Chronic Non-specific Cervicitis Research Articles

Spectrum, Clinicopathologic Profile, and p16 Expression Pattern of Nonmalignant Cervical Tissues in Enugu, South-East Nigeria

Abstract Background p16 is a marker for p16-induced transformation of high-risk human papilloma virus (hrHPV)-infected cervical epithelium. HPV is a known etiologic agent of cervical cancer. Persistent hrHPV infection of cervical epithelium causes transformation of the infected epithelial cells resulting in increased proliferative potential of the cells and subsequent progression to frank malignancy. Early detection of transformation in cervical cells is crucial in reducing morbidity and mortality associated with cervical cancer. Materials and Methods We aimed to study the clinicopathologic profile of nonmalignant cervical lesions and their p16 staining pattern. Histopathology requisition forms, blocks, and slides of cases containing cervical tissue with nonmalignant diagnosis received into the morbid anatomy department of University of Nigeria Teaching Hospital, Enugu, from 2009 to 2018 were studied. Fresh sections from the blocks were immunohistochemically stained with p16 and examined. Results One-hundred and ninety-one cases were studied. Majority of the cases are normal cervical epithelium. Chronic nonspecific cervicitis was the major non-neoplastic lesion present and accounted for 33.3% of the biopsy and the mean age was 50.5 years. Other lesions were nabothian cyst (8.4%), cervical polyp (10.5%), low-grade and high-grade squamous intraepithelial lesion (LSIL and HSIL; 6.3 and 2.6%, respectively). The mean age for LSIL was 40.3 years, while that of HSIL was 45.2years. Four LSIL, two HSIL, one polyp, one chronic nonspecific cervicitis, and one lobular endocervical hyperplasia stained positively with p16. Conclusion The most common benign lesion of the cervix is cervicitis. Chronic cervicitis is negative to p16 immunoreactivity. There are more low-grade cervical intraepithelial neoplasia (CIN) than high-grade CIN. The low-grade CIN overexpress p16 in one-third of cases. There are more cases of p16-negative high-grade CIN in this study.

Surgical outcomes of laparoscopic trachelectomy following supracervical hysterectomy: a multicenter study.

To evaluate the feasibility, safety, and surgical outcomes of laparoscopic trachelectomy after supracervical hysterectomy. This multicenter study was conducted at Tanta University, Benha University, and Aminah Laparoscopy Center (Benha, Egypt) from June 1, 2018 to October 31, 2021. Forty patients were recruited for this study and counseled on laparoscopic trachelectomy to treat their symptoms after supracervical hysterectomy. Furthermore, cervical biopsy was performed to detect and exclude any malignancy. Histopathological examination of cervical specimens was performed after surgery. Operative details and outcomes were recorded. The median age of the patients was 42 years (range, 38-47). The median body mass index was 25 years (range, 22- 28). The median interval between hysterectomy and the clinical presentation was 4.40 years (range, 3.58-5.25). Most patients presented with abnormal vaginal discharge (40%) and bleeding (25%). Moreover, a cervical biopsy result revealed stump carcinoma in three cases (7.5%) that were excluded. The median operative time was 210 minutes (range, 170-220). The median blood loss was 270 mL (range, 220-320). Additionally, histopathological examinations revealed that chronic non-specific cervicitis was present in 54.05% of trachelectomy specimens. There were no significant differences between symptomatic and asymptomatic patients regarding operative outcomes, except adhesions, which were more significantly increased in symptomatic patients (P=0.015). Minimal complications, both operative and postoperative, were related to the procedure. Although the operative time was long and adhesions were common during laparoscopic trachelectomy, the procedure was feasible and safe, with minimal complications.

Metastatic leiomyosarcoma of vault post – hysterectomy

Fibroids/Leiomyomas are the most common benign mesenchymal neoplasms and consist of smooth muscle cells with variable amounts of fibrous stoma. Atypical leiomyomas are rare forms of myoma (fibroid uterus), of which recurrent atypical leiomyoma post hysterectomy is rarer and its converting into leiomyosarcoma rising from the vault is rarest. The tumor occurs most frequently in uterus, affecting 20-30% of women of reproductive age. We report a case of 51 years old P4L4A2 patient presented with complaints of PV bleeding for 4 days, hysterectomy was done 1 year back for chronic nonspecific cervicitis and cervical leiomyomatous polyp. In January 2022, polypoidal growth from vault for which Laparoscopic excision of the mass was performed, Sample has been sent for histopathology and suggestive of mitotically active leiomyoma. Radical vaginectomy and reconstruction was done, small bowel deposits was found and diagnosed as Metastatic Leiomyosarcoma. Hence, diagnosis of leiomyosarcoma should always kept in mind though the patient is hysterectomized.

