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Kim TJ, Kim HS, Park CT, Park IS, Hong SR, Park JS, Shim JU. Clinical evaluation of follow-up methods and results of atypical glandular cells of undetermined significance (AGUS) detected on cervicovaginal Pap smears. Gynecol Oncol 1999; 73:292-8. [PMID: 10329049 DOI: 10.1006/gyno.1999.5360] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the efficacy of the follow-up methods and results of atypical glandular cells of undetermined significance (AGUS) detected on cervicovaginal Pap smears. METHODS From May 1991 to December 1996, we have performed 407, 451 cervicovaginal Pap smears, of which 326 patients were identified as AGUS. Of the 326 patients, 268 patients were followed by repeat Pap smears, colposcopy, cone biopsy, or endometrial curettage. RESULTS The incidence of AGUS on Pap smears is approximately 0.08%. The mean age of the patients was 43 years (range 22-79 years). The most common complaint was abnormal vaginal bleeding. The gross findings of the cervix were normal to mild erosion. The following past histories of patients could affect the AGUS results on Pap smear: 30 had cone biopsy, 21 had Pap smears on pregnancy and within 8 weeks after delivery or evacuation, 3 were on hormonal replacement therapy, 2 had intrauterine devices for contraception, and 5 were undergoing follow-up after treatment of cervical cancer. The benign lesions detected during follow-up periods were 6 microglandular hyperplasia of the cervix, 5 atypical squamous metaplasia of the cervix, 2 cervical endometriosis, 2 tubal metaplasia, 10 cervical myoma, 11 cervical polyps, 9 endometrial polyps, 3 uterine myoma, 1 pelvic endometriosis, 1 ovarian endometriosis, and 4 uterine adenomyosis. The premalignant or malignant lesions of the cervix were 4 low-grade squamous intraepithelial lesions, 24 high-grade squamous intraepithelial lesions, 8 glandular atypia/dysplasia, 5 adenocarcinoma in situ, 3 microinvasive adenocarcinoma, and 4 invasive adenocarcinoma. The neoplastic lesions of the uterus were 6 endometrial hyperplasia, 11 endometrial adenocarcinoma, 1 malignant mixed Müllerian tumor, and 1 metastatic endometrial adenocarcinoma. Sixty-seven (25%) of 268 patients followed up were identified as having clinically significant lesions of the cervix or uterus. The detection rates of abnormal lesions were 3.1% with repeated Pap smears (3/98), 28.4% with colposcopic-directed biopsy (31/109), 63.6% with cone biopsy (35/55), and 29.7% with endometrial curettage (19/64). CONCLUSION AGUS on Pap smears showed various benign and malignant lesions of the cervix or uterus. The clinicians must communicate with the pathologists regarding the patient's clinical information as well as the origin of the atypical glandular cells in Pap smears. We recommend that patients with AGUS on Pap smear should undergo immediate intensive diagnostic studies, including colposcopic-directed biopsy with endocervical curettage or cone biopsy, to detect cervical lesions and endometrial curettage to detect endometrial lesions.
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277
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Makanin MA, Zagvodkin SS, Shishkina VA. [A case of primary actinomycosis of internal female genitalia]. KLINICHESKAIA MEDITSINA 1999; 76:60-1. [PMID: 10067297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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278
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Waldhuber MG, Denham I, Wadey C, Leong-Shaw W, Cross GF. Detection of herpes simplex virus in genital specimens by type-specific polymerase chain reaction. Int J STD AIDS 1999; 10:89-92. [PMID: 10215112 DOI: 10.1258/0956462991913691] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Viral isolation is the standard method for the detection of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in clinical specimens. This study describes the development of a type-specific polymerase chain reaction (PCR) assay for detection and typing of HSV-1 and HSV-2, and a comparison of its sensitivity with that of isolation in a clinical setting. Specimens from patients presenting with genital ulcers were tested for the presence of HSV by both methods. Oligonucleotide primers were selected to enable type-specific amplification of HSV-1 and HSV-2 DNA. Conditions were optimized to allow detection and typing from a single reaction tube using a multi-primer PCR method. When compared with PCR, the sensitivity of isolation was 67% and the specificity 97%. This protocol allowed rapid, sensitive and accurate detection and typing of HSV with a single PCR assay.
