Correlation of cervical pap smears with histopathological diagnosis in cervical lesions

Background: Cervical cancer is the most common genital cancer in India. In India alone,almost,130000 new cases occur with the death toll of 70000 everywhere. Objective of current study was correlation of pap smear with histopathological diagnosis.Methods: A retrospective study was conducted in tertiary care hospital in 130 sexually active women. Pap smears were taken and histopathological diagnosis was performed in all such patientsResults: From pap smear findings, out of 130 patients, maximum number of cases, 74 (56.9%) were categorized as. Out of epithelial cell abnormality, ASCUS was seen in 25 patients (10.2%), LSIL in 17 patients (13.1%), HSIL in 11 patients (8.5%). SCC was seen in 2 patients (1.5%) and adenocarcinoma in 1 patient (0.8%). From cervical biopsy reports, 51 cases(39.2%) were diagnosed as chronic cervicitis, 34 cases (26.2%) were diagnosed as chronic cervicitis with squamous metaplasia, CIN I in 31 patients (23.8%), CIN II in 8 patients (6.2%) and CIN III in 3 patients (2.3%), squamous cell carcinoma in 2 patients (1.5%) and adenocarcinoma in 1 patient (0.8%). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pap smear test was 91.1%, 82.4%,73.2%, 94.6% and 85.4%, respectively.Conclusions: Pap smear has excellent correlation with histopathological diagnosis. Therefore it should be encouraged as effective tool for cervical cancer screening program to reduce incidence and mortality caused by cervical cancer.

Histopath Salpingo-oophorectomy Cervical Moderate Dysplasia: A Case Report

Introduction: Cervical dysplasia is a term used to describe a condition that is on the verge of becoming malignant where aberrant cell proliferation takes place on the cervix or endocervical canals surface lining. Another name for it is cervical intraepithelial neoplasia (CIN) can occur at any age. It has a strong relationship to human papillomavirus (HPV) infection spread through sexual contact. Case History: A case of 34 year old woman admitted in gynecology unit on date June 3, 2021, a month ago when she started experiencing pain in abdomen. It was insidious in onset, continuous type, not associated with bleeding per vaginal. Patient has previous history of five abortions. Patient underwent investigations like complete blood count, kidney function test, liver function test, radiographic investigations and colposcopy where she was found to have moderate dysplasia and chronic cervicitis. Histopathology report also indicated moderate dysplasia with chronic cervicitis. Interventions: Primarily, the pain management is necessary for such patients. Later on all further investigations and procedures performed to confirm the diagnosis and treat the patient accordingly. The aim during the treatment is to safeguard the life and further complications. Outcomes: Over this period of long course treatment, the patient significantly reduced the severity of infection and pain. Improved the daily activities, appetite and sleep. Progress of patient towards her goal of recovering as early as possible. Discussion: The patients response was quite good to treatment, however additional interventions could be used in the future for her greater improvements in disease.

B7-H4 Expression in Precancerous Lesions of the Uterine Cervix

Over 10% of patients diagnosed with cervical intraepithelial neoplasia (CIN) have no lesions detected in their cervical conization specimens. The purpose of this study was to determine the factors related to the absence of such lesions. We particularly sought to investigate whether the expression of B7-H4 in precancerous lesions and cancer of the uterine cervix plays a role in the presence or absence of residual lesions in conization specimens and whether this protein is associated with T cells (i.e., Foxp3+ regulatory T cells, CD4+, and CD8+) and interferon-γ production. Of the 807 patients with CIN treated by conization, 104 (12.9%) had no lesions in their conization specimens. Seventy-five of these patients were deemed the study group and were matched with 75 patients who did have CIN detected in their conization specimens (the control group). Immunohistochemistry and immunofluorescence staining were used to detect B7-H4, Foxp3, CD4, CD8, and interferon-γ in the 75 pairs of specimens obtained via biopsy; 20 samples were found to have chronic cervicitis, and another 20 had squamous cell carcinoma of the cervix. Menopause, the absence of human papillomavirus, low-grade histological findings, and a diagnosis of CIN1 and CIN2 on biopsy correlated with a low probability of lesions on conization specimens. B7-H4 expression was detected in 11.1% of CIN2, 46.6% of CIN3, and 70% of cervical cancer samples, but not in tissues representing chronic cervicitis or CIN1. B7-H4 expression was associated with the presence of lesions on conization specimens, increased regulatory T cells, decreased CD8+ T cells, and lower interferon-γ production. These data suggest that close follow-up and thorough reevaluation should be considered for patients diagnosed with CIN2 who are negative for B7-H4 expression on biopsy before proceeding with cervical conization.

