Adenoid cystic carcinoma of the Bartholin's gland is underpinned by MYB- and MYBL1- rearrangements.

OBJECTIVE: Adenoid cystic carcinoma (AdCC) of the Bartholin's gland (AdCC-BG) is a very rare gynecologic vulvar malignancy. AdCC-BGs are slow-growing but locally aggressive and are associated with high recurrence rates. Here we sought to characterize the molecular underpinning of AdCC-BGs. METHODS: AdCC-BGs (n = 6) were subjected to a combination of RNA-sequencing, targeted DNA-sequencing, reverse-transcription PCR, fluorescence in situ hybridization (FISH) and MYB immunohistochemistry (IHC). Clinicopathologic variables, somatic mutations, copy number alterations and chimeric transcripts were assessed. RESULTS: All six AdCC-BGs were biphasic, composed of ductal and myoepithelial cells. Akin to salivary gland and breast AdCCs, three AdCC-BGs had the MYB::NFIB fusion gene with varying breakpoints, all of which were associated with MYB overexpression by IHC. Two AdCC-BGs were underpinned by MYBL1 fusion genes with different gene partners, including MYBL1::RAD51B and MYBL1::EWSR1 gene fusions, and showed MYB protein expression. Although the final AdCC-BG studied had MYB protein overexpression, no gene fusion was identified. AdCC-BGs harbored few additional somatic genetic alterations, and only few mutations in cancer-related genes were identified, including GNAQ, GNAS, KDM6A, AKT1 and BCL2, none of which were recurrent. Two AdCC-BGs, both with a MYB::NFIB fusion gene, developed metastatic disease. CONCLUSIONS: AdCC-BGs constitute a convergent phenotype, whereby activation of MYB or MYBL1 can be driven by the MYB::NFIB fusion gene or MYBL1 rearrangements. Our observations further support the notion that AdCCs, irrespective of organ site, constitute a genotypic-phenotypic correlation. Assessment of MYB or MYBL1 rearrangements may be used as an ancillary marker for the diagnosis of AdCC-BGs.

A histologic study on growth promoter target organs of slaughtered beef in Molise Region (Italy).

A gross pathology and histological investigation was carried out on bovine target organs of anabolic substances in the Molise Region (Italy). One hundred forty-four bovines (12-24 months old, 123 males and 21 females) were included in the survey. An antemortem assessment of their behavior and clinical examination were performed. After slaughter, samples of prostate, Cowper's glands, Bartholin's glands, mammary gland, ovaries, thymus and thyroid were collected, inspected and processed for histopathology, as suggested in the guidelines of the Italian national program for residue surveillance (PNR). Overall, 15.3% of the examined animals were classified as "suspect," 44.4% were classified as "uncertain," and the remaining 40.3% were classified as "negative." The most frequent lesion was a severe thymus atrophy with fat infiltration (15.4% of males and 14.3% of females), strongly suggesting the illegal use of corticosteroids.

Physiologic measures of sexual function in women: a review.

OBJECTIVE: To review and describe physiologic measures of assessing sexual function in women. DESIGN: Literature review. SETTING: Studies that use instruments designed to measure female sexual function. PATIENT(S): Women participating in studies of female sexual function. INTERVENTION(S): Various instruments that measure physiologic features of female sexual function. MAIN OUTCOME MEASURE(S): Appraisal of the various instruments, including their advantages and disadvantages. RESULT(S): Many unique physiologic methods of evaluating female sexual function have been developed during the past four decades. Each method has its benefits and limitations. CONCLUSION(S): Many physiologic methods exist, but most are not well-validated. In addition there has been an inability to correlate most physiologic measures with subjective measures of sexual arousal. Furthermore, given the complex nature of the sexual response in women, physiologic measures should be considered in context of other data, including the history, physical examination, and validated questionnaires. Nonetheless, the existence of appropriate physiologic measures is vital to our understanding of female sexual function and dysfunction.

The pathomorphology of Bartholin's gland. Analysis of surgical data.

