What does the Data of 354,725 Patients from Turkey Tell Us About Cervical Smear Epithelial Cell Abnormalities? - The Epithelial Cell Abnormality Rate is Increasing - Quality Control Studies and Corrective Activity are Musts

OBJECTIVE

There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories.

MATERIAL AND METHOD

In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire.

RESULTS

The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08% in the total 354,725 smears and ranging between 0.3% to 16.64% among centers. The Atypical squamous cells /Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers.

CONCLUSION

There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.

An in vitro study comparing the coagulation and cautery effects of bipolar and unipolar cutting modalities on prostatic tissue

INTRODUCTION

We aimed to compare plasmakinetic prostate resection (PKRP), plasmakinetic prostate vaporization (PKVP) and transurethral prostate resection (TURP) procedures according to cautery artifacts in tissue specimens and to compare the coagulation depths of these procedures.

MATERIALS AND METHODS

The prostate specimens of 10 patients that underwent open transvesical prostatectomy were used. TURP, PKVP and PKRP procedures were performed immediately. Artifactual pathological patterns that were identified in the specimens included: abnormal cellular orientation and spindling, artifactual cellular detachment from the underlying basement membrane, atypical cytological changes and stromal coagulative artifacts. The severity of cautery artifact was graded as absent, mild, moderate or severe according to the sum of points in each specimen.

RESULTS

When the groups were compared according to moderate and severe artifacts, it was observed that PKRP caused more moderate artifacts and TURP caused more severe artifacts than the other two groups (p < 0.05). The depth of the tissue affected by coagulation was 1.52 +/- 1.29 mm with the TURP procedure. There were significant differences between TURP and the other two methods (p < 0.05).

CONCLUSIONS

Three transurethral procedures cause cautery artifacts of varying grades. The application of TURP seems to cause more severe artifacts and PKRP and PKVP procedures seem to result in a deeper coagulation zone in the residual prostatic tissue.

Late-onset superficial lymphatic malformation: report of a case and review of the literature

BACKGROUND

Superficial lymphatic malformations are predominantly developmental malformations of infancy, but they may arise at any age.

OBJECTIVE

To describe a patient with a late-onset superficial lymphatic malformation.

METHODS

Case report and literature review.

RESULTS

A 53-year-old woman was evaluated for a colored lesion that developed spontaneously on the anterior abdominal wall. The lesion was treated by surgical excision. Findings on histopathologic examination of the specimen were consistent with superficial lymphatic malformation. There was no recurrence of the lesion at 4 months after the operation.

CONCLUSION

Superficial lymphatic malformations can develop in adults spontaneously without the presence of any predisposing condition. Because the majority of such late-onset malformations reported in the literature are localized lesions similar to the one in our patient, surgical removal with inclusion of subcutaneous tissue usually results in cure without recurrence.

Radiation-induced malignant fibrous histiocytoma of the neck in a patient with laryngeal carcinoma

Fibrohistiocytomas are soft tissue tumors of histiocytic origin that have a variety of histological patterns. Although cases of malignant fibrous histiocytoma (MFH) of the head and neck have been reported with increasing frequency in recent years, they are considered rare. We report a case of the giant cell variant of MFH of the neck in which the patient had been given radiotherapy for T1 glottic cancer. Prognosis of MFH, the use of radiation as primary treatment, and its role in the development of secondary primary tumors in the head and neck region are reviewed. [Editorial comment: The authors stress the important relationship between prior radiation therapy and the induction of new tumors.]

Papillary adenocarcinoma of the ciliary body simulating retinoblastoma

PURPOSE

To report a 2 1/2-year-old boy who had papillary adenocarcinoma of the ciliary body that simulated retinoblastoma.

METHOD

Initially treated for congenital glaucoma, the patient was referred with a white mass involving the iris, chamber angle, and ciliary body.

RESULTS

Enucleation of the right eye, which was initially diagnosed as retinoblastoma, showed a papillary adenocarcinoma of the ciliary body epithelium involving the posterior chamber, iris, anterior chamber, and trabeculum.

CONCLUSION

Adenocarcinoma of the ciliary body must be included in the differential diagnosis of tumors originating from the ciliary body in young children.