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Petrov M, Sokolov I. Machine Learning Allows for Distinguishing Precancerous and Cancerous Human Epithelial Cervical Cells Using High-Resolution AFM Imaging of Adhesion Maps. Cells 2023; 12:2536. [PMID: 37947614 PMCID: PMC10650179 DOI: 10.3390/cells12212536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023] Open
Abstract
Previously, the analysis of atomic force microscopy (AFM) images allowed us to distinguish normal from cancerous/precancerous human epithelial cervical cells using only the fractal dimension parameter. High-resolution maps of adhesion between the AFM probe and the cell surface were used in that study. However, the separation of cancerous and precancerous cells was rather poor (the area under the curve (AUC) was only 0.79, whereas the accuracy, sensitivity, and specificity were 74%, 58%, and 84%, respectively). At the same time, the separation between premalignant and malignant cells is the most significant from a clinical point of view. Here, we show that the introduction of machine learning methods for the analysis of adhesion maps allows us to distinguish precancerous and cancerous cervical cells with rather good precision (AUC, accuracy, sensitivity, and specificity are 0.93, 83%, 92%, and 78%, respectively). Substantial improvement in sensitivity is significant because of the unmet need in clinical practice to improve the screening of cervical cancer (a relatively low specificity can be compensated by combining this approach with other currently existing screening methods). The random forest decision tree algorithm was utilized in this study. The analysis was carried out using the data of six precancerous primary cell lines and six cancerous primary cell lines, each derived from different humans. The robustness of the classification was verified using K-fold cross-validation (K = 500). The results are statistically significant at p < 0.0001. Statistical significance was determined using the random shuffle method as a control.
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Affiliation(s)
- Mikhail Petrov
- Department of Mechanical Engineering, Tufts University, Medford, MA 02155, USA;
| | - Igor Sokolov
- Department of Mechanical Engineering, Tufts University, Medford, MA 02155, USA;
- Departments of Physics and Biomedical Engineering, Tufts University, Medford, MA 02155, USA
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Saksena A, Jain A, Pack SD, Kim J, Lee I, Tyagi M, Xi L, Pittaluga S, Raffeld M, Jaffe ES. Follicle Center Lymphoma (FCL) of the Lower Female Genital Tract (LFGT): A Novel Variant of Primary Cutaneous Follicle Center Lymphoma (PCFCL). Am J Surg Pathol 2023; 47:409-419. [PMID: 36461146 PMCID: PMC9974907 DOI: 10.1097/pas.0000000000002003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Primary cutaneous follicle center lymphoma has been distinguished from nodal follicular lymphoma (FL) based on genomic and clinical features. The nature of other extranodal FLs is not well defined. We report 15 cases of follicle center lymphoma involving the lower female genital tract. Cases were evaluated using an immunohistochemical panel for B-cell lymphoma, B-cell clonality, fluorescence in situ hybridization for BCL2 gene rearrangement, and next-generation sequencing. All patients had localized disease with no evidence of bone marrow involvement. Most cases (12/15, 80%) had a follicular pattern, at least focally. Large centrocytes were a prominent feature leading to concern for diffuse large B-cell lymphoma by referring pathologists. Neoplastic cells were positive for CD20 and BCL-6, while BCL-2 was positive in 2/15 (13%) cases. Fluorescence in situ hybridization for BCL2 gene rearrangement was negative in 10/11 (91%) cases. Next-generation sequencing performed in 10 cases revealed TNFRSF14 as the most frequently mutated gene in 6/10 (60%) cases. No case had CREBBP or KMT2D mutations as seen in nodal FL. None of the patients had progressive disease with durable complete remission achieved in 10/12 (83%) cases. The median follow-up period was 7.8 years (range: 0.2 to 20.5 y) with a 5-year overall survival of 100%. We conclude that follicle center lymphoma of the lower female genital tract is a novel variant of primary cutaneous follicle center lymphoma. Despite a frequent component of large cells, it is characterized by localized disease and low risk for dissemination. Awareness and recognition are important to distinguish these lesions from aggressive B-cell lymphomas.
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Affiliation(s)
- Annapurna Saksena
- Laboratory of Pathology, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD
| | - Ashish Jain
- CCR Collaborative Bioinformatics Resource (CCBR), CCR, NCI, Bethesda, MD
- Advanced Biomedical Computational Science, Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Svetlana D. Pack
- Laboratory of Pathology, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD
| | - Jung Kim
- Laboratory of Pathology, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD
| | - Ina Lee
- Laboratory of Pathology, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD
| | - Manoj Tyagi
- Laboratory of Pathology, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD
| | - Liqiang Xi
- Laboratory of Pathology, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD
| | - Stefania Pittaluga
- Laboratory of Pathology, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD
| | - Mark Raffeld
- Laboratory of Pathology, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD
| | - Elaine S. Jaffe
- Laboratory of Pathology, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD
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He S, Xiao B, Wei H, Huang S, Chen T. SVM classifier of cervical histopathology images based on texture and morphological features. Technol Health Care 2023; 31:69-80. [PMID: 35754238 DOI: 10.3233/thc-220031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Cervical histopathology image classification is a crucial indicator in cervical biopsy results. OBJECTIVE The objective of this study is to identify histopathology images of cervical cancer at an early stage by extracting texture and morphological features for the Support Vector Machine (SVM) classifier. METHODS We extract three different texture features and one morphological feature of cervical histopathology images: first-order histogram, K-means clustering, Gray Level Co-occurrence Matrix (GLCM) and nucleus feature. The original dataset used in our experiment is obtained from 20 patients diagnosed with cervical cancer, including 135 whole slide images (WSIs). Given an entire WSI, the patches on its tissue region are extracted randomly. RESULTS We finally obtain 3,000 patches, including 1,000 normal, 1,000 hysteromyoma and 1,000 cancer images. Among them, 80% of the entire data set is randomly selected as training set and the remaining 20% as test set. The accuracy of SVM classification using first-order histogram, K-means clustering, GLAM and nucleus feature for extracting features are respectively 87.4%, 90.6%, 91.6% and 93.5%. CONCLUSIONS The classification accuracy of the SVM combining the four features is 96.8%, and the proposed nucleus feature plays a key role in the SVM classification of cervical histopathology images.
