Involvement Of Reproductive Organs Research Articles

Reproductive organ involvement in women undergoing radical cystectomy for urothelial bladder cancer: a nationwide multicenter study.

Radical cystectomy in women generally includes the removal of the uterus, ovaries, and anterior vaginal wall, but the criteria for reproductive organ sparing are not clear. A total of 2674 patients with bladder cancer were retrospectively reviewed, having undergone cystectomy at this nationwide multicenter from January 2013 to December 2019. We evaluated the incidence of malignancy in reproductive organs in a cohort of 417 women and analyzed the clinicopathological features of reproductive organ involvement. Recurrence-free survival and overall survival were reported using Kaplan-Meier survival curves. Median follow-up was 36.9months. Of the 417 patients with urothelial carcinoma of the bladder, 325 underwent hysterectomy, and 92 had a spared uterus and anterior wall of the vagina. Twenty-nine (8.9%) patients exhibited reproductive organ involvement; this consisted of 22 (6.8%) uteri, 16 (4.9%) vaginas, and two (0.6%) ovaries. Incidental primary reproductive malignancies were found in only two (0.6%) patients. Recurrence-free survival and overall survival were significantly shorter in patients with reproductive organ involvement than in those without. Patients with reproductive organ involvement were more likely to have tumors with ≥ cT3 or sub-localization at the posterior/trigone/bladder neck. The risk of reproductive organ involvement cannot be ignored in women undergoing radical cystectomy for urothelial carcinoma of the bladder, therefore, the eligibility criteria for reproductive organ preservation should be considered carefully.

Seed nutrient is more stable than leaf in response to changing multiple resources in an alpine meadow

BackgroundIt has been long thought that nitrogen (N), phosphorus (P) concentrations and their ratios (N:P) in metabolically active or functional organs (i.e., leaves) are less responsive to environmental changes. Little attention, however, has been paid to the reproductive organs—seeds, while seeds may maintain their nutrients more stable for the evolutionary fitness of next generation.MethodsHere, we conducted a field experiment of N, P addition and drought in an alpine meadow, aiming to compare the difference of leaf and seed nutrients and stoichiometric ratios in response to these resource treatments and their interactions. Four dominant species were selected among grass and forb functional groups, including Elymus nutans, Deschampsia caespitosa, Artemisia roxburghiana and Polygonum viviparum.ResultsUnder natural conditions, leaf N and P concentrations were consistently lower than seed among species. However, leaf nutrients were much more sensitive than seed nutrients to N and P addition. Specifically, N or P addition accordingly increased leaf N or P concentration by 22.20–44.24% and 85.54–93.61%, while only enhanced seed N or P concentration by 5.15–17.20% and 15.17–32.72%, respectively. Leaf N or P concentration was significantly reduced by P or N addition, but seed nutrients remained unchanged. In contrast, drought did not change both organ nutrients. Similarly, nutrient addition and drought had synergistic interactions on leaf nutrients, but not on seed nutrients.ConclusionsThis study highlights that seed nutrient concentrations could be more stable than metabolically active leaf organ when facing multidimensional resource changes. This complements the traditional view on the ‘Stable Leaf Nutrient Hypothesis’ with the involvement of reproductive organs. The less responsiveness of seed nutrients suggests the adaptive strategy to ensure the success of next generations and long-term plant demographic stability.

Testicular thrombotic microangiopathy: An unrecognized complication

Thrombotic microangiopathy (TMA) causes global endothelial damage and multiorgan injury. No study has described reproductive organ involvement in TMA. Our study aimed to characterize testicular involvement in TMA. We reviewed autopsies from four patients who underwent hematopoietic cell transplant (HCT) complicated by TMA. Three patients had striking histologic evidence of TMA, while the fourth had normal testicular histology. This suggests that TMA injures the testicles and may adversely affect fertility. There is now an urgent need for a larger analysis of reproductive organ involvement in TMA.