Impact of chronic cervicitis on recurrent pelvic inflammatory disease

Pelvic inflammatory disease (PID) is a sexually-transmitted infection (STI); and, as such, sometimes it is difficult to treat because of partner(s) issues. PID generally is accompanied by chronic cervicitis (CC). We observed that in spite of patients strictly complying with their therapy, there are some individuals that develop recurrent disease; and we tried to establish a relationship between CC and its recurrence in such patients. This study was prospectively designed. Patients in one group were treated with electrocauterization and another group who did not receive this therapy was retrospectively compared by reviewing their clinical records. Patients with CC and PID who did not undergo electrocauterization had 82% recurrence rate compared to those who underwent electrocauterization, who showed a 24% recurrence rate. We concluded that patients who had CC with different manifestations and who underwent electrocauterization or cervical fulguration developed significantly less recurrence of PID.

Optimization of the Tactics of Examination and Treatment of Women of Reproductive Age with Cervical Pathology in Chronic Cervicitis and Vaginitis

The article is a description of the effectiveness of treatment of patients of reproductive age with chronic nonspecific exo-, endocervicitis and vaginitis in the presence of benign and precancerous diseases of the cervix of the uterus of mild degree. Comparative characteristics of the use of the combined preparation for intravaginal administration Elzhina and intravaginal administration of metronidazole with oral fluconazole were carried out. The advantages of using the drug Elzhina in terms of preoperative preparation over the use of radio wave excisional and surgical methods of treatment are noted. The efficacy, tolerability, and safety of the therapy were also evaluated in both treatment options. It is noted that the drug containing ornidazole 500 mg, prednisolone 3 mg, econazole 150 mg, neomycin 65 000 IU, will reduce the severity of inflammatory processes, which has a beneficial effect on the results of radio wave and surgical methods for the treatment of benign and precancerous diseases of the cervix. Against the background of chronic, long-term nonspecific exo-, endocervicitis and vaginitis

Estudio Descriptivo: Colposcopia en el diagnóstico de lesiones de cuello uterino en el Hospital de Especialidades José Carrasco Arteaga, Cuenca – Ecuador. 2015-2019

BACKGROUND: Cervical cancer is a public health issue, being one of the main causes of morbidity and mortality in developing countries. Cervical cytology (Papanicolaou) is performed for screening and diagnosis of cervical lesions. In case of a suspicious cytology report, colposcopy is an essential procedure for evaluation of the lower genital tract, to detect early lesions and cancer. The aim of this study was to characterize the colposcopy procedures performed, as a diagnostic and therapeutic method, in patients with abnormal Papanicolaou results. METHODS: This is an observational, descriptive cross-sectional study, whose universe were all the patients with abnormal cytological diagnosis in pap smear, who underwent a colposcopy procedure between 2015 and 2019 at Hospital José Carrasco Arteaga, with a total of 1 628 patients. RESULTS: 1 628 colposcopic procedures were included. 55.46% of the population were between 27 to 46 years of age. The predominant marital status was married status (75%). 63.45% of women had their first sexual experience between 21 and 30 years of age. 95.20% of the patients had between 1 and 3 sexual partners. Abnormal pap smear results represent; 37.28% to LSIL, followed by ASC-US (35.81%), and HSIL (14.18%). 67.32% of colposcopies were classified as satisfactory. Biopsy was performed in 71% of the patients, followed by loop electrosurgical excision procedure (LEEP) (13.69%), endocervical curettage in 11.05%. The pathology results reported HSIL in 46.56% of the cases, followed by 22.23% as LSIL and chronic cervicitis in 16.27%, 12.28% of the results were negative. CONCLUSION: Three-quarters of all colposcopies were performed on women between 27 and 56 years of age. The most frequently abnormal Pap smear results were: LSIL, followed ASC-US. 67% of the colposcopies were satisfactory. After colposcopy, biopsy was performed in most of the patients, in lower percentage: loop electrosurgical excision procedure (LEEP), endocervical curettage and diagnostic hysterectomy. Pathology results reported HSIL in 46.56%, LSIL IN 22.23% and chronic cervicitis in 16.27%; 12.28% of studies were negative.

