Colposcopic features of cervical oncotropic papilloma-virus infection in patients with various pathology of uterine cervix

In order to estimate the colposcopic manifestations of cervical oncotropic human papilloma-virus (HPV)-infection, a total of 693 patients were examimed. Among them, there were 298 patients with benign tumors pathology, 57 patients with 1-3 Grade cervical dysplasia of mucosa, 50 patients with uterine cervix cancer, 288 healthy women. All patients underwent bimanual examination, taking of cervical smears for cytological examination and uterine cervix colposcopy. Diagnosis for HPV16/18 infection was made by the method of polimerase chain reaction. А large variety in colposcopic manifestations of HPV-infection was found, namely: areas of atypical vessels, leukoplakia sites,fields of atypical epithelium, iodine-negative sites. It was related to the influence of oncogenic types of HPV infection. In these patients,fields of atypical epithelium, atypical vessels, iodinenegative areas were observed 1.2, 2.5, 10.5 times more frequently, respectively. It was found that all varieties of papillomas occurred among patients with pathology, whereas flat condylomas presenting the most difficulties of or diagnosis prevailed in patients with cervical neoplasms and uterine cervix cancer The most pronounced colposcopic evidences of uterine cervix epithelium malignancy were observed in patients with virus-positive uterine cervix cancer.

NUT Midline Carcinoma Mimics Anaplastic Thyroid Carcinoma

Introduction/Objective NUT carcinoma (NC) is an extremely rare, aggressive subtype of squamous cell carcinoma defined by rearrangement of the NUTM1 (aka NUT) gene. NC most commonly arises within the thorax and head and neck and predominantly affects teens and young adults. For the first time, we described a rare case of NC mimics anaplastic thyroid carcinoma. Methods/Case Report A 27-year female with no significant past medical history presented with neck pain and swelling for a few months and was noted to have a “thyroid” mass. An ultrasound guided fine needle aspiration of the mass showed a hypercellular specimen composed of highly atypical epithelial cells with irregular nuclear membrane and prominent nucleolus, high nuclear to cytoplasmic ration, dense cytoplasm, lying singly or in flat sheet mixed with acute inflammatory exudate (Fig. A, B). No thyroid follicular cells or colloid are present. It was signed out as suspicious for squamous cell carcinoma since there was no cell block for further workup. A following excisional biopsy demonstrated similar atypical epithelium detached or embedded in skeletal muscle and soft tissue with acute, chronic inflammation and necrosis (Fig C). By immunohistochemical stains, the atypical cells are positive for p40 (Fig D) and p53. The Ki-67 proliferation index is ranging from 40 % to 70 %. Scattered tumor cells are weakly positive for PAX-8 and TTF-1. These findings raise the possibility that the squamous cell carcinoma might be a component of anaplastic thyroid carcinoma. However, molecular studies revealed a NSD3-NUTM1 fusion, which is characteristically identified in a subtype of squamous cell carcinoma know as NUT “midline” carcinoma. Results (if a Case Study enter NA) NA Conclusion Diagnosis of NC can be established by positive NUT nuclear immunohistochemical staining. Recognizing the typical morphology and keeping low threshold for the NUT immunohistochemical staining will increase the diagnostic efficacy.

A Case Report of Tongue Lymphoepithelial Carcinoma with a Histological Diagnostic Dilemma

Most head and neck lymphoepithelial carcinomas (LECs) arise in the nasopharynx and harbor Epstein–Barr virus (EBV). LEC is also a rare subtype of the oral squamous cell carcinoma (SCC). Morphologically, LEC is defined as resembling non-keratinizing nasopharyngeal carcinoma, undifferentiated subtype. The histological features and pathogenesis of oral LEC are not established. We describe a case of tongue LEC with histopathological diagnostic difficulties. A 72-year-old Japanese female presented with a whitish change on her left-side tongue. The diagnosis was atypical epithelium; neoplastic change could not be ruled out by a biopsy. Although the lesion was monitored at our hospital per her request, invasive carcinoma was detected 11 months later. Microscopically, conventional SCC was observed with the characteristic features as LEC confined to the deep part of the lesion. We briefly discuss this unusual histological finding and make a novel proposal for distinguishing oral LEC from LECs in other regions based on these histological findings.

Segmentation of blood vessels in colposcopic images using polarized light and Sauvola thresholding

Cervical cancer is one of the two most common gynecological cancers in the world, including breast cancer. Signs of cervical disease are usually the presence of atypical epithelium, superficial bleeding or abnormal vascular proliferation. Most of these signs are directly related to cervical intraepithelial neoplasia (CIN) and cervical cancer. Currently, to detect epithelial lesions as well as to observe the shape of blood vessels, the main diagnostic methods used are colposcopy and visual examination. This method has low sensitivity and specificity because subjective factors still exist and the method does not clearly distinguish the shape of proliferating blood vessels. Therefore, in order to improve the efficiency of disease diagnosis, many studies applying image processing techniques to support auto-diagnosis have become topics of interest. However, studies that support automatic identify abnormal blood vessel shape and density are very limited. In this study, colposcopy images were recorded by digital colposcopes. These images are taken under polarized light to help reduce reflections from the surface and support for better image processing steps. Then, Sauvola threshold method is used to separate blood vessels on the surface of the cervix. It is combined with three different image preprocessing methods to enhance the contrast between the blood and the background. Finally, the sensitivity and specificity of these methods were calculated and evaluated. The results of the study set the stage for cervical blood vessel identification studies as well as cervical cancer assessment.

