Faculty of Medicine
Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14
Browse
14 results
Search Results
- Some of the metrics are blocked by yourconsent settings
Item type:Publication, Human papillomavirus testing in patients with cytological diagnosis of atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions(Monduzzi Editore, 2002-06); ; Plaseska-Karanfilska, DijanaAim of the Study: To determine whether human papillomavirus (HPV) testing is useful in the evaluation of patients diagnosed with atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LGSIL). Patients and Methods: The results of 46 patients with ASCUS/LGSL diagnoses of Papanicolaou smears were reviewed taking into consideration the results of HPV polymerase chain reaction (PCR) tests and histological findings.40 of them were with LGSL and 6 with ASCUS cytological diagnosis. Results: 25 (54,3) of the patients were positive for HPV DNA and of them 16 (34,8) with high-risk HPV types, 6 (13,0) with low-risk types and 3 (6.5) with uncharacterized types of HPV. Biopsies and/or endocervical curettage of the cervix confirmed that 6 of the patients had a higher-grade lesion - CIN2/CIN3. Five of them (three LGSIL-s and two ASCUS-es) were with high-risk types of HPV and 1 patient (cytological smear - LGSIL) was HPV negative. That means that 5 (of 16) or 31,2 of the patients with high-risk types (in four patients HPV type 16 and in one HPV type 31) and only one from the HPV negative patients were diagnosed a higher grade of SIL. Conclusion: Although PCR HPV testing is expensive as a screening tool it is very useful in selection and proper histologic diagnosis of high-grade squamous intraepithelial lesions. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Clinicopathological analysis of incidentally detected blue nevi of the uterine cervix in biopsy and curettage specimens. A report of 7 cases.(Springer, 2019-09); Ognenoska-Jankovska, BiljanaBackground & Objectives: Blue nevi (BN) of the uterine cervix (UC) are rare incidental lesions; they are often found in hysterectomy specimens from middle-aged women, or rarely in specimens obtained during more conservative diagnostic procedures (e.g. biopsy, curettage). The objective of our study was to analyse the clinicopathological features of 7 incidentally detected cases of the BN of the UC in biopsy or curettage specimens. Methods: Among a total of 60 BN of the UC diagnosed on operative and biopsy specimens in our Department between 2000-2019, in 7 (7/60, 11.7%) cases BN were found in biopsy or curettage specimens that had been taken for an examination of a clinically or cytologically suspicious cervical lesion (3/7, 42.9%) or a dysfunctional uterine bleeding (4/7, 57.1%), respectively. The mean age of the patients was 44 years (range, 29-57 years). In addition to routine hematoxylin&eosin, histochemical and immunohistochemical stainings were also performed. Results: Histologically, all cases showed loose aggregates of pigmented, spindle-shaped, dendritic or nevoid, epithelioid cells in the superficial stroma in one (4/7, 57.1%) or >2 fragments of cervical mucosa (3/7, 42.9%). The lesions ranged in size from 0.5 to 6mm (mean, 2.4mm), while their thickness ranged between 0.5-4mm (mean, 1.5mm). In one case the BN was presenting as an endocervical polyp. The pigmented cells in all tested cases were positive for melanin (Fontana-Masson), S100, Melan-A, as well as for HMB45 in 3 cases. Conclusion: Although the BN of the UC seem to be lesions of low clinical significance, they require careful differential diagnosis with other pigmented lesions including malignant melanoma, especially because they are rarely detected and might easily be missed or misinterpreted in scanty endocervical curettage or cervical biopsy specimens due to their small size, more frequent endocervical localization and occasional discrete findings. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Benign granular cell tumor of the uterine corpus: A case report(The Arab Division of the International Academy of Pathology In Collaboration with the Jordanian Society of Pathologists, 2018-10); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Androgen insensitivity (testicular feminization) syndrome and XY gonadal dysgenesis (Swyer syndrome)(Kliničko-bolnički centar Zemun, 2018)Case 1: Clinical History -The patient was an 18-year-old woman with a history of primary amenorrhea. The physical examination revealed normal female external genitalia, moderate breast development, scarce pubic hair, and scant axillary hair. Pelvic examination revealed an absence of a uterus. The vagina ended in a blind pouch and measured 6cm in length. An abdominal ultrasonogram showed solid bilateral gonadal structures measuring 31x15mm right, and 30x 6mm left in the pelvic cavity without any evidence of a uterus. These findings were confirmed by MRI scan. Serum levels of estradiol and testosterone were 45.7pg/mL and 7.5nmol/L, respectively. FSH and LH levels were 8.46mlU/ml and 20.2mlU/ml. Cytogenetic analysis of peripheral blood lymphocytes revealed a 46,XY karyotype, with translocation t(13,14) inherited from her father. The molecular investigation confirmed active SRY with amplification of 6 nonpolymorphic loci on AZFa, AZFb, and AZFc regions on Y chromosome. Three