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279
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Maiti H, Al-Izzi M. When recurrent genital sores are not genital herpes. Sex Transm Infect 1999; 75:58-9. [PMID: 10448345 PMCID: PMC1758181 DOI: 10.1136/sti.75.1.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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280
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Olivé A, Fuente MJ, Veny A, Romeu J. Vasculitis and oral and genital ulcers: Behçet's syndrome or HIV infection? Clin Exp Rheumatol 1999; 17:124. [PMID: 10084048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
MESH Headings
- Adult
- Anti-HIV Agents/therapeutic use
- Anti-Inflammatory Agents/therapeutic use
- Behcet Syndrome/complications
- Behcet Syndrome/drug therapy
- Behcet Syndrome/pathology
- Drug Therapy, Combination
- Female
- Genital Diseases, Female/drug therapy
- Genital Diseases, Female/etiology
- Genital Diseases, Female/pathology
- HIV Infections/complications
- HIV Infections/drug therapy
- HIV Infections/pathology
- Humans
- Oral Ulcer/drug therapy
- Oral Ulcer/etiology
- Oral Ulcer/pathology
- Prednisone/therapeutic use
- Recurrence
- Ulcer/drug therapy
- Ulcer/etiology
- Ulcer/pathology
- Vasculitis, Leukocytoclastic, Cutaneous/drug therapy
- Vasculitis, Leukocytoclastic, Cutaneous/etiology
- Vasculitis, Leukocytoclastic, Cutaneous/pathology
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281
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Brady M, Brook G. Influence of genital infection on cervical cytology. Sex Transm Infect 1998; 74:457-8. [PMID: 10195065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
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282
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Abstract
BACKGROUND Condyloma acuminatum, an infection caused by human papillomavirus (HPV), has become one of the most common sexually transmitted diseases. Correspondingly, anogenital warts are more frequently diagnosed in children. Twenty-five years ago a landmark prospective study showed that untreated common cutaneous warts in children spontaneously regress within 2 years in two thirds of cases, but a similar study of condyloma has not been published. Several treatment options are available for condyloma in adults; none have been studied or approved by the US Food and Drug Administration for treatment of children. OBJECTIVE Our purpose was to review a cohort of children with condyloma to determine the natural history. METHODS Of 75 originally identified subjects with condyloma, 41 qualified for further retrospective or prospective evaluation, including distribution of lesions, duration of disease, gender, and treatment, if any. RESULTS Overall, condylomas in 31 of 41 children (76%) experienced resolution. Spontaneous resolution occurred within 5 years in 22 of 41 subjects (54%), including 6 of 8 (75%) who never received treatment, and 16 of 33 (49%) in whom treatment failed. In 9 of 33 treated children (27%), resolution occurred during treatment. Girls presented three times more often than boys and resolution occurred comparatively more often in girls. CONCLUSION Spontaneous resolution of pediatric condyloma occurred in more than half of our subjects. Nonintervention is a reasonable initial approach to managing venereal warts in children.
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283
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Clark R, Anderson J. Idiopathic genital ulcer disease in an HIV-infected woman. AIDS Patient Care STDS 1998; 12:819-23. [PMID: 11362037 DOI: 10.1089/apc.1998.12.819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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284
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Bishop JW, Emanuel JM, Sims KL. Disseminated mucosal papilloma/condyloma secondary to human papillomavirus. Am J Surg Pathol 1998; 22:1291-5. [PMID: 9777992 DOI: 10.1097/00000478-199810000-00015] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This report details the histopathologic findings in a woman who acquired the human papillomavirus 6/11 in her late teens and developed papilloma/condyloma of the nasopharynx, oropharynx, anogenital region, urethra, and urinary bladder. General evaluations of immune function reveal no defect, and there was no evidence of HIV infection. The morphologic expression of HPV 6/11 infection appears to be completely dependent on the mucosal epithelium affected. The complete spectrum of benign and premalignant epithelial changes induced by the human papillomavirus family-papilloma, verrucae, condyloma acuminatum, epithelial hyperplasia, and dysplasia-were present in this patient with a single papillomavirus infection. We postulate that this patient has a specific immune deficiency that limits her ability to control local infection and spread of the papillomavirus.
