Clinical Usefulness of Endometrial Cytology in Determining the Therapeutic Effect of Fertility Preserving Therapy

<b><i>Introduction:</i></b> The significance of endometrial cytology in determining the therapeutic efficacy of medroxyprogesterone acetate (MPA) therapy is unclear. This study aimed to evaluate the clinical usefulness of endometrial cytology during MPA therapy. <b><i>Methods:</i></b> Overall, 77 patients who underwent dilatation and curettage (D&amp;C) to evaluate the therapeutic efficacy of MPA therapy at our hospital between January 2018 and December 2019 were retrospectively analyzed. The results of D&amp;C, cytological evaluation, and other clinicopathological factors were analyzed based on the patients’ medical records. <b><i>Results:</i></b> The sensitivity and specificity of cytology were 61% and 92%, respectively, with D&amp;C being the gold standard for diagnosis in 142 D&amp;C/cytological examinations. Among patients with no residual disease on D&amp;C, 5 (4%) had suspicious or positive cytology. Although MPA therapy was terminated in 3 of these patients, only 1 patient had early recurrence, and the frequency of recurrence was similar to that of patients who showed negative results in both D&amp;C and cytology. <b><i>Discussion/Conclusion:</i></b> The sensitivity of endometrial cytology in determining the therapeutic effect of MPA therapy is low, and we confirmed that the omission of D&amp;C is unacceptable. Our findings also suggested that the addition of cytological evaluation to D&amp;C during MPA therapy had a low clinical significance.

Acrylamide-induced changes of granulopoiesis in porcine bone marrow

Introduction Due to the widely documented and diverse toxic effects of acrylamide, the authors decided to evaluate the impact of high and low doses of this compound on the process of granulopoiesis in porcine bone marrow. Material and Methods The experiment was conducted on 15 Danish Landrace pigs at the age of 8 weeks. The animals were randomly assigned into three equal groups (n = 5). Control animals received empty gelatine capsules as placebo. Animals in the first experimental group (the LD group) received a low dose of acrylamide of 0.5 μg/kg b.w./day, and animals in the second experimental group (the HD group) received a tenfold higher dose of acrylamide of 5 μg/kg b.w./day. Placebo and acrylamide capsules were administered with feed every morning for 28 days. Bone marrow was collected into tubes without an anticoagulant twice – before the first capsule administration (day 0) and on the 28th day of the study. After drying and staining, bone marrow smears were subjected to detailed cytological evaluation under a light microscope. Results Changes in cell morphology, i.e. degenerative changes in the cellular nuclei, were observed in both experimental groups. Both low and high doses of acrylamide decreased the number of segmented eosinophils, neutrophilic and segmented metamyelocytes, neutrophils, as well as basophils and basophilic metamyelocytes. Conclusion Acrylamide at doses of 0.5 μg/kg b.w./day and 5 μg/kg b.w./day clearly influences porcine granulopoiesis.

Penile Squamous Cell Carcinoma in A Boerboel Dog in Ibadan, Nigeria – A Case Report

This report describes the first case of penile squamous cell carcinoma (SCC) in a Boerboel from our environment while emphasizing the importance of cytology as a quick and reliable diagnostic tool in clinical setting. The dog presented with a complaint of bloody urination had a noticeable growth on the penis. There was high cellularity of neoplastic squamous cells admixed numerous neutrophils and keratin within the background upon cytological evaluation. Therefore, cytological evaluation can become a ready tool for the diagnosis of SCC for appropriate treatment.

Painless umbilical nodule in a nulliparous female – A clinical quandary

Background: Endometriosis is a well-known entity most often found within the pelvis and extra pelvic sites like skin, diaphragm, gastrointestinal tract and brain. Primary umbilical endometriosis is a rare form of cutaneous endometriosis, typically presenting as a hyperpigmented umbilical nodule with or without cyclical pain. We present a case of painless umbilical nodule with discolouration in a nulliparous woman, unsuspected clinically with the diagnosis being made primarily on cytology. Case report: A forty-year old female presented with a painless, brownish discoloured umbilical nodule, which was present since two months, was irreducible and had a negative cough impulse. She had no prior surgeries. Ultrasonography of abdomen and pelvis revealed a hypodense lesion of 2cm in the umbilicus, suggesting a possibility of umbilical granuloma. Uterus showed leiomyomata. Cytological evaluation of the umbilical nodule was suggestive of endometriosis. The patient underwent hysterectomy for leiomyomata and omphalectomy. Histopathology confirmed the diagnosis of umbilical endometriosis supported by the immunohistochemistry marker (CD10) being positive for endometrial stromal cells. The uterus had adenomyotic foci in addition to leiomyomata. Conclusion: The clinical distinction between primary umbilical endometriosis and other causes of umbilical nodules is challenging. Imaging modalities do not show pathognomonic signs in establishing this diagnosis. A definitive diagnosis is possible on cytology based on classical morphological features with histopathological examination being the gold standard diagnostic modality.