Modern ideas about the etiology, pathogenesis, diagnosis and treatment of chronic nonspecific cervicitis

Currently, cervicitis of nonspecific etiology is one of the urgent problems of modern gynecology due to the extremely high frequency of their occurrence, a tendency to a chronic relapsing course, a negative impact on reproductive health, and the risk of developing a number of complications. The role of violations of vaginal microbiocenosis and local immune status in the development of CNC has been convincingly shown. The replacement of lactobacilli with predominantly anaerobic microorganisms (Ureaplasma, Mycoplasma, Gardnerella vaginalis, Prevotella, Peptostreptococcus spp. and Bacteroides spp.), characteristic of bacterial vaginosis, is extremely often detected in patients with CNC. Of particular importance from the point of view of clarifying the pathophysiological mechanisms of development and the development of new diagnostic and prognostic markers, as well as the personalization of CNC therapy, is the study of the cytokine status. Cervicitis and other inflammatory diseases of the lower genital tract are characterized by an increase in the expression of pro-inflammatory cytokines with simultaneous inhibition of the formation of anti-inflammatory cytokines. Significant multidirectional changes in the balance of pro- and anti-inflammatory cytokines were revealed in active and chronic sluggish cervicitis. It should be noted that, despite the variety of proposed approaches to CNC therapy, this problem is still far from being solved to date. One of the promising directions is the personalization of CNC therapy based on molecular genetic markers (polymorphisms of cytokine genes, Toll-like receptors, genes of the detoxification system). The use of such a personalized approach can significantly increase the effectiveness of CNC treatment and reduce the risk of disease recurrence.

Distribution of cd1a dendritic cell density in benign and malignant lesions of human cervix – An immunohistochemical study

Dendritic cells, the potent antigen presenting cells, originate from the bone marrow cells and are mostly seen in the lymphoid organs of the human body. Their main purpose is to induct T-helper immune responses whenever they come across an antigenic stimulus. The presence of dendritic cells in the human cervix evoked interest in many researchers to assess their locations, distribution in cervix and to analyze their actual contribution to host immune system. In our present study, we have analyzed the actual distribution of CD1a positive dendritic cells in the benign, premalignant and malignant lesions of the human cervix. This prospective analysis was done on cervical tissue taken from hysterectomy specimens or from cervical punch biopsies. A total of 30 specimens were included in the study. The number and distribution of the dendritic cells in each of the specimens per high power field was calculated. Bleeding per vaginum was the most common presentation. Chronic non-specific cervicitis constituted the most common histological variety. The mean age at presentation was 44.7 years. The mean dendritic cells per high power field in the benign (including pre-malignant) and the malignant tissues were 9.3 and 5.8 cells respectively (p+0.0001). An overall increase in the number and distribution of dendritic cells were found in benign than in malignant tissues.