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Affiliation(s)
- Siqi He
- Key Laboratory of Laser Life Science, Ministry of Education, College of Biophotonics, South China Normal University, Guangzhou, Guangdong, China
| | - Bo Xiao
- Key Laboratory of Laser Life Science, Ministry of Education, College of Biophotonics, South China Normal University, Guangzhou, Guangdong, China
| | - Huajiang Wei
- Key Laboratory of Laser Life Science, Ministry of Education, College of Biophotonics, South China Normal University, Guangzhou, Guangdong, China
| | - Shenjiao Huang
- GuangZhou Woman and Children's Medical Center, Guangzhou, Guangzhou, China
| | - Tongsheng Chen
- Key Laboratory of Laser Life Science, Ministry of Education, College of Biophotonics, South China Normal University, Guangzhou, Guangdong, China.,SCNU Qingyuan Institute of Science and Technology Innovation Co. Ltd., South China Normal University, Qingyuan, Guandong, China
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Peng F, Li J, Mu S, Qin Y, Ma J, Ai L, Hu Y. Epidemiological features for primary lymphoma of the female genital tract patients and development of a nomogram to predict survival. Ann Med 2022; 54:962-976. [PMID: 35416104 PMCID: PMC9009932 DOI: 10.1080/07853890.2022.2046289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Primary lymphoma of the female genital tract (PLFGT) is a sporadic extranodal lymphoma. Its epidemiology and prognosis are not fully recognized. Our study aimed to construct and validate prognostic nomograms for predicting survival for patients with PLFGT. METHODS Incidence rate from 1975 to 2017 and patients with PLFGT from 1975 to 2011 in the Surveillance, Epidemiology and End Results (SEER) database were retrospectively reviewed. The nomograms of overall survival (OS) and disease-specific survival (DSS) were established according to the multivariate Cox regression analyses. The concordance index (C-index) and calibration plots were used to demonstrate its robustness and accuracy. RESULTS A total of 617 PLFGT patients were identified. The overall incidence of PLFGT is 0.437/1,000,000 (adjusted to the US standard population in 2000) from 1975 to 2017. Age, histological subtype, Ann Arbor Stage, and therapeutic strategy were identified as independent prognostic factors for OS and DSS by multivariate Cox regression (p < .05). Nomograms to predict 1-, 5-, and 10-year OS and DSS were established. The C-index and calibration plots showed a good discriminative ability and an optimal accuracy of the nomograms. Patients were divided into three risk groups according to the model of OS. CONCLUSIONS The incidence of PLFGT has increased in the past 40 years, and the nomograms were developed and validated as an individualized tool to predict OS and DSS for all PLFGT patients and DLBCL patients. All patients are divided into three risk groups to assist clinicians to identify patients at high-risk and choose the optimal individualized treatments for patients.HighlightsThe incident of PLFGT and its subtypes were calculated and compared.Nomograms were constructed to predict the 1-, 5-, and 10-year OS and DSS.Patients are divided into the low-risk, medium-risk, and high-risk according total score of the nomogram.
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Affiliation(s)
- Fei Peng
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingwen Li
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shidai Mu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - You Qin
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiewen Ma
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lisha Ai
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Collaborative Innovation Center of Hematology, Huazhong University of Science and Technology, Wuhan, China
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5
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Menon PD, Tariq H, Forker C, Nazarullah A. Diagnosis of uterine lymphoma on cervical pap smear: Case report and review of literature. HUMAN PATHOLOGY: CASE REPORTS 2021. [DOI: 10.1016/j.ehpc.2020.200466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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6
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Saleh GA, Alghandour R, Rashad EY, Tawfik AM, Elmokadem AH. The adjunctive value of diffusion weighted imaging in diagnosis and follow up of uterovaginal diffuse B-cell lymphoma: A case report and literature review. Curr Med Imaging 2021; 17:1159-1166. [PMID: 33494680 DOI: 10.2174/1573405617666210120094711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 11/28/2020] [Accepted: 12/04/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Lymphoma of the female gynecologic tract is extremely rare. Typically, lymphoma is managed non surgically unlike other non-lymphomatous malignant tumors raising the importance to differentiate between both entities. CASE REPORT We describe the magnetic resonance imaging (MRI) features of a case of uterovaginal diffuse large B-cell lymphoma in a 50-year-old postmenopausal woman emphasizing Diffusion-Weighted Imaging (DWI) as a diagnostic and follow up tool. We reviewed the literature regarding the diagnostic methods for female genital lymphoma. Forty-five cases including our patient were reviewed with age range from 22 to 85 years. Vaginal bleeding was the most common presentation. The diagnosis was established by Papanicolaou smear, cervical biopsy (25/45), endometrial biopsy (6/45), vaginal biopsy (2/45), pelvic mass biopsy (2/45), iliac LN biopsy (1/45) and surgical diagnosis (8/45). Diffuse large B-cell lymphomas (DLBCL) constitute the vast majority of the cases (82%). The uterine cervix was involved at diagnosis in the majority of these cases (68%) while uterine body (42%) and vagina (28%) were less involved. Pelvic lymphadenopathy was found in 15 cases while extra genital lymphomatous infiltration in 13 cases. Sonographic findings were nonspecific while CT provided excellent data about extra-genital involvement. Thirteen cases underwent pelvic MRI that displayed superior detection of disease extension and parametric involvement. Diffusion restriction was reported only in one case without quantitative analysis of ADC map. CONCLUSION MRI shows unique features that help to differentiate uterovaginal lymphoma from the much more common carcinomas and discriminate post-operative changes from tumor recurrence. It exhibits a marked restricted diffusion pattern with lower ADC values than carcinomas and post-operative changes.
