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International Journal of Gynecological Pathology

Sandra Lee, Marianne S Rose, Vikrant V Sahasrabuddhe, Rachel Zhao, Máire A Duggan
Immunohistochemistry is widely used to support a pathology diagnosis of cervical adenocarcinoma despite the absence of a systematic review and meta-analysis of the published data. This systematic review and meta-analysis was performed to investigate the sensitivity and specificity of immunohistochemistry biomarkers in the tissue-based diagnosis of cervical adenocarcinoma histotypes compared with normal endocervix and benign glandular lesions. The systematic review and meta-analysis used a PICOT framework and QUADAS-2 to evaluate the quality of included studies...
October 31, 2016: International Journal of Gynecological Pathology
Rajeev Shah, W Glenn McCluggage
We report 3 cases of primary extraovarian unclassifiable malignant sex cord-stromal tumors. In all cases, the tumors involved the pelvis, peritoneum, and/or omentum and the morphologic features were essentially those of a poorly differentiated malignant neoplasm. A diagnosis of sex cord-stromal tumor was made on the basis of expression of several markers of ovarian sex cord-stromal tumors and exclusion of other neoplasms. In 1 case, an elevated serum testosterone was present at tumor progression. In reporting these cases, we draw attention to the problems in establishing a diagnosis that can be attributed to the extreme rarity of sex cord-stromal tumors in an extraovarian location and the rarity of unclassifiable malignant sex cord-stromal tumors in general, resulting in pathologists not considering this diagnosis...
October 31, 2016: International Journal of Gynecological Pathology
Colin J R Stewart, Louise M Stewart, C D'Arcy J Holman, Susan Jordan, James Semmens, Katrina Spilsbury, Timothy Threlfall
Ovarian neoplasia comprises a heterogenous group of tumors with distinct clinicopathologic and molecular features and therefore assessment of potential risk factors should be tumor subtype specific. As part of ongoing epidemiological investigations of ovarian neoplasia in Western Australia, we performed an initial review of original pathology reports followed, in selected cases, by reassessment of histology material to optimize accurate diagnosis. Additional immunohistochemistry, often using antibodies unavailable at the time of initial assessment, was also performed as required...
October 31, 2016: International Journal of Gynecological Pathology
Vatsal Patel, Edward J Wilkinson, Srikar Chamalan, Xiaomin Lu, Jacqueline Costagno, Demaretta Rush
Endometrial thickness as measured by transvaginal ultrasound (TVUS) is being increasingly used as a first-line method to evaluate patients with vaginal bleeding. Our study aims to examine correlation between the histopathologic diagnosis and the results of TVUS and find a threshold that could reliably exclude carcinoma. We included women, age 55 years and above, who presented with postmenopausal bleeding and had a TVUS within 30 days of their endometrial biopsy. Total of 304 patients met our criteria and were divided into 4 groups...
October 31, 2016: International Journal of Gynecological Pathology
Jonathan J Davick, Megan Samuelson, James T Krone, Colleen K Stockdale
Women with vulvar lichen sclerosus (LS) have an increased risk of developing differentiated vulvar intraepithelial neoplasia and vulvar squamous cell carcinoma (SCC). Our primary aim was to determine the prevalence of LS among women with vulvar SCC. All patients who underwent excision for invasive SCC of the vulva from January 1, 2009 to December 31, 2013 were identified by searching our institution's electronic laboratory information system (n=111). The vulvar excision specimens from these patients were reviewed for the presence of adjacent LS...
October 31, 2016: International Journal of Gynecological Pathology
Rania Kilzieh, Natalia Rakislova, Aureli Torné, Rafael Salvador, Alfons Nadal, Jaume Ordi, Adela Saco
The malignant transformation of endometriosis is very uncommon. Whereas 75% of tumors arising from endometriosis arise in the ovary, location in extra-genital organs is rare and mesenchymal neoplasms are exceptional. A 47 year-old woman who underwent hysterectomy with bilateral salpingo-ooforectomy due to endometriosis 13 years before presented with abdominal pain. The magnetic resonance imaging (MRI) showed a 9.7×7.5 cm solid-cystic supravesical mass and a recto-vaginal tumor, as well as endometriotic nodules in the sigma, right parametrium and peritoneum that had significantly increased in size over a six months period...
