Cervical Squamous Intraepitherial Lesions at King Faisal Hospital: A Systematic Review: April 2009 - April 2011

Background: The cervical cancer is the most common cause of mortality with cancer among women in developing countries. Cervical screening tests are used to detect precancerous lesions in various stages of development when they can be treated. Screening for cervical cancer involves women who are at risk for cervical cancer but have no current signs; symptoms or complaints referable to the cervix; or have no previous abnormal Pap smear and have no high risk factors for cervical cancer. This retrospection study was to review cervical smears evaluated in 24 months and squamous intraepithelial lesions detected among the 1;673 cases studied. Methods: Ethanol and spray fixed cervical smears were received by the laboratory from the outpatients department at King Faisal Hospital and from collaborating institutions. The smears were stained by Papanicolaou method and evaluated on the light microscope. 1;673 smears were selected for this study. Results: There were 19 (19/1673) squamous intraepithelial lesions of various grades. 7 (7/19) were low grade squamous intraepithelial (LS1Ls); 11 (11/19) were high grade squamous intraepithelial lesions (HSILs) and 1 (1/19) was adenocarcinoma. 5 (5/19) lesions were associated with human papillomavirus (HPV) infection. Conclusion: This review shows a low incidence of cervical squamous intraepithelial lesions due to the high cost of the test in a high cost health care institution; hence the small number of risky women accessing the test. A bigger study to include a spectrum of all risky women is required

Effusion Cytology at King Faisal Hospital; Kigali: A Review of 151 Cases

Introduction: The clinical management of patients presenting with effusions requires the determination of the cause of the effusion for direction of options of management. The cytologic examination of the effusion is usually required to rule out or confirm malignancy. This is a retrospective review of 151 effusions cytologically investigated at King Faisal Hospital. Methods: One hundred and fifty one effusions collected in EDTA tubes were investigated. The specimens were centrifuged; and from the sediment alcohol-fixed; air-dried smears were prepared for Papanicolaou and Diff-Quik staining; respectively. Results: From the total of 151 effusions; malignant cells were identified in 26 cases as follows: 15 pleural; 8 ascitic and 3 peritoneal malignancies consisted of 15 adenocarcinomas; 5 lymphomas; 3 mesotheliomas 2 myelomas and 1 small cell carcinoma. Conclusions: Malignant effusions constituted 17 percent of all the effusions examined. Adenocarcinomas were the most frequently diagnosed metastatic malignancies in both pleural and ascitic effusions and in both females and males. Primary sites of most of the malignancies could not be determined except for mesotheliomas and small cell carcinoma