"Cotyledonoid dissecting leiomyoma" or "Sternberg tumor" is a very rare variant of smooth muscle tumors with a distinctive gross appearance. We describe a similar lesion, probably the sixth reported case, comparing its clinicopathological features with those of previous cases. A 26-yr-old nulliparous woman underwent laparotomy for a large pelvic mass replacing the postero-lateral aspect of the uterus with extension into the left pelvic cavity in the form of numerous exophytic congested small nodules. The tumor was removed by resection without hysterectomy after frozen section examination. Histologically, there were variable sized micronodules of benign smooth muscle fascicles, which were separated by fibrous connective tissue with a marked hydropic change and rich vascularity. Immunohistochemical and ultrastructural studies were helpful for confirmation of the smooth muscle nature, but not useful for the definitive diagnosis. Due to bizarre, sarcoma-like gross appearances, this type of lesion should be subjected to frozen section examination in order to avoid overtreatment and preserve the fertility in young women.
Adult ; Female ; Humans ; Immunohistochemistry ; Laparotomy ; Leiomyoma/*diagnosis/*pathology ; Microscopy, Electron ; Uterine Diseases/*diagnosis/*pathology ; Uterine Neoplasms/*diagnosis/*pathology ; Uterus/pathology/ultrastructure

Endosalpingiosis is a non-neoplastic proliferation of ectopic tubal epithelium. It may be found incidentally or the patients may present with chronic pelvic pain. It may resemble a gynecologic malignancy on imaging findings and clinicians and radiologists should be aware of this benign entity to render a correct diagnosis and to avoid over-treatment. We report here the MR imaging appearance of a case of florid cystic endosalpingiosis.
Adult ; Diagnosis, Differential ; Endometriosis/*diagnosis/pathology/surgery ; Fallopian Tube Diseases/*diagnosis/pathology/surgery ; Female ; Humans ; Magnetic Resonance Imaging/*methods ; Uterine Diseases/*diagnosis/pathology/surgery

Adolescent ; Adult ; Breast Neoplasms ; pathology ; Carcinoma ; pathology ; Diagnosis, Differential ; Endothelium, Vascular ; pathology ; Fasciitis ; pathology ; Female ; Hemangiosarcoma ; pathology ; Histiocytoma, Malignant Fibrous ; pathology ; Humans ; Hyperplasia ; pathology ; Leiomyoma ; pathology ; Leiomyosarcoma ; pathology ; Middle Aged ; Soft Tissue Neoplasms ; pathology ; Uterine Neoplasms ; pathology ; Vascular Diseases ; pathology

Cervical stenosis is a challenging condition that often recurs despite intervention. Multiple therapeutic options have been described, but a clearly effective and reliable treatment method has yet to be identified. Patients with recurrent stenosis are at risk of developing severe complications such as chronic pelvic pain and infertility. We describe a case of congenital cervical stenosis with secondary haematometra in which repeated cervical dilatation, hysteroscopic canalisation and administration of medications to retard endometrial development were unsuccessful in relieving the obstruction and preventing re-accumulation of menstrual blood. Total hysterectomy was eventually mandated by spontaneous rupture of the haematometra.
Adult ; Constriction, Pathologic ; complications ; diagnosis ; Endometrium ; pathology ; Female ; Hematometra ; complications ; diagnostic imaging ; surgery ; Humans ; Infertility ; Pelvic Pain ; Recurrence ; Risk ; Rupture, Spontaneous ; complications ; Tomography, X-Ray Computed ; Uterine Cervical Diseases ; complications ; diagnosis ; Uterine Diseases ; complications ; diagnosis ; Uterine Hemorrhage ; complications ; diagnosis ; Uterine Rupture ; diagnostic imaging ; etiology ; surgery

The association of intramuscular myxoma and fibrous dysplasia is a rare disease known as Mazabraud's syndrome. We present a case of Mazabraud's syndrome coexisting with a uterine tumor and resembling an ovarian sex cord tumor (UTROSCT). This uterine tumor showed a high mitotic index and cytological atypia. To the best of our knowledge, the coexistence of the two different entities has not been reported in the literature.
Aged ; Biopsy ; Buttocks/pathology/surgery/ultrasonography ; Diagnosis, Differential ; Female ; Fibrous Dysplasia, Monostotic/complications/*diagnosis/surgery ; Humans ; Magnetic Resonance Imaging ; Myxoma/complications/*diagnosis/surgery ; Ovarian Neoplasms/*diagnosis ; Rare Diseases ; Sex Cord-Gonadal Stromal Tumors/*diagnosis ; Syndrome ; Uterine Neoplasms/complications/*diagnosis/surgery

OBJECTIVETo investigate the association between HPV genotypes and cervical lesion in Hybrid Capture 2 (HC2) HPV test positive samples.

METHODS602 cervical samples randomly obtained detected as HPV positive by the HC2 high-risk probe cocktail were determined by polymerase chain reaction (PCR)-reverse dot blot (RDB), among them 344 participated Thinprep Cytology test.

RESULTS569 (94.5%) samples were successfully amplified. The most common HPV genotypes were HPV16 (31.6%), 52 (16.7%), 58 (15.1%), 56 (8.1%), 39 (7.9%); HPV16 or HPV16/18 infection was significantly related to ASCUS, LSIL and HSIL; 24 samples suggested single HPV infection with the genotypes not available for HC2.

CONCLUSIONThe most common HPV genotypes in random screening were HPV16, 52 and HPV58; Our data demonstrated the pseudo-positivity of HC2 test was 4.0%; HPV16 was a index for progression of HSIL.

