Cytologic detection of cervical granuloma inguinale.
ABSTRACT Two cases of granuloma inguinale detected cytologically on routine Papanicolaou-stained cervical smears are presented; the cytologic and histologic features are described in detail, and the electron microscopic appearances are shown. The suitability of the Papanicolaou stain in the detection of granuloma inguinale is discussed, with emphasis on possible differential diagnoses to be considered. It is concluded that a definitive diagnosis of granuloma inguinale can be made on routine Papanicolaou-stained smears showing the following spectrum of changes: intact capillaries indicative of epithelial and stromal ulceration; a marked inflammatory cell infiltrate consisting predominantly of neutrophils; epithelioid histiocytes representing granuloma formation; and Donovan bodies located in characteristic single or multiple intracytoplasmic vacuoles within large histiocytes. Recognition of this cytologic picture may enable early diagnosis, even in nonendemic areas, of a potentially disfiguring venereal disease.
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ABSTRACT: Rare entities in the Pap test, including neoplastic and non-neoplastic conditions, pose challenges due to their infrequent occurrence in the daily practice of cytology. Furthermore, these conditions give rise to important diagnostic pitfalls. Infections such as tuberculosis cervicitis may be erroneously diagnosed as carcinoma, whereas others, such as schistosomiasis, are associated with squamous cell carcinoma. These cases include granuloma inguinale (donovanosis), tuberculosis, coccidioidomycosis, schistosomiasis, taeniasis, and molluscum contagiosum diagnosed in Pap tests. Granuloma inguinale shows histiocytes that contain intracytoplasmic bacteria (Donovan bodies). Tuberculosis is characterized by necrotizing granulomatous inflammation with Langhans-multinucleated giant cells. Coccidioidomycosis may show large intact or ruptured fungal spherules associated with endospores. Schistosoma haematobium is diagnosed by finding characteristic ova with a terminal spine. Molluscum contagiosum is characterized by the appearance of squamous cells with molluscum bodies. This article reviews the cytomorphology of selected rare infections and focuses on their cytomorphology, differential diagnosis, and role of ancillary diagnostic studies.CytoJournal 06/2012; 9:15. DOI:10.4103/1742-6413.97763
Article: DonovanosisClinical Infectious Diseases 08/1997; 25(1):24-30; quiz 31-2. DOI:10.1086/514495 · 9.42 Impact Factor
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ABSTRACT: Background: Soft-tissue fillers have become more prevalent for facial augmentation in the last 2 decades, even though complications of permanent fillers can be challenging to treat. An investigative imaging tool could aid in assessing the nature and extent of these complications when clinical findings are ambiguous. Objectives: The authors analyzed the value of magnetic resonance imaging (MRI) in the assessment of delayed-onset complications after injection of patients with permanent fillers. Methods: Thirty-two patients with complications related to facial fillers were evaluated in this prospective cohort study. Their medical history was documented, and MRI was conducted before treatment of the complications. Radiologists were informed of the injection sites but were blinded to the results of other clinical evaluations. Levels of agreement between clinical and radiologic findings were calculated with the Jaccard similarity coefficient. Results: A total of 107 site-specific clinicoradiologic evaluations were analyzed. The level of agreement was assessed as strong for deposits without complications and noninflammatory nodules (combined 85%), moderate for abscesses (60%), fair for low-grade inflammations (32%), and slight for migrations (9%). Results from the MRI examinations aided in subsequent treatment decisions in 11% of cases. Conclusions: Study results show that MRI may be useful for diagnosing complications associated with fillers that have migratory potential, for depiction of the extent of deposits before treatment, and for follow-up of low-grade inflammation and abscesses after surgery.Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery 06/2014; 34(6). DOI:10.1177/1090820X14539504 · 2.03 Impact Factor