Medline data did not reveal any statistical approach to Bartholin's gland pathomorphological lesions, especially when the social aspect was considered. Objectives. To complete knowledge and data according to this subject on the basis of own surgical material analysis. Microscopic examinations of histopathological 5 microm thick specimens stained with hematoxylin-eosin and in selected cases with histochemical and immunohistochemical methods on 104 Bartholin's glands taken from 103 female patients in age of 39.4 +/- 9.6. Retention cysts, suppurating lesions (abscesses), extrauterine endometriosis and neoplasms were separated from obtained samples. Localization of lesions, the patients' age and education status were determined. P < 0.05 was considered as statistically significant. Retention cysts were observed in 84.6% of cases, abscesses in 10.6%, extrauterine endometriosis in 2% and neoplasms in nearly 3% of patients. In 54.1% of cases the lesion was localized on the left side, in 45.9% on the right. 17.2% of female patients presented with university education, 29.9% with elementary education, while 52.9% with secondary education. The average age of operated patients amounted to 33 +/- 9.8 years in case of university education, being significantly lower as compared to the average age of secondary (40.5 +/- 7 years) and elementary (42.4 +/- 12 years) education (p < 0.01 and p < 0.02 respectively). 47.7% of retention cysts demonstrated various degrees of inflammatory infiltration. However, the anatomical variability of the ductal and glandular epithelium was higher in cases of non-inflammatory cysts. Considering three Bartholin's gland neoplasms, two were diagnosed as adenocarcinomas and one as a fibromyoma. All of them were observed in female patients with a rare blood type (twice Rh-minus and once AB Rh-plus). There was no significant relationship between the type of pathomorfological lesions and age of operated patients, in spite of the fact that the lowest mean age was observed in woman with endometriosis while the highest in those with neoplasms. The pathology of Bartholin's gland mostly concerns female patients with secondary education. However, early diagnosis is associated with patients with university education. Thus, further investigations considering the statistical analysis of Bartholin's gland neoplasms in order to determine the possible relationship between blood type antigens and neoplasm development are required.

Nodular Hyperplasia of the Bartholin Gland: A Clinicopathological Study of Two Cases, Including Detection of Clonality by HUMARA.

The authors report two examples of nodular hyperplasia of the Bartholin gland. Each occurred in the vulva, close to the introitus of women aged 33 and 49 years, who presented with slightly painful lesions that were clinically thought to be cysts. Grossly, both masses exhibited a multilobular architecture, were elastic, were gray in color, and measured 4 cm and 3.2 cm in greatest dimension. On microscopic examination, the lesions looked similar and exhibited an increased number of secretory acini, with maintenance of the normal duct-acinar relationship--features compatible with nodular hyperplasia. Rare dilated ducts were observed, and intraluminal inspissated secretions were occasionally seen. In one case, there were a focal mild inflammatory infiltrate, squamous metaplasia of larger ducts, and rare ruptured ducts with extravasated stromal mucin. Clonality analysis performed in one case revealed a monoclonal pattern, suggesting that the lesion may be a neoplastic process rather than simple reactive hyperplasia.

Nodular hyperplasia of Bartholin's gland.

AIMS: There has been very little mention of benign solid lesions of the Bartholin's gland (BG) in pathology and gynaecology textbooks, and very few cases have been reported in the literature. Among these lesions, the distinction between nodular hyperplasia (NH) and adenoma has not been well defined. We report ten cases of NH of the BG, describe their clinicopathological, immunohistochemical and ultrastructural findings, and review the literature. METHODS: We examined retrospectively all lesions involving BGs from our surgical pathology records from 1990 to 2004 with emphasis on NH. To separate NH from adenoma, we applied the criteria proposed by Koenig and Tavassoli. Special stains (PAS with and without prior digestion, Mayer's mucicarmine and Alcian blue with and without hyaluronidase) and immunohistochemistry (CAM5.2, AE1/AE3, HMWK, monoclonal CEA, EMA, ER, PR, ALA, SMA, Ki-67, p53 and polyclonal CEA) were performed on NHs. Two cases were examined ultrastructurally. RESULTS: Using specific criteria, ten cases (age range 23-45 years; mean 36.1) of NH were identified, two of which were diagnosed previously as adenoma, but re-classified as NH. Clinically, these lesions were described either as Bartholin's duct cysts (BDCs) or vulvar lumps. Grossly, NHs were solid, tan and unencapsulated, measuring 12.5-45.0 mm in maximum dimension (mean 23.8). Histologically, the NHs were composed of a proliferation of mucus-secreting acini with preservation of the normal duct-to-acinar relationship. Chronic inflammation and squamous metaplasia were present. Eight lesions focally involved the surgical margins. Intracytoplasmic and intra-luminal secretions were positive for PAS with and without digestion, Alcian blue with and without hyaluronidase and mucicarmine. All lesions showed positive staining for CAM5.2, AE1/AE3, HMWK, EMA, and polyclonal CEA. There was negative staining for Ki-67, ER, PR, ALA, p53 and monoclonal CEA. Periacinar myoepithelial cells stained for SMA. Ultrastructurally, the findings included abundant intracytoplasmic secretory granules, granulofibrillar bodies, prominent Golgi and ribosomes. Myoepithelial cells were identified. There was no tumour recurrence or malignant transformation in eight patients with clinical follow-up. CONCLUSION: NH of the BG is a rare lesion with benign behaviour. It is a distinct entity and can be separated histologically from an adenoma.

