A Case of Suspected Neurosarcoidosis Evading Diagnosis With Cervical Biopsy.

Neurosarcoidosis is a rare manifestation of sarcoidosis, posing diagnostic challenges due to its varied clinical presentation and the lack of definitive diagnostic tests. We present a case of a 46-year-old African American female with progressive ascending bilateral sensory loss, weakness, and a bifrontal headache. Despite undergoing extensive diagnostic workup including cerebrospinal fluid analysis, neuroimaging, and bronchoscopic evaluation, a definitive diagnosis remained elusive. The patient underwent an open cervical spinal cord biopsy, which did not yield conclusive evidence of neurosarcoidosis. Subsequent complications included suspicion of an epidural abscess and post-operative cervical kyphosis. This case underscores the diagnostic dilemma and potential complications associated with the evaluation and management of neurosarcoidosis, highlighting the importance of a multidisciplinary approach in such cases.

Immediate risk of cervical intraepithelial neoplasia and diagnostic value of colposcopy among cytology-negative women with oncogenic HPV: a retrospective study.

BACKGROUND: Cervical cancer screening results that are negative for cytology but positive for high-risk human papillomavirus (HR-HPV) are not uncommon. One-year follow-up is suggested for patients with no history of HPV positivity under the most recent American Society of Colposcopy and Cervical Pathology (ASCCP) guidelines (2019). The aim of this study was to evaluate the immediate risk of cervical intraepithelial neoplasia (CIN) among cytology-negative patients positive for HR-HPV. The diagnostic accuracy of colposcopy in these patients was investigated. METHODS: A retrospective study was conducted in patients who were cytology negative but HR-HPV positive and referred for colposcopy from January 2022 to August 2023. Patients were compared in terms of the immediate rate of CIN lesions among the HPV16-positive group, the HPV18-positive group and the non-16/18 HR-HPV-positive group. The distribution of CIN2 + lesions according to age was evaluated. The factors associated with the accuracy of colposcopy were evaluated using univariate and multivariate logistic regression. RESULTS: Among the 372 patients, 195 had chronic cervicitis, 131 had CIN1, 37 had CIN2/3, and nine had carcinoma. The immediate rates of CIN2 + lesions and CIN3 + lesions in patients who were not HR-HPV16/18-positive were comparable to those in patients who were HPV16/18-positive (P = 0.699). In addition, among patients diagnosed with CIN2 + lesions, 8 (17.39%) patients were women aged < 30 years. When pathological results were used as a reference, the consistency rate of colposcopy was 61.0% (227/372). Multivariate analyses revealed that age and the type of cervical transformation zone were independent factors affecting the accuracy of colposcopy (P < 0.001). CONCLUSIONS: In countries with limited resources, immediate colposcopy referral should be recommended for patients who are cytology negative but HR-HPV-positive (including non-16/18 HR-HPV-positive), and cervical cancer screening via cotesting should be suggested for women aged < 30 years. Colposcopy has moderate diagnostic value and can be affected by age and the type of cervical transformation zone.

Efficacy of Lidocaine Spray for Pain Reduction during Colposcopy-Directed Cervical Biopsies: A Randomized Controlled Trial.

Objectives: The objective of this study was to evaluate the efficacy of lidocaine spray in reducing the pain during colposcopy-directed cervical biopsy (CDB). Methods: From December 2017 to February 2019, 312 women undergoing CDBs were enrolled. The participants were randomized to three groups: group 1 (lidocaine spray), in which lidocaine spray was applied thoroughly to the cervix; group 2 (placebo), in which normal saline was applied thoroughly to the cervix; and group 3 (control), in which no anesthetic agent was applied to the cervix. Each woman completed a 10 cm visual analog scale to classify the subjective pain experience at three time points: baseline, immediately after biopsy, and 10 min after the procedure. The primary outcome of this study was the biopsy pain score. Results: The 312 enrolled women were randomly assigned to the three groups, amounting to 104 women per group. The clinical and pathological characteristics of the participants in all groups were comparable. The baseline, the biopsy, and the post-procedure pain scores were comparable among the three groups. There was a significant increase in the pain score from baseline to biopsy and from baseline to post-procedure in each group. The pain-score changes from baseline to biopsy in the lidocaine spray group significantly decreased when compared with the normal saline group (<0.001), and tended to decrease, though not significantly (p = 0.06), when compared with the control group. No complication with the intervention was observed. Conclusions: The application of lidocaine spray to the cervix has the benefit of reducing the pain associated with CDBs by a small amount. However, the intervention is safe and may be considered in nulliparous and/or overly anxious women undergoing the procedure.

