ABSTRACT
Introducción. Las recomendaciones del cribado de cáncer de cérvix en España incluyen la participación en programas de control de calidad externos a los laboratorios de citología. La Sociedad Española de Citología (SEC) ha iniciado un programa de control de calidad de la citología ginecológica (CG). Objetivo. Presentar y analizar los resultados de la segunda ronda del control de calidad de la SEC. Material y métodos. Se incluyeron casos procesados mediante citología en medio líquido. Se escanearon las laminillas mediante la plataforma Aperio. Se seleccionaron 23 muestras procedentes de un banco de casos con al menos un 75% de acuerdo entre 4 expertos citopatólogos. Los diagnósticos de los casos para estudio incluyeron: uno negativo, 15 lesiones de bajo grado (4 ASCUS y 11 LSIL) y 7 lesiones de alto grado (uno ASCH y 6 HSIL). La CML correspondía a ThinPrep® en 16 casos y a SurePath® en 7. Se realizó el estudio de la correlación diagnóstica interobservador. Resultados. Participaron 16 hospitales. Las concordancias medias fueron: global 70,6% y por tipo de lesión 63,1%. En negativo 71,9%, en ASCUS 56,2%, en LSIL 69,5% y en HSIL 82,8%. Los casos discordantes correspondían con mayor frecuencia a negativos y a ASCUS. Se observó discordancia severa (HSIL/ASCH frente a negativo) en un 4,4% de los casos. Conclusiones. Nuestros resultados son similares a los descritos en la literatura, encontrando muy escasas discordancias severas (AU)
Introduction. In Spain, the guidelines for cervical cancer screening include a recommendation to enroll in external quality control programs. The Spanish Society of Cytology (SEC) has initiated its own quality control program of gynecological cytology (QCPGC). Aim. To describe and discuss the results of the second round of SEC¿s QCPGC. Material and method. The cases are selected by a group of expert cytologists. The cases with an agreement of 75% of four cytopathologists were used. The cases were scanned with Aperio. The scanned cases not available were excluded. We included a total of 23 cases, 1 negative, 15 low grade lesions (4 ASCUS and 11 LSIL) and 7 high grade lesions (1 ASCH and 6 HSIL). Sixteen cases were studied with ThinPrep™ platform and in 7 cases the SurePath™ platform was used. Results. Sixteen hospitals participated. The global mean concordance was 70.6%. The mean concordance in the type of lesion was 63.1%. The concordance was 71.9% in negative diagnoses, 56.2% in ASCUS, 69.5% in LSIL and 82.8% in HSIL The discordant cases were diagnosed more frequently as negative and ASCUS. 4.4% of cases had major discordances (HSIL or ASCH versus negatives). Conclusions: Our results are similar to those reported in the literature, with very little severe discordance. The method of exchanging slides does not allows continuous training, since the review of discordant cases can not be made. Therefore, methodological corrections are contemplated for future rounds (AU)
Subject(s)
Humans , Genital Neoplasms, Female/pathology , Histological Techniques/trends , Histocytochemistry/standards , Early Detection of Cancer/methods , Mass Screening/methods , Quality Control , Quality of Health CareABSTRACT
INTRODUCTION: In Spain, the guidelines for cervical cancer screening include a recommendation to enroll in external quality control programs. The Spanish Society of Cytology (SEC) has initiated its own quality control program of gynecological cytology (QCPGC). AIM: To describe and discuss the results of the second round of SECs QCPGC. MATERIAL AND METHOD: The cases are selected by a group of expert cytologists. The cases with an agreement of 75% of four cytopathologists were used. The cases were scanned with Aperio. The scanned cases not available were excluded. We included a total of 23 cases, 1 negative, 15 low grade lesions (4 ASCUS and 11 LSIL) and 7 high grade lesions (1 ASCH and 6 HSIL). Sixteen cases were studied with ThinPrep™ platform and in 7 cases the SurePath™ platform was used. RESULTS: Sixteen hospitals participated. The global mean concordance was 70.6%. The mean concordance in the type of lesion was 63.1%. The concordance was 71.9% in negative diagnoses, 56.2% in ASCUS, 69.5% in LSIL and 82.8% in HSIL The discordant cases were diagnosed more frequently as negative and ASCUS. 4.4% of cases had major discordances (HSIL or ASCH versus negatives). CONCLUSIONS: Our results are similar to those reported in the literature, with very few severe discordances.
