PURPOSE: Uterine myoma is the most common benign uterine neoplasm, and assosiated with gynecologic and obsteric complications. Preoperative acurrate analysis of the number, location and type of the myoma is important, especially in reproductive women. We analyze the MR findings of uterine myoma for evaluation of the role of MR in diagnosis of uterine myoma. MATERIALS AND METHODS: We analyze MR findings of 76 myomas in 40 patients, and 34 myomas in 17 patients of them were confirmed by surgery. With 2. 0T Spectro-20000(Gold-star, Korea), TlWl axial images and T2Wl axial and sagittal images were obtained. Locations were classified into fundus, anterior body, posterior body, right body, left body, and cervix. Types were classified into submucosal, intramural, and subserosal. Associated findings were analiyed also. RESULTS: The most common location and type wre posterior body and intramural type, respectively. Ten myomas were confirmed on surgery only, and the causes were as follows:first, all 10 myomas were less than 2 cm in size;second, 1 subserosal myoma was abutted to a large ovarian mass;third, small myomas were abutted to each other, or small one was adjacent to larger one and considered as one large myoma. Degenerative change was noted in 50% of histologically confirmed cases. High signal halo on T2Wl was noted in 14%. CONCLUSION: MR is excellent in detection and localization of uterine leiomyoma larger than 2cm, and may be a preoperative diagnostic method of choice in patient who need myomectomy for preservation of childbearing function.
Cervix Uteri ; Diagnosis* ; Female ; Humans ; Leiomyoma* ; Myoma ; Uterine Neoplasms

It is often difficult to conclude that improvements in survival with time are due to a screening programme alone. Although a reduction in the death rate from a given cancer may reflect the benefits of early detection or improved treatment, the benefits may also result from lead time bias and over-diagnosis, the former resulting in longer survival of screen-identified cancers because the time before the cancer would have been clinically diagnosed is included in calculations. Furthermore, recent reviews on randomised clinical trials of cancer screening have provided strong evidence that misclassifications in causes of death have been a major problem, leading to an over-estimation of the effectiveness (or alternatively an under-estimation of potential harm) of screening.
Cervix Neoplasms/*diagnosis ; Endometrial Neoplasms/diagnosis ; Female ; Genital Neoplasms, Female/*diagnosis/epidemiology/mortality ; Human ; Incidence ; Ovarian Neoplasms/diagnosis ; Risk

Adult ; Cervix Uteri ; pathology ; Female ; Humans ; Sarcoma, Alveolar Soft Part ; diagnosis ; Uterine Cervical Neoplasms ; diagnosis

PURPOSE: To evaluate the efficacy of the arterial phase of spiral CT in parametrial invasion of uterine cervical carcinoma. MATERIALS AND METHODS: Two-phase spiral CT images of 22 patients with pathologically proven cervical carcinomas were retrospectively, studied. With regard to the lateral margin of the cervix, eccentric parametrial soft tissue, Parametrial strands and obliteration of periureteral fat, images of the arterial phase were compared by three radiologists with those of the late phase. RESULTS: Five of 15 surgically-proven cervical cancers with no parametrial involvement (33%) showed parametrial strands or eccentric soft tissue lesion in the late phase. Four of the five patients (80%) showed early vascular enhancement of the linear strands or eccentric soft tissue mass in the arterial, phase and because of this additional scan, correct diagnosis was possible. Six of seven cases of invasive cervical cancer (85.7%) showed linear strands in the late phase but two patients showed partial vascular enhancement of the parametrial strands and correct diagnosis was therefore possible. For the evaluation of the lateral margin of the cervix (4/7, 57.1%) and periureteral fat obliteration (3/7, 42.9%), images of the late phase were superior to those of the arterial phase. CONCLUSION: In uterine cervical carcinoma, the late phase of conventional CT is normally used to identify vascular structures as false-positive parametrial strands ; the arterial phase of spiral CT is, however, superior.
Cervix Uteri ; Diagnosis ; Female ; Humans ; Retrospective Studies ; Tomography, Spiral Computed* ; Uterine Cervical Neoplasms

The significance of cervical erosion with benign cellular change on Papanicolaou smear has not been evaluated. A retrospective review of 430 coloscopically directed punch biopsies performed over 15 months revealed 206 cases who had a benign cellular change on cytologic smear. Of these 206 smears, 48(23%) had clear cervix without erosion, 99(48%) had mild erosion on cervix, 41(20%) had moderate cervical erosion and 18(9%) had severe cervical erosion. The false negative rate that revealed more than mild dysplasia on histologic diagnosis was 2% in patients without cervical erosion, 3% in patients with mild cervical erosion, 5 % in patients with moderate cervical erosion, and 11% in patients with severe cervical er- osion. Koilocytotic change that suggested human papilloma virus infection was 17% in each group regardless cervical erosion. In conclusion, benign cellular change on Pap smears in patients with severe cervical erosion may be associated with significant cervical cancer pathology.
Biopsy ; Cervix Uteri ; Diagnosis ; Female ; Humans ; Papanicolaou Test* ; Papilloma ; Pathology ; Retrospective Studies ; Uterine Cervical Neoplasms

