Transvaginal sonography versus saline infusion sonohysterography, which has better diagnosing accuracy in detecting cause of abnormal uterine bleeding in perimenopausal women?

Background: Saline infusion sonohysterography (SIS) is a simple, safe, reliable, effective and well-tolerated method without complications that complements transvaginal sonography (TVS) in the pre-operative examination of uterine pathology. SIS has been found to be superior to TVS in most studies that have compared their effectiveness in detecting intracavitary lesions and has also been found to decrease the number of diagnostic hysteroscopies to as much as 50%. Patients in whom no intracavitary abnormality is detected by SIS require no further evaluation and are best treated with medical therapy.Methods: The observational study was conducted in the postgraduate department of gynaecology and obstetrics, Lalla Ded Hospital, Government Medical College Srinagar. All consecutive patients with perimenopausal abnormal uterine bleeding attending gynaecology OPD were enrolled in the study after taking informed written consent.Results: SIS has better accuracy than TVS in diagnosing the cause of AUB in perimenopausal women. TVS had sensitivity, specificity and PLR of 60 and 93.8, 9.8, respectively for fibroids while polyps had 27.3, 98.8 and 17.5, respectively, AUP had 81.8, 79.2, 3.9 respectively. SIS had sensitivity, specificity, PLR and NLR values of 80.0, 96.9, 40.7 and 0.21, respectively for diagnosing fibroids, while 63.6, 98.4, 26 and 0.37 respectively for polyp, and 90.9, 94.3, 16.1 respectively for AUP.Conclusions: Accuracy of SIS as a test for detecting pathology in AUB in perimenopausal patients is moderately good and suitable for developing countries.

Histopathologic findings in uteri and ovaries collected from clinically healthy dogs at elective ovariohysterectomy: a cross-sectional study

Opinions on ovariohysterectomy (OHE) of bitches vary depending on region and country. In this descriptive, prospective cross-sectional study, uterine tracts and ovaries exhibiting gross pathologic findings (n = 76) were collected post-surgery from a reference population of 3,600 bitches (2.11% incidence) that underwent elective OHE during September to November 2013 and evaluated by histopathology examination. Data were evaluated by using descriptive statistics and chi-squared tests. Bitches were of crossbred background with average age 5 years (range 0.6–8.0 years) and most were nulliparous (69.7%) with no anamnesis of reproductive diseases (81.6%). Frequencies of proestrus, estrus, and diestrus were 42.1%, 6.6%, and 19.7%, respectively. The presence of mammary gland masses (5.3%) significantly correlated with histopathologic findings in ovaries and age of the bitch (p < 0.05). Predominant uterine histopathologies included cystic endometrial hyperplasia, periglandular fibrosis, lymphoplasmocytary endometritis, and adenomyosis (19.7%, 14.5%, 4.0%, and 2.6%, respectively). In ovaries, hyperplasia of rete ovarii, follicular cysts, oophoritis, adenoma of the rete ovarii, cysts of superficial structures, and granulosa cell tumors (10.5%, 10.5%, 7.9%, 4.0%, 2.6%, and 2.6%, respectively) were observed. The results reveal the presence of subclinical pathologies in healthy bitches, suggesting that OHE at an early age is beneficial for prevention of reproductive pathologies.

Adenomiose uterina em gata associada à piometra / Uterine adenomyosis in a queen associated to pyometra

Adenomyosis, a non-neoplastic myometrial proliferation, is a rare pathologic condition in domestic animals, of unknown etiology. There is a lack of information about the clinical and pathological features of this disease in cats, therefore just a few reports in that species. The study describes a case of adenomyosis in a feline female. A cat, six years old, undefined breed, not spayed, had abdominal swelling history and vaginal discharge. Clinically, upon abdominal palpation, a diffuse increase suggesting a uterine change was found. The vulva had sanguine-purulent exudates. The choice was for the neutering surgical. Uterine macroscopy revealed cystic endometrial hyperplasia/pyometra in uterine horns, and the presence of a diffuse mass on uterine corpus. Fragments of the mass were sent for histopathological analysis, which revealed adenomyosis of the uterine corpus. The patient exhibited adequate post-operative recovery. The adenomyosis should be considered as a differential diagnosis of uterine neoformation in domestic cats.(AU)

Hemangiosarcoma hepático con metástasis a útero en un felino. Reporte de un caso / Hemangiosarcoma hepático com metástases a útero em um gato. Reporte de um caso / Hepatic haemangiosarcoma with metastasis in uterus in a feline. Case report

El hemangiosarcoma (HSA) es un tumor maligno del endotelio vascular. En gatos esta neoplasia es rara, pues solo un 2% de los diagnósticos de tumores malignos corresponde a HSA hepático. En este informe se presenta el caso de un paciente felino con dilatación abdominal, un mes de evolución, dolor abdominal y anorexia con duración de 3 días. En la necropsia se halló: hidrotórax, dilatación cardiaca derecha, hígado con moteado blanco o amarillo claro de 1 a 2 mm de diámetro y zonas necróticas multifocales de color rojo oscuro sobre la superficie. En útero se encontró dilatación del cuerno izquierdo con múltiples masas sólidas con contenido sanguinolento. Microscópicamente se diagnosticó un HSA hepático con metástasis en útero.

The Haemangiosarcoma (HSA) is a malignant tumor of the vascular endothelium. It is a rare neoplasic in cats, just a 2% are reported from all the malignant tumors presented this species and is highly metastasic. The hepatic HSA embraces from 0 to 6-12% of the primary hepatic neoplasics. In this report a case of a feline patient which was suffering from one month of evolution abdominal dilatation, and tree day abdominal pain and anorexia is presented. During necropsy hydrothorax, right cardiac dilatation, liver with white or light yellow mottled appearance on cut surfaces of 1-2 mm of diameter and necrotic multifocal zones with dark red color and in the uterus, dilatation of the left horn with multiples solid masses with bloody content were found. The case was microscopically diagnosed as a hepatic HSA with metastasis to the uterus.

O hemangiossarcoma (HSA) é um tumor maligno endotelial vascular. Em gatos esta neoplasia é rara, pois só 2% dos diagnósticos de tumores malignos correspondem a HSA do fígado. Este relatório apresenta o caso de um paciente felino com inchaço abdominal, um mês de evolução, dor abdominal e anorexia de três dias de evolução. A autópsia foi encontrada: hidrotórax, dilatação cardíaca direita, fígado manchado com branca ou amarela, de 1 a 2 mm de diâmetro e áreas necrótica multifocales vermelhas escuras na superfície. Em útero foi encontrada dilatação do corno esquerdo com múltiplas massas sólidas com conteúdo sangrento. Microscopicamente foi diagnosticado HSA hepático com metástases no útero.