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Affiliation(s)
- Gehad A Saleh
- Diagnostic radiology Department, Mansoura University. Egypt
| | | | | | - Ahmed M Tawfik
- Diagnostic radiology Department, Mansoura University. Egypt
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Extramedullary Leukemia, Presenting at the Cervix of the Uterus. Case Rep Obstet Gynecol 2020; 2020:8492036. [PMID: 32934855 PMCID: PMC7479477 DOI: 10.1155/2020/8492036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 08/04/2020] [Accepted: 08/17/2020] [Indexed: 11/28/2022] Open
Abstract
Extramedullary relapse of leukemia is encountered more often than in the past. The reason is that leukemia survival rates increase with improved treatment schemes. We present a rare case of involvement of the cervix of the uterus in an adult B Acute Lymphocytic Leukemia (B-ALL) survivor. Relapses affect various organs but rarely the female genital tract. Nevertheless, in this case, a woman with a history of induced amenorrhea due to treatment for leukemia presented to the gynecologist because of vaginal spotting. Colposcopy evaluation of the vagina/cervix, sonography and cytological and histological sampling established the diagnosis of leukemia relapse in the cervix of the uterus. Under these circumstances, our study highlights the rare extramedullary presentation of leukemia in the cervix of the uterus of a young lady considered to be disease-free and listed for bone marrow transplantation. In this rare case of relapse in the cervix of the uterus, Pap smears alarmed physicians, and radiology examinations assisted the diagnostic workup. Still, only biopsy, microscopic evaluation, and immunohistochemistry studies established the exact diagnosis. Prognosis in the situation of extramedullary disease relapse in the female genital tract was poor, but gynecologists' high suspicion led to a prompt diagnosis. Survival is in general limited, but together with high suspicion, multidisciplinary team involvement is imperative to improve the reduced chances of survival.
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8
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Kazma J, Johnson C, Jain N, Gali VL, Young KH, Jazaeri AA. B-cell acute lymphoblastic leukemia/lymphoma in relapse presenting as a cervical mass: A case report and review of literature. Gynecol Oncol Rep 2019; 29:94-97. [PMID: 31467959 PMCID: PMC6710557 DOI: 10.1016/j.gore.2019.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/07/2019] [Accepted: 08/11/2019] [Indexed: 12/21/2022] Open
Abstract
The involvement of the cervix as a site of relapse for hematologic malignancies is rare. We herein present a case of relapsed B-cell Acute Lymphoblastic Leukemia/Lymphoma (ALL) mimicking advanced cervical cancer. The patient is a 61-year-old female with history B-cell ALL and had multiple relapses confined to the bone marrow and had received several different chemotherapy regimens. She presented with lower abdominal pain after the end of her last cycle for which an MRI abdomen and pelvis was done and it showed the presence of an asymmetrical cervical mass. Further imaging included a PET-CT showing the presence of hypermetabolic cervical mass with left pelvic and retroperitoneal lymph node involvement. She underwent a biopsy of 3 distinct lesions in the cervix and vagina and a diagnosis of relapsed B-cell ALL was confirmed in two out of the three specimens. The cervix as a site of relapse for hematologic malignancies is rare. History of leukemia should raise suspicion of extra-medullary involvement. Imaging along with histologic specimen provide a better diagnosis.
