Intraoperative imprint cytological diagnosis of heterotopic thyroid presenting as sellar mass

A 43-year-old woman presented with headache, nausea, severe visual impairment and galactorrhea and decreased visual acuity. A 4 x 3.5 x 3 cm mass completely filling the sphenoid sinus, elevating the pituitary gland and stalk was observed. The patient underwent transsphenoidal removal of the lesion to alleviate visual loss. The tumor cells showed strong positivity for thyroglobulin and TTF-1. This patient was followed up for 2 years after the operation; the laboratory study and computed tomography showed no lesions. In conclusion, this is a rare benign finding in which complete surgical resection achieves a cure

Cost is a Barrier to Widespread Use of Liquid-Based Cytology for Cervical Cancer Screening in Korea

This study aimed to document current cervical cancer screening practices of physicians in Korea. Questionnaires were distributed to 852 Korean obstetricians and gynecologists, who attended the 91st Conference of the Korean Society of Obstetrics and Gynecology held during May, 2005. Questionnaires were returned by 30.6% (260/852) of the recipients and 254 of these were eligible for analysis. Sixty-seven percent started cervical cancer screening women at age 20, and 65% replied that they would continue annual screening in a 35-yr-old woman with three consecutive normal cytologic tests. Over 65% of respondents preferred conventional cytologic screening to liquid-based cytology. The cost was a major determinant for selecting screening method. Fifty-three percent used the human papillomavirus DNA test as a triage for atypical squamous cells of undetermined significance. Our findings suggest that majority of Korean obstetricians and gynecologists in hospital prefer annual conventional cytologic testing to liquid-based cytology for financial reason.

Diseño y métodos de un estudio de la historia natural de la neoplasia del cuello uterino en la población de una provincia rural de Costa Rica: el proyecto de Guanacaste / Design and methods of a population-based natural history study of cervical neoplasia in a rural province of Costa Rica: the Guanacaste Project / Des

This paper reports on the enrollment phase of a population-based natural history study of cervical neoplasia in Guanacaste, a rural province of Costa Rica with consistently high rates of invasive cervical cancer. The main goals of the study are to investigate the role of human papillomavirus (HPV) infection and its co-factors in the etiology of high-grade cervical neoplasia, and to evaluate new cervical cancer screening technologies. To begin, a random sample of censal segments was selected and enumeration of all resident women 18 years of age and over was conducted with the aid of outreach workers of the Costa Rican Ministry of Health. Of the 10 738 women who were eligible to participate, 10 049 (93.6%) were interviewed after giving written informed consent. After the interview on cervical cancer risk factors was administered, a pelvic examination was performed on those women who reported previous sexual activity. The pelvic examination included a vaginal pH determination and collection of cervical cells for cytologic diagnosis using three different techniques. Additional cervical cells were collected for determination of the presence and amount of DNA from 16 different types of HPV, and two photographic images of the cervix were taken and interpreted offsite by an expert colposcopist. Finally, blood samples were collected for immunologic and micronutrient assays. Women with any abnormal cytologic diagnosis or a positive Cervigram, as well as a sample of the whole group, were referred for colposcopy, and biopsies were taken when lesions were observed. The enrollment screening will serve as the basis for a prevalent case-control study, and the members of the cohort free from serious disease will be followed actively, at intervals of no more than a year, to study the natural history of HPV infection and the origins of high-grade squamous intraepithelial lesions (HSIL). Details of the field operation are outlined, with particular reference to the realization of this kind of study in developing countries. Descriptive data on the prevalence of disease and exposure to various risk factors are also presented.