BACKGROUND: Prior studies of p16, p53, and Ki-67 expression have suggested that these markers may be preferentially expressed in cervical neoplasms. The purpose of this study was to assess the expression and clinical significance of p16, p53 proteins, and the Ki-67 labeling index in the cervical lesions. METHODS: We analyzed 54 uterine cervical specimens obtained by surgical biopsy. The expression of p16, p53 proteins, and Ki-67 was evaluated by immunohistochemical methods. The immunohistochemical findings were then correlated with the histologic diagnosis. RESULTS: Positive scores for p16, p53, and Ki-67 were seen in 75% (6/8), 0% (0/8), and 13% (1/8) of low grade intraepithelial lesions (LSIL), respectively, and 100% (23/23), 17% (4/23), and 74% (17/23) of high grade intraepithelial lesions (HSIL), respectively, and 100% (10/10), 20% (2/10), and 70% (7/10) of invasive squamous cell carcinomas, respectively. Both normal epithelium and inflammatory lesions scored negative for these three markers in all of the 13 cases. p16 and Ki-67 expression correlated with the severity of uterine cervix lesions. CONCLUSIONS: p16 and Ki-67 are complementary surrogate biomarkers for cervical squamous intraepithelial neoplasia. However, immunohistochemical expression for p53 has no correlation with the grade of cervical squamous intraepithelial neoplasia.
Biomarkers ; Biopsy ; Carcinoma, Squamous Cell ; Cervix Uteri* ; Diagnosis ; Epithelium ; Female ; Immunohistochemistry ; Uterine Cervical Neoplasms

Primary squamous cell carcinoma of the endometrium is extremely rare malignancy. In 1928 Fluhmann proposed three criteria to establish the diagnosis: (1) no coexisting endometrial adenocarcinoma, (2) no connection between the endometrial tumor and the squamous epithelium of the cervix, and (3) no squamous cell carcinoma of the cervix present. Historically, this malignancy has been associated with short survival (<24 months) despite complete surgical extirpation, with or without pre- or postoperative external beam irradiation. In this report, a case of endometrial squamous cell carcinoma is presented with a review of related current knowledge.
Adenocarcinoma ; Carcinoma, Squamous Cell* ; Cervix Uteri ; Diagnosis ; Endometrial Neoplasms ; Endometrium* ; Epithelium ; Female ; Myoma*

Adenoma malignum (minimal deviation adenocarcinoma) is an extremely well-differentiated adenocarcinoma of uterine cervix. Despite its benign histological appearance, this tumor is thought to be malignant and has a poor prognosis. Because Pap smear and punch biopsy have low sensitivity, accurate diagnosis of the tumor may be difficult. If it is diagnosed, it must be treated same as in cervical cancer. We presented one case of preoperatively diagnosed adenoma malignum by deep cone biposy with a brief review of literature.
Adenocarcinoma ; Adenoma* ; Biopsy ; Cervix Uteri* ; Diagnosis ; Female ; Prognosis ; Uterine Cervical Neoplasms

The purpose of this study was to investigate the differences in MR findings of adenocarcinoma (AC) and squamous cell carcinoma (SCC) of the uterine cervix and to compare MR findings with pathologic findings. MR images of 17 patients with pathologically proven AC, using a fast spin-echo (FSE) T2-weighted image (T2WI) with pelvic phased-array coil on a 1.5-T unit, were retrospectively evaluated. After measurement of the signal intensity (SI) ratios of the region of interest between tumors and gluteus maximus muscle, we compared the ratios of AC with those of 16 patients with SCC. AC showed relatively high SI on FSE T2WI with multiseptated lesions in four cases and hydrometrocolpos in three cases. The mean SI ratio was 3.82 +/- 1.68 in AC and 2.35 +/- 0.42 in SCC (p < 0.0001, t-test). Multiple tumorous glands with cytoplasmic and intraglandular mucin or serous fluid were pathologically found in AC, but SCC revealed the compact cellularity of stratified squamous tumor cells. The cervical AC showed higher SI than SCC on FSE T2WI with occasional multiseptated lesions and hydrometrocolpos. If the SI ratio of the tumor was more than 3.0, AC could be diagnosed with a sensitivity of 68.8% and a specificity of 100%.
Adenocarcinoma/pathology ; Adenocarcinoma/diagnosis* ; Adult ; Aged ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/diagnosis* ; Cervix Neoplasms/pathology ; Cervix Neoplasms/diagnosis* ; omparative Study ; Diagnosis, Differential ; Female ; Human ; Magnetic Resonance Imaging* ; Middle Age

This study was performed to evaluate the diagnostic value of colposcopy by comparing colposcopic findings with cytology, histology of colposcopically directed biopsy and final biopsy result on hysterectomy. From January 1, 1988 to August 31, 1996, the colposcopic examinations was undertaken in 1200 patients, excluding grossly visible carcinoma of the cervix. The result were as follows : 1. Colposcopic examinations were satisfactory in 95.4% and unsatisfactory in 4.58%. 2. The accuracy rate of cytologic diagnosis was 73.1% and colposcopic impression was 93.1%. 3. The false negative rate of colposcopic impression was 2.6%, much less than 24,7% of cytologic examination. 4. The cytologic accuracy rate in cervicitis was higher than that of colposcopic impression but the accuracy rate of colposcopic impression in diagnosis of cervical intraepithelial neoplasia was higher than that of cytology. 5. Among 97 cases in which colposcopically directed biopsy were performed, more advanced lesion were disclosed in 12 cases(12.4%).
Biopsy ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Colposcopy* ; Diagnosis ; Early Diagnosis* ; Female ; Humans ; Hysterectomy ; Uterine Cervical Neoplasms* ; Uterine Cervicitis