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285
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Mertz KJ, Weiss JB, Webb RM, Levine WC, Lewis JS, Orle KA, Totten PA, Overbaugh J, Morse SA, Currier MM, Fishbein M, St Louis ME. An investigation of genital ulcers in Jackson, Mississippi, with use of a multiplex polymerase chain reaction assay: high prevalence of chancroid and human immunodeficiency virus infection. J Infect Dis 1998; 178:1060-6. [PMID: 9806035 DOI: 10.1086/515664] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
In 1994, an apparent outbreak of atypical genital ulcers was noted by clinicians at the sexually transmitted disease clinic in Jackson, Mississippi. Of 143 patients with ulcers tested with a multiplex polymerase chain reaction (PCR) assay, 56 (39%) were positive for Haemophilus ducreyi, 44 (31%) for herpes simplex virus, and 27 (19%) for Treponema pallidum; 12 (8%) were positive for > 1 organism. Of 136 patients tested for human immunodeficiency virus (HIV) by serology, 14 (10%) were HIV-seropositive, compared with none of 200 patients without ulcers (P < .001). HIV-1 DNA was detected by PCR in ulcers of 6 (50%) of 12 HIV-positive patients. Multivariate analysis indicated that men with chancroid were significantly more likely than male patients without ulcers to report sex with a crack cocaine user, exchange of money or drugs for sex, and multiple sex partners. The strong association between genital ulcers and HIV infection in this population highlights the urgency of preventing genital ulcers in the southern United States.
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286
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Oztürk F, Gürses N, Sancak R, Bay A, Baris S. Acquired secondary syphilis in a 6-year-old girl with no history of sexual abuse. Cutis 1998; 62:150-1. [PMID: 9770132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
A case of secondary syphilis acquired by nonsexual household contact in a prepubertal girl is presented.
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287
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Tyring SK, Arany I, Stanley MA, Tomai MA, Miller RL, Smith MH, McDermott DJ, Slade HB. A randomized, controlled, molecular study of condylomata acuminata clearance during treatment with imiquimod. J Infect Dis 1998; 178:551-5. [PMID: 9697742 DOI: 10.1086/517472] [Citation(s) in RCA: 205] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Imiquimod, an immune response modifier, has been demonstrated to be safe and effective in the treatment of external genital and perianal warts caused by human papillomavirus (HPV). To identify the molecular mechanism(s) by which condylomata acuminata clear during topical treatment with imiquimod, wart skin biopsies were taken from patients before treatment, at treatment week 6, and at the end of treatment. Tissues were analyzed for HPV DNA and for mRNA of several cytokines and HPV gene products. Wart clearance was associated with evidence of tissue production of interferon-alpha, -beta, and -gamma and tumor necrosis factor-alpha. Regression of warts was strongly associated with a decrease in HPV DNA and in mRNA expression for both early and late viral proteins. Thus, topical imiquimod treatment of anogenital warts led to significant increases in local production of multiple interferon mRNAs and a significant reduction in virus load as measured by decreases in HPV DNA and mRNA for early HPV proteins.
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MESH Headings
- Administration, Topical
- Adolescent
- Adult
- Aminoquinolines/therapeutic use
- Condylomata Acuminata/drug therapy
- Condylomata Acuminata/immunology
- Condylomata Acuminata/pathology
- Condylomata Acuminata/virology
- Cytokines/analysis
- Cytokines/genetics
- Female
- Genital Diseases, Female/drug therapy
- Genital Diseases, Female/immunology
- Genital Diseases, Female/pathology
- Genital Diseases, Female/virology
- Genital Diseases, Male/drug therapy
- Genital Diseases, Male/immunology
- Genital Diseases, Male/pathology
- Genital Diseases, Male/virology
- Humans
- Imiquimod
- Interferon Inducers/therapeutic use
- Male
- RNA, Messenger
- Treatment Outcome
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288
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Francke ML, Mihaescu A, Chaubert P. Isolated necrotizing arteritis of the female genital tract: a clinicopathologic and immunohistochemical study of 11 cases. Int J Gynecol Pathol 1998; 17:193-200. [PMID: 9656113 DOI: 10.1097/00004347-199807000-00001] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Isolated necrotizing arteritis (INA) of the polyarteritis-nodosa type localized to the female genital tract is rare. Approximately 30 case reports have been published to date. Eleven additional patients are described here, all with a favorable follow-up. INA is usually localized in the uterine cervix, but, when multifocal lesions are present, the latter is almost always involved. Patients most frequently report menorrhagia or postmenopausal bleeding. With immunohistochemical studies, immune-complex deposits (IgM, IgG, and C'3) in 7 of 11 patients with INA of the female genital tract were demonstrated for the first time. The inflammatory cells were composed mainly of T-lymphocytes with macrophages and scarce B-lymphocytes also present. These results suggest that INA is primarily an immune complex-mediated disease, implicating humoral and cellular mediator systems. Possible pathogenetic factors of INA are immune complex-mediated hypersensitivity reactions to drugs, foreign materials (after cone biopsy or curettage), and cancers, or an autoimmune reaction against constituents of the vessel walls caused by tissue injury after local surgical intervention through in situ immune-complex formation.