En este documento se informa sobre la fase de inscripción de un estudio de la historia natural de la neoplasia de cuello uterino basado en la población de Guanacaste, una provincia rural de Costa Rica con tasas constantemente elevadas de cáncer cervicouterino invasor. Las principales metas del estudio son investigar el papel de la infección por virus del papiloma humano (VPH) y otros factores relacionados con la etiología de la neoplasia cervicouterina de alto grado, así como evaluar las nuevas tecnologías de detección de cáncer de cuello uterino. Se comenzó por seleccionar una muestra aleatoria de segmentos censales y enumerar todas las mujeres de 18 años o más que residían en ellos, con ayuda de varios agentes de extensión del Ministerio de Salud de Costa Rica. De las 10 738 mujeres que reunían las condiciones exigidas para participar, se entrevistó a 10 049 (93,6%) que dieron su consentimiento informado por escrito. Una vez concluida la entrevista sobre los factores de riesgo de cáncer de cuello uterino, se les realizó un examen pélvico a las que declararon haber tenido actividad sexual previa. Dicho examen incluyó una determinación del pH vaginal y recolección de células del cuello de útero para diagnóstico citológico con tres técnicas diferentes. Se recolectaron otras células cervicouterinas para determinar la presencia y cantidad de ADN de 16 tipos diferentes de VPH y se tomaron dos imágenes fotográficas del cuello uterino, que fueron interpretadas en un establecimiento externo por un colposcopista experto. Por último, se tomaron muestras de sangre para inmunovaloración y análisis de micronutrientes. Las mujeres con diagnóstico citológico anormal o cervigrama positivo, junto con una muestra de todo el grupo, se enviaron a otros servicios para colposcopia, y se tomaron biopsias en los casos en que se observaron lesiones. El tamizaje realizado para efectos de la inscripción servirá de base para un estudio de casos prevalentes y controles (testigos) y se realizará un activo seguimiento de los miembros de la cohorte sin enfermedad grave, a intervalos no mayores de un año, para estudiar la historia natural de la infección por VPH y los orígenes de las lesiones intraepiteliales escamosas de alto grado. Aquí se dan detalles de la operación realizada sobre el terreno, con referencia en particular a la realización de esta clase de estudio en un país en desarrollo. También se presentan datos descriptivos de la prevalencia de la enfermedad y la exposición a varios factores de riesgo.

Controle do cancer cervical no Brasil / Cervical cancer control in Brazil

O cancer cervical no Brasil e um problema de resolucao tecnicamente possivel, porem ainda nao ha uma determinacao politica em se estabelecer o seu controle. Os autores relatam experiencias em Campinas e no Estado de Sao Paulo de Programas de Controle do Cancer do Colo Uterino e mostram sua viabilidade.

Fine-needle aspiration cytology in the diagnosis of breast masses

A study to detect the efficiency of Fine-Nieedlc Aspiration Cytology [FNAC] in evaluation of breast masses was carried out at DHQ Teaching Hospital, Abbotabad. During a period of 18 months, a total of 107 cases were studied, all of whom were females. They included 34 malignant and 73 benign lesions. A comparison, with histopathology of lesions showed a sensitivity of 76.47%; specificity of 100% and accuracy of 76.64% with no false-positive case on record. Hence it was concluded that FNAC could be adopted as a diagnostic tool in the evaluation of breast masses and conventional biopsy could be resorted to in lesions where FNAC is not conclusive

Indice de calidad en citología en una muestra probabilística en la Cd. de México / Quiality indez in cytology in Mexico Cyty acoording to a probability sample

Se realizó una evaluación externa de la calidad del espécimen en citología ginecológica (PAP) en el laboratorio de Citopatología del Hospital General de la Ciudad de México para lo cual se evaluaron 6011 pruebas de PAP seleccionadas en forma aleatoria de 31,378 estudios de PAP reportados previamente como negativos, en el período 1988-1989. Se construyó un índice de calidad del espécimen con base en la presencia de células encocervicales, moco y metaplasia epidermoide. El índice de calidad construido reveló que el 64.1 por ciento de los especímenes son de baja calidad. La correlación entre el error diagnóstico y la calidad del PAP fue de 0.87. Estos resultados muestran la necesidad de instrumentar programas de evaluación externa en el diagnóstico de PAP, así como adiestramiento permanente en registro, técnicas de monitoreo en obtención, fijación y transporte del material de citología en los laboratorios de detección de cáncer poblacional.