Biomedical subjects
Publications and source records attributed to C Crescini.
One case of large solitary luteinized follicle cyst of puerperium is reported. The patient presented with a palpable adnexal mass at four weeks post-partum. The ovarian cyst was solitary and unilocular and had a diameter of 14 cm. On microscopical examination the lining of the cyst consisted of luteinized cells that exhibited focal nuclear atypicality.
Thirty-four patients, with a history of persistent abnormal uterine bleeding and dilatation and curettage or suction curettage performed within the previous year, were evaluated by office hysteroscopy and biopsy. For 16 patients (47%) the hysteroscopic diagnosis was in agreement with the curettage. Hysteroscopy revealed more information in 18 patients (53%): 8 had polyps, 6 had submucous or pedunculated myoma, 2 had endometrial neoplasia, 1 had myoma and polyp, 2 had endometrial neoplasia and 1 had synechia. Moreover in 3 patients with diagnosis of suspected myoma by curettage, hysteroscopy revealed a normal cavity. The high incidence of missed diagnosis of pathologic conditions by "blind" curettage supports the opinion that diagnostic hysteroscopy is the method of choice in the evaluation of abnormal uterine bleeding.
The use of outpatient diagnostic hysteroscopy is discussed with reference to a series of 425 women. The test was performed in an outpatient setting with no form of analgesia, anesthesia or premedication in 385 patients (90.6%); the degree of acceptability was very low (intolerable) in 5.5%, supportable in 15.8% and excellent in 78.7% of patients. Fourty-two per cent of patients were aged between 45 and 54 years old, and the mean age was 47.5 years with a range between 18 and 83 years. The indication for the test was pre- or postmenopausal anomalous uterine bleeding in 74% of patients. Hysteroscopic diagnosis was normal in 56% of cases; endometrial polyps were diagnosed in 11.4% of patients; myomas in 11%; low-risk hyperplasia in 9.9% and malignant tumours in 3.6%. The correlation between hysteroscopic diagnosis and histological tests was above 95% in cases of malignant tumours, atrophy and functional endometrium, whereas it was 67% in cases of low-risk hyperplasia. No accidents or complications related to hysteroscopy were reported.
Colposcopy and biopsy were performed in 97 patients whose referral smears showed mild dysplasia (CIN 1). Of 97 women, 40 (41.2%) had a biopsy or a colposcopic examination alone considered normal, 36 (37.1%) had CIN 1 or HPV changes, 12 (12.4%) had CIN 2 and 9 (9.3%) had CIN 3. No invasive cancer was detected. This data suggest that, if colposcopy resources are available, repeat smear alone is inadequate to follow women who have a mild dysplasia smear.
We have taken into consideration the obstetric outcome in 173 women, with prior cesarean section, who were delivered in our hospital between june 1988 and january 1991. This group of patients represented 5.3% of our obstetric population. Overall 64 patients (37%) achieved vaginal delivery and 109 (63%) underwent an iterative cesarean section. Considering the 76 patients (44%) admitted to trial of labour, 64 (84.2%) achieved vaginal delivery and 12 (15.8%) were delivered with iterative cesarean section. No maternal or neonatal complications occurred, even though the silent dehiscence of the uterine scar, found during cesarean section, seems to occur four times (12%) more frequently than that reported in recent literature. It follows that vaginal delivery after prior cesarean section is, in our experience, lacking in risks, and we think that such management may be widely adopted. In 1986 iterative cesarean section represented 35% of cesarean section indications, in 1990 this rate was reduced to 23.7% by the introduction of a policy to allow women to undergo trial of labour.
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One case of large epidermoid cyst of the ovary is presented. This rare lesion was uniformly described previously in literature as incidental finding in the study of hysterectomy specimens.
Pruritic vulvar squamous papillomatosis (PVSP) is a recently described clinical entity whose aetiologic agent has been reported to be the human papilloma virus. We have seen 9 patients with PVSP. We believe that our clinical and histological data, along with the results of the in situ hybridizations stress out the evidence of a viral aetiology in the PVSP.
The clinicopathological and immunohistochemical features of three types of endometrial stromal neoplasms are analyzed. The tumors are divided into three groups on the basis of two observations: 1) the presence or absence of invasion; 2) the frequency of mitotic figures.
Authors report five cases of intravenous leiomyomatosis, one of which had colonized the inferior vena cava and the right atrium, and make a review of the literature. The morphology of the lesions is in keeping with that previously reported. Moreover the immunostainings confirm the nature and the intravascular location of the neoplastic tissue. Authors taking into consideration the two most likely differential diagnoses afford the problem of the so-called "metastasizing leiomyoma". Eventually they agree that intravenous leiomyomatosis is an underdiagnosed entity that possibly will be more easily recognized due to the modern non-invasive diagnostic procedures.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.