HISTOPATHOLOGICAL SPECTRUM OF NON NEOPLASTIC AND NEOPLASTIC LESIONS OF UTEROCERVIX IN NORTH WEST RAJASTHAN

Background: The female genital tract includes the uterine corpus, cervix, fallopian tubes and ovaries. Women worldwide suffer from gynaecologic and obstetric disorders that require hysterectomy as a treatment option. Hysterectomy is a definite treatment of pelvic pathology including fibroid, abnormal heavy bleeding, chronic pelvic pain, endometriosis, adenomyosis, uterine prolapse, pelvic inflammatory disease and cancer of reproductive organs. Hysterectomy specimens contribute a major component of histopathological work in Pathology laboratories.
 Methods: This is a prospective study carried out in the Department of Pathology, SPMC, Bikaner for two years from October 2018 to September 2020. All surgically excised hysterectomy specimens received by the department during study period were included in the study. Tissues were fixed and processed as per departmental protocols. Pieces taken from ectocervix, endocervix, uterine canal and fundus. Pieces also taken from any abnormal area. Tissue bits routinely processed 3 to 6 micron thick sections made from paraffin embedded blocks and were stained with H&E stain. Special stains will be done whenever necessary.
 Results: We included a total of 148 cases of hysterectomies received to our department during the study period in our study. Of total 148 cases, 87.83% hysterectomies were abdominal and 12.16% were vaginal and TAHBSO was the commonest procedure. In myometrium the most common finding was leiomyoma and adenomyosis with 79.73% and 43.92% cases respectively. In cervix, most cases were inflammatory lesions with chronic nonspecific cervicitis was the most common histopathological finding. Two cases (1.37%) of carcinoma cervix were reported.
 Conclusions: Most of the cases which underwent hysterectomy were for symptomatic untreatable benign conditions and few for malignancies. Majority of the cases were histopathologically consistent with clinical diagnosis. Histopathological examination and its correlative study with preoperative clinical diagnosis is very important. Thus, histopathological examination is still the gold standard test to diagnose and rule out malignancy and must be compulsory for all the surgical specimens.
 Keywords: Hysterectomy, Uterocervix, Pathology

HISTOPATHOLOGICAL STUDY OF BENIGN AND MALIGNANT LESIONS OF UTERUS AND CERVIX IN HYSTERECTOMY SPECIMENS

Background: The present study was aimed to obtain insight into the varied histopathological patterns of lesions of uterus and cervix in hysterectomy specimens and their age-wise distribution in Index MedicalCollege, Hospital and Research Center.
 Methodology: This was anobservational study conducted on 100 cases of hysterectomy specimens received at tertiary care hospital Indore. All the specimen was subjected to detailed gross and histopathological examination.
 Results: Mean age of patients was 44.78±8.64 years. The most common age group was 41-50yrs (42%). Maximum cases were diagnosed as AUB/ DUB/Menorrhagia (31%) followed by fibroid uterus (28%). Uterus was bulky in 70%, cut sections revealed single fibroid in majority i.e. 39% cases and endometrium was in proliferative phase (early 12%, mid 30%, late 19%). Most common histopathological diagnosis of uterus was leiomyoma in 39% cases whereas chronic nonspecific cervicitis (47%) was most common histological diagnosis of cervix. Intramural leiomyoma were most common and were associated with degenerative changes in 33 cases. Hyaline degeneration was observed in maximum cases.
 Conclusion: The most common indication for hysterectomies in our institution is excessive uterine bleeding. Fibroid uterus as the cause of bleeding is the most common pathology for which hysterectomy is performed. Chronic cervicitis is the most common finding and Adenomyosis continued to be missed preoperatively and diagnosed postoperatively on histopathological examination. Every hysterectomy specimen should be subjected to histopathological examination to confirm various pathological lesions.
 Keywords: Leiomyoma, histopathology, spectrum, uterus, cervix, hysterectomy

Histopathological study of cervical lesions: a hospital based study in teaching hospital Batticaloa, Sri Lanka

The uterine cervix is prone for infections and malignancies. The cervical cancer is fourth most common cancer in the world and second common female cancer in Sri Lanka. This hospital based retrospective study was done on 586 cervical specimens. This study was aimed for the histomorphology patterns of cervical lesions. Results; There were 10.2% malignant cases and 68.90% were non-neoplastic cervical specimens. Majority of the non- neoplastic cervical lesions were inflammation and polyp, constitute 37.2% and 17.7% of the total study samples. Majority of patients with cervical carcinoma (36.5%) presented with blood-stained, whitish per vaginal discharge and it is followed by (32.7%) abnormal uterine bleeding. The peak age incidence of cervical cancer was 50-59 years. Squamous cell carcinoma was by far the most common histological type accounting for 84.6%, followed by adenocarcinoma 11.5%. Squamous cell cervical carcinoma classified according to Broder’s grading system into well, moderately and poorly differentiated at the time of initial diagnosis and constituting cases as 20%, 71.1% and 8.9% respectively. The chronic nonspecific cervicitis was the most common inflammatory lesion constituting 86.2% of nonneoplastic cases. The main presenting complaints of blood-stained vaginal discharge or abnormal uterine bleeding, especially in the age group of 50-59 years, should be investigated to exclude malignancy. Public health education should be intensified to encourage early health seeking behavior in order to diagnose cervical malignancy at an early age especially when they have clinical symptoms of blood-stained vaginal discharge or abnormal uterine bleeding.