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289
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Meyer T, Arndt R, Christophers E, Beckmann ER, Schröder S, Gissmann L, Stockfleth E. Association of rare human papillomavirus types with genital premalignant and malignant lesions. J Infect Dis 1998; 178:252-5. [PMID: 9652449 DOI: 10.1086/517447] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Due to the limited number of reports concerning their association with particular dysplastic and neoplastic lesions, the oncogenic potential of so-called rare or novel human papillomavirus (HPV) types is still unclear. Cytologic smears or biopsy specimens from 538 patients were analyzed for dysplastic or neoplastic lesions and HPV infection. The HPV detection and typing system utilized allowed identification of all mucosal HPVs amplifiable by L1 polymerase chain reaction. Considering only patients infected with a single HPV type (n = 329), rare or novel HPVs (HPV-59, HPV-61, HPV-62, HPV-66, HPV-70, HPV-73, MM4, MM7, MM8, CP6108, and CP8304) were detected in 28% of normal specimens (n = 46), none of condylomatous lesions (n = 44), 12% of low-grade squamous intraepithelial lesions (SILs) (n = 42), 8% of high-grade SILs (n = 142), and 4% of cervical cancers (n = 54). Prevalence and oncogenic potential of distinct rare HPV types seems to be higher than previously assumed.
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290
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Wang KG, Chen TC, Wang TY, Yang YC, Su TH. Accuracy of frozen section diagnosis in gynecology. Gynecol Oncol 1998; 70:105-10. [PMID: 9698484 DOI: 10.1006/gyno.1998.5057] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE A retrospective study was undertaken to evaluate the accuracy of frozen section diagnosis in gynecological surgery. METHODS We compared the results of 792 consecutive gynecological frozen section diagnoses with their final diagnoses from January 1991 to June 1996. Slides for which the frozen section diagnosis was uncertain or incompatible with the final diagnosis were reviewed by an attending pathologist to determine the possible causes. RESULTS A total of 299 ovarian, 390 lymph node, 56 uterine lesions, and 77 other tissue samples were obtained. The frozen section diagnosis was compatible with the final diagnosis in 97.5% of cases. The sensitivity for nonbenign lesions was 90.9%, and the specificity was 99.5%. There were no false positives or overestimated cases; 1.3% of cases were falsely negative, 0.4% underestimated the degree of malignancy, and 0.9% were uncertain. Possible causes for incompatible or uncertain frozen section diagnoses were analyzed. The accuracy of frozen section diagnoses for ovarian, lymph node, uterine, and other tissues was also evaluated. Frozen section was found to identify correctly 13 of 17 ovarian malignancies metastaic from other organs, 14 of 15 germ cell malignancies, and 3 of 4 dysgerminomas. The low sensitivity in ovarian borderline malignancy was due to the even lower sensitivity in its mucinous subgroup. The relationship between section numbers and accuracy of frozen section diagnosis in mucinous ovarian tumors was assessed. CONCLUSIONS Frozen section diagnosis in gynecology is sufficiently accurate for clinical use, with a low false negative rate and an even lower false positive rate. Most incompatible frozen section diagnoses occurred in ovarian lesions, especially in mucinous ovarian tumors. Performing multiple sections (at least one section for every 10 cm in diameter) is recommended in the frozen section diagnosis of mucinous ovarian tumors.
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291
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Marzano AV, Gasparini G, Grammatica A, de Juli E, Caputo R. Langerhans cell histiocytosis and thyroid carcinoma. Br J Dermatol 1998; 138:909-10. [PMID: 9666849 DOI: 10.1046/j.1365-2133.1998.02239.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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292
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Proposed guidelines for secondary screening (rescreening) instruments for gynecologic cytology. Intersociety Working Group for Cytology Technologies. Acta Cytol 1998; 42:273-6. [PMID: 9479352 DOI: 10.1159/000331558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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293
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Chauffaille MDL, Valério RM, Diniz CM, Simões MM, Enokihara S, Michalany N, Ferreira KV, Martinez JA, Hassun KM, Atallah AN, Kerbauy J. Langerhans cell histiocytosis. SAO PAULO MED J 1998; 116:1625-8. [PMID: 9699385 DOI: 10.1590/s1516-31801998000100006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The authors present a rare case of Langerhans cell histiocytosis in a 31 year old female patient with vulvar, peri-anal and oral lesions, diabetes insipidus, pulmonary skin and bone infiltrations. Skin biopsy immunohistochemistry presented positive S100 protein and vimentin, but the diagnosis was done with the demonstration of Birbeck granules with electronic microscopy. The treatment was based on systematical chemotherapy although vulvar lesion has a bad response to chemotherapy.