Evaluation of the diagnostic performance of colposcopy in the detection of cervical high-grade squamous intraepithelial lesions among women with transformation zone type 3.

BACKGROUND: Inaccurate colposcopy diagnosis may lead to inappropriate management and increase the incidence of cervical cancer. This study aimed to evaluate the diagnostic accuracy of colposcopy in the detection of histologic cervical intraepithelial neoplasia grade 2 or worse (CIN2+) in women with transformation zone type 3 (TZ3). METHODS: Records from 764 patients with TZ3 who underwent colposcopy-directed biopsy and/or endocervical curettage in Putuo Hospital China between February 2020 and March 2023 were retrospectively collected. Colposcopy was carried out based on 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) and Colposcopy nomenclature. The diagnostic performance of colposcopy for identifying CIN2 + was evaluated compared with biopsies. The Kappa and McNemar tests were used to perform statistical analyses. RESULTS: Among the study population, 11.0% had pathologic CIN2+. The relative sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of colposcopy for histologic CIN2 + were 51.2%, 96.5%, 64.2% and 94.1%, respectively. The senior colposcopists (80.6%) had a higher colposcopic accuracy to diagnose histologic CIN2 + than junior colposcopists (68.6%). In subgroup analyses, age group ≥ 60 years (70.3%) showed lowest diagnostic accuracy when compared with age groups of < 45 years (84.4%) and 45-59 years (74.9%). CONCLUSION: Our findings suggest an increased risk of diagnostic inaccuracy of colposcopy in identifying CIN2 + in those ≥ 60 years of age with TZ3, and the accuracy of colposcopy is required to be further improved.

P16/Ki-67 double dye the value of diagnosis of cervical intraepithelial lesions and cervical biopsy consistency analysis / 国际检验医学杂志

Objective To evaluate the role of P16/Ki-67 double dye in the diagnosis of cervical intraepithe-lial lesion(CIN)value,and to analyze its consistency with cervical biopsy.Methods A total of 92 patients with suspected CIN in Shanghai Songjiang District Central Hospital from November 2021 to April 2023 were selected as the research objects.All patients underwent high-risk human papillomavirus(HR-HPV)and P16/Ki-67 double dye.Taking cervical biopsy as the gold standard,the diagnostic value of the two detection meth-ods for CIN was analyzed,as well as the consistency of the two detection methods in the diagnosis of CIN clas-sification and cervical biopsy.Results The results of cervical biopsy showed that 74 cases(80.43%)of 92 suspected CIN patients were positive,including 26 cases of CIN Ⅰ,32 cases of CIN Ⅱ and 16 cases of CIN Ⅲ,and 18 cases(19.57%)were negative.Taking cervical biopsy results as the gold standard,P16/Ki-67 double dye was more accurate than HR-HPV test in the diagnosis of CIN(P<0.05).The receiver operating charac-teristic(ROC)curve showed that the area under the curve of HR-HPV and P16/Ki-67 double dye for CIN di-agnosis was 0.760 and 0.890,respectively,all of them had certain diagnostic value.The consistency between HR-HPV evaluation of CIN classification and cervical biopsy was consistent(Kappa=0.707,P<0.05).The consistency between P16/Ki-67 double dye and cervical biopsy was excellent(Kappa=0.832,P<0.05).Con-clusion P16/Ki-67 double dye with a high diagnostic value in CIN,consistency in determining CIN grade and cervical biopsy is wonderful,which can provide reference for clinical diagnosis.

Tuberculosis of the Cervix Mimicking Cervical Carcinoma: A Case Report.