Genital footprints of extragenital tuberculosis in infertile women: Comparison of various diagnostic modalities

BackgroundGenital tuberculosis (TB) continues to remain an important cause of infertility in women, especially in developing countries. It is mostly consequent to a primary infection elsewhere in the body. The diagnosis is challenging, considering its paucibacillary nature. Although there are many studies on association of genital tuberculosis with infertility, there is paucity of literature on impact of extragenital tuberculosis on fertility of women through involvement of female reproductive organs. The various diagnostic modalities available have limitations and quest is ongoing for the best diagnostic test. MethodThis was a prospective observational study conducted at the infertility clinic of a tertiary care health facility where 60 infertile women with either tubal factor or unexplained infertility with or without past history of extragenital tuberculosis were enrolled as study subjects or controls respectively. Mantoux test was performed in all women and diagnostic laparo-hysteroscopy was performed in all women to look for any evidence of uterine and/or tubal damage. The peritoneal fluid was sent for GeneXpert and Liquid culture for mycobacterium tuberculosis. Results of Mantoux test, GeneXpert and liquid culture were compared with the laparohysteroscopic findings. ResultOf the thirty infertile women in the study group, 27/30 (90%) had a history of pulmonary tuberculosis and 3/30 (10%) had history of tubercular cervical lymphadenopathy. It was observed that Mantoux test was positive (induration >10 mm) in 27/30 (90%) of women in the study group as compared to only 4/30 (13.3%) controls. Abnormal hysteroscopic findings were documented in 26.6% (8/30) study group women as compared to 6.6% (2/30) women in the control group. Similarly, 60% (18/30) of women in the study group had abnormal laparoscopic findings compared to 33% (10/30) in the control group. Seven out of thirty (23.3%) women were positive for GeneXpert in the study group compared to only 1/30 (3.3%) in the control group. Similarly, liquid culture was positive in 6/30 (20%) of women in the study group as compared to 1/30 (3.3%) in the control group. All the above differences were statistically significant. We observed that the sensitivity of Mantoux test (75.8%) stand alone was higher than the other tests combined (50%). However, specificity and positive predictive value (PPV) increases markedly (up to 100%) to when all the three tests are combined. ConclusionThe authors conclude that all women presenting with infertility should be screened for a past history of tuberculosis and actively worked up for genital tuberculosis in case the history is positive. The various available tests (Mantoux test, GeneXpert and liquid culture) have their limitations for the diagnosis of genital tuberculosis. Thus an approach of early resort to laparohysteroscopy in suspected patients is desirable so that definitive management may be instituted timely and promptly.

Myeloid-Derived Suppressor Cells As Potential Contributors to Pregnancy-Associated Lymphoma Progression

