Diagnosis Of Hyperplasia Research Articles

Effectiveness of hysteroscopic transcervical resection in the diagnosis of lobular endocervical glandular hyperplasia: A case report

Effectiveness of hysteroscopic transcervical resection in the diagnosis of lobular endocervical glandular hyperplasia: A case report

Histomorphological Patterns of Endometrial Hyperplasia

Background and Aims Endometrial hyperplasia is a pathological condition characterized by an increase in the endometrial gland to stromal ratio when compared to the normal proliferative endometrium. It is the precursor of endometrial carcinomamdashthe most common malignancy of female genital tract. The increased risk of endometrial hyperplasia is found to be more evident in women with abnormal uterine bleeding. Hence we decided to study the histopathological pattern of endometrial hyperplasia in women of different age groups.Methods All the endometrial biopsies with microscopic diagnosis of endometrial hyperplasia over a period of 1 year were retrieved from histopathology records. Information related to age and clinical diagnosis was noted from the accompanying laboratory request forms. Histological typing of endometrial hyperplasia was done depending on the new criteria used in the World Health Organization WHO classification.Results The present study included 40 cases n 40 of endometrial hyperplasia diagnosed by histopathological examination on endometrial biopsies. Age of the patients ranged from 21-70 years. About half of the patients 45 presented with abnormal uterine bleeding and were in the 5th decade of life. Non-atypical endometrial hyperplasia n 34 cases 85 was the most common histological type of endometrial hyperplasia.Conclusions Histopathological examination of endometrium is used for the diagnosis of abnormal uterine bleeding. Endometrial biopsy and curettage are the important sampling methods to detect endometrial hyperplasia. Hence vigilant screening of the endometrial samples plays an important role in the diagnosis and further management.

The Clinical Application Value of RDW, CA153, and MPV in Breast Cancer.

Early detection of tumors is beneficial to the treatment of patients. Certain indicators in the blood routine, such as red blood cell distribution width (RDW), are considered to be used to assess the patient's condition and prognosis. Mean platelet volume (MPV) is also used to assess the prognosis of patients. Carbohydrate antigen 153 (CA153) is considered to be a more specific antigen marker for breast cancer. The purpose of our study was to explore the diagnostic value of RDW, MPV, and CA153 for breast cancer (BC) and breast hyperplasia (BH). The study included 104 breast cancer patients, 100 breast hyperplasia patients, and 100 healthy controls. CA153 was detected by an automatic electrochemical luminescence analyzer (Cobas e601, Roche Diagnostics, Switzerland). The concentration of RDW and MPV in serum was measured by Sysmex XN-10-B3 (Sysmex, Ja¬pan). Compared with the breast hyperplasia group, the RDW and CA153 of the breast cancer group were increased. The healthy control group, mammary gland hyperplasia group, and breast cancer were positively correlated with RDW and CA153. Logistic regression results show that increasing age, increasing RDW, and increasing CA153 can increase the risk of breast cancer. The area under the ROC (AUC) analysis showed that the combined specificity and sensitivity of the combined application of RDW, MPV, and CA153 for the identification of breast cancer is better than that of a single marker. The combined application of RDW, MPV, and CA153 can improve the differential diagnosis of breast cancer and breast hyperplasia.