Subject(s)
Cytodiagnosis/standards , Genital Diseases, Female/pathology , Quality Control , Female , Humans , Program Evaluation , Societies, Medical , SpainABSTRACT
Pancreatic metastases represent 2% of pancreatic tumors. The neoplasms most frequently metastasizing to the pancreas are breast, lung, melanoma and kidney tumors. We present the cases of two patients with pancreatic metastases from renal carcinoma diagnosed 4 and 8 years after the diagnosis and surgical treatment of the primary renal tumor. In both patients, endoscopic ultrasound was useful in the detection and characterization of these pancreatic lesions and allowed fine-needle aspiration for cytological study to be performed.
Subject(s)
Carcinoma, Renal Cell/diagnostic imaging , Carcinoma, Renal Cell/secondary , Endosonography , Kidney Neoplasms , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/secondary , Biopsy, Needle , Carcinoma, Renal Cell/pathology , Female , Humans , Kidney Neoplasms/pathology , Kidney Neoplasms/surgery , Male , Middle Aged , Nephrectomy , Pancreas/pathology , Pancreatectomy , Pancreatic Neoplasms/surgery , Pancreaticoduodenectomy , Radiography, Abdominal , Radiography, Thoracic , Time Factors , Tomography, X-Ray ComputedABSTRACT
Las metástasis pancreáticas representan el 2% de los tumores pancreáticos. Las neoplasias que con más frecuencia metastatizan en el páncreas son: mama, pulmón, melanoma y riñón. Presentamos los casos clínicos de 2 pacientes con metástasis pancreáticas de carcinoma renal detectadas a los 4 y 8 años del diagnóstico e intervención quirúrgica del tumor primario renal. En ambos casos la ecoendoscopia resultó ser una técnica útil en la detección y la caracterización de estas lesiones pancreáticas, y permitió la realización de una punción para el estudio citológico
Pancreatic metastases represent 2% of pancreatic tumors. The neoplasms most frequently metastasizing to the pancreas are breast, lung, melanoma and kidney tumors. We present the cases of two patients with pancreatic metastases from renal carcinoma diagnosed 4 and 8 years after the diagnosis and surgical treatment of the primary renal tumor. In both patients, endoscopic ultrasound was useful in the detection and characterization of these pancreatic lesions and allowed fine-needle aspiration for cytological study to be performed
Subject(s)
Male , Female , Middle Aged , Humans , Carcinoma/pathology , Endosonography , Kidney Neoplasms/pathology , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/secondaryABSTRACT
Las limitaciones de la cirugía oncológica cutánea han llevado a buscar nuevas modalidades terapéuticas que, con una seguridad y eficacia similares a las de la cirugía, la superen en resultado estético y funcional. En el tratamiento de lesiones cutáneas malignas y premalignas es cada vez más frecuente el uso de la laserterapia, la criocirugía y los inmunomoduladores tópicos o intralesionales. En la mayoría de los casos se recurre a estos tratamientos cuando la cirugía va a ser excesivamente mutilante, desfiguradora, o técnicamente difícil, lo cual suele ser relativamente frecuente en localizaciones como la cara o las zonas acrales. La respuesta favorable observada en el tratamiento con interferón (IFN) intralesional de metástasis cutáneas inoperables de melanoma ha llevado a probar su utilidad en casos seleccionados de melanoma primario, y existen ya varios trabajos que sugieren la eficacia y seguridad de este fármaco en el lentigo maligno. Se describe un caso de lentigo maligno localizado en el canto externo del ojo izquierdo que fue tratado con interferón alfa-2b (IFN-alfa2b) intralesional. Se objetivó la desaparición clínica e histológica de la lesión sin efectos adversos destacables y con un resultado estético excelente. El IFN intralesional puede ser una opción terapéutica válida para casos seleccionados de lentigo maligno (AU)
