ABSTRACT
A 54-year-old man was referred with nonresolving pneumonia. He had been treated for community-acquired pneumonia 6 weeks earlier. He reported grade 2 dyspnea, malaise, and a nonproductive cough. He had also experienced three episodes of minimal hemoptysis but denied weight loss, fever, or any other constitutional symptoms. He was a nonsmoker and was being treated for dyslipidemia.
Subject(s)
Community-Acquired Infections/etiology , Lung Neoplasms/complications , Lung Neoplasms/diagnosis , Lymphoma, B-Cell, Marginal Zone/complications , Lymphoma, B-Cell, Marginal Zone/diagnosis , Pneumonia/etiology , Antibodies, Monoclonal, Murine-Derived/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Drug Therapy, Combination , Humans , Lung/diagnostic imaging , Lung Neoplasms/drug therapy , Lymphoma, B-Cell, Marginal Zone/drug therapy , Male , Middle Aged , Prednisone/therapeutic use , Rituximab , Tomography, X-Ray Computed , Treatment Outcome , Vincristine/therapeutic useABSTRACT
OBJECTIVE: To apply cytomorphologic features and a limited panel of immunocytochemistry to cervicovaginal smears to distinguish between primary endocervical adenocarcinoma (ECA) and primary endometrial adenocarcinoma (EMC). STUDY DESIGN: The study was a retrospective analysis of 35 cases, of which 21 were of primary endometrial origin and 14 were of primary endocervical origin. In all cases included in the study, the site of origin of adenocarcinoma was confirmed by examination of the surgical specimen. Twenty-four cytomorphologic characteristics and a limited panel of antibodies (estrogen receptor, carcinoembryonic antigen and vimentin) were applied to conventional cervicovaginal smears to ascertain whether a combination of these would be sufficiently distinctive to allow reliable distinction between ECA and EMC. The slides were scored using defined cytomorphologic characteristics and immunocytochemistry. The score was calculated by using the receiver operating curve (ROC). RESULTS: Statistical analysis identified 7 variables that were significant in distinguishing between ECA and EMC: necrosis, altered blood, histiocytes, strips of cells, palisading of cells, pseudorosettes and positive immunocytochemical staining for carcinoembryonic antigen. Using the ROC, a numerical score < 4 was indicative of an EMC and a score > or = 4 of ECA. CONCLUSION: This study found that the proposed scoring system based on these 7 variables could reliably distinguish between ECA and EMC and assist in definitive management of patients.