Focal nodular hyperplasia diagnosis with contrast-enhanced ultrasound

Focal nodular hyperplasia diagnosis with contrast-enhanced ultrasound

English

BACKGROUND Concurrent carcinoma endometrium occurs in around 40 % of hysterectomy specimen done for premalignant endometrial intraepithelial neoplasia. We intend to study the prevalence of coexisting endometrial cancer in patients who were diagnosed with endometrial hyperplasia with atypia and had undergone hysterectomy. METHODS This cross-sectional study conducted at Government Medical College, Thrissur, included all women with a pre-operative diagnosis of endometrial hyperplasia with atypia (WHO) undergoing hysterectomy during the study period. RESULTS A total of 40 women were found to have atypical endometrial hyperplasia in the study period. The mean age of presentation was 51 ± 2. 7 yrs. and was more common in multiparous postmenopausal women. Postmenopausal bleeding was the most common presenting symptom and more than 50 % of women were overweight. The proportion of concurrent endometrial carcinoma in women with atypical endometrial hyperplasia was found to be 37. 5 %. 93 % of cases with concurrent endometrial carcinoma were of grade I endometrioid type. High risk features were defined as > 50 % myometrial invasion, seen in 47 % patients. Stage 2 endometrial carcinoma was seen in 27 % patients. 53 % patients had less than 50 % myometrial invasion. Stage 1a and 1b endometrial carcinoma was seen in 53 % and 20 % of patients respectively. CONCLUSIONS Large dicer of overlap exists between atypical endometrial hyperplasia (AEH) and early-stage endometrial carcinoma. Therefore, we should recognise the limitation of endometrial sampling in distinguishing between these two groups. KEYWORDS Atypical Endometrial Hyperplasia, Endometrial Carcinoma, Endometrial Sampling

Unilateral bifid condyle: a case report

In the present case report, a patient attended the Surgical Clinic of PUC-MG for extraction of third molars. When performing the panoramic radiography, an atypical shaping of the mandibular condyle was detected. For the correct diagnosis, a cone-beam computed tomography was requested. The axial, sagittal, and coronal tomographic sections clearly showed the structure and its position in relation to the skull. The exam showed unilateral hyperdense masses on the left, in the form of mediolaterally oriented secondary condylar heads. Although they were adjacent to the condylar head, a constriction between them was observed in the superior condylar pole region. This image analysis, associated with the absence of functional changes and symptomatology, was decisive for the diagnosis of a bifid condyle, as it allowed to exclude any pathological alteration. As its etiology is diverse, this type of anatomical variation is usually found in routine imaging exams, as in the present study. The bifid condyle can be considered a differential diagnosis of condylar hyperplasia, osteochondromas, or alterations related to temporomandibular dysfunction in two-dimensional radiographic exams.

TRNA-derived fragments tRFGlnCTG induced by arterial injury promote vascular smooth muscle cell proliferation

tRNA-derived fragments (tRFs) and tRNA halves (tiRNAs) are originated from the specific cleavage of endogenous tRNAs or their precursors and regulate gene expression when the cells are in stressful circumstances. Here, we replicated the rat common carotid artery (CCA) intimal hyperplasia model and investigated the expression of tRFs/tiRNAs in the artery. The normal and the balloon-injured rat CCAs were subjected to small RNA sequencing, and then the differentially expressed tRFs/tiRNAs were identified and analyzed. The expression profiles of tRFs/tiRNAs in the healthy and injured CCAs were remarkably different. tRNAGlnCTG-derived fragments (tRFGlnCTG) were found to be overexpressed with a high abundance in the injured CCA. In in vitro experiments, the synthetic tRFGlnCTG mimetics elevated the proliferation and migration of rat vascular smooth muscle cells (VSMCs). Through bioinformatics analysis and an overexpression experiment, tRFGlnCTG was found to negatively regulate the expression of FAS cell surface death receptor (FAS). This study revealed that tRFGlnCTG is a crucial regulator in promoting VSMC proliferation. The investigation of the roles of tRFs/tiRNAs is of significance for understanding the mechanism, diagnosis, and treatment of intimal hyperplasia.

Pathomorphological Characteristics Of Glandular Hyperplasia Endometry In Women According To The Data Of The Bukhara Regional Pathological Bureau

The results of examination of 107 patients with glandular hyperplasia of the endometrium are presented. The age of women ranged from 43 to 67 years, on average it was 41.2 + 2.6 years, of which 76 patients were of reproductive age and 49 during the perimenopause. The diagnosis of glandular hyperplasia was established on the basis of morphological scraping of the uterine mucosa. The morphological forms of glandular hyperplasia of the endometrium were analyzed and a comparative analysis of the frequency of all this pathology in the Bukhara region was carried out. The results of the study showed a high growth of this pathology, the cause of which is uterine bleeding, which was confirmed by morphological examination.