Introduction: Non-Hodgkin lymphoma (NHL), the most frequent hematological malignancy observed during pregnancy, is reported to be associated with advanced disease stage at diagnosis, essential involvement of reproductive organs, and a turbulent course. Immunosuppression is one of the key players in maternal-fetal tolerance that may have an impact on the tumor microenvironment (TME), thus contributing to cancer progression in this setting. Immunomodulatory cells, such as regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs), recruited by TME, are capable of inhibiting anti-tumor immune responses. The current study was designed to explore potential contribution of the pregnancy milieu to induction of immunosuppressive microenvironment supporting lymphoma growth and progression. Methods: A20 murine lymphoma B cells were injected subcutaneously to pregnant and non-pregnant female wild type Balb/C mice. The tumor volume was measured twice weekly and a multiple comparison was done with Bonferroni correction. Following delivery, mice from both groups were sacrificed and tumor cells were harvested. RNA was extracted from tumors of 5 control and 6 pregnant mice and RNAseq data were generated. Then, statistical analysis was performed for differentially expressed genes in these two groups. Tregs (CD4+CD25+) and MDSCs (CD11b+Gr1+) within tumors were estimated by FACS analysis. Results: Pregnant mice demonstrated significantly accelerated tumor growth compared to non-pregnant animals. The tumor volume in mice sacrificed after parturition reached 752.3 ± 492.7 mm3 versus 499.3 ± 373.5 mm3 in the control group (n = 41 and 29, respectively; p<0.05). Similarly, a significant intergroup difference in tumor weight at time of sacrifice was observed (1.73 ± 0.94 vs. 1.3 ± 0.65 g; n = 32 and 22, respectively; p=0.05). Gene expression profiling of tumor samples revealed a significant difference between the groups in the expression pattern of 180 out of 25,000 examined genes. Eighty-four of these genes can be categorized according to specific cellular pathways into those associated with T cell differentiation, cytokine-cytokine receptor interaction and adhesion molecules, all potentially involved in immunosuppressive cell migration to TME. Examination for the presence of inhibitory cell subpopulations in TME did not demonstrate significant difference in percentage of Tregs between pregnant and non-pregnant mice (1.18% ± 1.35 vs. 1.15% ± 1.09; n = 16 & 13, respectively). However, pregnant mice exhibited a greater granulocytic MDSC subpopulation (CD11b+Gr1high) within the tumor compared with their control counterparts (0.41% ± 0.3 vs. 0.22% ± 0.13; p<0.05; n = 17 & 14, respectively). To evaluate whether this finding was related to pregnancy alone or to a cumulative effect of tumor and pregnancy, spleen peripheral blood mononuclear cells (PBMCs) were immunophenotyped for these markers. The results obtained showed that the expansion of the CD11b+Gr1+ subpopulation in pregnant mice was limited to the TME only, while spleen PBMCs failed to exhibit this effect (2% ± 2 in pregnant mice vs. 1.88% ± 1.16 in the controls; n = 8 & 6, respectively). A parallel analysis of spleen samples for Treg percentage also did not reveal a difference between the two groups (0.27% ± 0.07 vs. 0.25% ± 0.09, n = 8 & 6, respectively). Conclusions: Pregnant mice demonstrated accelerated tumor growth following lymphoma cell inoculation. The tumor gene expression profile in pregnant mice is likely to reflect the cellular pathways that could be associated with differentiation and recruitment of immunosuppressive cells to the TME. In this regard, MDSCs emerge as potential candidates contributing to pregnancy-associated lymphoma progression. Further studies are warranted to define the kinetics of this cell subpopulation and identify biological effects of MDSCs in such setting. Disclosures No relevant conflicts of interest to declare.

Polycystic Ovary Syndrome, Fertility, Diet, and Lifestyle Modifications

Polycystic ovary syndrome (PCOS) is a complex metabolic disorder impacting women of reproductive age. Globally, PCOS is estimated to impact 5% to 18% of the female population. Diagnosis is based on various characteristics, including hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. Given the involvement of female reproductive organs, PCOS impacts fertility. Currently, there are no evidence-based guidelines for dietary management. The purpose of this article is to describe PCOS, the role it plays in fertility, and the management of the disease through diet and lifestyle modification.

Gynecologic Organ Involvement During Radical Cystectomy for Bladder Cancer: Is It Time to Routinely Spare the Ovaries?

