Accuracy of Thinprep Imaging System in detecting atypical glandular cells.

The aim of this study was to evaluate the accuracy of the ThinPrep Imaging System (Imager) in detecting atypical glandular cells (AGC) or adenocarcinoma in the 22 selected fields. All cases reported as AGC or adenocarcinoma from January 2005 to December 2006 that had been initially screened by the Imager were retrospectively reviewed to determine whether the most diagnostically relevant groups/cells were within the 22 selected fields. A total of 39 cases were reviewed. The cases were divided into two groups: the group with diagnostic cells detected within the 22 selected fields (accurately detected group) and the group with upgraded diagnosis following rescreening process (underdetected group). The Imager accurately detected 32 (82%) of cases with abnormal glandular cells, including six cases reported as adenocarcinoma, one case as adenocarcinoma in situ (AIS), and 25 cases as AGC. In seven (18%) cases, the Imager failed to detect the most abnormal cells within the 22 selected fields. Among these, one case was adenocarcinoma, while the rest were reported as AGC. Overall, four cases were assessed as atypical during quality control (QC) rescreening even though the Imager detected abnormal groups in most. Fourteen of 32 cases had abnormalities proven by histologic follow-up. Overall, the Imager was effective in detecting most AGC, AIS and invasive adenocarcinomas. In a minority (18%) of cases, the Imager failed to detect the cells of interest within the 22 selected fields. However, full manual review of cases with potential atypical/reactive groups or endometrial groups in women > or = 40 and QC rescreening of selected cases may help to minimize the underdetected cases.

Pseudallescheriasis: a summary of patients from 1980-2003 in a tertiary care center.

CONTEXT: Pseudallescheria boydii is being increasingly isolated in immunocompromised patients. OBJECTIVE: To present 24 years of data on patients from whom P. boydii was isolated. DESIGN: Retrospective review of archival laboratory data and patient charts at a tertiary care hospital with a full service mycology laboratory. All patients evaluated from whom P. boydii was isolated between 1980 and 2003 were included in this study. RESULTS: Twenty-four patients from whom P. boydii had been isolated were identified. The majority of cases represented pulmonary involvement, particularly in cystic fibrosis patients. Three additional patients had infections in surgical or traumatic lesions of the head and 4 had disseminated disease. Invasive disease was associated with underlying malignancy or transplantation and resulted in death secondary to the fungal infection in the majority of cases. CONCLUSIONS: Pseudallescheria boydii may cause significant disease in humans. Invasive infections with P. boydii are often misdiagnosed and inadequately treated. Aggressive treatment of locally invasive disease may be of value in preventing rapid and fatal dissemination with this organism.

Periurethral carcinosarcoma: a report of 2 cases with a review of the literature.

Carcinosarcomas are rare, aggressive tumors that can arise in various sites of the body, especially the genitourinary system. In this system, the most common location for the tumor is the uterus in the female and the urinary bladder in the male. To our knowledge, only 2 cases with a periurethral location for this tumor have been previously described in the English literature. We describe 2 additional cases in this location, one in either sex, with a review of the relevant literature.