Pap smears of patients with extramammary Paget's disease of the vulva
ABSTRACT Extramammary Paget's disease (EMPD) of the vulva is a rare entity. The diagnosis is almost always made on biopsy. Tumor cells are seen rarely in Papanicolaou (Pap) smears. We encountered three cases of EMPD that were detected in Pap smears. One patient had vulvar and vaginal involvement and the abnormal cells seen in the vaginal smear initially were interpreted as high-grade squamous intraepithelial lesion. Retrospective review showed scattered single atypical cells with enlarged hyperchromatic nuclei, coarse chromatin, inconspicuous nucleoli, high nuclear/cytoplasmic (N:C) ratio, and scanty basophilic cytoplasm. Rare signet ring cells and cells within cells were present. In the other two patients who had cervical involvement, the correct diagnosis was made on Pap smears. The slides showed both single and cohesive sheets of glandular cells with enlarged round to oval nuclei, coarse chromatin, prominent nucleoli, and abundant basophilic cytoplasm containing prominent vacuoles with signet ring-cell appearance. Cells within cells were abundant. EMPD has distinct cytomorphological features. Although infrequently encountered, EMPD can be diagnosed on Pap smears with adequate clinical history.
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ABSTRACT: Breast cancer is a common disease in Western societies, with an incidence of 46.31/100,000 women/year in Brazil. The tumor suppressor gene TP53 is one of the most studied genes regarding the presence of mutations. Indeed, 50% of all tumors are known to exhibit changes in the TP53 nucleotide sequence due to carcinogenic processes. As to the presence of polymorphism, the TP53 gene is polymorphic at the nucleotide residue 347 (codon 72). In the current study, we examine if this polymorphism is associated with the clinicopathological parameters of breast cancer patients in a Brazilian population. One hundred and thirteen patients with breast cancer were included. The polymorphic region of the TP53 gene was PCR-amplified from genomic DNA obtained from buccal cells. Specific primers for the Pro and Arg allele were used. Correlations of polymorphism with age, staging, nuclear grade, lymph node status, estrogen receptor status and lymphatic and/or blood vessel invasion were evaluated. Statistical analysis was performed using the Fisher's exact test. The frequency of p53 Arg/Arg was 57% and of the heterozygous allele Arg/Pro it was 39%. There was no correlation between polymorphism and clinicopathological parameters. According to our results, the TP53 polymorphism, at the 347 residue, is not associated with any clinicopathological findings of patients with breast cancer.European journal of gynaecological oncology 02/2008; 29(4):364-7. · 0.60 Impact Factor
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ABSTRACT: To examine the efficacy of intraoperative irrigation with alteplase, a tissue plasminogen activator, for the prevention of adhesion formation associated with intraperitoneal chemotherapy. Rats, in which serosal injury was induced in the right uterine horn and ipsilateral parietal peritoneum, were randomly divided into four groups. Group 1 (n = 10) had intraoperative intraperitoneal irrigation with alteplase following the standard operation. Group II (n = 10) had irrigation with normal saline, while the rats in Group III (n = 10) and Group IV received no peritoneal irrigation. All rats, except for those in Group IV, received intraperitoneal (IP) paclitaxel plus carboplatin chemotherapy on the seventh postoperative day, and all rats were sacrificed seven days after chemotherapy. Total adhesion scores in the induced standard defects were calculated by evaluating percentage of adhesion formation, as well as the severity and degree of the adhesions. The scores were compared among the groups. Comparison of the severity, percentage, degree and total score of adhesions among the groups demonstrated that subjects in Group I, where intraoperative alteplase irrigation was used, had fewer adhesion components (severity, percentage, degree) and a lower total adhesion score when compared to the other groups (p < 0.05). Adhesion components and the total adhesion score in Group IV, which did not receive chemotherapy, were found to be significantly lower when compared to Groups II and III (p < 0.05). Intraoperative Alteplase irrigation may reduce adhesion formation associated with intraperitoneal chemotherapy. Thus, intraperitoneal chemotherapeutic agents may be ensured to reach all peritoneal surfaces easily.European journal of gynaecological oncology 02/2008; 29(4):386-9. · 0.60 Impact Factor