Investigation of the feasibility of synthetic MRI in the differential diagnosis of non-keratinising nasopharyngeal carcinoma and benign hyperplasia using different contoured methods for delineation of the region of interest

To assess the feasibility and preliminary diagnostic performances of relaxation times derived from synthetic magnetic resonance imaging (syMRI) for differentiating nasopharyngeal carcinoma from nasopharyngeal benign lymphoid hyperplasia, and to assess the influence of tissue segmentation method on relaxation estimates. Fifty participants with nasopharyngeal carcinoma (NPC) and 40 participants with benign hyperplasia (NPH) who underwent syMRI examination were enrolled prospectively. T1, T2, and proton density (PD) values were obtained from four different regions of interest (ROIs), namely, partial-section, single-section, three-sections, and whole-lesion. The metrics between NPC and NPH or among different ROIs were compared using Student's t-test or one-way ANOVA. The area under curve (AUC) was calculated to assess the performance of metrics obtained from different ROIs to differentiate NPC and NPH. The T1, T2, and PD values for NPH were significantly higher than those for NPC, regardless of the type of ROI used, except for the PD value obtained from the whole-lesion ROI. The T2 values obtained from the single-section ROI showed the highest diagnostic accuracy in distinguishing NPC from NPH, with an AUC of 0.894, sensitivity of 0.900, and specificity of 0.800. Additionally, the T1, T2, and PD values for nasopharyngeal lesions showed no statistical difference among different kinds of ROI, except for the difference in T1 value between partial-section and other methods. Quantitative analysis of syMRI has the potential to distinguish NPC from NPH. Moreover, different types of ROI showed limited influence on the relaxation time estimation for nasopharyngeal lesions.

Reference values of mandibular condyles metabolic activity: A study using 99m Tc-MDP single-photon emission computed tomography.

To assess the condylar bone metabolic activity in patients with temporomandibular joint health by measuring 99m Tc-MDP uptake using a single-photon emission computed tomography (SPECT) to establish reference values of the uptake difference between condyles and the ratio with respect to the clivus. Eighty consecutive patients of both sexes who were admitted to a Nuclear Medicine Centre between 2017 and 2019 were included in the study. This was an observational cross-sectional study in patients with SPECT indications to evaluate pathologies other than those of the temporomandibular joint. The values of the total and normalized counts in a fixed region of interest of five trans-axial slides were obtained to assess the percentage difference between the sides and the uptake ratio. The reference values are expressed as median and 5th and 95th percentiles. The sample included 53 women (66.25%) and 27 men (33.75%) aged 15-55years. The percentage of uptake difference between condyles was 5.04% (0.46-14.78) for men and 5.17% (0.27-13.21) for women (difference not significant, P=.9). The uptake difference was below 10% in 85% of the subjects (n=68). The ratio values for total counts in women (0.87, 0.46-1.33) were significantly different (P=.0030) from those in men (1.08, 0.61-2.09). No significant correlation with age was found. These new reference ranges are applicable to the diagnosis of unilateral and bilateral condylar hyperplasia.

Value of endometrial thickness in diagnosis of endometrial hyperplasia during selective estrogen receptor modulator therapy in premenopausal breast cancer patients

ObjectiveThe weak estrogenic-like effect of selective estrogen receptor modulator (SERM) may lead to series of endometrial lesions, including proliferation, hyperplasia, polyp formation, and even endometrial cancer. This study aimed to explore the effectiveness of different endometrial thickness in diagnosis of endometrial hyperplasia during SERM therapy in premenopausal patients. MethodsThe clinical data of 115 patients receiving hysteroscopic endometrial biopsy during SERM therapy in Peking Union Medical College Hospital, China from January 2010 to December 2018 were retrospectively analyzed. ResultsAverage age at the beginning of SERM therapy was 43.4 ± 5.7 years old. Mean duration time of SERM therapy was 31.0 ± 22.1 months. The mean endometrial thickness was 14.3 ± 6.1 mm. 4 cases of atypical endometrial hyperplasia (3.5 %), and 4 cases of endometrial hyperplasia without atypia (3.5 %) were detected. Endometrial thickness was higher in endometrial hyperplasia patients than in no endometrial hyperplasia patients (18.8 vs 13.9 mm, p = 0.029). Endometrial thickness in 8 out of 8 endometrial hyperplasia patients and 38 out of 107 no endometrial hyperplasia patients were ≥ 15 mm (p = 0.002). The negative predictive value in the diagnosis of endometrial hyperplasia during SERM therapy in premenopausal patients was 100 % when endometrial thickness < 15 mm chosen as cutoff value. ConclusionEndometrial hyperplasia was less likely to occur in premenopausal patients during SERM therapy when endometrial thickness < 15 mm.