Histopathological spectrum of cervical lesions- Our institute experience

Introduction: The aim of the study is to find out various cervical lesions with histopathological correlation and age. Materials and Methods: This is a retrospective study conducted at department of Pathology in Tertiary care center from January 2015 to October 2015. The data of 208 patients were retrieved from past records who were diagnosed with various cervical lesions. Cervical biopsies were available for 119 cases and specimens of uterus with cervix were found in 88 cases and vault biopsy in one case. Results: Out of 208 cases, 67 cases (32.2%) were that of Chronic non-specific cervicitis, 33 cases (15.86%) were papillary endocervicitis, 24 cases (11.5%) were Cervical intraepithelial neoplasia (CIN), 72 cases (34.6%) were cervical cancer, 6 cases(2.8%) were hyperplasia, One case (0.9%) showed squamous metaplasia with koiliocytic changes, 4 cases (1.9%) did not show any remarkable pathology. Most common age group from squamous cell carcinoma were 41-50 years. Conclusion: Most common cervical lesion is Squamous Cell carcinoma and most common age group is 41-50 years. Keywords: Histopathology, Cervical lesions.

HISTOPATHOLOGICAL SPECTRUM OF LESIONS OF CERVIX IN A TERTIARY CARE HOSPITAL: A RETROSPECTIVE STUDY

INTRODUCTION: Majority of the specimens which reach the histopathology laboratory are from gynecology department. The accessibility of the cervix to direct examination makes it the object of intensive and large scale study. Various inflammatory as well as infectious lesions are common in uterine cervix due to vulnerability to sexual trauma and being an easy access to various infections. Cervical cancer is one of the most frequently seen cancer in women in India. AIM: The present study is aimed to find out the most common types of the cervical lesions, incidence and histological variants of malignancies in women so as to understand the distribution of various diseases. MATERIAL AND METHODS: This is a retrospective study done in Government Medical College , Ananthapuram , a Tertiary Care Centre, for a period of 2 years, from January 2017 to December 2018. RESULTS: A total of 448 cases were retrieved from histopathology department and evaluated. The age group of the patients was between 20-80years. There was about 388 (86.6%) cases were non –neoplastic and 60 (13.39%) cases were neoplastic. CONCLUSION: The most common of non neoplastic lesions was chronic non-specific cervicitis. Most common neoplastic lesion was squamous cell carcinoma.

Histopathological patterns of benign lesions in hysterectomy specimens

Aims: To audit and evaluate the surgical indications, routes of surgery and types of hysterectomies performed along with histopathological analysis of those hysterectomies in respect to disease of endometrium, myometrium, cervix and fallopian tubes and ovaries for benign conditions.
 Methods: This is retrospective cross sectional study of all hysterectomy specimens received in the department of Pathology, B and C teaching hospital and research center, Jhapa, Birtamode, Nepal from May 2017 to May 2019. Clinical details were received from the data provided by gynecologists in histopathological requisition forms. Only specimens received for the benign indication for hysterectomy were taken.
 Results: Out of 115 specimens, the number was equal on both abdominal and vaginal route. The common indications were leiomyoma (60%, n=69), abnormal uterine bleeding (24%, n=28) and uterine prolapsed in 11% (n=13). Uterovaginal prolapse was seen commonest indication for hysterectomy in age group of 5th and 6th decade of life. Myometrial pathology was seen in 74% (n=75) comprising mostly of leiomyoma. Endometrial pathology was present in 14% (n=16) and chronic non-specific cervicitis in 24% (n=28). Abnormal tubo-ovarian pathology was found in 40% (n=51).
 Conclusions: Leiomyoma, abnormal uterine bleding and uterovaginal prolapsed are the common benign conditions undergoing hysterectomy.

