RESUMO
We present a case of serous cystadenofibroma 2 cm in diameter in the epiploic appendix of the sigmoid as incidental finding in a 72-year-old patient who underwent hysterectomy and oophorectomy for endometrial carcinoma. The tumor showed the same histology as analogous tumors of the ovary and was associated with endosalpingiosis. Further findings were large adhesions between the epiploic appendices of the sigmoid and the parietal peritoneum and atypical cells in the peritoneal washings. Both may be explained by occult peritoneal endosalpingiosis. The histogenesis, histology, and locations of extraovarian müllerian tumors are reviewed.
Assuntos
Adenofibroma/patologia , Neoplasias do Apêndice/patologia , Tumor Mulleriano Misto/patologia , Idoso , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Histerectomia , OvariectomiaRESUMO
OBJECTIVE: To compare the AutoCyte PREP direct-to-vial procedure to the conventional Pap smear in two large and similar patient groups compiled from the testing experience of three cytology laboratories in Switzerland and France. STUDY DESIGN: Randomly selected, large patient groups were evaluated using either the conventional Pap smear or the AutoCyte PREP direct-to-vial liquid-based preparation. Results were then compared statistically as to disease detection and sample adequacy. RESULTS: Specimen adequacy was greatly improved in the group tested with the AutoCyte PREP. PREP also demonstrated a significant reduction in ASCUS and ASCUS:LSIL+ ratios. The three laboratories participating in this review found significantly improved detection of both low and high grade SIL. Routine use of AutoCyte PREP for cervical cytology screening offers substantial improvements in adequacy and disease detection.
Assuntos
Laboratórios Hospitalares/normas , Teste de Papanicolaou , Patologia Clínica/métodos , Patologia Clínica/normas , Esfregaço Vaginal/métodos , Esfregaço Vaginal/normas , Técnicas Citológicas , Europa (Continente) , Feminino , Humanos , Processamento de Imagem Assistida por Computador/instrumentação , Processamento de Imagem Assistida por Computador/métodos , Processamento de Imagem Assistida por Computador/normas , Programas de Rastreamento/instrumentação , Programas de Rastreamento/métodos , Programas de Rastreamento/normas , Patologia Clínica/instrumentação , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia , Esfregaço Vaginal/instrumentaçãoRESUMO
Cervical smears of 554 outpatients of a hospital were examined using a blinded, split sample match pair protocol for which a conventional PAP-smear (CS) was first prepared with Cervex brush and the reminder of the sample was used for the thin-layer-preparation (TLP) according to the manual CytoRich System. The preparations of the two methods were compared with respect to quality and to sensitivity for atypias. In addition the HPV status was determined on the same cell suspension in cases with borderline changes (BLC) and dysplasias including carcinoma using the Hybrid Capture System. The use of TLP reduced the proportion of suboptimal preparations by more than 50% (14.6% vs. 35%) and eliminated the only inadequate preparation registered in CS. The DSP detected more than twice as many dysplasias of all degrees as CS (3.4% vs. 1.4%) and reduced the proportion of BLC to one third (3.2% vs. 9.6%). The percentages of cases positive for high- and intermediate-risk HPV in preparations with BLC, LSIL and HSIL were 17, 62.5% and 100% respectively. The TL-method improves significantly the efficiency of PAP-smears and allows the typing of HPV which is of clinical importance for the management of low grade squamous intraepitelial lesions and borderline changes. The findings speak against the further use of CS for cervical screening.
Assuntos
Teste de Papanicolaou , Papillomaviridae , Infecções por Papillomavirus/patologia , Infecções Tumorais por Vírus/patologia , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/patologia , Esfregaço Vaginal/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Colo do Útero/patologia , Criança , Neoplasias do Endométrio/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Sensibilidade e EspecificidadeRESUMO
The occurrence of serous peritoneal tumors (SPT) with the same histology as serous neoplasms arising within the ovary is explained by the common origin of the peritoneum and the ovaries from the coelomic epithelium. They occur alone or in combination with analogous tumors of the ovary and are often misinterpreted as metastatic ovarian carcinomas. Their histology shows considerable variations. As lesions with and without invasive properties may coexist, visible lesions should be resected and examined as completely as possible. The prognostic significance of some histological findings is still under study. It appears that besides invasion the grade of nuclear atypia is of importance. It is therefore possible that the use of cytometry provides new prognostic criteria, allowing the identification of high risk groups. This holds also for the malignant forms of SPT, which seem to have a similar prognosis to analogous tumors of the ovary. For this purpose, peritoneal cytology is of special value and constitutes an integral part of the investigations.
Assuntos
Cistadenocarcinoma Papilar/patologia , Cistadenocarcinoma Seroso/patologia , Cistadenoma Papilar/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias Ovarianas/patologia , Neoplasias Peritoneais/patologia , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Ovário/patologia , Peritônio/patologiaRESUMO
Eight primary testicular germ cell tumors, one teratocarcinoma cell line, and one Leydig cell tumor were studied to determine the importance of modifications of the nucleolar organizer regions (NORs) in human testicular tumors. Cytogenetic analysis after silver staining showed active ectopic NORs in two primary embryonal carcinomas (EC) in the cell line and in single cells of each of two seminomas (S). In one EC, an ectopic NOR was localized to chromosomal region 1q4; the others were on unidentified rearranged chromosomes. All tumors in which ectopic NORs were observed were hyperdiploid and possessed marker chromosomes typical of human germ cell tumors. Quantitative DNA analysis was performed on three tumors: a teratocarcinoma (TC) and the Leydig cell tumor, which had provided no analyzable mitoses, and a seminoma which was cytogenetically diploid. In all three cases, the major populations were hyperdiploid. The results, in combination with those of an earlier study, provide evidence that active ectopic NORs are common in human testicular tumors.
Assuntos
Aberrações Cromossômicas , Neoplasias Embrionárias de Células Germinativas/genética , Região Organizadora do Nucléolo/patologia , Neoplasias Testiculares/genética , Aneuploidia , Southern Blotting , Cromossomos Humanos Par 1 , Cromossomos Humanos Par 12 , DNA de Neoplasias/análise , Disgerminoma/genética , Humanos , Cariotipagem , Tumor de Células de Leydig/genética , Masculino , Nitrato de Prata , Teratoma/genética , Células Tumorais CultivadasRESUMO
Quantitative DNA analysis by the CAS 100 Cell Analysis System was performed on 120 cases of primary breast carcinoma using touch preparations from fresh biopsy specimens in 110 cases and archival, restrained fine needle preparations in 10 cases. Fifteen cases of metastatic breast carcinoma and 15 cases of benign breast lesions were also analyzed. Overall, 76.7% of the carcinomas examined were aneuploid, with most DNA indices between 1.6 and 2.0. DNA anomalies were strongly related to nuclear atypia but not to structural differentiation. The hormone receptor content, when compared with DNA data and morphologic features, emerged as a biologically independent factor. Agreement between quantitative immunocytochemical assay (QICA) using the CAS system and traditional dextran-coated charcoal assay (DCCA) in discriminating positive and negative status for estrogen receptors and progesterone receptors was 86% and 82%, respectively. Marked variations, however, occurred in the numerical values. Considering the advantages of QICA and the importance of tumor heterogeneity in particular, the use of traditional DCCA as the reference technique and only guide for therapy no longer seems justified.