Pygomelia and True Hermaphroditism in a Nine Week Old Large White Piglet Case Report

A nine weeks old female Large White piglet which was presented to the Veterinary Teaching Hospital, Federal University of Agriculture, Abeokuta, with a complaint of extra limbs was diagnosed with pygomelia and concurrent true hermaphroditism based on gross morphologic features, radiography, exploratory laparotomy and histopathology of the malformed organs. The piglet had two well-developed extra hind limbs consisting of the femur, tibia, fibula and the phalanges. Radiographically, the accessory limbs were attached to the ischium through a rudimentary pelvic bone. The supernumerary limbs were smaller than the normal appendages, but contained equal digits. The anal orifice was observed cranial to the right supernumerary limb. Caudal to the left supernumerary limb a rudimentary penis was observed. Two oval shaped fibrous masses were palpated in the inguinal canal of the piglet. In addition, there was a transparent tubular tract measuring 24 cm in length which contained serous fluid. The right kidney was rudimentary measuring 2.10 cm, while the left kidney appeared hypertrophied measuring 6.10 cm. The histology of the left kidney showed dysplastic areas of undifferentiated mesenchymal stroma in the cortex and medulla with the presence of groups of immature glomeruli in the cortex. The tubules in the medulla were scanty in number and had atypical epithelium. The adrenal glands had normal architecture with ectopic adrenal tissue in the adrenal capsule, while the ovaries and uterus were normal. It was concluded that the complex anomalies in the piglet might be as a result of a complex mode of inheritance.

Severe dysplasia of the epithelium of the cervix and intraepithelial carcinoma (CIN 3) with spreading to the vaults and walls of the vagina. Diagnosis and treatment

The objective: to study and systematize the main clinical variants of CIN 3 with the spread of atypical epithelium to the vaults and walls of the vagina; to develop complex approaches to the treatment of patients with CIN 3 with the spread of atypical epithelium to the vaults and walls of the vagina with neoadjuvant therapy and surgical treatment; to study the therapeutic effectiveness of the use of a2b-interferon in the form of vaginal suppositories and Tyloron in the complex treatment of patients with CIN 3 with the spread of abnormal epithelium to the vaults and walls of the vagina during the first stage of complex drug treatment. Patients and methods. A survey of 62 patients with histologically verified CIN 3 with the spread of atypical epithelium to the vaults and walls of the vagina was carried out. At the stage of neoadjuvant etiotropic therapy, the patients were randomized into two groups. 31 patients were included in the main group (A), 31 patients were included in the control group (B). In group A, patients with neoadjuvant were given б2b-interferon at 500 000 IU in the form of vaginal suppositories twice a day for 14 days and a Tyloron 1 tablet 125 mg once a day in a day No.10. In group B, the standard therapy is intended for patients – an a2b-interferon of 500 000 IU in the form of vaginal suppositories twice a day for 14 days. The surgical stage of treatment was carried out in accordance with the clinical and histological diagnosis and the variant of the process spread to the walls of the vagina. Diathermoconization of the cervix and combined vaginal trachelectomy type A with resection of the upper third of the vagina were performed. Results. Three clinical variants of CIN 3 with spreading to the vaults and walls of the vagina were established. The first clinical variant – CIN 3 is localized to ectocervix, CIN 1–2 (IHC p16 negative) is localized on the vaults and walls of the vagina. The second clinical variant – CIN 3 is localized on ectocervix and extends to the vault and walls of the vagina. The third clinical variant – CIN 3 is localized on ectocervix and multicentric dissemination of CIN 3 – on vaults and walls of the vagina. The choice of an integrated treatment program with a surgical component depends on the clinical option. Conclusions. 1. Three clinical variants of CIN 3 with spreading to the vault and walls of the vagina have been established. Half the patients had the first clinical variant. 2. The main colposcopic signs of CIN 3 with spreading to the vaults and walls of the vagina: dense acetic-white epithelium, coarse mosaic, a sign of the internal border. 3. In 3 weeks after the course of treatment with neoadjuvant therapy in combination of Тyloron with a2b-interferon in the form of vaginal suppositories, it is possible to achieve from 85 to 100.0% positive dynamics, whereas in the traditional method of treatment, from 41 to 75%, which is statistically significant less (p<0.01). 4. The study showed that there is a relatively strong statistically significant association of neoadjuvant therapy using a combination of Tyloron with interferon-a2b suppositories in the complex treatment of CIN3 with spreading to the vault and vaginal walls compared to conventional therapy (c21=10.64; j=0.41; p<0.01). After three weeks, the positive dynamics in the main group (A) significantly increased (RR=1.6; 95% CI: 1.2–2.2; p<0.01). Key words: CIN 3, vaginal vault, vagina, trachelectomy, treatment.