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Affiliation(s)
- Jamil Kazma
- Department of Internal Medicine, American University of Beirut Medical Center, Lebanon
| | - Cynae Johnson
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, USA
| | - Nitin Jain
- Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, USA
| | - Vasantha Lakshmi Gali
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, USA
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, USA
| | - Amir A Jazaeri
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, USA
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Tamba-Sakaguchi M, Oshiro H, Minakata D, Yanagita M, Kohri T, Nikaido T, Kikuchi M, Suzuki T, Yoshimoto T, Fukushima N. Cytological detection of recurrence of acute myeloid leukemia in a postmenopausal woman presenting with abnormal uterine bleeding. Diagn Cytopathol 2018; 46:1077-1080. [PMID: 30353703 DOI: 10.1002/dc.24085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 08/13/2018] [Accepted: 09/05/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Mio Tamba-Sakaguchi
- Department of Diagnostic Pathology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Hisashi Oshiro
- Department of Diagnostic Pathology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Daisuke Minakata
- Department of Hematology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Miki Yanagita
- Department of Diagnostic Pathology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Toshikatsu Kohri
- Department of Diagnostic Pathology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Takaaki Nikaido
- Department of Diagnostic Pathology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Midori Kikuchi
- Department of Diagnostic Pathology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Tomoko Suzuki
- Department of Diagnostic Pathology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Taichiro Yoshimoto
- Department of Diagnostic Pathology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Noriyoshi Fukushima
- Department of Diagnostic Pathology, Jichi Medical University Hospital, Shimotsuke, Japan
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Koyanagi T, Kondo H, Toyama A, Ando M, Imaoka S, Inamura M, Yamamoto H, Nakamura S, To Y, Fukami T, Goto M, Tsujioka H, Eguchi F. Malignant lymphoma of the uterine cervix presumptively diagnosed by Pap smear: A case report. Oncol Lett 2018; 15:6678-6680. [PMID: 29725409 DOI: 10.3892/ol.2018.8146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 02/21/2018] [Indexed: 11/06/2022] Open
Abstract
Malignant lymphoma of the uterine cervix is exceedingly rare and is difficult to diagnose by cervical cytology. The current study presents a case of malignant lymphoma of the uterine cervix that was presumptively diagnosed by cervical cancer screening in which the patient had no clinical symptoms. The anterior lip of the uterine cervix was occupied by a macroscopic hemorrhagic tumor. The obtained tumor cells exhibited typical cytological features of malignant lymphoma and were positive for CD20. The final diagnosis was diffuse large B cell lymphoma of the uterine cervix, stage IIEA (Ann Arbor classification). The patient received 6 courses of R-CHOP chemotherapy and achieved complete remission. Despite its rarity, the possibility of malignant lymphoma should be considered while screening for cervical cancers using Pap smears. The Pap test screening may be useful for the early diagnosis of malignant lymphoma of the uterine cervix in certain cases. By reaching a rapid and accurate diagnosis, immediate treatment may be initiated and surgery may be avoided.
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Affiliation(s)
- Takahiro Koyanagi
- Department of Obstetrics and Gynecology, ASO Iizuka Hospital, Iizuka, Fukuoka 820-8505, Japan
| | - Haruhiko Kondo
- Department of Obstetrics and Gynecology, ASO Iizuka Hospital, Iizuka, Fukuoka 820-8505, Japan
| | - Atsushi Toyama
- Department of Obstetrics and Gynecology, ASO Iizuka Hospital, Iizuka, Fukuoka 820-8505, Japan
| | - Miho Ando
- Department of Obstetrics and Gynecology, ASO Iizuka Hospital, Iizuka, Fukuoka 820-8505, Japan
| | - Sakiko Imaoka
- Department of Obstetrics and Gynecology, ASO Iizuka Hospital, Iizuka, Fukuoka 820-8505, Japan
| | - Masayo Inamura
- Department of Obstetrics and Gynecology, ASO Iizuka Hospital, Iizuka, Fukuoka 820-8505, Japan
| | - Hiroko Yamamoto
- Department of Obstetrics and Gynecology, ASO Iizuka Hospital, Iizuka, Fukuoka 820-8505, Japan
| | - Sumie Nakamura
- Department of Obstetrics and Gynecology, ASO Iizuka Hospital, Iizuka, Fukuoka 820-8505, Japan
| | - Yoko To
- Department of Obstetrics and Gynecology, ASO Iizuka Hospital, Iizuka, Fukuoka 820-8505, Japan
| | - Tatsuya Fukami
- Department of Obstetrics and Gynecology, ASO Iizuka Hospital, Iizuka, Fukuoka 820-8505, Japan
| | - Maki Goto
- Department of Obstetrics and Gynecology, ASO Iizuka Hospital, Iizuka, Fukuoka 820-8505, Japan
| | - Hiroshi Tsujioka
- Department of Obstetrics and Gynecology, ASO Iizuka Hospital, Iizuka, Fukuoka 820-8505, Japan
| | - Fuyuki Eguchi
- Department of Obstetrics and Gynecology, ASO Iizuka Hospital, Iizuka, Fukuoka 820-8505, Japan
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11
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Wang F, Jing X, Liu B, Meng X, Sun X, Gao Y, Wang L, Fu Z. Primary non-Hodgkin's lymphoma of the vagina: A case report. Oncol Lett 2018; 15:3504-3507. [PMID: 29556272 PMCID: PMC5844002 DOI: 10.3892/ol.2018.7805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 11/07/2017] [Indexed: 12/23/2022] Open
Abstract
Primary non-Hodgkin's lymphoma (NHL) of the vagina is uncommon. The present case study reports the case of a 54-year-old female with a palpable mass between the rectum and vagina. The patient presented with symptoms consistent with vaginal cancer but lacked any of the ‘B’ symptoms often associated with systemic lymphoma, including fever, weight loss, night sweats and fatigue. The mass was resected under anesthesia. Immunohistochemistry and biopsy confirmed diffuse large B-cell NHL (DLBCL). Following surgery, six cycles of chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone were administered. Subsequently, a vertebral body metastasis was observed using a computed tomography scan and whole-body bone imaging. The patient received palliative radiation for the vertebral body metastasis. Additionally, the available literature was reviewed in order to further characterize this rare disease.