Role of Suction Pipelle in Diagnosis of Endometrial Lesions in Patients with Abnormal Uterine Bleeding

Background: Abnormal uterine bleeding (AUB) is a major clinical problem among women in the reproductive, perimenopausal and postmenopausal age groups. It may have a significant impact on woman physical, social, emotional and material quality of life. Along with the direct impact on the woman and her family, there are significant costs to both economy and health service. The AUB in women aged 40 and older, especially in peri and postmenopausal age group requires exclusive assessment, to exclude atypical endometrial hyperplasia and carcinoma. Objective: This study aimed to determine the efficacy of suction pipelle in diagnosis of endometrial lesions in cases of abnormal uterine bleeding. Patients and Methods: The current study was designed as cross-sectional study conducted in Zagazig University Maternity Hospitals, Al-Ahrar Teaching Hospital and the Department of Pathology, Zagazig University during the period from April 2018 to July 2019. The study was conducted on 92 patients presented with abnormal uterine bleeding. Results: The 2 methods were 100% matched in diagnosis of secretory endometrium, hormone-dependent endometrium, atypical hyperplasia and EEC grade 1. The pipelle succeeded to diagnose some cases of proliferative endometrial and simple hyperplasia, which were missed by D & C (18.5% and 17.4% by pipelle versus 16.3% and 13% by D & C respectively for proliferative endometrial hyperplasia and 8.7% and 17.4% by pipelle versus 16.3% and 19.6% by D&C for simple hyperplasia respectively). Conclusion: Pipelle had high sensitivity and specificity for diagnosis of proliferative endometrial, secretory endometrium, hormonedependent endometrium, simple endometrial hyperplasia, atypical hyperplasia and EEC grade 1.

Role of Suction Pipelle in Diagnosis of Endometrial Lesions in Patients with Abnormal Uterine Bleeding

Background: Abnormal uterine bleeding (AUB) is a major clinical problem among women in the reproductive, perimenopausal and postmenopausal age groups. It may have a significant impact on woman physical, social, emotional and material quality of life. Along with the direct impact on the woman and her family, there are significant costs to both economy and health service. The AUB in women aged 40 and older, especially in peri and postmenopausal age group requires exclusive assessment, to exclude atypical endometrial hyperplasia and carcinoma. Objective: This study aimed to determine the efficacy of suction pipelle in diagnosis of endometrial lesions in cases of abnormal uterine bleeding. Patients and Methods: The current study was designed as cross-sectional study conducted in Zagazig University Maternity Hospitals, Al-Ahrar Teaching Hospital and the Department of Pathology, Zagazig University during the period from April 2018 to July 2019. The study was conducted on 92 patients presented with abnormal uterine bleeding. Results: The 2 methods were 100% matched in diagnosis of secretory endometrium, hormone-dependent endometrium, atypical hyperplasia and EEC grade 1. The pipelle succeeded to diagnose some cases of proliferative endometrial and simple hyperplasia, which were missed by D & C (18.5% and 17.4% by pipelle versus 16.3% and 13% by D & C respectively for proliferative endometrial hyperplasia and 8.7% and 17.4% by pipelle versus 16.3% and 19.6% by D&C for simple hyperplasia respectively). Conclusion: Pipelle had high sensitivity and specificity for diagnosis of proliferative endometrial, secretory endometrium, hormonedependent endometrium, simple endometrial hyperplasia, atypical hyperplasia and EEC grade 1.

