- Gastric-type Adenocarcinoma of the Cervix: Tumor With Wide Range of Histologic Appearances. [Journal Article]
- AAAdv Anat Pathol 2018 Sep 18
- Gastric-type endocervical adenocarcinoma (GAS) is a recently described diagnostic entity originally characterized as a tumor with (1) voluminous cytoplasm that is (2) clear or pale eosinophilic, and ...
Gastric-type endocervical adenocarcinoma (GAS) is a recently described diagnostic entity originally characterized as a tumor with (1) voluminous cytoplasm that is (2) clear or pale eosinophilic, and (3) cells showing distinct cell borders. Since the initial tumor description there has been accumulating experience that the neoplasm, in addition to classic features, may show a wide spectrum of morphologic appearances. This paper describes and illustrates cases of GAS with focal or diffuse findings that include: densely eosinophilic cytoplasm, foamy cytoplasm, goblet cells, glands with elongated, stratified nuclei, glands with small cuboidal cells, glands with flattened cells, papillary growth, single cell infiltration and infiltration with microcystic elongated and fragmented pattern. All these patterns may bring up a differential diagnosis with other cervical malignancies such as usual, intestinal, endometrioid, clear cell, serous, and mesonephric adenocarcinoma. The paper describes the patterns of immunostaining of respective lesions that may aid in the diagnostic process and summarizes the main points of the differential diagnosis. GAS is associated with somatic and germline STK11 mutations and TP53 mutations but is invariably negative for human papilloma virus when tumor only is tested. It shows variation in incidence between countries. Awareness of the spectrum of morphologic appearances in GAS is important for accurate and confident diagnosis. Correct identification of GAS is important due to its propensity for ovarian and other distant metastases, markedly worse prognosis as compared with usual endocervical adenocarcinoma, and its relative resistance to chemotherapy.
- A study on cervical cancer screening in asymptomatic women using Papanicolaou smear in a tertiary care hospital in an urban area of Mumbai, India. [Journal Article]
- JFJ Family Med Prim Care 2018 Jul-Aug; 7(4):652-657
- CONCLUSIONS: Pap smear test is a very easy, noninvasive, useful, simple, safe, and very economical tool to detect preinvasive cervical epithelial lesions. It is evident and proven that every woman above the age of 30-35 years must be subjected to cervical screening and this must be continued even in the postmenopausal period.
- Intensity-modulated radiotherapy for synchronous cancer of the anal canal and cervix. [Journal Article]
- OLOncol Lett 2018; 16(4):4512-4518
- Due to recent advancements in diagnostic techniques, the incidence of multiple primary cancer has increased; however, synchronous cancer of the anal canal and cervix (SCACC) is rare, and no previous ...
Due to recent advancements in diagnostic techniques, the incidence of multiple primary cancer has increased; however, synchronous cancer of the anal canal and cervix (SCACC) is rare, and no previous studies have investigated the treatment of this disease. The present study reports a case in which intensity-modulated radiotherapy (IMRT) was used to treat a 64-year-old female with SCACC, inguinal lymphadenopathy and anal pain. The patient was diagnosed with cT3N3M0 stage IIIb anal canal squamous cell carcinoma and cT1b1N0M0 stage Ib1 cervical squamous cell carcinoma, based on biopsy and imaging study data. According to the definitive treatment for advanced-stage anal canal cancer, outpatient treatment with chemoradiotherapy (CRT) using S-1 for SCACC was recommended, as the patient did not want to undergo resection of the anus. Considering the lymph node regions involved in SCACC and the necessary doses, the treatment plan was as follows: Whole pelvis and inguinal lymph node region radiation (36 Gy/20 fractions); a first booster radiation dose (9 Gy/5 fractions) for the whole pelvis; and a second booster radiation dose (14.4 Gy/8 fractions) for the primary lesions. The patient was prescribed S-1 at a dose of 60 mg/m2/day twice daily on days 1-14 and 29-42. The patient experienced grade 2 diarrhea and anal mucositis, but CRT was completed without discontinuation and hospitalization. The patient exhibited a complete response and remained disease-free without any treatment-associated complications at the 6-month follow-up. In conclusion, SCACC was successfully treated with IMRT in the present case. It is important to determine the treatment strategy for synchronous cancer types, taking into consideration the tumor stage, tumor location and patient situation.
- Detection of Regulatory T Cell Phenotypic Markers and Cytokines in Patients with Human Papillomavirus Infection. [Journal Article]
- JMJ Med Virol 2018 Sep 07
- Infection with human papillomavirus (HPV) is the main cause of cervical cancer. Viral persistence is considered the main risk factor for neoplastic progression and evidence suggests that regulatory T...
Infection with human papillomavirus (HPV) is the main cause of cervical cancer. Viral persistence is considered the main risk factor for neoplastic progression and evidence suggests that regulatory T cells (Treg) play an important role in the failure of viral elimination. The aim of this study was to detect phenotypic markers of Treg and cytokines IL-10 and TGF-β, in the cervical microenvironment of HPV-infected patients. One hundred and one samples of uterine cervix embedded in paraffin were analyzed. We used immunohistochemistry to examine the co-expression of the CD25/FOXP3 and CD4/TGF-β markers, and the expression of GITR and IL-10 in cells present in the cervical stroma. We detected a microenvironment composed of high proportions of CD25+ FOXP3+ , CD4+ TGFβ+ , IL-10+ , and GITR+ cells in samples with high viral loads and severe lesions of HPV-infected patients. The abundance of these markers, indicative of the presence of Treg cells and immunosuppressive cytokines, was significantly associated with severe lesions and elevated viral loads in the examined samples. These results suggest that Treg cells may be involved in maintaining a microenvironment favorable for viral persistence and neoplastic progression. Our findings support those of previous studies that suggested that these markers could be used to predict HPV persistence and neoplastic progression, and as potential targets for immune response modulation. This article is protected by copyright. All rights reserved.