Adult ; Aged ; Alphapapillomavirus ; classification ; genetics ; isolation & purification ; Cervix Uteri ; pathology ; virology ; China ; epidemiology ; Female ; Humans ; Middle Aged ; Papillomavirus Infections ; diagnosis ; epidemiology ; pathology ; virology ; Risk Factors ; Uterine Cervical Diseases ; diagnosis ; epidemiology ; pathology ; virology ; Vaginal Smears ; Young Adult

In gynecology, endosalpingiosis is a benign condition in which the fallopian tube-like epithelium is found outside the fallopian tube. The thirty-four point five percent of endosalpingiosis cases have concurrent endometriosis and 40% of the endosalpingiosis group are in postmenopausal states. In contrast with endometriosis, there are no significant links between infertility, chronic pelvic pain and endosalpingiosis. The symptoms of endosalpingiosis are not yet settled. Endosalpingiosis is almost always an incidental finding; it is commonly found through microscopic examinations, and is then confirmed by pathologists for excision and biopsy. Therefore, the clinical differential diagnosis of an intramural mass is more important for clinicians when discussing further surgery with the patients. We report case of woman who has endosalpingiosis and is presented with vaginal bleeding. We first suspect the disease during physical examination. Under the impression of pelvic mass, laboratory tests and radiological images of contrast enhanced chest computer tomography are taken. Images show multisepted cystic masses in left adnexa. To rule out the pelvic mass, we executed exploratory laparotomy. Pathologic results show endosalpingiosis near the ovary section. But the endosalpingiosis, is not generally considered a pathology, and thus, no treatment is necessary.
Aged* ; Biopsy ; Diagnosis, Differential ; Endometriosis ; Epithelium ; Fallopian Tube Diseases ; Fallopian Tubes ; Female ; Gynecology ; Humans ; Incidental Findings ; Infertility ; Laparotomy ; Menopause ; Ovary ; Pathology ; Pelvic Pain ; Physical Examination ; Thorax ; Uterine Hemorrhage

Adenoma ; metabolism ; pathology ; surgery ; ultrastructure ; Adnexa Uteri ; pathology ; surgery ; Adnexal Diseases ; metabolism ; pathology ; surgery ; Carcinoma, Endometrioid ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Granulosa Cell Tumor ; metabolism ; pathology ; Humans ; Hysterectomy ; Keratins ; metabolism ; Leiomyomatosis ; pathology ; surgery ; Microscopy, Electron ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; ultrastructure ; Sertoli-Leydig Cell Tumor ; metabolism ; pathology ; Uterine Neoplasms ; pathology ; surgery ; Vimentin ; metabolism ; WT1 Proteins ; metabolism

Radiotherapy plays a major role in the treatment of cervical cancer. A successful radiotherapy program integrates both external beam and brachytherapy components. The principles of radiotherapy are strongly based on the anatomy of the organ and patterns of local and nodal spread. However, in patients with distorted anatomy, several practical issues arise in the delivery of optimal radiotherapy, especially with brachytherapy. Müllerian duct anomalies result in congenital malformations of the female genital tract. Though being very commonly studied for their deleterious effects on fertility and pregnancy, they have not been recognized for their potential to interfere with the delivery of radiotherapy among patients with cervical cancer. Here, we discuss the management of cervical cancer among patients with Müllerian duct anomalies and review the very sparse amount of published literature on this topic.
Brachytherapy ; Diagnostic Imaging ; Female ; Genital Diseases, Female ; diagnosis ; diagnostic imaging ; pathology ; Humans ; Magnetic Resonance Imaging ; Mullerian Ducts ; abnormalities ; diagnostic imaging ; pathology ; Radiography ; Radiosurgery ; Radiotherapy ; methods ; Uterine Cervical Neoplasms ; radiotherapy ; surgery

OBJECTIVETo investigate the clinicopathological features of intermediate trophoblastic non-tumor lesions, and to evaluate the position of immunohistochemistry in differential diagnoses.

METHODSClinical presentation and morphological study of 15 cases of exaggerated placental site (EPS) and 4 cases of placental site nodule or plaque (PSNP) were reviewed. Immunohistochemical stains for hCG, hPL, inhibin-alpha, PLAP, CK18 and Ki-67 were performed.

RESULTSThe age of patients ranged from 25 to 40 years with an average of 31.5 years for EPS and 26 to 39 years with an average of 34.3 years for PSNP. Microscopically, EPS was characterized by cords and small sheets of implantation site intermediate trophoblasts infiltrating the endometrium, myometrium and arterial walls. The general histological structures of the endometrium and myometrium were preserved. PSNP was characterized by multiple circumscribed nodular lesions consisting of so-called chorionic-type intermediate trophoblasts and hyaline-like matrix present in the endometrium. Immunohistochemical stainings for hPL and CK18 were positive in the 15 EPS cases. Immunoreactivity for CK18, Inhibin-alpha and PLAP was detected in 4 PSNP cases. The Ki-67 labeling index in 15 EPS cases was low (< or = 5%), while Ki-67 index in 4 PSNP cases was close to 0.

CONCLUSIONSThe clinical presentation and pathological features of EPS and PSNP differ from those of trophoblastic tumors (placental site trophoblastic tumor, epithelioid trophoblastic tumor and choriocarcinoma). Immunochemical staining is of great value in their differential diagnoses.

Adult ; Diagnosis, Differential ; Endometrium ; pathology ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; methods ; Inhibins ; metabolism ; Keratins ; metabolism ; Myometrium ; pathology ; Placenta ; metabolism ; pathology ; Placenta Diseases ; metabolism ; pathology ; surgery ; Placental Lactogen ; metabolism ; Pregnancy ; Trophoblastic Neoplasms ; pathology ; Trophoblastic Tumor, Placental Site ; pathology ; Trophoblasts ; pathology ; Uterine Neoplasms ; pathology