Prevalence and characteristics of abnormal papanicolaou smear in central Saudi Arabia

To assess the prevalence and characteristics of abnormal pap smear in the central region of Saudi Arabia. In this retrospective case control study conducted in the Departments of Obstetrics and Gynecology, and Histopathology at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, all pap smears screened for Saudi women between 2008 and 2011 were reviewed. Approximately 5000 pap smears are screened annually at King Abdulaziz Medical City utilizing the Bethesda III System [2001]. All abnormal smears patients' data were collected and compared to the data of randomly selected 200 normal smears' patients. Abnormal pap smear prevalence was found to be 4.3% [841/19,650 Saudi patients were found with atypical epithelial cells abnormalities]. Its prevalence in the years 2008 was 5.7%, 2009 was 4.9%, 2010 was 4.2%, and 2011 was 2.5%. Abnormal smear patients have lower parity [p=0.001], and were less likely to use intra-uterine devices [p=0.03] compared with normal smear patients. Presence of abnormal cervical appearance was associated with increased epithelial cell abnormalities [p=0.045]. The only positive history that has characterized patients with epithelial cell abnormalities was their previous history of abnormal pap smear [p=0.001]. Squamous cell abnormalities were identified in 91% of the patients [767/841], and glandular cell abnormalities were identified in 9% of the patients [74/841]. Prevalence of abnormal pap smears in central Saudi Arabia is relatively low, while advanced glandular abnormalities prevalence was observed to be high

Sinus histiocytosis with massive lymphadenopathy [Rosai-Dorfmans Disease] as cause of isolated hilar lymphadenopathy and complete remission after high dose steroid

Rosai-Dorfman's Disease, also known as sinus histiocytosis with massive lymphadenopathy SHML, is a rare histiocytic proliferative disorder and a distinct clinico-pathological feature of unknown origin. Painless cervical lymphadenopathy is the most common clinical presentation. Different treatment modalities have been tried with variable responses, however, there is no consensus on the best modality of treatment. Here, we present a case report of SHML causing isolated hilar lymphadenopathy with complete remission for more than 6 years, after a short course of high dose steroid dexamethasone 20 mg daily for 3 days