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294
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Bykov VL. [Dendritic antigen-presenting cells of the distal section of the female reproductive tract in normal, experimental and in pathological conditions]. Arkh Patol 1997; 59:69-74. [PMID: 9483225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Female lower genital tract (the vulva, vagina and uterine cervix) contains a system of dendritic antigen-presenting cells (APCs) which are the main elements of the afferent limb of its local immune system. These cells are found both in mucosal epithelium and lamina propria and possess specific ultrastructural, cytochemical, immunocytochemical and functional properties. Most numerous and well-studied populations of APCs in female lower genital tract are Langerhans cells which are highly sensitive to hormones and noxious factors. This review summarizes recent data on distribution, morphological and functional characteristics of dendritic APCs in female lower genital tract under normal and experimental conditions and in some pathological states (viral infections, preneoplastic and neoplastic processes).
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295
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Patel VH, Somers S. MR imaging of the female pelvis: current perspectives and review of genital tract congenital anomalies, and benign and malignant diseases. CRITICAL REVIEWS IN DIAGNOSTIC IMAGING 1997; 38:417-99. [PMID: 9391749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
MR imaging continues to be an integral problem-solving modality in the evaluation of congenital anomalies and acquired diseases of the female genital tract organs and provides effective clinical information to the practicing gynecologist in those patients in whom sonography is technically suboptimal or the results are equivocal. This article describes the state-of-the art MR imaging of the female pelvis and addresses its current perspectives in the following sections: (1) technical aspects of MR in imaging the female pelvis, (2) normal pelvic anatomy and variations that are seen on MRI, (3) role of MRI in the diagnosis of congenital uterine and vaginal anomalies, (4) MR imaging approach to diagnose congenital uterine and vaginal anomalies, (5) advantages and limitations of MR in the evaluation of various benign diseases and malignant neoplasms of the female genital tract, (6) a MR staging system and criteria for each gynecologic malignancy, (7) fundamental MR criteria to differentiate benign from malignant tumors and recurrent tumors from fibrosis, and (8) the present cost-effective value of MR in pregnancy and obstetrics. Magnetic resonance (MR) technology continues to be an important problem-solving modality in the evaluation of benign, malignant, and recurrent diseases of the female pelvic organs with the development of new software and improved hardware over the last few years. The main issues addressed in this article are (1) to review the basic and expanded applications of the current state-of-the art MR imaging in the diagnosis and management of various congenital and acquired disorders of the female pelvic organs, (2) to illustrate a simplified clinico-radiologic (MRI) approach to the diagnosis of congenital and acquired pathologies of the pelvic organs, (3) to provide relevant information to the clinicians to make rational choices among the competing imaging modalities, and (4) to outline the future potential of this modality in the pelvis.