months after her first referral the patient underwent bilateral prophylactic laparoscopic gonadectomy. The patient is being followed up regularly and she has no complaints after five years. Pathological Findings- Grossly, the right gonad was 4.3x1.8x1.8cm and the left gonad was 4.5x2.0x1.7cm. The right fallopian tube was 3.8cm long and 0.2cm in diameter, while the left one was 1.5cm long and 0.2cm in diameter. In addition, 4 cysts measuring 0.3-1cm in diameter were found in the fat tissue on the surface of the left fallopian tube. The cut surface of the right gonad resembled testicular tissue showing two discrete, firm, well-demarcated, slightly bulging, homogenous, light grey-tan colored nodules, measuring 0.1 and 0.9cm in maximal dimension. Three similarly looking nodules were present in the left gonad measuring 0.4-0.5cm in diameter. In addition, a white whorled, firm, smooth muscle body fused to one pole of the gonad was found bilaterally measuring 1.2cm right, and 1.3cm left. Microscopically, both gonads were composed of varying proportions of small and solid, or less frequently larger, with early lumen formation seminiferous tubules lined by immature Sertoli cells, surrounded with fibrous, focally edematous stroma in which prominent Leydig cells were present. Rare tubules contained Sertoli cells with abundant cytoplasm filled with coarse, eosinophilic granules. The nodules were composed of solid immature tubules lined by cylindrical immature Sertoli cells separated by fibrous stroma containing fewer Leydig cells. Fallopian tubes were hypoplasic, while the cysts were lined by a single layer of cuboidal to columnar cells some of which had cilia. Thus, the clinical, laboratory, imaging, genetic and histological findings confirmed the diagnosis of complete androgen insensitivity syndrome with bilateral testicular hamartomas. Discussion: Androgen insensitivity syndrome (AIS) is a disorder where there is resistance to androgen actions influencing both the morphogenesis and differentiation of androgen-responsive body structures. It is the most common type of male pseudohermaphroditism, characterized by an absence of androgen receptor activity due to a mutation at Xq11–q12 localization on the androgen receptor gene. the. In the largest series of 43 patients with the AIS published by Rutgers and Scully hamartomas were present in 63% of the cases, while Sertoli cell adenomas were reported in 23% and malignant tumors including two seminomas, one intratubular germ cell neoplasm with early stromal invasion and a malignant sex cord tumor in 9% of the cases. Case 2: Clinical History- The patient was a 17-year-old girl with primary amenorrhea. On external examination, she had an unambiguous female phenotype albeit with poor breast development. Her external genitalia had a normal appearance but internal examination showed a hypoplastic uterus. Ultrasonography failed to show follicular activity in the gonads. Her gonadotropins were high (FSH, 55.6mU/ml; LH, 18.3mU/ml) and estradiol was low (20.0pg/ml). Nonmosaic 46,XY karyotype was detected in patient’s leukocytes by cytogenetic analysis. Under the tentative clinical diagnosis of pure gonadal dysgenesis, a prophylactic bilateral laparoscopic gonadectomy with bilateral salpingectomy was performed. A biopsy specimens from the gonads were sent for cytogenetic analysis. The sequencing of the SRY gene of the proband revealed a C/G substitution at the first nucleotide of codon 133, leading to Arg/Gly replacement in the SRY protein. The mutation was also present in patient’s father, who is a phenotypically normal male. The patient is alive and well 12 years after the operation without any evidence of disease. Pathological Findings- Macroscopically, both fallopian tubes were 4cm long and 0.4cm in diameter, while the gonads were measuring 3x2.2x1.2cm the right, and 2.2x0.8x1cm the left. Upon dissection, both gonadal streaks had a similar, variegated appearance with multiple areas of microcalcification. The histological evaluation of the gonads confirmed a gonadoblastoma of 3cm in diameter in the right gonad and a predominantly “burnt-out” gonadoblastoma of 2.2cm in the left gonad with only a microscopic focus of recognizable gonadoblastoma less than 1mm in diameter. The tumors were composed of primordial germ cells intimately admixed with sex cord elements, which surrounded round spaces filled with eosinophilic basement membrane-like material. The atypical germ cells had abundant clear or pale, slightly granular cytoplasm and round vesicular nuclei with prominent nucleoli. The small, often fusiform sex cord element cells had uniform round or oval nuclei with indiscernible nucleoli and scant cytoplasm. The uninvolved gonadal tissue bilaterally had the morphology of a streak gonad composed largely of ovarian-type stroma, with extended calcification and small germinal inclusion cysts present, without any follicles. The fallopian tubes were infantile. Therefore, the histopathological findings confirmed the diagnosis of bilateral gonadoblastoma in streak gonads, FIGO Stage IB, in a patient with a XY gonadal dysgenesis (Swyer syndrome). Discussion: XY gonadal dysgenesis (GD) is a result of abnormal testis development in utero. Pure 46,XY GD should be considered when an adolescent presents as a phenotypic female with delayed puberty and primary amenorrhea. Rarely, they may present with a detectable abdominal or pelvic gonadoblastoma mass. When the presumptive diagnosis suggests GD, further criteria may strengthen the diagnosis, while ultimately, the most definitive diagnosis is through biopsy of the gonads. Bilateral streak gonads are seen in pure XY GD. The risk of otherwise undetected gonadoblastoma in XY GD patients is high, and prophylactic or therapeutic gonadectomy is therefore often indicated when XY GD is diagnosed. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ovarian Leydig cell tumor (hilus cell tumor): A case report(Macedonian Association of Pathology, 2016-09) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ovarian cellular fibromas: A cliniopathological and immunohistochemical analysis of 10 cases.(Springer, 2007-08); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Apocrine carcinoma in situ with microinvasion – A case report(Macedonian Association of Pathology, 2016-09) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Liquid-based cytology versus conventional cytology in women with squamous intraepithelial lesions of the uterine cervix(Macedonian Association of Pathology, 2016-09); ; ; ; Objective: The aim of the study was to compare the results of two cervical cytology techniques, liquid-based and conventional, using the cervical biopsy as the gold standard for diagnosis of squamous intraepithelial lesion (SIL) of the uterine cervix. Material and Methods: This comparative prospective study was conducted in a series of 200 sexually active patients, aged from 19 to 49, who came to their annual gynecological exam at University Clinic of Gynecology and Obstetrics in Skopje between January and October 2015. In all patients, simultaneously, conventional Papanicolaou smear and Thin Prep liquid-based samples were taken. The performance of both techniques was compared with the gold standard of the biopsy results in a series of 118 patients with squamous cell abnormalities of the uterine cervix. In all these patients a colposcopically directed biopsy with endocervical curettage was taken. Results: When comparing the cytological diagnoses the agreement between two cytology methods for all 200 cases was 76%. The diagnostic efficiency between the two methods was further evaluated by comparing the cytological diagnosis of each method with the histopathological diagnosis in the series of 118 patients. Histology confirmed a presence of a low-grade squamous intraepithelial lesion in 54 and a high-grade squamous intraepithelial lesion in 6 cases, while the remaining 58 cases had negative diagnostic interpretation. The liquid-based cytology was in agreement with histology in 81% of the biopsies in comparison to the conventional cytology which was in agreement with histology in 61% of the biopsies. Conclusions: In conclusion, the results of our study suggest that the liquid-based cytology is a more sensitive (80%) and specific (83%) technique than the conventional cytology (sensitivity=57%, specificity=65%) in comparison to histology as a gold standard. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Correlation between cytopathology and histopathology in women with squamous cell abnormalities of the uterine cervix(Macedonian Association of Pathology, 2016-09); ; ; ; Objective: The objective of our study was to investigate the correlation between cytology and cervical biopsy findings in women with squamous cell abnormalities on cervical cytology. Material and Methods: A comparative retrospective study was conducted in the period from September 2015 to March 2016 in a series of 184 sexually active women, aged from 20 to 60 years, with squamous cell abnormalities in the liquid-based cytology test. In all women, cervical biopsy with endocervical curettage was performed colposcopically for histopathological analysis. Results: Cytologically, there were 118 (64.13%) atypical squamous cells of undetermined significance (ASC-US), 22 (11.96%) low-grade squamous intraepithelial lesions (LSIL), 38 (20.65%) high-grade squamous intraepithelial lesions (HSIL) and 6 (3.26%) invasive squamous cell carcinoma cases. According to the histopathological findings in the cervical biopsy and/or endocervical curettage material in 108 (58.70%) women only nonneoplastic lesions were diagnosed. Twenty-four (13.04%) women had histologically confirmed LSIL, 42 (22.83%) had HSIL and in 10 (5.43%) cases invasive SCC was confirmed. For all squamous cell abnormalities, the sensitivity of the liquid-based cytology test in LSIL and higher grade lesions was 58.70% (108/184) and false positivity was 41.30% (76/184). Excluding ASC-US lesions, the sensitivity of the liquid-based cytology test was 78.80% (52/66) and the false positivity was 21.21% (14/66). The positive predictive value was 100% (6/6) for invasive SCC, 68.42% (26/38) for HSIL and 31.82% (7/22) for LSIL. Conclusions: The high sensitivity of the liquid-based cytology test for HSILs shows that it is an effective screening test for cervical cancer and its precursor lesions. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Atypical polypoid adenomyoma with coexistent well-differentiated endometroid adenocarcinoma(Macedonian Association of Pathology, 2016-09)