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The aim of this study is to investigate the feasibility of the conventional Papanicolaou stain in diagnosing Pneumocystis carinii pneumonia in patients with HIV infection in comparison with the special stain, Grocott modified Gomori’s methenamine silver (GMS.) Bronchial washing bronchoalveolar lavage specimens from 28 HIV - positive patients, admitted to Srinagarind Hospital, Khon Kaen University during the Period from January 1992 to September 1993, were first screened for Pneumocystis carinii in Papanicolaou – stained slides. The main diagnostic criteria included the presence of foamy masses and the apparent outline of the parasite cyst wall . After this, the slides were dstained, then restained with silver stain by the GMS method in 12 out of the 28 cases, while 10 cases were positive using the Papanicolaou technique. The sensitivety, specifivity and accuracy of the Papanicolaou stain in the diagnosis of Pneumocystis carinii in bronchial washing bronchoalveolar lavage were 83.3% , 100%, and 92.5% , respectively, when compared with the GMS method. There was no significance in the fequency of detection between both methods. Therefore, the Papanicolaou technique, which is used routinely in the cytology laboratory, can be used for the simple and rapid initial diagnosis of Pneumocystis pneumonia in bronchial washing / bronchoalveolar lavage specimens.
RESUMEN
From January 1989 to December 1993, 53,526 cervical smears were studied to detect common specifec infection including fungus, Trichomonas, Leptothrix, HSV and HPV infection in Cytology Laboratory, Department of Pathology, Faculty of Medicine, Khon Kaen Uiversity. The prevalence of fungus, Trichomonas, Leptothrix, HSV add HPV infection were 17.9% 0.1%, 0.1% and 0.5% respectively. In the 3,414 abnormal Pap smear, the coexisted infection of fungus, Trichomonas, Leptothrix, HSV and HPV infection were 10.2%, 3.5%, 0.1%, 0.7% and 7.5% respectively. It is noted that, most of these infection could be detected alone much more than coexisting with abnormal Pap smear, except HPV infection where all cases coexisted with abnormal Pap smear. And HSV infection that occurred alone was 55.8% comparing to infection associated with abnormal Pap smear was 44.2% , which is about the same proportion. The diagnosis of these micro – organism in Pap smear is useful for routine screening examination in the large population study . It is useful in convincing the clinician to pay special attention to the patients, who had HPV and HSV infection. They were considered to be a high risk patients for cervical cancer who should be closely followed in order to detect precncerous lesion which can be satisfactory treated.
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Background: Cholangiocarcinoma, the cancer of biliary epithelium, is highly prevalent in Northeast Thailand and is associated with the liver fluke, Opisthorchis viverrini, infection and the consumption of carcinogen contaminated daily food. Diagnosis of this cancer is practically based on clinical and utrasonography. However, several markers can be used in conjunction with the standard procedure to increase diagnosis accuracy including biliary cytology as described in carcinoma of other pancreatobiliary diseases. On the basis of cancer cells can be exfoliated into the bile and they can be detected by routine Papanicolaou staining. In endemic areas of cholangiocarcinoma and opisthorchiasis, there is no report about biliary cytology and percentage of positive malignant cells presented in the bile, here we examined biliary cytology of the gallbladder and/or hepatic bile to clarify its usefulness potential for using in diagnosis.Objective: To study biliary cytology and examine Opisthorchis-ova in the gallbladder/hepatic bile in patients with cholangiocarcinoma in Northeast Thailand.Patients and Methods: Aspirated gallbladder and/or hepatic bile from 100 histological proven cholangiocarcinoma cases who admitted to Srinagarind Hospital during December 1996 to July 1998 were studied. Four Papanicolaou\’s stained smears per bile sample per case were examined for the presence of malignant or atypical cells and O. viverrini ova. Positive specimens for malignancy contained singly, numerous malignant cells and/or in three dimensional clusters. Liver fluke positive cases contained ova with distinct bilaminar walls and prominent shoulder.Results: Overall, the positivity for malignant cells and O. viverrini ova was 51 % (51/100) and 27 % (27/100), respectively. Five cases were suspicious for malignancy. Paired gallbladder and hepatic bile specimens were obtained in 32 cases. Of these, the positivity for cancer cells was significantly higher in the hepatic bile than in the gallbladder bile (2-test, p\<.01). Five cases with gallstone were negative for malignant cells.Conclusion: The results indicate that cancer cells are frequently detected in the bile, particularly in hepatic bile from patients with cholangiocarcinoma. This study implicates the potential application of biliary cytology in diagnosis of this cancer, i.e. in the bile from ERCP or duodenal drainage which is less invasive, in conjunction with other investigations in endemic areas.
RESUMEN
Objective: To compare the cytologic diagnosis of a liquid-base, Thin-layer preparation and conventional cervical smear.Material and Method: Ninety nine cervical smears were processed conventional method and with the ThinPrepÒ Pap test. Cytologic diagnosis based on the Bethesda system 2001.Results: Of the 99 pair slides of conventional and ThinPrep Pap test smears interpreted during the study period. All smears were cytologic diagnosed as negative for intraepithelial lesion or malignancy (90 conventional and 85 ThinPrep smears), atypical squamous cells of undertermined significance, ASC-US (1 conventional and 5 ThinPrep smears), low-grade squamous intraepithelial lesion, LSIL (0 conventional and 2 ThinPrep smears), high-grade squamous intraepithelial lesion, HSIL (4 conventional and 3 ThinPrep smears), Invasive cervical cancer (4 agreement by conventional and ThinPrep smears).Conclusion: The ThinPrep Pap test is more sensitive method of detecting ASC-US and squamous intraepithelial lesion than the conventional Pap smear in this preliminary study.