To determine a subset of women who could undergo ovary-sparing radical cystectomy (OSRC) for bladder cancer without compromising oncologic safety. A retrospective review was performed of 164 consecutive women who underwent cystectomy at a single tertiary-care center from 1997 to 2018. Clinicopathologic and preoperative radiographic data were reviewed. Univariable and multivariable logistic regression models adjusting for pathologic stage, lymphovascular invasion (LVI), and carcinomain-situ were performed to evaluate the risk of ovarian and reproductive organ (RO) involvement. A total of 123 women with a median age of 71 years underwent radical cystectomy (RC) with removal of ROs for primary bladder cancer. Nineteen women (15%) had RO involvement by bladder cancer, and 5 of them (4%) were specifically found to haveovarian involvement. Patients with ovarian involvement of bladder cancer had more locally advanced disease (P= .01), LVI (P= .003) and positive margins (P= .003). On multivariable logistic regression,≥ pT3 (odds ratio= 10.2; 95% confidence interval, 2.0-51.6; P= .005) and LVI (odds ratio= 3.9; 95% confidence interval, 1.1-14.2; P= .037) were associated with increased risk of RO involvement. Among 15 patients excluded for having a nonbladder primary malignancy, a third had RO involvement, and 2 (13%) had ovarian metastases. No women in our cohort had a primary ovarian malignancy detected at the time of RC. Women with ovarian involvement by malignancy at the time of RC either had locally advanced disease with LVI or a non-bladder primary malignancy. The risk of incompletely resecting the primary malignancy would be rare if OSRC was performed on women with organ-confined (≤T2) urothelial carcinoma.

Genital and reproductive organ complications of Crohn disease: technical considerations as it relates to perianal disease, imaging features, and implications on management.

A relatively large proportion of patients with Crohn disease (CD) develop complications including abscess formation, stricture, and penetrating disease. A subset of patients will have genital and reproductive organ involvement of CD, resulting in significant morbidity. These special circumstances create unique management challenges that must be tailored to the activity, location, and extent of disease. Familiarity with the epidemiology, pathogenesis, imaging features, and treatment strategies for patients with genital CD can aid imaging diagnoses and guide appropriate patient management. The purpose of this study is to illustrate the spectrum of CD in the genital tract and reproductive organs and discuss the complex management strategies in these patients as it relates to imaging. Given the impact on patient outcome and treatment planning, familiarity with the epidemiology, pathogenesis, imaging features, and treatment of patients with genital Crohn disease can aid radiologic diagnoses and guide appropriate patient management.

Uterine, but not ovarian, female reproductive organ involvement at presentation by diffuse large B‐cell lymphoma is associated with poor outcomes and a high frequency of secondary CNS involvement

Involvement of the internal female reproductive organs by diffuse large B-cell lymphoma (DLBCL) is uncommon, and there are sparse data describing the outcomes of such cases. In total, 678 female patients with DLBCL staged with positron emission tomography/computed tomography and treated with rituximab-containing chemotherapy were identified from databases in Denmark, Great Britain, Australia, and Canada. Overall, 27/678 (4%) had internal reproductive organ involvement: uterus (n=14), ovaries (n=10) or both (n=3). In multivariate analysis, women with uterine DLBCL experienced inferior progression-free survival and overall survival compared to those without reproductive organ involvement, whereas ovarian DLBCL was not predictive of outcome. Secondary central nervous system (CNS) involvement (SCNS) occurred in 7/17 (41%) women with uterine DLBCL (two patients with concomitant ovarian DLBCL) and 0/10 women with ovarian DLBCL without concomitant uterine involvement. In multivariate analysis adjusted for other risk factors for SCNS, uterine involvement by DLBCL remained strongly associated with SCNS (Hazard ratio 14·13, 95% confidence interval 5·09-39·25, P<0·001). Because involvement of the uterus by DLBCL appears to be associated with a high risk of SCNS, those patients should be considered for CNS staging and prophylaxis. However, more studies are needed to determine whether the increased risk of secondary CNS involvement also applies to women with localized reproductive organ DLBCL.

Haematological malignancies in pregnancy: An overview with an emphasis on thrombotic risks.