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MESH Headings
- Adolescent
- Adult
- Aged
- Child
- Child, Preschool
- Diagnosis, Differential
- Female
- Genital Diseases, Female/diagnosis
- Genital Diseases, Female/pathology
- Genital Neoplasms, Female/diagnosis
- Genital Neoplasms, Female/pathology
- Genitalia, Female/abnormalities
- Genitalia, Female/pathology
- Humans
- Image Enhancement/instrumentation
- Infant
- Infant, Newborn
- Magnetic Resonance Imaging/instrumentation
- Middle Aged
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/pathology
- Neoplasm Staging
- Pregnancy
- Reference Values
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296
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Darville T, Andrews CW, Laffoon KK, Shymasani W, Kishen LR, Rank RG. Mouse strain-dependent variation in the course and outcome of chlamydial genital tract infection is associated with differences in host response. Infect Immun 1997; 65:3065-73. [PMID: 9234755 PMCID: PMC175432 DOI: 10.1128/iai.65.8.3065-3073.1997] [Citation(s) in RCA: 141] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Whether there is a pathogenic or protective outcome to chlamydial infection may be defined by the host response. We infected C57BL/6 (C57) and C3H/HeN (C3H) mice with the human biovar of Chlamydia trachomatis, serovar E, and, in select experiments, with the mouse pneumonitis agent of C. trachomatis (MoPn). We compared the courses of infection, histopathology, and host responses that resulted from these infections. The duration of infection with either chlamydial biovar was significantly increased in the C3H strain of mice. The intensity of infection was examined in mice infected with serovar E, and it was significantly increased in the C3H strain. Histopathology revealed the incidence of severe hydrosalpinx to be significantly greater in C3H mice than in C57 mice. In contrast, severe distention of the uterine horns was observed in all infected C57 mice compared to none of the C3H mice infected with serovar E and only 25% of those infected with MoPn. Acute inflammation was significantly increased in the uterine horns of C57 mice compared to that of C3H mice. Examination of antigen-specific responses revealed qualitatively similar responses in the two strains. Determination of gamma interferon- versus interleukin 4- producing cells revealed the predominance of a Th1 response in both strains. Serum enzyme-linked immunosorbent assays for immunoglobulin G1 (IgG1) and IgG2a revealed a predominance of IgG2a antibody in both strains, although the levels of antibody were significantly greater in C3H mice. Lymphocyte proliferation studies revealed increased proliferation in the iliac nodes of both strains at 1 to 3 weeks after infection. Because of the early eradication of infection observed in the C57 strain, we explored the relative production of tumor necrosis factor alpha (TNF-alpha) in the two strains. TNF-alpha levels were significantly increased in the genital tract secretions of C57 mice compared to that of C3H mice during the first week of infection. Increased TNF-alpha may be beneficial to the host by leading to earlier eradication of infection, thereby preventing infection of the oviduct and thus the major disease sequelae associated with chlamydial infection of the genital tract.
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297
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Kinkel K, Ariche M, Tardivon AA, Spatz A, Castaigne D, Lhomme C, Vanel D. Differentiation between recurrent tumor and benign conditions after treatment of gynecologic pelvic carcinoma: value of dynamic contrast-enhanced subtraction MR imaging. Radiology 1997; 204:55-63. [PMID: 9205223 DOI: 10.1148/radiology.204.1.9205223] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE To compare dynamic contrast material-enhanced subtraction and T2-weighted spin-echo (SE) magnetic resonance (MR) imaging in the differentiation of fibrosis from tumor recurrence during the follow-up of treated gynecologic pelvic malignancy. MATERIALS AND METHODS Thirty-four patients (aged 24-82 years) with 18 benign and 35 malignant lesions confirmed by means of surgery (n = 18), biopsy (n = 25), or 18-month follow-up examination (n = 10) underwent dynamic contrast-enhanced subtraction and T2-weighted SE MR imaging. Contrast material enhancement of an abnormal pelvic structure within the first 90 seconds on dynamic contrast-enhanced subtraction images or high signal intensity on T2-weighted SE images was considered indicative of malignancy. RESULTS The sensitivity, specificity, accuracy, and positive and negative predictive values were 91%, 67%, 83%, 86%, and 86%, respectively, for dynamic contrast-enhanced subtraction imaging and 91%, 22%, 68%, 70%, and 57%, respectively, for T2-weighted SE imaging. More lesions were correctly classified with dynamic contrast-enhanced subtraction imaging than with T2-weighted SE imaging (P < .01). CONCLUSION Dynamic contrast-enhanced subtraction imaging is more accurate than T2-weighted SE imaging for differentiating fibrosis from tumor recurrence during the follow-up of treated gynecologic pelvic malignancy. However, use of both sequences is recommended.
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298
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Avci O, Gürler N, Güneş AT. Efficacy of cyclosporine on mucocutaneous manifestations of Behçet's disease. J Am Acad Dermatol 1997; 36:796-7. [PMID: 9146551 DOI: 10.1016/s0190-9622(97)80354-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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299
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300
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Amin MB, Young RH. Primary carcinomas of the urethra. Semin Diagn Pathol 1997; 14:147-60. [PMID: 9179975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Urethral carcinomas are rare, and information reported in the literature is relatively limited. In this review, the authors present separate discussions on the pathology of carcinomas occurring in men and women with emphasis on the diverse histological subtypes. Because tumor type and prognosis correspond to anatomic location, normal anatomy and histology have been given due consideration. Of particular note in the recent literature is an expanded experience with clear cell carcinoma, a distinctive tumor primarily of the female urethra that has generated considerable interest with respect to its prognosis and relationship to urethral diverticulum. The authors use this review to illustrate several features of the pathology of these neoplasms synthesize the literature, and place into perspective the clinical, pathological, and prognostic features.
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