- Low-Grade Squamous Intraepithelial Lesion, Cannot Rule Out High Grade Lesion "LROH": Diagnosis, Histologic Outcomes, and HPV Results. [Journal Article]
- CCytopathology 2018 Sep 06
- CONCLUSIONS: In our study cohort, LROH interpretation is associated with a higher number of CIN 2 or higher lesions on follow-up compared to patients with LSIL (p<0.0001), and is associated with a significant percentage of positive other hrHPV, supporting LROH as a useful diagnostic category that triggers appropriate follow-up in the affected women. This article is protected by copyright. All rights reserved.
- ALK rearrangement in lung adenocarcinoma with concurrent cervix and breast metastases: A case report. [Case Reports]
- TCThorac Cancer 2018 Aug 24
- Distant metastases of pulmonary adenocarcinoma are regularly observed in the bones, brain, adrenal gland, and liver, but rarely in the breast or cervix. In this report, we describe a novel case of co...
Distant metastases of pulmonary adenocarcinoma are regularly observed in the bones, brain, adrenal gland, and liver, but rarely in the breast or cervix. In this report, we describe a novel case of concurrent cervix and breast metastases from lung adenocarcinoma, with ALK rearrangements that were strongly consistent between the primary and metastatic cancers. A 44-year-old Chinese woman with a chief complaint of abdominal discomfort was referred to our hospital. Based on diagnostic imaging, pathology, immunohistochemistry, and next-generation sequencing, the patient was diagnosed with lung adenocarcinoma with breast and cervical metastases, and ALK rearrangements were found in all three lesions. The patient was prescribed crizotinib as first-line treatment, which showed a steady reduction of the lung lesion. To our knowledge, this is the first report of concurrent breast and cervical metastases from lung adenocarcinoma. We conclude that physicians should consider that metastases may invade the breast and cervix uteri when making a diagnosis.
- Squamous cell carcinoma of the cervix arising in a patient on adalimumab � a need for cervical screenings in patients on tumor necrosis factor inhibitors. [Journal Article]
- DODermatol Online J 2018 May 15; 24(5)
- Adalimumab, a tumor necrosis factor (TNF) inhibitor, has been approved for treatment of hidradenitis suppurativa. We report a case of cervical cancer in a patient with hidradenitis suppurativa taking...
Adalimumab, a tumor necrosis factor (TNF) inhibitor, has been approved for treatment of hidradenitis suppurativa. We report a case of cervical cancer in a patient with hidradenitis suppurativa taking adalimumab, which prompted discontinuation of the medication. Physicians should obtain a detailed cervical medical history before putting a female patient on a TNF inhibitor. Patients on TNF inhibitors who have pre-existing cervical issues such as human papillomavirus (HPV), dysplasia, or high grade intraepithelial lesions should be counseled about an increased risk of developing squamous cell carcinoma (SCC) of the cervix while on a TNF inhibitor. Furthermore, patients on TNF inhibitors should comply with the national screening guidelines for cervical cancer and be tested for human papillomavirus.
- Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement. [Practice Guideline]
- JAMAJAMA 2018 08 21; 320(7):674-686
- CONCLUSIONS: The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. (A recommendation) The USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with hrHPV testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting) in women aged 30 to 65 years. (A recommendation) The USPSTF recommends against screening for cervical cancer in women younger than 21 years. (D recommendation) The USPSTF recommends against screening for cervical cancer in women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer. (D recommendation) The USPSTF recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and do not have a history of a high-grade precancerous lesion or cervical cancer. (D recommendation).
- Association of HIV status with infection by multiple HPV types. [Journal Article]
- TMTrop Med Int Health 2018 Aug 22
- CONCLUSIONS: HIV immunosuppression favors infection by multiple high-risk HPV types, mainly in women affected by low-grade squamous intraepithelial lesions. Antiretroviral therapy had no effect on infection by multiple HPV types. Risk factors related to progressive damage to the cervix were positively associated with infection by multiple HPV types in women living with HIV. This article is protected by copyright. All rights reserved.
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- Immunohistochemical detection of E7 human papillomavirus protein in pre‑malignant and malignant lesions of the uterine cervix. [Journal Article]
- MMMol Med Rep 2018 Aug 22
- Human papillomavirus (HPV) E7 protein expression is caused by HPV viral DNA integration into human cellular DNA, and is a prerequisite for the development and progression of cervical cancer. The pres...
Human papillomavirus (HPV) E7 protein expression is caused by HPV viral DNA integration into human cellular DNA, and is a prerequisite for the development and progression of cervical cancer. The present study aimed to evaluate the role of E7 protein as a biomarker for identification of transformed cervical epithelial cells during the early stages of cervical cancer. Specific monoclonal antibodies to the E7 protein of high‑risk HPVs were generated and characterized for applications in immunocytochemistry and immunohistochemistry using cervical epithelial cells or biopsy tissue slides. The specificity and feasibility for detecting precancerous cells in cervical exfoliated epithelial cells was demonstrated. In addition, antibody staining of cervix biopsies indicated the pathological grades of cervical cancer and precancerous lesions. The results of the present study demonstrated the potential benefit of using E7 protein as a novel and specific clinical diagnostic marker to distinguish transient HPV infections from malignant and pre‑malignant lesions.