ABSTRACT
Uterine mullerian adenosarcoma (MA) is a rare biphasic tumour that accounts for less than 0.5% of uterine neoplasms. The age range of presentation is wide, with the median age in the 5th decade of life. It usually has a good prognosis; however, it worsens when it presents with sarcomatous overgrowth, heterologous elements or infiltrates the myometrium. We report the case of a 63-year-old woman presenting with abnormal vaginal bleeding and a sensation of solid material coming out of the cervical canal who was diagnosed with mullerian adenosarcoma with sarcomatous overgrowth (MASO) and presence of heterologous elements after performing a mass biopsy and subsequent hysterectomy. We reviewed the literature, focusing especially on the differential diagnoses to be evaluated, as well as the differences in prognosis and treatment according to whether or not they present histologic features of poor prognosis.
Subject(s)
Adenosarcoma , Uterine Neoplasms , Humans , Female , Adenosarcoma/pathology , Middle Aged , Uterine Neoplasms/pathology , Hysterectomy , Sarcoma/pathology , Diagnosis, DifferentialABSTRACT
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.