With increase of maternal age, the incidence of haematological malignancies during pregnancy is rising and posing diagnostic and treatment challenges. Lymphoma is the fourth most common malignancy diagnosed in pregnancy; Hodgkin lymphoma is more frequent in pregnant women than non-Hodgkin lymphoma (NHL). The proportion of highly aggressive lymphomas in pregnant women is significantly higher than in non-pregnant women of reproductive age. Reproductive organ involvement is observed in almost half of pregnant women with NHL. The association of acute leukaemia and pregnancy is infrequent and it is assumed that pregnancy does not accelerate the disease course. Both cancer and pregnancy induce a procoagulant state which can lead to maternal venous thromboembolism (VTE) and placental occlusion. Pregnancy in woman with myeloproliferative neoplasms (MPN) promotes thrombotic environment, associating with an augmented risk of placental thrombosis, intrauterine growth retardation or loss and maternal thrombotic events.Haematological malignancies during pregnancy often require urgent diagnosis and management and are associated with potential adverse fetal outcomes. Most chemotherapeutic agents are teratogenic and should be avoided during the first trimester. Their use during the second and third trimesters may cause intrauterine growth restriction, premature birth and intrauterine fetal death. All chemotherapeutic drugs should be administered only after a detailed discussion with the patient and with close fetal monitoring. Chemotherapy and biological agents might also augment thrombotic risk. Guidelines for VTE prophylaxis in pregnant women with hematologic malignancies, apart from MPN, are currently unavailable, and therefore, clinical judgment should be made in each case.

Does gender matter in non-hodgkin lymphoma? Differences in epidemiology, clinical behavior, and therapy.

Non-Hodgkin lymphoma (NHL) is one of the most common hematologic malignancies worldwide. The incidence of NHL has been rising for several decades; however, in the last 20 years, it reached a plateau. NHL incidence among males is significantly higher than in females. In addition to gender itself, gravidity has a protective role against NHL occurrence. Gender also matters in terms of NHL clinical characteristics. For example, female predominance was found in three extra-nodal sites (the breast, thyroid, and the respiratory system) occasionally involved in NHL. The diagnosis of NHL during pregnancy is associated with a unique clinical behavior. It is usually diagnosed in the second or third trimester and in advanced stage. Furthermore, the histological subtype is highly aggressive, and reproductive organ involvement is common. The reduced rate of NHL among females may be explained by direct effects of estrogens on lymphoma cell proliferation or by its effect on anti-tumor immune response. Gender has an important role in responsiveness to standard B cell NHL treatment. Among older adults, women benefited more from the addition of the anti-CD20 antibody rituximab to standard chemotherapy regimens. This phenomenon can be explained by the difference in clearance rate of rituximab that was found to be significantly lower among older females than older males. In mantle cell lymphoma, women receiving lenalidomide have higher rates of response. An understanding of the mechanisms responsible for gender-associated NHL differences will ultimately improve the clinical approach, allowing for a more accurate assessment of prognosis and patient-tailored treatment.

Non-Hodgkin lymphomas in pregnancy: Tackling therapeutic quandaries

Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) often present with systemic symptoms such as fatigue, shortness of breath and night sweats, mimicking pregnancy-related features which may result in delayed disease diagnosis. Furthermore, the wish to avoid investigational imaging, aiming to protect the fetus from radiation exposure, may lead to a further delay, which does not often result in significant changes in HL clinical nature and patient outcome. In contrast, a more aggressive behavior (i.e., advanced disease stage and reproductive organ involvement) of most NHL types diagnosed in pregnancy may require urgent therapeutic intervention to prevent disease progression.Current management of pregnancy-associated NHL depends on histological subtype of the disease, gestational stage at diagnosis and the urgency of treatment for a specific patient. Patients diagnosed with indolent lymphoma may often be just followed, whereas those presenting with aggressive or highly aggressive disease need to be urgently treated with chemoimmunotherapy, either after undergoing an elective pregnancy termination if diagnosed at an early gestational stage, or with pregnancy preservation, if diagnosed later.Supportive care of NHL is also important; however, granulocyte colony stimulating factor (G-CSF) which is commonly used outside of pregnancy, should be cautiously employed, considering its established teratogenicity in animals, though this is less proven in humans. In conclusion, given the paucity of studies prospectively evaluating the outcome of pregnant women with NHL, international efforts are warranted to elucidate critical issues and develop guidelines for the management of such patients.