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Affiliation(s)
- Feng Wang
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong 250200, P.R. China.,Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong 250117, P.R. China
| | - Xuquan Jing
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong 250117, P.R. China
| | - Bo Liu
- Department of Medical Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong 250117, P.R. China
| | - Xue Meng
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong 250117, P.R. China
| | - Xindong Sun
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong 250117, P.R. China
| | - Yongsheng Gao
- Department of Pathology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong 250117, P.R. China
| | - Linlin Wang
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong 250117, P.R. China
| | - Zheng Fu
- Department of Computed Tomography, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong 250117, P.R. China
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12
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Yang G, Deisch J, Tavares M, Haixia Q, Cobb C, Raza AS. Primary B-cell lymphoma of the uterine cervix: Presentation in Pap-test slide and cervical biopsy. Diagn Cytopathol 2016; 45:235-238. [PMID: 27863160 DOI: 10.1002/dc.23627] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 10/02/2016] [Accepted: 10/12/2016] [Indexed: 11/12/2022]
Abstract
This case involved a 69-year-old female who presented with irritative urinary voiding. Imaging studies showed an 18-cm uterine mass centering on the cervix and extending into the bladder. The Pap test slide demonstrated necrotic background and degenerative changes in single and grouped atypical "small round blue cells" with high nuclear/cytoplasm ratio, scant cytoplasm, and hyperchromatic focally cleaved nuclei with occasional nuclear membrane "snout projections." Cervical biopsies showed similar findings. The tumor cells were positive for CD45, CD20, and PAX-5, and negative with epithelial, neuroendocrine, and muscle markers. A Ki-67 immunostain showed a markedly elevated proliferative index and the MUM1 stain was diffusely positive. Molecular study identified clonal immunoglobulin heavy chain gene rearrangement. Owing to its rarity, cervical lymphoma may sometimes be confused with other types of malignant neoplasms or inflammatory processes. Therefore, it is important to recognize the cytological features of cervical lymphomas and be aware of the potential diagnostic pitfalls for timely diagnosis and therapy. Diagn. Cytopathol. 2017;45:235-238. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Guang Yang
- Department of Pathology, Loma Linda University Medical Center, Loma Linda, California
| | - Jeremy Deisch
- Department of Pathology, Loma Linda University Medical Center, Loma Linda, California
| | - Margaret Tavares
- Department of Pathology, Loma Linda University Medical Center, Loma Linda, California
| | - Qin Haixia
- Department of Medicine, Loma Linda University Medical Center, Loma Linda, California
| | - Camilla Cobb
- Department of Pathology, Loma Linda University Medical Center, Loma Linda, California
| | - Anwar S Raza
- Department of Pathology, Loma Linda University Medical Center, Loma Linda, California
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13
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Sahu KK, Prakash G, Sanamandra P, Khadwal A, Dey P, Sharma P, Varma SC, Malhotra P. An Unusual Site of Acute Lymphoblastic Leukaemia Relapse: Challenge for Gynaecologists. J Obstet Gynaecol India 2016; 66:656-661. [PMID: 27803537 PMCID: PMC5080235 DOI: 10.1007/s13224-015-0787-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/12/2015] [Indexed: 10/22/2022] Open
Affiliation(s)
- Kamal Kant Sahu
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Gaurav Prakash
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Prudhviraj Sanamandra
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Alka Khadwal
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Pranab Dey
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Prashant Sharma
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Subhash Chander Varma
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Pankaj Malhotra
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
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14
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Aytac Korkmaz S. Diagnosis of cervical cancer cell taken from scanning electron and atomic force microscope images of the same patients using discrete wavelet entropy energy and Jensen Shannon, Hellinger, Triangle Measure classifier. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2016; 160:39-49. [PMID: 26921605 DOI: 10.1016/j.saa.2016.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 02/11/2016] [Indexed: 06/05/2023]
Abstract
The aim of this article is to provide early detection of cervical cancer by using both Atomic Force Microscope (AFM) and Scanning Electron Microscope (SEM) images of same patient. When the studies in the literature are examined, it is seen that the AFM and SEM images of the same patient are not used together for early diagnosis of cervical cancer. AFM and SEM images can be limited when using only one of them for the early detection of cervical cancer. Therefore, multi-modality solutions which give more accuracy results than single solutions have been realized in this paper. Optimum feature space has been obtained by Discrete Wavelet Entropy Energy (DWEE) applying to the 3×180 AFM and SEM images. Then, optimum features of these images are classified with Jensen Shannon, Hellinger, and Triangle Measure (JHT) Classifier for early diagnosis of cervical cancer. However, between classifiers which are Jensen Shannon, Hellinger, and triangle distance have been validated the measures via relationships. Afterwards, accuracy diagnosis of normal, benign, and malign cervical cancer cell was found by combining mean success rates of Jensen Shannon, Hellinger, and Triangle Measure which are connected with each other. Averages of accuracy diagnosis for AFM and SEM images by averaging the results obtained from these 3 classifiers are found as 98.29% and 97.10%, respectively. It has been observed that AFM images for early diagnosis of cervical cancer have higher performance than SEM images. Also in this article, surface roughness of malign AFM images in the result of the analysis made for the AFM images, according to the normal and benign AFM images is observed as larger, If the volume of particles has found as smaller.
