The prognostic value of flow cytometry for thyroid papillary carcinoma in aged patients was studied and compared with that of tumor histology. Seventy-five surgically removed primary papillary thyroid carcinomas larger than 30 mm in diameter were obtained from patients over 60 years of age. A subtotal thyroidectomy with modified radical neck dissection was performed in all patients. Sixteen female patients died of the carcinoma (non-survivors) and 18 survived longer than 12 years without recurrence (survivors). Histologically, papillary carcinoma was subclassified into poorly and well differentiated types, and the presence of stromal bone formation was noted. Flow cytometry was performed using paraffin-embedded materials. The incidence of the poorly differentiated type was 2/18 among the tumors of survivors and 6/16 among the tumors of non-survivors (P = 0.08). Stromal bone formation was only found in the tumors of the survivors (6/18 and 0/16; P = 0.014). In flow cytometry, tumors of the survivors showed a DNA diploid pattern (14/14), whereas half of the tumors of non-survivors (6/12) showed an aneuploid pattern (P = 0.004). Moreover, in the remaining six tumors of the non-survivors, two showed a third peak at 6C and one showed a higher S fraction. Therefore, only three showed a DNA diploid pattern that was indistinguishable from that of the survivors. These results suggest that flow cytometry is useful for estimating the prognosis of thyroid papillary carcinoma.

Aged↗

PubMedDate not supplied

Human papillomavirus. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

ISSUES: Cervical squamous cell carcinomas, adenocarcinomas and their precursors are caused by the human papillomavirus (HPV). Although HPV appears to be essential to the transformation of these epithelial cells, it is not sufficient, and a variety of cofactors and molecular events must take place between when an HPV infection occurs and a cervical cancer or its precursor develops. This review examines the data supporting these contentions, briefly outlines the molecular events that occur, considers the epidemiology and natural history of the disease, and details the implications of using HPV detection and typing in both clinical management and population-based screening programs. CONSENSUS POSITION: 1. Based on the available molecular, clinical and epidemiologic data, a subset of HPVs are unequivocally the etiologic agents for cervical cancers and their precursors. 2. Different mucosotropic HPVs have varying neoplastic potential. However, the great majority of cervical HPVs have oncogenic potential. Since oncogenic HPV-induced epithelial transformation to a high grade lesion or cancer is rare relative to the rate of infection, the term high risk is discouraged. 3. HPV's interaction with host cells has two principal biologic consequences: a) All anogenital HPVs induce low grade squamous lesions, which are the morphologic correlate of a productive infection. b) Rarely, HPVs induce a proliferative epithelial phenotype that pathologists recognize as a high grade lesion and that is the proximate cytohistologic precursor of invasive cervical carcinoma. 4. HPV biology and issues of practical clinical management should be reflected in the classification systems used for cytologic and histologic diagnosis. ONGOING ISSUES: The molecular identification of HPVs (HPV testing) potentially may be very useful for primary screening or secondary triage of patients with certain lesions. However, the technology available to the practicing clinician is still evolving. Optimization of type spectrum, sensitivity, specificity and ease of use is under development. Data regarding these factors as well as a clear cost benefit analysis are sparse or pending in several large trials. Until such data are available, caution in clinical implementation of HPV testing is warranted.

Adenocarcinoma↗

PubMedDate not supplied

Clinical and cytologic aspects of primary fallopian tube carcinoma. A report of ten cases.

The clinical and cytologic findings in ten cases of primary fallopian tube carcinoma, a very rare malignancy, are presented. All ten patients had vaginal pool (V), cervical (C), endocervical (E) and endometrial aspiration (EA) smears examined preoperatively; peritoneal smears were also prepared from cul-de-sac fluid aspirated during surgery. In the preoperative cytodiagnosis, some of V, C, E and EA smears were positive for malignant cells in six of the ten patients (60%). Examination of the EA smear was the most effective means of discovering this disease. A watery discharge was noted in two patients, both of whom were negative in the preoperative cytodiagnosis. In such patients, it is necessary to repeat the smear examinations. The cytologic appearance of this disease is contrasted to that of endometrial carcinoma.

Adult↗