Female Organ-Sparing Robotic Cystectomy: A Step-by-Step Anatomic Approach

Abstract Introduction: Anterior pelvic exenteration is the standard operation for muscle-invasive bladder cancer in females. However, recent data suggest that involvement of reproductive organs wit...

Reproductive organ involvement in female patients undergoing radical cystectomy.

274 Background: Anterior pelvic exenteration is traditionally the treatment of choice for women with invasive bladder carcinoma. Female reproductive organ involvement is reported to be low, but there is not enough evidence to abandon this part during radical surgery. We evaluated the pathological involvement of reproductive organs (RO) in female patients undergoing radical cystectomy for invasive bladder urothelial carcinoma. Methods: 2,098 patients with bladder cancer underwent cystectomy between 1971 and 2008 at USC, of whom 458 were female. 411 (90%) had urothelial and 47 had non-urothelial bladder cancer. The cohort of female cystectomy patients with pathologic RO involvement is reviewed and their RFS and OS are discussed. Results: In the TCC group, 20 patients (4.8%) had RO involvement by urothelial cancer (UC-RO); 10 (2.5%) had vaginal, 2 (0.5%) cervical and one (0.25%) only uterus involvement with the rest (7) having a combination. In non-UC group, only two (4%) had RO involvement. In the UC-RO cohort, median age was 71 yo (38-89). Only one patient (5%) underwent orthotopic diversion. 19 cases (95%) were high grade TCC. Clinical stage T4a was diagnosed in 25% of cases preoperatively. Associated CIS, multifocality, LVI and histologic type of cancer had no significant correlation with RO involvement. Patients with a palpable mass or hydronephrosis were 5 times more likely to have RO involvement (P&lt;0.001). RO involvement was associated with higher chance of positive lymph nodes (60%) (P=0.001). Three (15%) and seven (35%) patients underwent neo-adjuvant and adjuvant chemotherapy respectively. Urethral pathology was positive in 1 patient. 5 (25%) developed local recurrence and 9 (45%) developed distant metastasis at a median follow up of 12.2 yrs (0.1 to 35.5 yrs). Two-year RFS and five-year OS in UC-RO group were both 10%. Conclusions: The risk of RO involvement in female patients undergoing cystectomy for bladder cancer is about 5%, with the vagina being the most commonly involved organ. A palpable mass and/or hydronephrosis are a strong predictor of RO involvement, although other clinical criteria are not predictive.

Reproductive Organ Involvement in Female Patients Undergoing Radical Cystectomy for Urothelial Bladder Cancer

We evaluated pathological involvement of the reproductive organs in a cohort of female patients treated with anterior pelvic exenteration for invasive urothelial carcinoma of the bladder. A total of 2,098 patients with bladder cancer underwent cystectomy at our institution between 1971 and 2008, including 458 females, of whom 411 had urothelial carcinoma of the bladder. Median followup was 12.2 years (range 0.1 to 35.5). We reviewed the clinicopathological features of female patients treated with cystectomy who had pathological reproductive organ involvement. Recurrence-free and overall survival is reported using Kaplan-Meier survival curves. Of 411 patients with urothelial carcinoma of the bladder 267 underwent reproductive organ removal with cystectomy. A total of 20 patients (7.5%) had reproductive organ involvement, including 10 (3.8%) with vaginal, 2 (0.7%) with cervical and 1 (0.3%) with uterine involvement only, while the remaining 7 (2.6%) had multiple reproductive organs involved. Median age was 71 years. Clinical stage T4a was diagnosed in 25% of cases. A palpable mass, hydronephrosis (each p <0.001) and positive lymph nodes at anterior pelvic exenteration (p = 0.001) were associated with reproductive organ involvement. Recurrence developed in 14 patients (70%) at a median of 7 months (range 1 to 22). Five-year recurrence-free and overall survival rates were 14.9% and 8.8%, respectively. The risk of reproductive organ involvement in female patients who undergo anterior pelvic exenteration for urothelial carcinoma of the bladder was about 7.5% with the vagina the most commonly involved organ. A palpable mass and hydronephrosis were among the preoperative clinical factors associated with reproductive organ involvement. The prognosis is poor in patients with reproductive organ involvement.

