place of transvaginal color and pulsed Doppler sonography in the diagnosis of benign and malignant endometrial pathology in patients with post menopausal bleeding

Transvaginal color Doppler ultrasound [TVCDUS] may play significant role in diagnosis of endometrial pathology particulary endometrial carcinoma in women with postmenopausal bleeding [PMB]. Increasing experience in this field may help many women to overcome long waiting lists for surgery. In [65] women with postmenopausal bleeding we measured endometrial thickness [ET] [double layer] considering [8] mm as cut-off point to differentiate between benign and malignant endometrial lesions. We also looked for homogenicity, regularity of endometrium and integrity of sub endometrialhalo. [TVCDUS] was used to asses the vascularity, and vascular density of endometrium, myometrium and endometrial tumor. Resistance index [RI] and peak systolic velocity [PS] were also measured for endometrial, myometrial and uterine arteries. Correlation between [TVCDUS] and results of histopathology of endometrial specimens [24 hysterectomy and 41 D and C] was done. [ET] of [8] mm was found to be predictive for endometrial carcinoma with sensitivity of 100% and visualization rate of endometrial flow was significantly higher in case of carcinoma versus benign conditions of endometrium. Vascular density was significantly higher in case of carcinoma. [RI] of [0.42] was considered as cut-off point to differentiate between benign and malignant lesions with sensitivity of [80%]. [PI/ ] for myometrial and uterine arteries were not significantly different between cancer and benign conditions. TVCDUS has an important role in diagnosis of endometrial carcinoma especially in high risk group of women. Intra-tumoral blood flow is more sensitive marker of carcinoma than uterine blood flow. Adopting this method with increasing experience may result with considerable saving of both potential and economic costs

Granulosa cell tumour a clinico pathologic study

19 granulosa cell tumour [GCT] were reviewed and re-evaluated clinically and histologically. The age range between 18-53 years. Patients were divided into two age groups. They young age group [younger than 40 years] which Consisted of eight patients, and the old age group [older than 40] which consisted of eleven patients. The usual clinical presentation of those patients was generally vaginal bleeding in the older age group, or-post-menopausal bleeding, and/or abdominal mass. while the young age group presented with amenorrhea, vaginal bleeding and abdominal mass in order of frequency. Juvenile G C T. has distinctive clinical and pathological subtype and is associated with better prognosis. The operative and histologica findings are of great importance in the assessment of the outcome. Patients with juvenile G.C.T. carry better outcome even with the presence of cytological atypia and mitotic divisions. The operative finding of a tumour that invades the surface of the ovary with Local and omental metastasis needs more aggressive treatment. Since a large group of our patients are of the child bearing age, the critical decision of treatment for young women with stage la disease [whether conservative or to chose more radical treatment] is the responsibility of both the pathologist and the clinician

Long-term cytologic follow-up studies of copper intrauterine contraceptive device users

Cytologic evaluation in the form of multiple follow-up studies was carried out in [210] women using Copper IUCD for a period ranging from 18-72 months. Age of those women ranged from 21-42 years. Pre-insertion smears were available for nearly half of them. The main encountered cytologic abnormalities included squamous metaplasia [70.5%] endocervial cell proliferation and repair [59%], abnormal endometrial cell shedding [24%] and dysplais: [9.5%]. While the former two lesions showed a significant association with loop insertion, the rate of dysplasia did not reveal any significant change during the six-month period of follow up. The results of the present work, therefore, support the observation noted by other major studies that there is no significant enhancement of cervical cytologic neoplasia from up to six years of using IUCD

Comparative study: laparoscopic hormonal and cytological assessment of ovulation

To assess ovarian function in forty nine infertile women seen and managed at Saddam Medical City Teaching Hospital where laproscopy, hormonal and cytological studies were performed. Serial vaginal sears and 24-hours urine collection were arranged weekly for 4-8 weeks for cytological and hormonal study regarding ovarian function. Results revealed; congenital adrenogenital syndrome was noted in 4%. Stein-Leventhal syndrome in 25%, ovarian hypofunction with apparently normal looking ovarian in 18%, ovarian failure 14%, and groups leuteum insufficiency in 8% while the rest of 31% had normal ovulation

importance of cytological study of cervical smears

Cervical smears stained by papanicolou technique were examined in 1000 patients referred from the Gynaecology outpatient Department in the Medical City Teaching Hospital Inflammatory cells were found in 615[61.5%] patients, different grades of dysplasis in 169 [16.9%] patients, malignant cells in 11 [1.1%] patients; whereas no abnormal cells were found in 205 [20.5%] patients. Routine pap smear can be performed to detect high risk group of patients for further detailed diagnostic means of cervical cancer