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Affiliation(s)
- Sevcan Aytac Korkmaz
- Engineering Faculty, Department of Electrical-Electronic Engineering, Firat University, 23100 Elazığ, Turkey.
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15
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Guz NV, Dokukin ME, Woodworth CD, Cardin A, Sokolov I. Towards early detection of cervical cancer: Fractal dimension of AFM images of human cervical epithelial cells at different stages of progression to cancer. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2015; 11:1667-75. [PMID: 25959926 DOI: 10.1016/j.nano.2015.04.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 04/21/2015] [Accepted: 04/22/2015] [Indexed: 01/22/2023]
Abstract
UNLABELLED We used AFM HarmoniX modality to analyse the surface of individual human cervical epithelial cells at three stages of progression to cancer, normal, immortal (pre-malignant) and carcinoma cells. Primary cells from 6 normal strains, 6 cancer, and 6 immortalized lines (derived by plasmid DNA-HPV-16 transfection of cells from 6 healthy individuals) were tested. This cell model allowed for good control of the cell phenotype down to the single cell level, which is impractical to attain in clinical screening tests (ex-vivo). AFM maps of physical (nonspecific) adhesion are collected on fixed dried cells. We show that a surface parameter called fractal dimension can be used to segregate normal from both immortal pre-malignant and malignant cells with sensitivity and specificity of more than 99%. The reported method of analysis can be directly applied to cells collected in liquid cytology screening tests and identified as abnormal with regular optical methods to increase sensitivity. FROM THE CLINICAL EDITOR Despite cervical smear screening, sometimes it is very difficult to differentiate cancers cells from pre-malignant cells. By using AFM to analyze the surface properties of human cervical epithelial cells, the authors were able to accurately identify normal from abnormal cells. This method could augment existing protocols to increase diagnostic accuracy.
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Affiliation(s)
- Nataliia V Guz
- Department of Physics, Clarkson University, Potsdam, NY, USA
| | - Maxim E Dokukin
- Department of Mechanical Engineering, Tufts University, Medford, MA, USA
| | | | - Andrew Cardin
- Department of Physics, Clarkson University, Potsdam, NY, USA
| | - Igor Sokolov
- Department of Mechanical Engineering, Tufts University, Medford, MA, USA; Department of Biomedical Engineering, Tufts University, Medford, MA, USA; Department of Physics, Tufts University, Medford, MA, USA.
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16
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Dokukin ME, Guz NV, Woodworth C, Sokolov I. Emerging of fractal geometry on surface of human cervical epithelial cells during progression towards cancer. NEW JOURNAL OF PHYSICS 2015; 17:033019. [PMID: 25844044 PMCID: PMC4380278 DOI: 10.1088/1367-2630/17/3/033019] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Despite considerable advances in understanding the molecular nature of cancer, many biophysical aspects of malignant development are still unclear. Here we study physical alterations of the surface of human cervical epithelial cells during stepwise in vitro development of cancer (from normal to immortal (premalignant), to malignant). We use atomic force microscopy to demonstrate that development of cancer is associated with emergence of simple fractal geometry on the cell surface. Contrary to the previously expected correlation between cancer and fractals, we find that fractal geometry occurs only at a limited period of development when immortal cells become cancerous; further cancer progression demonstrates deviation from fractal. Because of the connection between fractal behaviour and chaos (or far from equilibrium behaviour), these results suggest that chaotic behaviour coincides with the cancer transformation of the immortalization stage of cancer development, whereas further cancer progression recovers determinism of processes responsible for cell surface formation.
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Affiliation(s)
- M. E. Dokukin
- Department of Mechanical Engineering, Tufts University, Medford, MA 02155, USA
| | - N. V. Guz
- Department of Physics, Clarkson University, Potsdam, New York 13699-5820, USA
| | - C.D. Woodworth
- Department of Biology, Clarkson University, Potsdam, New York 13699-5820, USA
| | - I. Sokolov
- Department of Physics, Clarkson University, Potsdam, New York 13699-5820, USA
- Department of Biomedical Engineering, Tufts University, Medford, MA 02155, USA
- Department of Physics, Tufts University, Medford, MA 02155, USA
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17
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Postcoital bleeding: a review on etiology, diagnosis, and management. Obstet Gynecol Int 2014; 2014:192087. [PMID: 25045355 PMCID: PMC4086375 DOI: 10.1155/2014/192087] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 05/29/2014] [Accepted: 06/05/2014] [Indexed: 12/15/2022] Open
Abstract
Postcoital bleeding refers to spotting or bleeding that occurs after intercourse and is not related to menstruation. The prevalence of postcoital bleeding ranges from 0.7 to 9.0 percent of menstruating women. There are multiple etiologies for this common complaint in which most are benign such as cervicitis or cervical polyps. However, the most serious cause of postcoital bleeding is cervical cancer. There are currently no recommendations from governing bodies such as the American College of Obstetricians and Gynecologists on evaluating and treating women with postcoital bleeding. The purpose of this paper is to discuss the common causes of postcoital bleeding, the etiologies of postcoital bleeding, and the likelihood that malignancy is the underlying cause. After an extensive literature review, we compiled a paper illustrating the key concepts a practitioner should know when it comes to postcoital bleeding. Finally, this review will conclude with treatment options for women who are found to have an identifiable source for their bleeding and a discussion on the natural history of postcoital bleeding in women who are found to have no identifiable etiology on evaluation.