October 31, 2016: International Journal of Gynecological Pathology
Sharon B Sams, Julie A Rosser
Urothelial carcinoma (UC) rarely metastasizes to the gynecologic tract, occurring in descending order of frequency, within the vagina, uterus, ovaries, and cervix. Significant morphologic overlap exists between primary gynecologic squamous lesions (both benign and malignant) and metastatic UC, thus potentially hindering a timely and accurate diagnosis. We present a case of UC metastatic to the uterine cervix in a 69-year-old female initially found to have noninvasive high-grade papillary UC of the bladder. Complaints of vaginal spotting lead to identification and biopsy of a mass in the uterine cervix...
October 31, 2016: International Journal of Gynecological Pathology
Abhijit Chougule, Priya Singh
No abstract text is available yet for this article.
October 31, 2016: International Journal of Gynecological Pathology
Jeffrey D Seidman, Jayashree Krishnan
Ovarian epithelial inclusions lined by mucinous epithelium are rare and of uncertain origin. Ovaries containing such inclusions were studied in 42 women. The inclusions were divided into 3 groups: serous epithelial lined with typical ciliated morphology but with distinct basophilic cytoplasmic mucin in some or all of the lining cells, those lined by typical mucinous epithelium, and those lined by a combination of typical mucinous epithelium and serous epithelium. The mean patient age was 61.5 years. Pure mucinous inclusions were found in 27 patients, serous-type inclusions with cytoplasmic mucin in 20, and mixed type in 10...
October 31, 2016: International Journal of Gynecological Pathology
W Glenn McCluggage, Lynn Hirschowitz, C Blake Gilks, Nafisa Wilkinson, Naveena Singh
Accumulating recent evidence suggests that the majority of extrauterine high-grade serous carcinomas (HGSCs) do not arise from the ovary as historically accepted but from the distal, fimbrial end of the fallopian tube from a precursor known as serous tubal intraepithelial carcinoma. There has been variable acceptance of this evidence among pathologists and clinicians dealing with "ovarian" cancer and this has resulted in wide variation in the assignment of primary site between different institutions when HGSC involves >1 anatomic site...
October 31, 2016: International Journal of Gynecological Pathology
Satoru Kudose, Hannah R Krigman
Although intravascular thrombi and infarct-type necrosis have been reported in leiomyomas following with tranexamic acid therapy, intratumoral vasculopathy resembling acute atherosis has not been reported to date in patients without exposure to gonadotropin receptor agonist. We describe a case of intratumoral vasculopathy resembling acute atherosis in a leiomyoma in a 49-year-old woman, with hereditary hemorrhagic telangiectasia and menorrhagia, treated with tranexamic acid. The patient had no exposure to gonadotropin receptor agonists...
October 31, 2016: International Journal of Gynecological Pathology
Brooke E Howitt, Marisa R Nucci, Robert H Young
No abstract text is available yet for this article.
November 2016: International Journal of Gynecological Pathology
Susanna Maddali Bongi, Martina Orlandi, Angelina De Magnis, Daniela Moncini, Angela Del Rosso, Felice Galluccio, Alessandro Franchi
The goal of this study was to evaluate the characteristics and the prevalence of histopathologic and immunohistochemical changes in vulvar biopsies, in women with Primary Sjögren Syndrome (pSS) and non-Sjögren Sicca Syndrome (nS-SS). Twenty-one women with pSS and 11 with nS-SS (investigated by xerophtalmia and xerostomia tests, biopsy of minor salivary glands, gynecological history, and gynecologic symptoms score) underwent vulvar biopsies, evaluated for histopathologic and immunohistochemicalchanges, and compared with those obtained from 26 patients with lichen sclerosus...
November 2016: International Journal of Gynecological Pathology
Stephanie Gray, Yongxin Chen, Tyler Litton, Bassel Jallad, Nishant Poddar, John T Hoff, Katie Schroeder, Jason Taylor, Jula Veerapong, Jin-Ping Lai
Well-differentiated neuroendocrine tumors (NET) of the ileum are generally slow-growing tumors with metastatic potential that may cause systemic symptoms from the secretion of serotonin, cortisol, and other biologically active substances. Likewise, steroid cell tumors of the ovary are slow-growing tumors that cause systemic symptoms from the functional production of androgens, estrogens, and other hormones. To the best of our knowledge, synchronous ileal NET and ovarian steroid cell tumors have not been previously reported in the English literature...