Clinico-Histomorphological Spectrum of Non-Neoplastic Lesions of the Uterine Cervix at a Tertiary Care Center of a Remote Indian Island

The uterine cervix is liable to suffer from several neo¬plastic and non-neoplastic gynaecologic lesions commonly seen in sexually active women. It is important to categorize and recognize the histomorphological features of cervical non-neoplastic lesions for better management of the patient. The present study was undertaken to study the microscopic features of the uterine cervix in non-neoplastic lesions. It was a retrospective cross-sectional study conducted over a period of two years in Department of Pathology. The study included 282 specimens of uterine cervix received at histopathology section. Detailed clinical details including age, parity, clinical findings and provisional diagnosis were noted. Out of these 282 specimens, 27.3% (77/282) were from cervical biopsy either endocervical curettage or punch biopsy, and 72.7% (205/282) were hysterectomy specimen. Most common clinical symptoms was irregular/excessive menses (44.68%, 126/282) followed by white discharge per vaginum (34.4%, 97/282). Out of 282 of the cases, 80.5% (227/282) showed chronic non-specific cervicitis (CNSC) followed by endocervical polyp (33/282, 11.7%) followed by squamous metaplasia (21/282, 7.4%). Koilocytic change was seen in 3.2% of cases (9/282). One case each for granulomatous cervicitis, microglandular hyperplasia, tunnel cluster, and condyloma acuminata was also noted. CNSC is the most common inflammatory lesion followed by endocervical polyp and squamous metaplasia. Prevalence of HPV related koilocytosis and condylomata acuminata is low in the study area as compared to other parts of India.

Histopathological and clinical Analysis of variants in cervical lesion at Bhuj, Kutch, Gujarat

Background: Aim of the study was to know various histopathological variants in cervical lesion, its incidence with respect to age in Bhuj city of Gujarat.Materials & Methods: A total of 618 cases of cervical lesions were analysed prospectively in a period of 2 years to assess various pattern of cervical lesion. Cases were studied in detail about history, clinical examination and other findings.Results: Of the total 618 cases, 516 (83.50%) were non neoplastic all of which were inflammatory and 102(16.5%) were neoplastic of which cervical malignancies, benign lesions and cervical intraepithelial neoplasia (CIN) constituted 80(12.94%), 12(1.94%) and 10(1.62%) respectively. Amongst inflammatory lesions, the commonest lesion was chronic nonspecific cervicitis 428(82.95%) followed by papillary endocervicitis 88(17.05%). The associated changes of chronic nonspecific cervicitis were nabothian cyst (11.92%), squamous metaplasia (11.68%), and koilocytic change (22.43%). Inflammatory lesions were commonly found in the sexually active period of women i.e. 31-50 years with a peak incidence in the age group of 31-40 years. Cervical malignancies were common in the age group of 40-60 years and presented most commonly with bleeding per vagina. CIN was most common in the age group of 41-50 years with CINII as the predominant grade having white discharge as the most common symptom.Conclusion: Non-neoplastic were the commonest lesions of the cervix. Women in the older age group with bleeding per vagina should be suspected for cervical malignancy and should be examined for the same.DOI:10.21276/APALM.1716

Histopathological Spectrum of Non-Neoplastic Uterine Cervical Lesions in a Tertiary Care Centre

Background: Uterine cervix in our routine hysterectomies and biopsies from gynecological specimens constitutes major portal for nonneoplastic lesions. Routine histopathological study of suspicious cases enhances early detection of these uterine cervical lesions. Methods: 250 cases of uterine cervical non-neoplastic lesions were evaluated either from hysterectomy or cervical biopsy specimens. The purpose of this study is to analyze and determine the frequency and histomorphological patterns of non-neoplastic cervical lesions at the tertiary care center and to study various metaplasias of the endocervical epithelium. The cervical lesions were subjected to detailed gross and microscopic examination and further classified into various non-neoplastic lesions Result: Our study showed that 48 % of cases featured chronic nonspecific cervicitis. The commonest encountered endocervical epithelial lesions were chronic polypoidal endocervicitis (20%) and squamous metaplasia (36%) and the uncommon lesions included micro glandular adenosis (3.2%), endocervical glandular hyperplasia (4%), diffuse laminar endocervical glandular hyperplasia(0.8%) tunnel clusters (0.4%) and mesonephric rests (0.4%). A majority of the ectocervical lesions includes Koilocytic changes, exocytosis, Suprabasal bulla and prolapse changes like hyperkeratosis and parakeratosis. Conclusion: In the present study we emphasized mainly about nonneoplastic uterine cervical lesions among which Chronic non-specific cervicitis is the most confronted lesion in histopathological specimens. However, there are many lesions that appear to be exuberant and can be misdiagnosed to be malignant. On the basis of this, a detailed histomorphological study of the nonneoplastic lesions of the cervix was taken up and further categorized into various lesions which can cause serious morbidities and detailed histopathological study is considered as the gold standard. DOI: 10.21276/APALM.1405