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18
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Hematopoietic tumors of the female genital system: imaging features with pathologic correlation. ACTA ACUST UNITED AC 2014; 39:922-34. [DOI: 10.1007/s00261-014-0102-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Tambouret R. Female genital tract. Cancer Treat Res 2014; 160:241-272. [PMID: 24092373 DOI: 10.1007/978-3-642-38850-7_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Rosemary Tambouret
- Department of Pathology, Massachusetts General Hospital, Warren 105/55 Fruit Street, Boston, MA, 02114, USA,
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20
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Arce J, Broadway K, Somma J, Khader S. A case of plasmablastic lymphoma diagnosed on liquid-based pap test. Diagn Cytopathol 2013; 42:956-8. [PMID: 24273019 DOI: 10.1002/dc.23063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 09/05/2013] [Accepted: 10/10/2013] [Indexed: 11/09/2022]
Abstract
Primary gynecological lymphomas are rare and difficult to diagnose with Pap test. Herein, we report an uncommon case of plasmablastic lymphoma in a 61-year-old female with human immunodeficiency virus that presents with vaginal bleeding. The following case report shows the cytological features on liquid-based Pap test, cell block studies with diagnostic immunohistochemistry, discussion of the diagnostic difficulties, and a literature review.
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Affiliation(s)
- Julian Arce
- Department of Pathology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
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21
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Recurrent precursor-B acute lymphoblastic leukemia presenting as a cervical malignancy. Int J Gynecol Pathol 2013; 32:234-7. [PMID: 23370653 DOI: 10.1097/pgp.0b013e31825bd828] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A 59 year old woman with a history of acute lymphoblastic leukemia in remission presented with right flank pain. An abdominal ultrasound showed mild to moderate right hydronephrosis due to obstruction, and computed tomography scan showed a bulky mass near the cervix, concerning for cervical or uterine malignancy. A Papanicolaou smear was suspicious for malignancy, and immunocytochemical stains were positive for terminal deoxynucleotidyl transferase (TdT) and cluster of differentiation (CD)-10, focally positive for CD34 and CD79a, and negative for CD3, CD20, and paired box protein-5 (PAX-5). Cervical biopsies showed an infiltrating population of cells with immunophenotype similar to the cells on cervical cytology. The cytologic and histologic workup was compatible with infiltration of the uterine cervix by recurrent precursor-B acute lymphoblastic leukemia. A bone marrow biopsy showed normocellular marrow without evidence of tumor or infiltrative disease. Complete blood count and peripheral blood smear showed no evidence of leukemic involvement. Acute lymphoblastic leukemia diagnosed on cervical Pap smear has been very rarely reported. The majority of cases of hematologic malignancy involving the uterine cervix present with vaginal bleeding. To our knowledge, only three cases of recurrent precursor-B acute lymphoblastic leukemia in the uterine cervix have been reported, two of which occurred in pediatric patients. One pediatric patient presented with vomiting and abdominal pain, and was found to have hydronephrosis on imaging. This is perhaps the first case of precursor-B acute lymphoblastic leukemia diagnosed on cervical cytology in an adult patient with hydronephrosis and without vaginal bleeding.
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22
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23
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Bellevicine C, Zabatta A, Malapelle U, Vetrani A, Troncone G. Diffuse large B-cell extranodal lymphoma of the uterine cervix: an incidental pap smear finding with histological and immunohistochemical correlation. Diagn Cytopathol 2013; 42:644-6. [PMID: 23441015 DOI: 10.1002/dc.22966] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 01/01/2013] [Indexed: 12/11/2022]
Affiliation(s)
- Claudio Bellevicine
- Department of Public Health, University of Naples Federico II, Naples, Italy
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24
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Yalta T, Taştekin E, Puyan FÖ, Usta U, Azatçam M, Altaner S. Non-Hodgkin's lymphoma: A rare diagnosis on cervicovaginal cytology. J Cytol 2012; 29:142-3. [PMID: 22787299 PMCID: PMC3391799 DOI: 10.4103/0970-9371.97161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Cervicovaginal smear screening is well known to reduce morbidity and mortality rates of invasive cervical carcinoma. Herein, we report a case of 56-year-old woman whose cervicovaginal smear was found to consist of malignant cells characterized by high nuclear/cytoplasmic ratio, scant rim of cytoplasm, coarsely granular nuclear chromatin and irregular nuclear membrane that were all reminiscent of a malignant lymphoma. Histopathological examination of the hysterectomy and unilateral adnexectomy specimen confirmed the presence of a diffuse large B-cell non Hodgkin's lymphoma involving the cervix, endometrium, myometrium, serosa and the right ovary.
