Discordance between uterine cervical cytology and biopsy: results and etiologies of a one-year audit.

To investigate the etiologies of discrepancies between cervicovaginal smear and corresponding cervical biopsy results, a total of 15,474 cervicovaginal smears were sampled in a one-year period. Among these, 427 patients were diagnosed with atypical squamous cells of undetermined significance (ASCUS), dysplasia, or malignancy. The screen positive rate was 2.8%. All of the positive cases had histologic follow-up. Forty-nine of the 427 patients had a discrepancy of at least two grades (the grades are divided to negative, ASCUS, mild dysplasia, moderate dysplasia, severe dysplasia and invasive carcinoma), between the cytologic and histologic diagnoses. The discrepancy rate was 11.5%. Ten of these discrepant cases had poorly-preserved slides or a not definitely final diagnosis. A total of 39 cases (79.6%) of discrepancy were reviewed in this study. In thirty (77%) of the 39 discrepant cases, the errors were cytologic and in 9 cases (23%) the errors were histologic. Cytologic error was the major cause of cytohistologic discrepancy. The etiologies of cytohistologic discrepancy included: cytologic interpretation error, 17 cases (44%); cytologic sampling error, 10 cases (25%); biopsy sampling error, 6 cases (15%); cytologic screen error, 3 cases (8%); and biopsy interpretation error, 3 cases (8%). The major etiology of cytohistologic discordances was cytologic interpretation error. In this retrospective study, we determined the etiologies of cytohistologic discrepancies. This information can be useful for improving diagnostic accuracy and the quality of patient care.

Sarcomatoid carcinoma of the small intestine: a case report.

Sarcomatoid carcinoma of the small intestine is a very rare tumor. Only limited cases have been reported in the literature. The tumor is more malignant than the usual adenocarcinoma of the small intestine. Here we report a 59-year-old female patient who was referred from a local hospital after suffering persistent hematochezia, abdominal pain and distention for three months. Because of persistent intestinal obstruction and bleeding, reoperation at our hospital was performed. A huge tumor, originating from the ileum and with multiple liver and bone metastasis, was found. Palliative resection of the tumor with two segments of the small intestine and sigmoid colon was carried out. Pathology confirmed the diagnosis of sarcomatoid carcinoma. She died two months after operation.

Bilioma after laparoscopic cholecystectomy: a case report.

A 68-year-old female, suffering from gallstones, received a laparoscopic cholecystectomy. One year later, a 4x2.5x2 cm mass was noted 3 cm left of the umbilicus. Under the impression of intraabdominal tumor, the tumor was excised and a bilioma was pathologically proved. Bilioma is an encapsulated bile fluid mass, formed after damage of the biliary tree and bile leakage. Only a few cases have been reported, but never in the periumbilical area according to review of the literature. In addition to sonography, computed tomography, and cholescintigraphy, the physicians' alertness is essential for this diagnosis. In general, the treatment of choice is percutaneous drainage. But, in this case, the bilioma of periumbilical abdominal wall was excised with good prognosis after a six-month follow-up.