Histochemical studies on the dependence of secretory function of the major vestibular gland (Bartholin's gland) on ovarian steroid hormones in the cat.

The dependency of the secretory function of the feline major vestibular gland (Bartholin's gland) on the ovarian steroid hormones was studied histochemically. After estrogen (estradiol-17 beta or diethylstilbestrol), progesterone or a combination of these was administered to cats which were previously ovariohysterectomized, the major vestibular glands were removed, embedded in paraffin, sectioned, and stained by alcian blue, periodic acid-Schiff or peroxidase-labeled lectin (peanut agglutinin and wheat germ agglutinin). The vividly positive reactions to the stainings applied were observed in the secretory epithelial cells of the major vestibular glands in the estrogen treated animals. The dependency of the secretory function of the major vestibular glands on the estrogen was demonstrated in this study.

Secretory glycoproteins of major vestibular glands (Bartholin's glands) in female calves. Studies with usual histochemical methods and with lectin-horseradish peroxidase conjugates in normal animals and in animals implanted with anabolic drugs.

The nature of mucins synthetized by the major vestibular glands of normal female calves and animals treated by anabolic drugs was investigated by usual histochemical methods and by lectin conjugate methods: Canavalia ensiformis (Con A), Limulus polyphemus (LPA), Lotus tetragonolobus (LTA), Arachis hypogaea (PNA), Ricinus communis (RCA I), Glycine max (SBA) and Triticum vulgaris (WGA). Two main secretory cell types, i.e. acinar and tubular cells, could be distinguished. The former produced sialomucins, whereas the latter produced neutral mucins. WGA and PNA showed strong binding to all secretory cells while LTA, RCA I and SBA exhibited a weaker affinity. Treatment with anabolic drugs enhanced O-acetyl sialic acid synthesis and we noted de novo synthesis of sulfomucins. However, the staining intensity of LTA was stronger than in control calves. Tubular secretory cells of treated animals revealed an intense secretion of neutral mucins but, in contrast, all tested lectins were less intensively bound. The present study provides additional histochemical information on Bartholin's glands. A shortened procedure is proposed to detect animals treated with anabolic drugs when morphological changes are lacking.

Pain during sex response due to occlusion of the Bartholin gland duct.

The greater vestibular glands produce a secretion during the plateau stage of sexual response. If the duct of the gland is partially or completely occluded, the secretion cannot be released and pain results from the pressure of the entrapped secretion. The pain is specific in its location and is elicited regardless of the mode of sexual stimulation. Four cases are presented in which duct occlusion appears to be the cause of pain during sex response. The gland was removed in 3 cases. In the fourth a marsupialization procedure was performed. The procedures were curative in all 4 cases. Relevant anatomy and sexual physiology are discussed.

Adenocarcinoma of Bartholin's gland.

Bartholin's gland carcinoma is an uncommon disease representing 0.1% of all female genital malignant neoplasms. Five Bartholin's gland adenocarcinomas were selected by the criteria of Chamlian and Taylor. Three patients died from metastatic disease within four years; two are free of apparent disease 14 months and 13 years, respectively, after initial diagnosis. Poor prognosis was associated with large tumor size, poor histopathologic differentiation, and lymph node involvement. Transmission electron microscopy verified the glandular nature of the poorly differentiated lesions. All five tumors demonstrated junctional complexes, abundant rough endoplasmic reticulum, secretory vacuoles, and glandular formation. Low levels of estrogen receptor and moderate levels of progesterone receptor were present in the one case measured. Endogenous peroxidase, and inducible enzyme in estrogen-sensitive tissues, was observed in two of the five tumors.

On a possible connection between deficiency of cervical and Bartholin secretion, the use of vaginal lubricants and the incidence of Down's anomaly.

The rate of mongolism is well known to increase with maternal age and has been suggested by German to be connected with the frequency of intercourse. The occurrence is discussed in relation to the possible use of vaginal lubricants as a consequence of deficient cervical and Bartholin secretion. The implications of this idea are discussed.