

Cervix is vulnerable to many pathological changes ranging from inflammation to malignancy. Uterine cervix is gateway to several non-neoplastic and neoplastic gynaecological lesions.. Histopathological studies of cervix along with clinical correlation helps in early diagnosis of lesions as they have advantages of being relatively cheap and technically easy.To study the histopathological features of cervical lesions. A retrospective study was done in the department of Pathology at Vinayaka Mission’s Kirupananda Variyar Medical College and Hospital, Salem for duration of 05 years i.e., from April 2016 to March 2021in 550 cervical samples.Non neoplastic (92.1%) lesions of cervix were more commonly reported in our study and neoplastic lesions were about 7.8%. Histopathology study of cervical biopsy lesions is a valuable diagnostic procedure. Early detection of cervical lesions may provide an opportunity for appropriate interventions to prevent further complications such as progression from benign to malignant conditions. Adequate screening procedure with follow up cervical biopsies helps in early diagnosis and management of premalignant and malignant lesions.

Prognostic impact of human papillomavirus infection on cervical dysplasia, cancer, and patient survival in Saudi Arabia: A 10-year retrospective analysis

BACKGROUND: Data on human papillomavirus (HPV) prevalence and survival rates among HPV-infected women are scarce in Saudi Arabia. OBJECTIVE: Assess the prevalence of HPV genotypes in cervical biopsy specimens and its effect on survival over a 10-year timeframe. DESIGN: Retrospective, cross-sectional. SETTINGS: Saudi referral hospital. PATIENTS AND METHODS: Cervical biopsy specimens were collected from women aged 23-95 years old who underwent HPV detection, HPV genotyping, p16 INK4a expression measurement using immunohistochemistry. Kaplan-Meier plots were constructed to analyze overall survival rates. MAIN OUTCOME MEASURES: Survival rate of HPV-positive cervical cancer patients. SAMPLE SIZE: 315 cervical biopsy specimens. RESULTS: HPV was detected in 96 patients (30.4%): 37.3% had cervical cancer; 14.2% cervical intraepithelial neoplasia (CIN) III, 4.1% CIN II, and 17.0% CIN I. A significant association was found between HPV presence and cervical cancer (χ 2 =56.78; P <.001). The expression of p16 INK4a was a significant predictor of survival: women who had p16 INK4a overexpression had poorer survival rates (multivariate Cox regression, hazard ratio, 3.2; 95% CI, 1.1–8.8). In addition, multivariate models with HPV status and cervical cancer diagnosis showed that HPV status was a significant predictor of survival: HPV-positive women had better survival rates than HPV-negative women. CONCLUSION: These findings suggest that implementing cervical and HPV screening programs may decrease cervical cancer rates and improve survival rates of women in Saudi Arabia. LIMITATION: Single center and small sample size. CONFLICT OF INTEREST: None.

Carcinosarcoma of the Cervix: A Case Report

Cervical carcinoma is the most common cause of mortality due to cancer in Nepal. Carcinosarcoma is a very rare subtype of cervical cancer which is characterized by the presence of both epithelial and mesenchymal malignant component. It constitutes less than 1% of cervical carcinoma. Due to the low occurrence of the disease, most of the data on treatment and prognosis are based on case reports and series. Here, we report a case of 69 years, female with cervical cancer (FIGO IIA2). Histopathological and immunohistochemical analysis of cervical biopsy initially showed primary adenosarcoma of the cervix. The tumor was non-responsive to primary treatment with concurrent chemoradiation. Later she was treated with abdominal hysterectomy and bilateral salpingo-oophorectomy. The final histopathology of the resected specimen showed a sarcomatous component along with carcinomatous changes in the endocervical glands favouring the diagnosis of carcinosarcoma of the cervix.

A Case of Genital Tuberculosis Presenting as HSIL on Cervical Biopsy

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.

A retrospective study of pap smear and cervical biopsy correlation in abnormal cervical cytology cases

Cancer cervix is a global health problem and Pap smear is an important screening tool, which has proven to be highly effective in reducing the number of cases and the mortality from cervical carcinoma. Any abnormality detected in Pap smear has to be confirmed with cervical biopsy, which is the gold standard for diagnosing the lesions of the cervix. To study the prevalence of abnormal cervical cytology cases detected by Pap smear testing in our setting, to find the distribution of cytologically abnormal cases and also the concordance and discordance between Pap smear and cervix biopsy in cytologically abnormal cases to assess the sensitivity of Pap smear in detecting the intraepithelial lesions / malignancy of cervix. The study included all the abnormal cervical cytology cases and their cervix biopsies, for five years. The cytologically abnormal cases were listed and a thorough search was made for their cervix biopsy. The histopathological diagnosis of the corresponding cervix biopsies (if done) were also listed and compared for concordance. There were totally 12600 cases of Pap smear done during the study period and there were 146 cytologically abnormal cases. Histopathology reports of the cervix biopsy were available for 44 cases. Out of the 44 cases, 40 cases were concordant. The sensitivity of Pap smear test in our setting was found to be 90.9%. Our study revealed a good correlation between Pap smear and cervix biopsy.

Analgesic effect of lidocaine in paracervical block in women undergoing colposcopy and cervical biopsy: a randomized clinical trial

Objective: To investigate the effect of lidocaine in paracervical block in women undergoing colposcopy and cervical biopsy.Methods: This a triple-blind randomized controlled trial (July-September 2020) was conducted on women who were candidate for the colposcopy and cervical biopsy with American Society of Anesthesiologists classification Class I or II. They were randomly allocated to receive a single dose of lidocaine hydrochloride 2% or injectable sodium chloride 0.9% paracervical block, and then, cervical biopsy was done. The pain score was asked and intra-procedural and 5-minutes post-procedural in both groups, using the VAS tool. Also, patients' satisfaction after the procedure and complications were recorded.Results: Totally, 74 patients (37 in each groups) were enrolled, with the mean±SD age of 35.91±8.10 years. The mean±SD of pain score intra-procedural was statistically higher in patients in the treatment group (0.92±1.53 vs. 2.73±2.34, P<0.001), as well the pain score 5-minutes post-procedural (0.27±0.65 vs. 0.95±1.15, P=0.003). Also, the mean±SD of patients' satisfaction score was higher in the treatment group (4.65±0.82 vs. 4.05±1.41, P=0.03). Dizziness were observed only in the treatment group, statistically (P<0.001).Conclusion: Paracervical block using lidocaine could reduce the intra-procedural and 5-minutes post-procedural pain. Also, it can increase the patients' satisfaction with the procedure.