Diagnostic efficacy of gel infusion sonography in post-menopausal bleeding

BackgroundOur purpose was to evaluate the diagnostic performance of two-dimensional transvaginal ultrasound (2D-TVUS) and gel infusion sonography (GIS) at offline analysis for endometrial characterization compared with real-time evaluation during scanning.One hundred fifty women presented with PMB. At TVUS, endometrial thickness was ≥ 4 mm in 122 (81.3%) women and < 4 mm in 28 (18.72%). Among 122 women with endometrial thickness > 4 mm, GIS was successfully performed in 117 (95.9%). Examinations were stored as video clips for later evaluation (offline analysis) by two less experienced radiologists. Endometrial lesions were classified into four categories: no endometrial abnormality, hyperplasia, polyps, and cancer. Diagnostic efficiency of real-time and offline analysis for diagnosis of each category was calculated and compared, and inter-observer agreement for offline analysis was calculated.ResultsAll patients underwent hysteroscopy and/or hysterectomy. Histopathological results confirmed no endometrial abnormality in (27.3%, 41/150), endometrial hyperplasia in (12.7%, 19/150), endometrial polyps in (17.3%, 26/150), and endometrial cancer in (42.7%, 64/150).Overall diagnostic accuracy of real-time imaging was 89.7% (CI 84–91%)). The highest accuracy 92.7% (CI 88–98%) was seen in the diagnosis of cancer, and polyps 91.5% (CI 86–97%). The lowest accuracy 75% (CI 69–82%) was seen in hyperplasia.Overall diagnostic accuracy of offline analysis was 81%, and it increased to 88% (CI 83–92%) after a restricted analysis of good quality clips. The highest accuracy 90.7% (CI 83–95%) was seen in the diagnosis of polyps, and cancer 90.4% (CI 83–96%). The lowest accuracy 71% (CI 69–75%) was seen in hyperplasia.At offline analysis, the inter-observer agreement was substantial k = 0.77 (CI 71–84) in the evaluation of four endometrial categories after the exclusion of bad quality videos. It was excellent in exclusion of endometrial abnormalities k = 0.85 (0.78–0.90), substantial in the diagnosis of polyps k = 0.71 (0.69–0.88), cancer k = 0.61 (0.61–0.77), and moderate in the diagnosis of hyperplasia k = 0.41 (0.30–0.41).ConclusionOffline 2D analysis with a good image quality has comparable accuracy to a real-time evaluation during scanning in the diagnosis of endometrial lesions. It can increase the accuracy of sonography in ruling out endometrial abnormalities and diagnose non-hyperplastic endometrial pathologies. High NPV and substantial reproducibility can make it an efficient initial screening method in a post-menopausal bleeding.

