Assessment of association of lobular neoplasia in tru-cut needle biopsy specimens with a low risk of ductal carcinoma on subsequent excision

To determine the rate of duct carcinoma in situ and invasive carcinoma in subsequent excisions for lobular neoplasia alone on core needle biopsy. It was an analytical study. Damanhour National medical Institute, Egypt from July 2004 to August 2006. Result of 117 cases of breast core needle biopsy diagnosed as lobular neoplasia were reviewed over a period of 2 yrs. Additional lesions were also identified including the presence of ductal carcinoma in situ [DCIS] or invasive carcinoma and atypical ductal hyperplasia [ADH] Tissue follow-up was obtained from hospital records. Statistical analysis was performed using a 2-tailed fisher exact test. Lobular carcinoma was diagnosed by core needle biopsy in 117 women; in 25 [21.6%], invasive carcinoma [IC] or ductal carcinoma in situ [DCIS] was diagnosed concurrently. Two patients had previous diagnoses of IC or DCIS, and 4 [3.6%] had a concurrent diagnosis of contra-lateral IC or DCIS. Of 92 patients without a concurrent diagnosis of IC or DCIS, subsequent tissue diagnoses were available for 39 eases [42.6%]. Of 15 cases of lobular neoplasia and atypical ductal hyperplasia on the biopsy, 1 had IC and 3 had DCIS on the excision. Of the women with lobular neoplasia and a mucoeele-like lesion on the biopsy, none had IC or DCIS on excision. Of 23 with lobular neoplasia alone on the biopsy, 2 had IC on excision. As lobular carcinoma is associated with a high overall rate of IC and DCTS [30%], women in whom biopsy sites are excised are still at risk for subsequent DCIS and IC

Comparative study of human papilloma virus DNA detection and results of histopathological examination of cervical colposcopic biopsies

In our study, we investigated the factors that may participate to false-negative colposcopic biopsy results. It was a descriptive study. Damanhour National Medical Institute Hospital [DNMI] during the period from January 2004 to August 2006. A computerized search identified patients with ASC Pap test results and positive results of reflexive high-risk HPV DNA testing during the period of study. Patients who underwent subsequent colposcopic-directed biopsy and/or endocervical curettage with no histologic evidence of HPV infection or dysplasia were selected for the study. Three levels were obtained from each block and stained with H and E. The original H and E-stained glass slides were reviewed. For cases that still were diagnosed as negative for dysplasia or HPV cytopathic effect on review, 3 additional H and E-stained levels were obtained. For the few cases in which there was disagreement with regard to the original and reviewed diagnoses, the discrepancy was recorded, and no other tissue sections were ordered. Patients with atypical squamous cells of undetermined significance [ASC] in Papanicolaou smears, with positive HPV DNA results, but negative cervical histopathologic findings accounted for 4.5% of all ASC smears submitted for HPV DNA testing. We found 4% of the cases had focal HPV infection or mild dysplasia. When serial sectioning of the biopsy material were examined, we found that 31% had clinically significant lesions: HPV infection or cervical intraepithelial neoplasia [CIN] 1, 19%; CIN 2/3, 8%; and dysplasia, not otherwise specified, 3%. Of the remaining patients, follow-up revealed squamous abnormalities in 25%. About 5% of patients with positive HPV DNA results had a negative follow-up biopsy result. [False-negative] biopsies.We recommend that additional levels have to be obtained when initial histologic sections do not demonstrate evidence of dysplasia or HPV cytopathic changes after a cytologic diagnosis of ASC and a positive HPV DNA test result