Utility of rapid staining of fine needle aspiration smears at the University Hospital of the West Indies

In a prospective study at the University Hospital of the West Indies, 187 fine needle aspiration cytology (FNAC) specimens, comprising 100 breast, 75 head and neck, and 12 miscellaneous specimens, were subjected to rapid Papanicolaou staining and immediate assessment. Inadequate aspirates were repeated, and all cases were also evaluated after routine Papanicolaou staining. Histologic and clinical follow-up data were obtained. The overall concordance between rapid and routine cytologic diagnoses ranged from 79 to 87 for the three specimen cohorts. Sensitivity and specificity values were similar for rapid and routine-stained slides and ranged from 80 to 100. There were no false positive or false negative diagnoses in the cases for which the outcome was known. Rapid staining of cytologic smears is a useful adjunct to the evaluation of aspirated material, improving adequacy rates and overall performance of the FNAC service, and should also result in significant savings in time and cost to patients

Angiomatosis of the breast in a male child. A case report with immunohistochemical analysis

Angiomatosis is a benign vascular lesion that has been described rarely in the breast. We describe a case in a seven-year-old boy of African descent who presented with progressively increasing, unilateral breast enlargement, the first such report in a male child. The patient underwent excisional biopsy of the breast mass followed by mastectomy. Pathologic examination revealed a diffuse proliferation of variably-sized, thin-walled vascular channels lined by flattened endothelium that showed negative immunohistochemical staining for von Willebrand factor, factor VIII-related antigen, CD34 and S-100 protein. There is no evidence of recurrence after 24 months of follow-up

Histopathological findings in women with postmenopausal bleeding in Jamaica

We investigated the histopathological findings in women presenting with postmenopausal bleeding in a population predominantly of African descent by conducting a six-year retrospective study of 716 gynaecological surgical specimens from 629 women accessed in the Department of Pathology, The University of the West Indies, Jamaica. Histopathological diagnoses were correlated with patients age, specimen volume, duration of bleeding and length of postmenopausal interval at presentation using t-tests and linear regression models. The mean (SD) age was 63.6 (9.3) years. The frequency of the main causes of postmenopausal bleeding was: endometrial hyperplasia (22.3); endometrial atrophy (21.3); non-diagnostic (19.9); endometrial carcinoma (9.5); cervical carcinoma (6.8); cervical polyps (4.5); endometrial sarcoma (3.5); proliferative endometrium (3.2). Mean (SD) duration of bleeding was 6.9 (12.7) months. The percentage of women with malignant lesions was two to three times greater than those reported in the United States of America and Europe subsequent to 1980. The delay between the onset of bleeding and presentation is worrisome and suggests the need for public educatio

Vaginitis emphysematosa associated with an abnormal Pap smear

Vaginitis emphysematosa is an uncommon inflammatory condition that is aetiologically linked to trichomonal or gardnerella infection, and has been associated with immunosuppressive disorders. The disease does not have deleterious sequelae and resolves on treating the underlying infection. We describe a case in which the disease predominantly affected the cervix leading to an abnormal pap smear and colposcopic investigation.

Severe pulmonary barotrauma

Pulmonary barotrauma is a well-known but rarely seen complication of mechanical intermittent positive pressure ventilation. It is thought to be related to raised pressures within alveoli which lead to their eventual rupture and the subsequent development of respiratory embarrassment. Mishaps related to faulty one-way valves in the self-inflating, bag-ventilation devices commonly used in cardiopulmonary resuscitation (CPR) can, although rarely, lead to severe barotrauma. In this report, we describe a case of pulmonary barotrauma that appeared to be related to the "locking" of the "Ambu" bag's one-way valve in the inspiratory position during routine CPR.

Testicular and paratesticular tumours at the University Hospital of the West Indies

A review of tumours of the testis and paratesticular region diagnosed at the University Hospital of the West Indies over a 30-year period revealed 14 of the former and 22 of the latter. The testicular tumours were all malignant, with 50 per cent of them being gerem-cell neoplasms. Seventeen of the 22 paratesticular tumours, (77.3%) were benign. The histological types, racial incidence and possible aetiological factors are discussed and compared with the findings of other series

Meckel-Gruber syndrome: a lethal combination of abnormalities

We herein describe two cases of Meckel-Gruber Syndrome identified in stilborn infants. Both had all three elements of the classical triad, namely, occipital encephalocele, renal cystic dysplasia and post-axial polydactyly. In addition, many of the other well-known accompanying abnormalities were present. Awareness of this entity in this region is important because of its high risk of recurrence in subsequent pregnancies

Amnion rupture sequence in Jamaica: a report on 2 cases

Two cases of amnion rupture sequence resulting in grossly malformed stillborn infants are described. One baby had marked craniofacial defects while the other had a combination of craniofacial, abdominal wall and limb abnormalities. These are the first such cases to be reported in the English-speaking Caribbean; and aspects of the aetiology, pathogenesis, clinical and pathological features are discussed