Non-diethylstilbestrol-associated primary clear cell carcinoma of the vagina: two case reports with immunohistochemical studies and literature review

Primary clear cell adenocarcinomas most commonly involve the genitourinary system, including the vagina. Previously, primary clear cell adenocarcinomas of the vagina have been discussed within the context of prenatal exposure to diethylstilbestrol. Due to its widely proven role in the development of this carcinoma, administration of diethylstilbestrol is prohibited. We present two cases of non-diethylstilbestrol-associated primary clear cell adenocarcinoma of the vagina from the archives of the Anatomical Pathology Department at King Abdulaziz University in order to improve our understanding of its biological behavior. Our findings suggest that primary clear cell adenocarcinoma of the vagina may be unrelated to diethylstilbestrol exposure and that non-diethylstilbestrol-associated primary clear cell adenocarcinoma of the vagina, when present at a younger age, may have a worse prognosis

Pattern of cervical smear abnormalities using the revised Bethesda system in a tertiary care hospital in western Saudi Arabia

To evaluate Pap smear [PS] diagnoses at a tertiary care hospital using the revised Bethesda system, and to compare the results with other similar studies. We designed a retrospective study to review all PS from the Cytopathology Department of King Abdulaziz University Hospital, Jeddah, Saudi Arabia from January 2005 to December 2009. Of the 7297 cases reviewed, 1254 cases [17.3%] had epithelial cell abnormalities. The categories included: atypical squamous cell of undetermined significance [ASC-US] found in 9.3%, atypical squamous cell, cannot exclude high squamous intraepithelial lesion [ASC-H] in 0.8%, low grade squamous intraepithelial lesion [LSIL] in 2.7%, and high grade squamous cell lesion [HSIL] in 0.9%. The mean age incidence [MAI] was 40 years for ASC-US, 42 years for ASC-H, 47 years for LSIL, and 45 years for MAI. Squamous cell carcinoma [SCC] was found in 0.06% with mean age incidence of 46 years. In the atypical glandular cell category, there was 3.2% atypical glandular cell of undetermined clinical significance not otherwise specified, 0.1% atypical glandular cells favoring neoplasm, and 0.08% atypical endometrial cells favoring neoplasm. The incidence of abnormal PS has increased from previously 4.7%, to 17.3% in the present study. The ASC-US among total PS examined has also significantly increased. The increase in the number of positive PS raises concerns of whether the new BS results are an artificial increase in the prevalence and the predictive value of cytology to some extent.

Age related prevalence and pattern of biopsy proven celiac disease in saudi patients

Celiac disease [CD] is an autoimmune enteropathy against gluten containing grains. The prevalence of the disease is well studied and known in the developed countries. Scarce studies about the prevalence of the disease in our region of the world were found. In the current retrospective study we calculated the age and sex related prevalence and pattern of CD in our institute. We studied all small intestinal biopsy samples that arrived to our histopathology laboratory from Saudi patients with clinical diagnosis or clinical suspicion of CD and that were histologically proven CD in the period between 2000-2009. We did the age and sex related correlations. Prevalence of CD was found to be 25.6% among 472 patients. The majority of the patients were females [64.78%], and the highest prevalence was between 17-60 years of age [29.75%]. CD was more prevalent among Saudi pediatric males than adults