Ultrasonic and Histopathological Evaluation to Exclude Premalignant and Malignant Lesions in Perimenopausal and Postmenopausal Women Presenting as Abnormal Uterine Bleeding.

INTRODUCTION: Abnormal uterine bleeding may be defined as bleeding pattern that differs in frequency, duration and amount from a pattern observed during a normal menstrual cycle or after menopause. AIM AND OBJECTIVE: The aim of this study was (1) to identify the different benign, premalignant and malignant conditions as the cause of abnormal uterine bleeding in perimenopausal and postmenopausal women and (2) to find out the different histopathological patterns of endometrium and cervix in these women. MATERIALS AND METHODS: This is a prospective study done in gynaecological oncology in 100 cases attending the OPD. Pap smear and cervical biopsy were done following clinical examination and then, the patients were sent for abdominal and pelvic ultrasound examination. Endometrial biopsy was done if endometrial thickness was increased with respect to age. The cut-off value of endometrial thickness in perimenopausal women was 11 mm, and for postmenopausal women, it was 4 mm, respectively. All the tissue specimens were sent for histopathological examination. RESULT: A total of 100 women were evaluated in which 50% were in the perimenopausal age group and 50% in the menopausal age group. Cervical pathology was present in 47% of cases, organic cause of uterine body like fibroid and adenomyosis was present in 26% of women, and thickened endometrium was seen in 24% of cases and endometrial polyp in 3 cases only. In this study, the incidence of benign cases was 49%, premalignant 9% and malignant condition 42%, respectively. Out of 42 malignant cases, 37 (88.09%) were cervical cancer, 3 (7.14%) endometrial carcinoma, 1 (2.38%) vulval cancer and 1 sarcoma of uterus. With regard to histology of endometrium, 34.48% had simple hyperplasia without atypia, 20.68% hyperplasia with atypia and secretory endometrium, and 10.34% endometrial carcinoma. Histologically, 94.59% of cervical cancer was squamous cell carcinoma and 5.40% was adenocarcinoma. CONCLUSION: Evaluation of cases of perimenopausal and postmenopausal bleeding differentiated premalignant and malignant lesions of the uterine body, endometrium and cervix. As our centre is a Regional Cancer Centre of Bihar, incidence of malignant lesions is higher in our centre.

Gonadal status of male recipient mice influences germ cell development in immature buffalo testis tissue xenograft.

Growth and development of immature testis xenograft from various domestic mammals has been shown in mouse recipients; however, buffalo testis xenografts have not been reported to date. In this study, small fragments of testis tissue from 8-week-old buffalo calves were implanted subcutaneously onto the back of immunodeficient male mouse recipients, which were either castrated or left intact (non-castrated). The xenografts were retrieved and analyzed 12 and 24 weeks later. The grafted tissue survived and grew in both types of recipient with a significant increase in weight and seminiferous tubule diameter. Recovery of grafts from intact recipients 24 weeks post-grafting was significantly lower than that from the castrated recipients. Seminal vesicle indices and serum testosterone levels were lower in castrated recipients at both collection time points in comparison to the intact recipients and non-grafted intact mouse controls. Pachytene spermatocytes were the most advanced germ cells observed in grafts recovered from castrated recipients 24 weeks post-grafting. Complete spermatogenesis, as indicated by the presence of elongated spermatids, was present only in grafts from intact recipients collected 24 weeks post-grafting. However, significant number of germ cells with DNA damage was also detected in these grafts as indicated by TUNEL assay. The complete germ cell differentiation in xenografts from intact recipients may be attributed to efficient Sertoli cell maturation. These results suggest that germ cell differentiation in buffalo testis xenograft can be completed by altering the recipient gonadal status.

Spermatogonial stem cells in the testis of an endangered bovid: Indian black buck (Antilope cervicapra L.).

Numerous wild bovids are facing threat of extinction owing to the loss of habitat and various other reasons. Spermatogonial stem cells (SSCs) represent the only germline stem cells in adult body that are capable of self-renewal and that can undergo differentiation to produce haploid germ cells. SSCs can, therefore, serve as a useful resource for preservation of germplasm of threatened and endangered mammals. The Indian black buck (Antilope cervicapra L.) is a small Indian antelope that is listed as endangered by the Indian Wildlife Protection Act, 1972. Immunohistochemical analysis of testes tissues of black buck revealed the presence of spermatogonia that were specifically stained by lectin-Dolichos biflorus agglutinin (DBA). The expression of pluripotent cell-specific markers, NANOG and stage-specific embryonic antigen-1 (SSEA-1), was detected in spermatogonia. Interestingly, the expression of POU5F1 (OCT3/4) was absent from spermatogonia, however, it was detected in differentiating cells such as spermatocytes and round spermatids but not in elongated spermatids. The expression of NANOG protein was also present in spermatocytes but absent in round and elongated spermatids. Using the testis transplantation assay, stem cell potential of black buck spermatogonia was confirmed as indicated by the presence of colonized DBA-stained cells in the basal membrane of seminiferous tubules of xenotransplanted mice testis. The findings from this study suggest the presence of SSCs in the testis of an endangered bovid for the first time and open new possibility to explore the use of SSCs in conservation.