Tuberculosis of the cervix is reported to be very rare with clinical features that are indistinguishable from that of invasive cancer of the cervix. We report the case of a 31-year-old nulliparous lady that presented with intermenstrual bleeding and a persistent abnormal vaginal discharge after receiving several forms of treatment for cervical cancer. Vaginal examination revealed an extensive friable erythematous lesion affecting the entire ectocervix. Tuberculosis was confirmed following biopsy of the lesion, and the patient was successfully managed with a course of anti-tuberculosis medication.

Clinical value of new rapid pathological diagnosis technique in the examination of cervical lesions in primary medical institution / 中国基层医药

Objective To explore the clinical value of new rapid pathological diagnosis technology in the examination of cervical lesions in primary medical institution.Methods In the Affiliated Hospital of Yangzhou University,25 cases of cervical scraping and 22 cases of cerrical biopsy were selected.Twenty-five cases of cervical scraping scraped two wipers during operation,the results were compared with conventional pathological techniques and new rapid pathological diagnosis techniques.Twenty-two cases of cervical biopsy used a new rapid pathological diagnosis technique to perform cytological diagnosis of biopsy tissue rolls in biopsy operation.According to the results of rapid pathological diagnosis,the biopsy operation plan was adjusted to analyze the clinical value of the new rapid pathological diagnosis technique in cervical lesions in primary medical institution.Results The new rapid pathological diagnosis technology required less space and no pollution,and the diagnosis took about 2-3 min,which did not affect the normal inspection operation.Twenty-five cases of cervical scraping were produced with new rapid pathological diagnosis technique,and the quality of cervical scraping produced with conventional pathological technique was consistent,which could satisfy the needs of pathological cytological diagnosis;twenty-two cases of cervical biopsy under the vaginal device were assisted by this technology and it could increase the positive rate of the first biopsy.Conclusion Cervical scraping and cervical biopsy are still the main methods for cervical lesions examination in primary hospitals.The new rapid pathological diagnosis technology can provide the real-time pathological diagnosis of cervical scraping,improve the positive detection rate of the first biopsy of cervical biopsy,and the cost is low,suitable for promotion in primary medical institution.

Clinical value of new rapid pathological diagnosis technique in the examination of cervical lesions in primary medical institution / 中国基层医药

Objective@#To explore the clinical value of new rapid pathological diagnosis technology in the examination of cervical lesions in primary medical institution.@*Methods@#In the Affiliated Hospital of Yangzhou University, 25 cases of cervical scraping and 22 cases of cervical biopsy were selected.Twenty-five cases of cervical scraping scraped two wipers during operation, the results were compared with conventional pathological techniques and new rapid pathological diagnosis techniques.Twenty-two cases of cervical biopsy used a new rapid pathological diagnosis technique to perform cytological diagnosis of biopsy tissue rolls in biopsy operation.According to the results of rapid pathological diagnosis, the biopsy operation plan was adjusted to analyze the clinical value of the new rapid pathological diagnosis technique in cervical lesions in primary medical institution.@*Results@#The new rapid pathological diagnosis technology required less space and no pollution, and the diagnosis took about 2-3 min, which did not affect the normal inspection operation.Twenty-five cases of cervical scraping were produced with new rapid pathological diagnosis technique, and the quality of cervical scraping produced with conventional pathological technique was consistent, which could satisfy the needs of pathological cytological diagnosis; twenty-two cases of cervical biopsy under the vaginal device were assisted by this technology and it could increase the positive rate of the first biopsy.@*Conclusion@#Cervical scraping and cervical biopsy are still the main methods for cervical lesions examination in primary hospitals.The new rapid pathological diagnosis technology can provide the real-time pathological diagnosis of cervical scraping, improve the positive detection rate of the first biopsy of cervical biopsy, and the cost is low, suitable for promotion in primary medical institution.