Clinico-histopathologic study of nonneoplastic uterine cervical lesions

Background: The cervix of uterus is prone to develop neoplastic and nonneoplastic gynecologic lesions. The histological lesions that are found in the uterine cervix cannot be always established only with conventional cytology. Thus, it is very important that any cytological abnormality be subsequently correlated with biopsy for certification of a cervical lesion. Objective: To evaluate histomorphologic features of all types of nonneoplastic lesions of the uterine cervix. Materials and Methods: The retrospective study consists of total 630 cases that were submitted for routine histopathologic investigations. All specimens were fixed, dehydrated, embedded, and subsequently stained with hematoxylin and eosin. Special stains, such as mucicarmine and PAS - Periodic acid–Schiif, were employed wherever necessary. Result: Among the 630 cervical specimens, inflammatory lesions formed the major part (71.42%) followed by cervical malignancies (12.69%). Benign cervical lesions and cervical intraepithelial neoplasia constituted 6.98% and 4.44%, respectively. The noninflammatory cervical glandular lesions constituted 2.85%. Conclusion: Inflammatory lesions were the most common cervical lesions followed by malignancies. Among inflammatory lesions, chronic nonspecific cervicitis was commonly found followed by papillary endocervicitis seen in sexually active females with pelvic inflammatory disease, dysfunctional uterine bleeding, uterine prolapsed, and so on. The most common cervical malignancy was squamous-cell carcinoma, moderately differentiated being the most common type.

English

ABSRACT: BACKGROUND: The infections of female genital tract are the “Gateway” predisposing the women not only to tubal infertility but also increase the risk of ectopic pregnancy. Now-a-days leucorrhoea is the common gynaecological problem in the women of all ages. Chronic nonspecific cervicitis is the commonest non-neoplastic lesion in all age groups, usually between 20-60 years, but rare before menarche or after menopause. Agents from bacterial, viral & metabolic diseases like diabetes mellitus, the infections are also due to local trauma, parturition, foreign bodies, diaphragm, pessaries and IUCD’s. The HPV and HSV play a major role and strongly associated with carcinoma. The age at first coitus, smoking, parity is the other etiological factors. These factors cause dysplastic changes in epithelium leading to carcinoma. The present study is undertaken in view of disease sequelae of chronic cervicitis, Ca – in situ & Ca cervix. AIM: To analyse the cervical lesions and also early detection of carcinoma. OBJECTIVES: To determine the incidence, relation to age, parity, and etiological factors and to study different benign, premalignant and malignant lesions of cervix. MATERIALS AND METHODS: The present prospective study is done for a period of 3 years in the Dept. of Pathology, RIMS, Kadapa. Cases were analysed pathologically according to WHO classification. RESULTS: The commonest lesions were neoplastic – Large cell non-keratinising squamous cell carcinoma (36.9%) noted in the age group of 40-50 yrs. Next common lesion noted was non-neoplastic with chronic cervicitis (25.5%) noted in the age group of 30-40yrs. The 3 rd common lesion noted was chronic endocerviitis (14.4%) seen in 40-50 yrs of age group. The next common were squamous intraepithelial lesions (5.6%) in the age group of 30-40yrs. Rare cases of leiomyomas of cervix, tuberculous cervicitis, actinomycosis, adenocarcinoma and adenosquamous carcinomas were noted. Precancerous and cancerous lesions were associated with increased parity and poor personal hygiene.

Morphological spectrum of non-neoplastic lesions of the uterine cervix in Warri, South-South, Nigeria