Lymphosarcomatous involvement of reproductive and endocrine organs in Indian buffalo.

Summary In a study of lymphosarcoma/leukaemia in Indian buffaloes, involvement of the udder, uterus, ovary, testes, epididymis, seminal vesicles, prostate, Cowper's gland, penile urethra, thyroid, adrenals, pituitary and pancreas was observed, along with lesions in other organs. The gross and microscopic lesions are described and discussed and compared with similar involvement in human leukosis. The importance of the lymphosarcomatous involvement of these vital organs is emphasized. Zusammenfassung Lymphosarkomatose der Fortpflanzungsorgane und des Endokrinsystems beim indischen Bufrel Im Rahmen von Studien uber die Lymphosarkomatose und Leukose des indischen Buffels wurde die Beteiligung der folgenden Organe untersucht: Euter, Uterus, Ovar, Testis, Nebenhoden, Samenblasen, Prostata, Cowpersche Druse, Harnrohre des Penis, Schilddruse, Nebennieren, Hypophyse sowie Veranderungen in anderen Organen. Die makro- und mikroskopischen Veranderungen werden beschrieben und mit der Leukose des Menschen vergleichend diskutiert. Es wird auf die Bedeutung der Lymphosarkomatose dieser lebenswichtigen Organe hingewiesen. Resume Lymphosarcomatose des organes genitaux et du systeme endocrinien chez le buffle indien On a examine la repartition suivante des organes dans le cadre d'etudes sur la lymphosarcomatose et la leucose du buffle indien: mamelle, uterus, ovaire, testicule, epididyme, glandes seminales, prostate, glande de Cowper, uretre du penis, glande thyroide, glandes surrenales, hypophyse ainsi que des modifications dans d'autres organes. On a decrit les lesions macro- et microscopiques et on les a comparees avec la leucose humaine. On attire l'attention sur la signification de la lymphosarcomatose de ces organes vitaux. Resumen Linfosarcomatosis en los organos de la reproduccion y en el sistema endocrino del bufalo indio En el marco de estudios sobre la linfosarcomatosis y leucosis del bufalo indio, se estudio la participacion de los organos siguientes: ubre, utero, ovario, testiculo, epididimo, vesicula seminal, prostata, glandula de Cowper, uretra masculina, tiroides, anterrenal, hipofisis y lesiones en otros organos. Se describen las lesiones macro y microscopicas, discutiendose comparativamente con la intrincacion similar en la leucosis humana. Se recalca la importancia de la complicacion linfosarcomatosa de estos organos vitales.

Incidence of fertility counseling of women of child-bearing age before treatment for colorectal cancer

Background The incidence of colorectal cancer in women of reproductive age is low. Physicians lack awareness of infertility difficulties in these patients. We studied the frequency of women of child-bearing age with colorectal cancer receiving pretreatment fertility counseling. Methods This retrospective review from 1996 to 2004 screened women of reproductive age treated for colorectal cancer for documentation of fertility counseling or referral to fertility specialists before initiating treatment. Results Twenty-one women met the age criteria (range, 18-45 y). Eight patients were excluded for prior sterilization procedures or tumor involvement of reproductive organs. In the 13 remaining women, 2 had pretreatment fertility counseling documentation. These 2 patients had fewer than 2 children and had rectal tumors. Thirty-eight percent had pregnancy or menses difficulty after treatment. Conclusions Few young women with colorectal cancer had pretreatment fertility counseling, whereas several had fertility complications posttreatment. Physicians need to discuss infertility concerns with their female colorectal cancer patients before intervention.