Levonorgestrel-releasing intrauterine system for endometrial hyperplasia

Levonorgestrel-releasing intrauterine system for endometrial hyperplasia

Dermoscopy as an adjuvant tool for the diagnosis of sebaceous hyperplasia

Dermoscopy as an adjuvant tool for the diagnosis of sebaceous hyperplasia

LINFOIDE HYPERPLASIA IN MOUTH: CASE REPORT

A 49-year-old female patient, a farmer, presented as the main complaint the presence of "lumps in the mouth that hurt when touching." At the clinical examination, a nodule of approximately 1.5 cm, dark red color, smooth surface, flaccid consistency, and painful symptoms were observed in the left tonsillar pillar. The other nodules were diagnosed as valvular papillae. An excisional biopsy was performed and the material was sent to the Oral and Maxillofacial Pathology laboratory for analysis. Histopathological examination revealed a proliferation of lymphoid cells in a follicular arrangement. In the focal area, diffuse arrangement of lymphocytes with a monotonous appearance was observed, irregular nuclei, sometimes with condensed chromatin, and scarce cytoplasm. The diagnosis was lymphoid cell lesions. Immunohistochemical reactions were performed, which were positive for the anti-CD3 and CD20 antibodies. After the immunohistochemical analysis, the diagnosis of lymphoid hyperplasia is concluded. Patient is in disease-free follow-up after 2 years. A 49-year-old female patient, a farmer, presented as the main complaint the presence of "lumps in the mouth that hurt when touching." At the clinical examination, a nodule of approximately 1.5 cm, dark red color, smooth surface, flaccid consistency, and painful symptoms were observed in the left tonsillar pillar. The other nodules were diagnosed as valvular papillae. An excisional biopsy was performed and the material was sent to the Oral and Maxillofacial Pathology laboratory for analysis. Histopathological examination revealed a proliferation of lymphoid cells in a follicular arrangement. In the focal area, diffuse arrangement of lymphocytes with a monotonous appearance was observed, irregular nuclei, sometimes with condensed chromatin, and scarce cytoplasm. The diagnosis was lymphoid cell lesions. Immunohistochemical reactions were performed, which were positive for the anti-CD3 and CD20 antibodies. After the immunohistochemical analysis, the diagnosis of lymphoid hyperplasia is concluded. Patient is in disease-free follow-up after 2 years.

ANGIOLYMPHOID HYPERPLASIA WITH EOSINOPHILIA: A CASE REPORT OF A RARE BENIGN VASCULAR TUMOR

Oral vascular lesions present a variety of clinicopathologic aspects and often lead to diagnostic difficulties. We describe the case of a 27-year-old male patient referred to our service for evaluation of an asymptomatic lesion in the oral cavity. Intraoral examination revealed a sessile, red nodule of soft consistency in lateral border of tongue, measuring approximately 0.5 cm in diameter. Based on clinical diagnosis of inflammatory fibrous hyperplasia, an excisional biopsy was performed. Histopathologic analysis revealed a benign vascular lesion characterized by proliferation of epithelioid endothelial cells, mostly constituting small-caliber tortuous blood vessels. Mononuclear inflammatory infiltrate with remarkable presence of eosinophils was also evident. Proliferating cells demonstrated diffuse immunopositivity for CD31, CD34, and S100. These findings led to the histopathologic diagnosis of angiolymphoid hyperplasia with eosinophilia. This report emphasizes the importance of knowledge regarding clinicopathologic features of oral vascular lesions for a correct diagnosis and management of the patient.

LYMPHOID HYPERPLASIA IN JUGAL MUCOSA: A CASE REPORT

The lymphoid tissue from the body plays an important role in the recognition and processing of antigens. In response to antigen-antibody reaction, lymphoid cells proliferate, increasing in number to combat the aggressor agent more effectively, resulting in hyperplasia of this tissue. A 61-year-old female patient attended a referral service in oral diagnosis because of a lesion on right jugal mucosa, fibrous consistency, smooth, painless, 1 cm in size, and lasting for 3 months. An excisional biopsy was performed, and clinical hypotheses were cyst of the salivary duct or mucocele. Histopathologic analysis revealed a well-circumscribed and encapsulated lymphoid aggregate fragment characterized by well-differentiated small lymphocyte layers and collections of reactive lymphoblasts. Macrophages were also identified by presence of phagocytic material in their cytoplasm, thus establishing the diagnosis of lymphoid hyperplasia. Currently, the patient is well undergoing preservation after 6 months.

FIBROMA BY NON-NUTRITIVE SUCTION: A CASE REPORT

Fibroma is a reactive hyperplasia that can be caused by a chronic traumatic agent. A 6-year-old female patient sought dental care complaining of a lip injury. Physical examination showed a lesion, which was well-circumscribed, painless, sessile, with fibrous consistency, localized in the lower lip, of slow growth, with mucosa-like staining, and it was in between the central incisors when the patient closes the mouth. With a diagnosis of fibrous hyperplasia, an excisional biopsy was performed. Histopathologic examination of the specimen revealed nodular growth of fibrous connective tissue, unencapsulated and covered by stratified squamous epithelium and presence of chronic inflammatory infiltrate. The final diagnosis was confirmed: fibrous hyperplasia by non-nutritive suction. The patient remains in clinical follow-up.