November 2016: International Journal of Gynecological Pathology
Stefano Fratoni, Elisabetta Abruzzese, Malgorzata M Trawinska, Pasquale Niscola, Paolo de Fabritiis, Giuseppe Santeusanio
A very rare case of primary diffuse large B-cell lymphoma of the uterine cervix characterized by "spindle cell variant" morphology ("sarcomatoid subtype") is described along with a discussion of the challenging diagnosis due to its rarity and presenting clinical and pathological features.
November 2016: International Journal of Gynecological Pathology
Emily A Goebel, W Glenn McCluggage, Joanna C Walsh
Sclerosing stromal tumor of the ovary is a rare neoplasm that typically occurs in the second and third decades of life. To date, all reported cases have behaved in a benign manner. In their usual form, these neoplasms exhibit scant, if any, mitotic activity. Herein, we report a case series of 6 sclerosing stromal tumors with increased mitotic activity (between 7 and 12 mitoses per 10 high-power fields in the most mitotically active areas). Follow-up is available in 4 of 6 cases (ranging from 3 wk to 68 mo) and 1 tumor recurred within the pelvis...
November 2016: International Journal of Gynecological Pathology
Cheng Liu, Renee L Gallagher, Gareth R Price, Elizabeth Bolton, Christopher Joy, James Harraway, Deon J Venter, Jane E Armes
Microcystic stromal tumor (MST) is a rare tumor of presumed sex-cord stromal differentiation. We present a case of MST arising within a patient with constitutional 5q deletion syndrome, whose deletion encompassed the APC gene. Genomic analysis of the MST revealed a point mutation in the remaining APC allele, predicted to result in abnormal splicing of Exon 7. Subsequent clinical investigation revealed multiple gastrointestinal polyps qualifying for a diagnosis of familial adenomatous polyposis. This case emphasizes the importance of an aberrant Wnt/β-catenin pathway in the development of MST and adds credence to the inclusion of MST as a rare phenotype of familial adenomatous polyposis...
November 2016: International Journal of Gynecological Pathology
Ali Sakhdari, Parnian A Moghaddam, Yuxin Liu
Approximately 75% of endometrial cancer occurs in women older than 55 yr of age. Postmenopausal bleeding is often considered endometrial cancer until proven otherwise. One diagnostic challenge is that endometrial biopsy or curettage generally yields limited samples from elderly patients. There are no well-defined and unified diagnostic criteria for adequacy of endometrial samples. Pathologists who consider any sample including those lacking endometrial tissue as "adequate" run the risk of rendering false-negative reports; on the contrary, pathologists requiring ample endometrial glands along with stroma tend to designate a greater number of samples as "inadequate," leading to unnecessary follow-up...
November 2016: International Journal of Gynecological Pathology
Susan M Bigby, Lois J Eva, Kah Leng Fong, Ronald W Jones
Squamous cell carcinoma of the vulva (SCCV) develops through either human papillomavirus (HPV)-dependent or HPV-independent pathways. Approximately 60% of SCCV arise independently of HPV, commonly in a background of an inflammatory dermatosis, particularly lichen sclerosus. The likely direct precursor to most of these lesions is vulvar intraepithelial neoplasia (VIN), differentiated type (dVIN), although the evidence is largely circumstantial. There are few reports of progression to carcinoma, and the natural history of this pathway is not well understood...
November 2016: International Journal of Gynecological Pathology
Jeffrey D Seidman, Jayashree Krishnan
Most non-neoplastic lesions of the ovaries have not been comprehensively examined in the contemporary literature. We evaluated completely embedded ovaries from 403 unselected, consecutive patients who had grossly normal adnexa. These included prophylactic specimens in high-risk women with BRCA mutations (38 women) and women with a personal history of breast cancer or a family history of breast and/or ovarian cancer (79 women). Transitional cell (Brenner) nests were found in 9.1%; 31% of these lesions were smaller than 1 mm, and 8 were solitary nests...
November 2016: International Journal of Gynecological Pathology
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