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Affiliation(s)
- Tulin Yalta
- Department of Pathology, Trakya University, Edirne, Turkey
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25
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Hoda RS, Loukeris K, Abdul-Karim FW. Gynecologic cytology on conventional and liquid-based preparations: a comprehensive review of similarities and differences. Diagn Cytopathol 2012; 41:257-78. [PMID: 22508662 DOI: 10.1002/dc.22842] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 01/10/2012] [Indexed: 02/06/2023]
Abstract
Liquid-based preparations (LBPs) have largely replaced conventional Papanicolaou smears (CPS) for cervical samples in the United States and in many other industrialized countries. The two FDA-approved LBP currently in use include ThinPrep (TP), (Hologic Inc., Bedford, MA) and SurePath (SP), (BD Diagnostic, Burlington, NC). Split-sample and direct-to-vial studies have shown that LBPs show an overall improvement in sample collection and processing, reduce artifacts that interfere in diagnosis, are more sensitive, can be utilized for ancillary tests and are a cost-effective replacement for CPS. Comparative analyses of diagnostic accuracy indicate that LBPs perform at least as well as CPS. However, the added advantages of standardized, automated preparations and screening, reduced unsatisfactory rate, improved specimen adequacy and ability to perform human papillomavirus (HPV) test, are enough to continue use of LBP. The cytologic features in LBP are similar to CPS with subtle differences, particularly in background information. There are also subtle differences between the two LBPs, SP and TP, which are reflective of different sampling devices, collection media, and processing techniques. Architecturally, LBP shows smaller cell clusters and sheets and more dyscohesion. Cytologically, enhanced nuclear features and smaller cell size are more prominent. Advances in liquid-based Papanicolaou's (Pap) test have lead to well-defined patient management guidelines by the American Society for Colposcopy and Cervical Pathology. Herein, we review these aspects of Pap test including, morphology, automation, ancillary tests (HPV and immunochemistry), pertinent QA/QC monitors, patient management guidelines, and review of pertinent literature.
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Affiliation(s)
- Rana S Hoda
- Department of Pathology & Laboratory Medicine, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York 10065, USA.
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26
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Chen X, Hamele-Bena D, Fai Chow K, Hawver M, He H, Raphael B, Jain S, Wright TC. B-cell lymphoma of the vagina occurring after treatment for classic Hodgkin lymphoma: a case report and literature review. Diagn Cytopathol 2011; 41:463-5. [PMID: 21953901 DOI: 10.1002/dc.21816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 07/08/2011] [Indexed: 11/09/2022]
Abstract
Malignant lymphomas of the female genital tract are very uncommon, and the development of a diffuse large B-cell lymphoma involving the vagina following treatment for classic Hodgkin lymphoma is extremely rare. Clinically and morphologically, this entity represents a challenge. We herein report such a case with liquid-based Pap test and tissue biopsy findings.
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Affiliation(s)
- Xiaowei Chen
- Department of Pathology and Cell Biology, Columbia University Medical Center/The New York Presbyterian Hospital, New York 10032, USA.
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27
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Kim J, Kim H, Hong SR, Chun YK, Kim HS. Liquid-Based Pap Smear Findings of Uterine Cervical Lymphoma - Three Cases Report -. KOREAN JOURNAL OF PATHOLOGY 2011. [DOI: 10.4132/koreanjpathol.2011.45.4.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jiyoung Kim
- Department of Pathology, Cheil General Hospital, KwanDong University College of Medicine, Seoul, Korea
| | - Hyesun Kim
- Department of Pathology, Cheil General Hospital, KwanDong University College of Medicine, Seoul, Korea
| | - Sung Ran Hong
- Department of Pathology, Cheil General Hospital, KwanDong University College of Medicine, Seoul, Korea
| | - Yi Kyeong Chun
- Department of Pathology, Cheil General Hospital, KwanDong University College of Medicine, Seoul, Korea
| | - Hy Sook Kim
- Department of Pathology, Cheil General Hospital, KwanDong University College of Medicine, Seoul, Korea
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28
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Abstract
A 46-year-old woman of Asian origin presented with heavy intermenstrual and postcoital bleeding caused by the rare entity of primary non-Hodgkin's lymphoma of the cervix uteri, with no evidence of disease elsewhere. Prompt diagnosis by biopsy avoided unnecessary surgery, and instead appropriate treatment with chemoradiotherapy was administered.
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Affiliation(s)
- Fatima Abu Amna
- Trafford Healthcare Trust, Obstetrics and Gynaecology, Moorside Road, Urmston, Manchester M41 5SL, UK
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29
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Postmenopausal bleeding as first sign of an acute myelogenous leukaemia: A case report and review of the literature. Med Oncol 2009; 27:815-9. [PMID: 19763918 DOI: 10.1007/s12032-009-9291-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Accepted: 08/06/2009] [Indexed: 12/24/2022]
Abstract
Postmenopausal bleeding (PMB) can have various causes and malignancy must always be excluded. Extramedullary manifestations of a haematological disease in the female genital tract are rare. We present the case of a woman with PMB as the first sign of an acute myelogenous leukaemia (AML). An 81-year-old patient presented with PMB. Manual and colposcopic examination raised suspicion of a cervical carcinoma, but histopathology and cervical Pap smear altered the diagnosis to granulocytic sarcoma (GS), an extramedullary manifestation of AML. The patient had a normal blood count 2 weeks prior to the examination, but at the time of presentation her leukocytes had risen to 116000/microl. The patient died 3 days later due to a pulmonary embolism, most probably as a result of leukostasis. In this case, GS of the cervix was the first sign of the AML with simultaneous appearance of leukocytosis and peripheral blasts. PMB was the reason for presentation. GS of the female genital tract is very rare and diagnosis is challenging, especially on the basis of the Pap smear. Abnormal inflammatory cells must be a warning sign and an indication for further examinations. GS as the presenting sign of AML has a poor prognosis with only 6% of patients surviving for more than 2 years.
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