Congenital Transformation Zone Mimicking Cervical Premalignant Lesion.

INTRODUCTION: Congenital transformation zone (CTZ) of the uterine cervix is a non-neoplastic, rare condition resembling high-grade lesions on colposcopic examination which leads to diagnostic dilemmas.Case DescriptionA multiparous woman was screened for cervical cancer. Visual inspection using acetic acid was positive for which further evaluation with colposcopy was done. An aceto-white lesion resembling high-grade precancerous condition was seen. Punch biopsy was taken from multiple areas and the histopathology report demonstrated chronic cervicitis with increased maturation of the superficial layers of squamous epithelium. The lesion persisted on the follow-up colposcopy even after a course of antibiotics. DISCUSSION: CTZ could be difficult to differentiate from cervical premalignant lesions. The main aim of this article is to help other colposcopists to understand this physiological variant. CONCLUSION: The CTZ is a physiological entity and differential diagnosis for cervical premalignant lesions on colposcopy.

Placental expression of asialoglycoprotein receptor associated with Hepatitis B virus transmission from mother to child.

BACKGROUND: Asialoglycoprotein receptor expression on hepatocytes has been associated with endocytosis, binding and uptake of hepatitis B virus. The role of asialoglycoprotein receptor in hepatitis B virus vertical transmission and its expression on placenta has not yet been studied. PATIENTS AND METHODS: Thirty-four HBsAg+ve and 13 healthy pregnant mothers along with their newborns were enrolled. The former were categorized into transmitting and non-transmitting mothers based on their newborns being hepatitis B surface antigen and hepatitis B virus DNA positive. Expression of asialoglycoprotein receptor and hepatitis B surface antigen in placenta and isoform of asialoglycoprotein receptor on dendritic cell in peripheral and cord blood dendritic cells were analysed using flowcytometry, immune histochemistry, immune florescence and qRT-PCR. RESULTS: Twelve HBsAg+ve mothers transmitted hepatitis B virus to their newborns whereas the rest (n = 22) did not. Hepatitis B virus-transmitting mothers showed increased expression of asialoglycoprotein receptor in trophoblasts of placenta. Immunofluorescence microscopy revealed colocalization of hepatitis B surface antigen and asialoglycoprotein receptor in placenta as well as in DCs of transmitting mothers. There was no significant difference in the expression of asialoglycoprotein receptor on peripheral blood mononuclear cells or chord blood mononuclear cells between the 2 groups. However, hepatitis B virus-transmitting mothers and their HBsAg+ve newborns showed increased mRNA levels of isoform of asialoglycoprotein receptor on dendritic cell in peripheral blood mononuclear cells. Hepatitis B virus-transmitting mothers and their HBsAg+ve newborns showed an increased expression of isoform of asialoglycoprotein receptor on dendritic cell on circulating dendritic cells compared to hepatitis B virus non-transmitting mothers and their negative newborns. CONCLUSIONS: This study revealed that increased expression of asialoglycoprotein receptor in placenta and colocalization with hepatitis B surface antigen strongly indicates its role in intrauterine transmission of hepatitis B virus. Asialoglycoprotein receptor-blocking strategy can be used for therapeutic intervention of vertical transmission.