Serum WNT-induced secreted protein 1 level as a potential biomarker for thyroid nodules

Background. Thyroid nodule (TN) is a common thyroid disease worldwide, and it has increased significantly last decades. Most TNs are usually incidental findings of asymptomatic, benign lesions discovered by imaging modalities performed for reasons unrelated to thyroid diseases. The purpose of this study was to investigate the value of serum WNT-induced secreted protein 1 (WISP1) level as a supporting biomarker to perform differential diagnosis of benign and non-benign thyroid nodules. Materials and methods. The study was completed with the 89 patients undergone fine needle aspiration biopsy and 43 controls. The patients were composed of 96 (72.7 %) females and 36 (27.3 %) males. And they were divided into 2 group according to the Bethesda cytological evaluation as Benign (Bethesda 2) and Non-Benign (Bethesda 3–6) groups. Their serum WISP1 levels were measured by an ELISA method. Results. There were 58 (43.9 %) patients in Benign (Bethesda 2) and 31 (23.5 %) in non-Benign (Bethesda 3–6) groups. In the contrary nodule size was bigger in the Non-benign group than that benign group (p = 0.006). The serum WISP1 level in the Benign (Bethesda 2) group was significantly higher than that in the and Non-Benign (Bethesda 3–6) group, and controls (p < 0). The difference between benign and non-benign group accordingly to their echogenicitiy was significant (p < 0.05). In benign group there was 76.9 % mixed echoic nodules, 76.7 % isoechoic nodules 68.4 % isohypoechoic nodules and 35.7 % hypoechoic nodules. In the non-benign group, the highest hypoechoic echo (64.3 %), the least mixed echo (23.1 %), while in the benign group, the most mixed echo (76.9 %), the least hypoechoic echo (35.7 %) was present. There was no relation between WISP1 levels and echogenicity with Kruskal-Wallis H test. Conclusions. According to the preliminary results of current study, addition of serum WISP1 measurement to the differential diagnostic work-up of thyroid nodules patients may provide supportive information. In thyroid nodules patients with Benign (Bethesda 2) category of cytological evaluation, a higher level of serum WISP1 may support cytological diagnosis.

EVALUATING EFFICACY OF CYTOLOGICAL DIAGNOSIS OR SEROUS EFFUSIONS BY SMEAR CYTOLOGY AND CELLBLOCK TECHNIQUE

Introduction :- Cytological examination of serous effusions is of paramount importance not only for diagnosing cancer, but it may also reveal information regarding various inammatory conditions, parasitic infestations, infection with bacteria, fungi or viruses, and some immunological diseases. Cellblock technique has many advantages over conventional smear cytology in improving the sensitivity of diagnosis. The main advantages of the cellblock technique are preserving tissue architecture and obtaining multiple sections from the same material for special stains and immunohistochemistry. Objectives :- To study the body uids, i.e., pleural, peritoneal, and pericardial, for the absence of local or systemic pathological situation. To evaluate the diagnostic efcacy of a combined approach of conventional smear study and cellblock technique in serous effusions. Methods:- A total of 100 uid samples from referral centers received in the Cytology section, After preparing two conventional smears for PAP and Giemsa stains, the residual sample was subjected to cellblock preparation. Nathan's Alcohol Formalin Substitute was added and xed for an hour. After xation, the specimen was centrifuged at 1500 rpm for 15min.The supernatant was decanted, and the sediment completely drained off by XIinverting tube over Whatman lter paper. After discarding the supernatant xative, the pellet formed was removed with a pointed spatula and placed on top of the lens paper inside the tissue cassette, and processed for parafn embedding. Results:- In the total of 100 samples were subjected for cytological evaluation. Pleural uids were 47%, peritoneal uids were 43%, and pericardial uids were 10%. Maximum samples were in age group of 41-50 years. By Conventional smear cytology, benign, suspicious and malignant lesions were 76%, 14.5%, and 9.5%, respectively. By cellblock study, benign and malignant lesions were 75.5% and 24.5%, respectively. Conclusion:- Morphological features were better appreciated by cellblock composition, which risen the sensitivity of cyst diagnosis hence serves as a useful adjunct to conventional smears.

Implementation of pre-captured videos for remote cytological evaluation of salivary gland lesions

Objective The objective of this study was to examine the feasibility of implementing videos captured by static telecytological applications for remote cytological evaluation of fine needle aspiration specimens from salivary gland lesions. Methods The current study was carried out on 102 fine needle aspiration specimens from salivary gland lesions with histological confirmation (benign lesions, 11; benign neoplasms, 68; malignant neoplasms, 23), retrospectively selected from the department’s registry. Videos were transferred via file transfer protocol to password-protected accounts for remote review by three independent cytopathologists. In addition to diagnosis, reviewers commented on overall digital video quality. Contributor’s and reviewer’s diagnoses were collected, recorded and statistically evaluated. Results Statistical evaluation of cytological diagnoses detected no significant difference in diagnostic accuracy between the diagnoses proffered on the basis of pre-captured videos and conventional slides. The overall interobserver agreement was ranging from substantial to almost perfect with κ values of 0.71–0.89. Conclusions Video production by static telecytology applications can be used as an alternative method for telecytological diagnosis of salivary gland fine needle aspirations. Videos of salivary gland fine needle aspirations can be used for rapid and accurate diagnosis, by diminishing turn-around times and improving the quality indices of small cytology departments. They can also be used for archiving, teleconsultation, educational and second opinion purposes, improving the performance of the already existing static telecytology stations.