Risks of cervical intraepithelial neoplasia grade 3 or invasive cancers in ASCUS women with different management: a population-based cohort study / 부인종양

OBJECTIVE: To investigate the progression risk of atypical squamous cells of undetermined significance (ASCUS) with different clinical managements. METHODS: Women with their first diagnosis of ASCUS cytology were retrieved from the national cervical cancer screening database and linked to the national health insurance research database to identify the management of these women. The incidences of developing cervical intraepithelial neoplasia grade 3 and invasive cervical cancer (CIN3+) were calculated, and the hazard ratios (HRs) were estimated using a Cox proportional hazards model. This study was approved by the Research Ethics Committee of the National Taiwan University Hospital and is registered at ClinicalTrials.gov (Identifier: NCT02063152). RESULTS: There were total 69,741 women included. Various management strategies including colposcopy, cervical biopsies and/or endocervical curettage, and cryotherapy, failed to reduce the risk of subsequent CIN3+ compared with repeat cervical smears. Loop electrosurgical excision procedure/conization significantly decreased risk of subsequent CIN3+ lesions (HR=0.22; 95% confidence interval [CI]=0.07–0.68; p=0.010). Women in their 40s–50s had an approximately 30% risk reduction compared to other age groups. Women with a previous screening history >5 years from the present ASCUS diagnosis were at increased risk for CIN3+ (HR=1.24; 95% CI=1.03–1.49; p=0.020). CONCLUSION: In women of first-time ASCUS cytology, a program of repeat cytology can be an acceptable clinical option in low-resource settings. Caution should be taken especially in women with remote cervical screening history more than 5 years.

Clinical analysis of 128 cases of cervical lesion diagnosed by multi-point biopsy of colposcopy and endocervical curettage / 中华肿瘤杂志

Objective@#To investigate the clinical values of colposcopy and cervical biopsy and/or endocervical curettage (ECC) in the diagnosis of cervical lesion.@*Methods@#Clinical data of 128 cases of cervical lesion diagnosed by Xuzhou Cancer Hospital from January 23, 2014 to October 11, 2016 were collected and retrospectively analyzed, all patients underwent colposcopy and cervical biopsy and/or ECC.@*Results@#Among them, the age between 30 to 50 years old were 70 cases, whose transformation zone types of Ⅰ, Ⅱ and Ⅲ were 28 cases (40.0%), 23 cases (32.9%) and 19 cases (27.1%), respectively. The age older than 50 years were 45 cases, whose transformation zone types of Ⅱ and Ⅲ were 1 case (2.2%) and 44 cases (97.8%), respectively. Among the 128 cases of cervical lesions, diagnostic results of colposcopy showed that the chronic inflammation were 57 cases, cervical intraepithelial neoplasia (CIN)Ⅰwere 35 cases, CINⅡor CINⅡ~Ⅲ were 8 cases, CIN Ⅲ were 5 cases and cervical cancer were 23 cases. Alternatively, the pathological results showed that the chronic inflammation were 81 cases, CINⅠwere 17 cases, CINⅡor CINⅡ~Ⅲ were 7 cases, CIN Ⅲ were 5 cases and cervical cancer were 18 cases, respectively. Among the 81 cases of chronic inflammation diagnosed by pathology, 52 cases (64.2%) were consistent with the diagnostic results of colposcopy. Among the 17 cases of low grade squamous epithelial cell lesion (LSIL) diagnosed by pathology, 10 cases were in agree with the diagnostic results of colposcopy. Among the 12 cases of high-grade squamous epithelial cell lesion (HSIL) diagnosed by pathology, 9 cases were concordant with the diagnostic results of colposcopy. Among the 18 cases of cervical cancer diagnosed by pathology, 17 cases were consistent with the diagnostic results of colposcopy.@*Conclusions@#The type of transformation zone is positively correlated with the age, and it can help to choose biopsy and therapeutic manner. The diagnostic accuracies of HSIL and early stage of cervical cancer by multi-point biopsy of colposcopy and/or ECC are high. The cervical lesions which are difficultly found by direct visualization can be identified by colposcopy, and thus provides objective evidence to determine the therapeutic manner for patients with stage ⅡA of cervical cancer.

A high prevalence of human papillomavirus 16 and 18 co-infections in cervical biopsies from southern Brazil

ABSTRACT HPV types 16 and 18 were studied in paraffin-fixed cervical biopsy collected in southern Brazil. HPV 16, HPV 18 and co-infection HPV 16/18 were identified in 10/57 (17.5%), 4/57 (7%) and in 43/57 (75.4%) samples, respectively. Southern Brazil has one of the highest prevalence rates of HPV 16/18 reported.