Histopathological span of diseases in patients going through hysterectomies: an audit of 190 consecutive hysterectomy specimens in Multan

Introduction: Gynecological diseases affect women’s lives in numerous manners. They are frequent in all communities but the types of disorders and their presentations differ substantially in various regions and races. However, the studies and researches specifying these disorders in particular regions and communities are very low in number. Hysterectomy is one of the most frequently opted operations worldwide particularly in developing countries and hardly any studies are done about its epidemiology and prevalence in Multan region of Pakistan. Objective: The objective of this study is to assess the variety of histopathological diseases in patients undergoing hysterectomies in Multan region Design: Retrospective study including 190 hysterectomy specimens. Place and duration: Department of Histopathology Bakhtawar Amin Medical & Dental College, Multan from January 2019 to December 2020. Methodology: Histopathology reports of all hysterectomy specimens removed due to gynecological disorders were included. All the relevant data like age, parity, clinical manifestations, indication and type of hysterectomy were recorded along with histopathological microscopic diagnosis of cervix, endometrium, myometrium, fallopian tubes and ovaries. The data was collected from medical track record, histopathological request form and histopathology report files. Results: A total of 190 hysterectomies were received in histopathology department. The mean age was 47.8 years (ranging from 25-75 years). Majority of the ladies were between age groups 41-50 years. The major presenting complaint was menstrual irregularity followed by abdominal pain. Out of 190 specimen, 170 (89.5%) of hysterectomies were done because of non neoplastic/ benign conditions. Chronic cervicitis, adenomyosis and leiomyomata were the most commonly noticed incidental findings. Conclusion: Hysterectomy is an extensively used therapeutic modality, largely for benign non neoplastic disorders to relieve the clinical symptoms and to enhance the living conditions. Presence of incidental diseases in majority of hysterectomy specimens indicates that for conclusive opinion, histopathological examination is must. Key words: Histopathology, hysterectomy, benign gynecological disorders, leiomyoma, adenomyosis

HISTOPATHOLOGICAL STUDY OF COLPOSCOPIC BIOPSY OF CERVICES IN A TERTIARY CARE HOSPITAL (RAJSHAHI MEDICAL COLLEGE) IN BANGLADESH

Introduction: Colposcopy is done to detect cervical cancer and changes that may lead to cervical cancer. We aimed our study to observe the incidence of different pathologies of the cervix in Colposcopic specimens in Rajshahi Medical College of Bangladesh. Materials and Methods: Retrospective data were collected from the routine histopathological laboratory in the department of pathology Rajshahi Medical College and were recorded during a study period of 1 year (July 2019 to June 2020). Observations: Colposcopic biopsy is one of the commonest diagnostic procedures for assessing cervical Pathosis. Out of 641 specimens more than half, 365 specimens (56.50%) were Chronic Cervicitis. In present study, Chronic Cervicitis with squamous metaplasia and Invasive squamous cell carcinoma became the 2nd, 16.39% (105 specimens), and 3rd, 13.42% (86 specimens) most pathology involving the cervix. Cervical polyp, Endocervical and Leiomyomatous constitute 6.39% and 1.57% of the specimens respectively. 4.36% (28 specimens) of the study sample were the Intraepithelial neoplasia (CIN I, CIN II, CIN III). Adenocarcinoma and Clear cell carcinoma constitute 0.79% and 0.16% of the study specimens. 50 % of the cervical squamous cell carcinoma was moderately differentiated and well-differentiated and poorly differentiated squamous cell carcinoma constitutes 30.23% and 19.77% respectively. Conclusions: Colposcopic examination of cervical biopsy specimens helps to detect the exact causes and underlined pathology