The uterine cervix is a gateway to several non-neoplastic and neoplastic gynecological lesions. Most of these non-neoplastic lesions are commonly found in women of reproductive age. These lesions constitute a source of morbidity and mortality in women worldwide hence the need to analyze them to provide a baseline data of the pattern of these lesions in our local environment. The purpose of this study is to determine the frequency and morphological patterns of non-neoplastic cervical lesions at the central hospital, Warri, Nigeria. All uterine cervical biopsies received at the Department of Pathology, Central Hospital, Warri over a 7 year period (January 2005-December 2011) were the specimens for this study. Slides were retrieved from the archives of the Department of Pathology. Where necessary, new sections were made from formalin fixed, paraffin embedded blocks. A total of 176 cervical specimens were received in the Pathology Department during this period. Of these, 56.3% were benign lesions while 43.7% were malignant. Among the benign cases, non-neoplastic lesions accounted for 92.9% of benign cervical lesions. The age range of non-neoplastic cervical lesions was 20 to 89 years with a mean age of 54.9 ± 4.6 years. The peak age incidence of non-neoplastic cervical lesion was 40-49 years which accounted for 33.7%. Inflammatory lesions and tumor-like lesions accounted for 59.8% and 40.2% of non-neoplastic cervical lesions respectively. Among the inflammatory lesions, chronic non-specific cervicitis was the most commonly encountered lesion constituting 72.2% of all inflammation. Human papilloma virus (HPV) cervicitis with koilocytic changes accounted for 14.5% of all inflammatory lesions. Inflammatory lesions were the most frequent non-neoplastic cervical lesions. These lesions therefore account for significant amount of gynecological problems in our environment. Adequate cervical screening with follow up histological biopsies is a relevant tool in diagnosing them to enhance early detection of premalignant and malignant cervical lesions.

Characterization of low molecular weight antimicrobial peptide from human female reproductive tract

Background & objectives:The mechanisms that protect female upper genital tract from ascending infection by microbes present in vagina are only partially understood. It is expected that epithelial cells in mucosal surfaces and their secretions directly interfere with microbial colonization and invasion. This study was aimed to demonstrate the expression of 2 kDa antimicrobial peptide which was identified and purified from female genital tract tissues using chromatographic techniques.Methods:Low molecular weight proteins were isolated from human female reproductive tract tissues obtained from premenopausal women. Antimicrobial activity of these LMW proteins was assessed against different reproductive tract pathogens viz., Neisseria gonorrhoeae, Group B streptococcus, Gardnerella vaginalis, Escherechia coli and Candida albicans. The expression of these peptides were also documented in reproductive tract tissues with the help of hyperimmune sera raised against the rabbits. The purified peptide was characterized by N-terminal sequencing.Results:Immunohistochemical and immunofluorescence studies demonstrated that 2 kDa peptide was expressed in the stratified squamous epithelial cells of the ectocervix while it was absent in columnar epithelial cells of upper genital tract. Upregulation of the expression of this peptide was observed in patients of chronic non-specific cervicitis and acute on chronic cervicitis. This purified antimicrobial peptide also showed broad spectrum antimicrobial activity against different reproductive tract pathogens.Interpretation & conclusions:Considering the emerging bacterial resistance against conventional antibiotics, isolation and understanding of the expression of antimicrobial peptides from female reproductive tissue extracts may provide some leads towards the development of strategies for the treatment of reproductive tract infections.

Non-neoplastic diseases of the cervix in Nigerians: a histopathological study.

Diseases of the cervix are common in young sexually active women. Non-neoplastic diseases are predominantly inflammatory and are common but there are a few publications on the subject compared to neoplastic diseases of the cervix. The surgical day books of the Histopathology department of the Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife, Nigeria from the year 1990-1999 (Ten years) were studied for all cervical biopsies. Four hundred (400) cervical surgical biopsies were received during this period. 150 (37.5%) of the cases were non-neoplastic lesions. Age range was 20-69 years with peak incidence at 40-49 years. Histological distribution showed 123 cases (82%) were chronic non-specific cervicitis. Eighteen cases (12%) were chronic cervicitis with koilocytic change pathognomonic of Human Papilloma Virus (HPV) infection, two-third (12 cases) of which occur within 40-49 years. There were five cases (3.3%) of chronic granulomatous cervicitis, three cases (2.0%) of acute cervicitis and only one case (0.7%) of microglandular endocervical hyperplasia. All the histological types were found within the peak age incidence of 40-49 years. Chronic non-specific cervicitis was the most common non-neoplastic cervical lesion and it occurs in all age groups of women studied. In 12% of patients it is associated with cytopathic effect of HPV. This has obvious implication for the occurrence of carcinoma of the cervix in our country. We recommend routine pap smear test in this group of patients especially, as a way of reducing the occurrence of carcinoma of the cervix.