A high prevalence of human papillomavirus 16 and 18 co-infections in cervical biopsies from southern Brazil

ABSTRACT HPV types 16 and 18 were studied in paraffin-fixed cervical biopsy collected in southern Brazil. HPV 16, HPV 18 and co-infection HPV 16/18 were identified in 10/57 (17.5%), 4/57 (7%) and in 43/57 (75.4%) samples, respectively. Southern Brazil has one of the highest prevalence rates of HPV 16/18 reported.

Value of combined application of high risk human papillomavirus DNAdetection and thinprep cytologic test for cervical cancer screening / 中国生化药物杂志

Objective To evaluate the diagnostic value of thinprep cytologic test (TCT) combined with high-risk human papillomavirus (HR-HPV) DNA for cervical cancer (CC). Methods 141 cases of patients with abnormal cervical lesions were abnormal examined by TCT and were graded by the results of TCT and cervical biopsy, the HR-HPV-DNA was detected by surface plasmon resonance (SPR). Results The cervical biopsy positive rate 65.2% (92/141) was significantly higher than the positive rate of TCT 39.0% (55/141) (χ2=19.45, P < 0.05). The positive rate of HR-HPV-DNA was 66.0% (93/141) was significantly higher than the positive rate of TCT 39.0% (55/141), (χ2=20.53, P < 0.05). Conclusion TCT, HR-HPV-DNA and cervical biopsy are important clinical diagnostic methods for cervical lesions, combine detection of TCT and HR-HPV-DNA can improve the detection rate of cervical lesions.

Analysis of the pap smear in the cervical cytopathology / 中国现代医生

Objective To evaluate cervical cytology smear in the screening of cervical cancer and precancerous lesions. Methods Analyzed the results of 13 751 cases of cervical smear cell detection by TBS classification, then compared the abnormal results with the pathological diagnosis of cervical biopsy. Results There were 515 positive in 13 751 cas-es. The positive rate was 3.78%. Among the 515 cases, 349 cases underwent cervical biopsy. There were 217 cases up-per than CIN, the positive rate was 62.18%. The coincidence rate was 79.50% between the cervical smear and cervical biopsy. Conclusion Cervical smear is a simple and effective method in screening of cervical cancer, it facilitates basic hospital in rural areas.

Biopsia de cérvix: serie de casos / Cervical biopsy: cases series

Objetivo: Realizar una descripción de los resultados de los estudios de anatomía patológica de biopsias de cérvix de pacientes atendidas en la Clínica Universitaria San Juan de Dios (Cartagena, Colombia). Metodología: Estudio de serie de casos de biopsias de cérvix tomadas durante tres meses de 2011. Resultados: Se seleccionaron 59 casos. La edad promedio fue de 46,017 años, con una SD de 10,47, con un rango entre 18 y 69 años y un 50 % de los valores centrales estuvo comprendido entre 42 y 52 años. El diagnóstico de patología más frecuentemente reportado fue la cervicitis crónica, con 32,2 %, seguido de LIE de bajo grado, con 16,9 %, y pólipo endocervical, 16,9 %, el LIE de alto grado estuvo en el 8,5 % de los casos y se identificó CA en 3 casos (5,1 %). Conclusiones: Las pacientes mayores son más atentas a realizarse citologías vaginales. Las LIEs se distribuyen en todos los grupos etáreos y en el 6,8 % se diagnosticó cáncer.

Objetives: To make a description of the results of the pathological studies of cervical biopsies from patients treated at the University Hospital San Juan de Dios. Methodology: Study of cases series of cervical biopsies taken during three months of 2011. Results: 59 cases were selected. The average age of 46.017 years in a SD of 10.47 with a range between 18 and 69 years and 50% of the mean values were between 42 and 52 years. The most frequent pathology diagnosis reported was chronic cervicitis 32.2%, followed by low-grade SIL with 16.9% and 16.9% endocervical polyp, the high-grade SIL was at 8.5% of CA case was identified in 3 cases (5.1%). Conclusions: The elderly patients are more prone to perform Pap smears. The IELs are distributed in all age groups, and 6.8% were diagnosed with cancer.