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Biomedical subjects

J Scurry

Publications and source records attributed to J Scurry.

At least 37 records · Page 2Linked to original sources
PubMed1997

Investigation of 100 consecutive negative cone biopsies.

OBJECTIVE: To investigate the reasons for cone biopsies reported as not containing intraepithelial or invasive malignancy and thereby find ways to decrease their incidence. DESIGN: One hundred cone biopsies reported as negative were identified out of a total of 436 consecutive cone biopsies. The patients' cytology, colposcopy and histology reports and cytology and histology slides were reviewed. Further opinions in cases of doubt were obtained in cytology and histology. In cone biopsies still considered negative after reviews, deeper levels were cut, exhausting all paraffin blocks. Follow up cytology, colposcopy and histology were reviewed. SETTING: Gynaecological oncology unit in a university teaching hospital. RESULTS: After re-evaluation the final diagnoses of cone biopsies initially reported as negative were positive (n = 21), unsatisfactory (n = 27) and true negative (n = 51), with one case excluded because of insufficient material for review. The positive cases were diagnosed on review (n = 11) or extra levels (n = 10). The unsatisfactory cases were all due to denudation. The 51 true negative cases were divided into those which never had had histologic confirmation by punch biopsy or endocervical curettage (n = 47) and those with a previously confirmed histological abnormality (n = 4). CONCLUSIONS: The number of negative cone biopsies can be reduced by: 1. taking Pap smears after correction of atrophy and inflammation; 2. more scrupulous colposcopy aimed at reducing the number of unsatisfactory colposcopies or misinterpreted colposcopic findings; this through examination should include the vagina and vulva; 3. confirmation of smear and colposcopic findings by biopsy prior to cold-knife conisation and performing a large loop excision of the transformation zone (LLETZ) for cases where there is a discrepancy between the smear abnormality and colposcopy/biopsy findings; 4. good quality cone biopsies using a technique that does not handle the mucosa and is performed after the mucosa has had time to regenerate following the colposcopic investigations; and 5. exhausting all blocks with multiple levels before reporting a cone biopsy as negative.

Adult↗
PubMed1996

High-grade endometrial carcinoma in secretory endometrium in young women: a report of five cases.

Five cases of high-grade carcinoma occurring adjacent to secretory endometrium are described. One of the patients had the Lynch II syndrome, the others appeared to be sporadic. None of these cases appeared to be related to hyperestrogen. The presenting symptom in four was abnormal vaginal bleeding, and the other case was found incidentally in the course of investigations for infertility. There were delays in diagnosis due to the patients not seeking medical attention for abnormal bleeding, a reluctance of clinicians to perform dilatation and curettage, and difficulty in pathologic interpretation of the curettings. The interpretive problems related to extremely small volumes of tumor, difficulty in distinguishing carcinoma from menstrual endometrium, and difficulty in determining whether a carcinoma was endometrial rather or endocervical in origin. The tumors were aggressive, manifest by their high grade and stage. The importance of these cases is to impress upon clinicians and pathologists that endometrial carcinoma may occur in young women without any of the usual risk factors.

Adult↗
PubMed1996

Vulvar Merkel cell tumor with glandular and squamous differentiation.

A case of a Merkel cell tumor of the vulva is presented. In addition to the typical microscopic, immunohistochemical, and ultrastructural features of Merkel cell tumor, there were areas of squamous and glandular differentiation. This is the ninth reported case of a vulvar Merkel cell tumor, and the first where squamous and glandular differentiation were seen. The findings support an origin of Merkel cell tumors from pluripotential stem cells.

Adenocarcinoma↗
PubMed1996

Primary and recurrent colorectal cancer masquerading as gynaecological malignancy.

To make clinicians more aware of the phenomenon of primary and recurrent colorectal and anal carcinoma masquerading as primary gynaecological malignancy, we reviewed the records of 8 women referred to our gynaecological oncology unit with primary colorectal cancer (1), recurrent colorectal cancer (6) and primary anal cancer (1). Seven of these patients presented with abnormal vaginal bleeding or discharge. All patients had Papanicolaou smears performed; 7 were abnormal and 1 unsuitable for cytological assessment. None of the 6 patients with recurrent carcinoma had been previously treated with more than standard anterior or abdominoperineal resection; no radiotherapy had been given, and only 1 patient had received chemotherapy. These patients were treated in our gynaecological oncology unit for their recurrence by surgery and/or chemotherapy and/or irradiation. All 6 had further recurrences in the pelvis despite this aggressive therapy. Follow-up of colorectal cancer in women should involve gynaecological history, pelvirectal examination and Pap smear at each visit. Correct diagnosis of the colorectal origin of a genital tract tumour is made on careful history, examination and biopsy. An abnormal Pap smear may be the first indication of recurrent colorectal cancer in the cervix and vagina, although most patients ultimately present with abnormal vaginal bleeding. The presence of a tumour invading both cervix and posterior vaginal wall is suggestive of spread from a colorectal tumour compared to the more common lateral spread of a cervical primary.

Adult↗
PubMed1995

Angiolymphoid hyperplasia with eosinophilia of the vulva.

Vulvar angiolymphoid hyperplasia with eosinophilia is a rare benign itchy vascular lesion that, because of its nonspecific clinical features, requires biopsy for accurate diagnosis. Surgical excision is the preferred method of treatment.

Adult↗
PubMed1993

Ligneous (pseudomembranous) inflammation of the female genital tract. A report of two cases.

Two women, aged 28 and 32, presented with primary infertility and severe dysmenorrhea. The younger woman developed recalcitrant and recurrent firm vaginal, cervical and possibly endometrial lesions over a period of six years; the older patient had similar material in the cervix, endometrium and a fallopian tube. The lesions were composed of amorphous eosinophilic hyaline or necrotic material, shown by histochemical and immunoperoxidase stains to be partly fibrin. Pathologic examination showed that the lesions were similar to those of ligneous (pseudomembranous) conjunctivitis, a rare disease that may occasionally affect the lower female genital tract. However, neither patient had eye disease, and ligneous conjunctivitis has not previously been reported to involve the upper genital tract. Endometrial and tubal involvement could readily explain primary infertility and dysmenorrhea in these patients.

Adult↗
PubMed1993

Vulvitis circumscripta plasmacellularis. A clinicopathologic entity?

Four cases of vulvitis circumscripta plasmacellularis (plasma cell vulvitis) are presented. One case was associated with cutaneous lupus erythematosus and another with a history of desquamative vaginitis. Two patients were postmenopausal, and two were premenopausal. The presenting symptoms were pruritus, tenderness, superficial dyspareunia and vulvar dysuria. The lesions were situated in the introitus in three patients and on the lateral aspect of the labium minus in the fourth and appeared as well-circumscribed, glistening, erythematous patches with a faint orange hue. Histologically, epidermal edema and inflammation, a dense upper dermal band of chronic inflammatory cells, including many plasma cells, dilated capillaries, extravasated red blood cells and hemosiderin deposition, were seen. There was a variable response to local steroid therapy, but one of the postmenopausal patients responded to local estrogen alone. The term vulvitis circumscripta plasmacellularis is useful to describe an idiopathic form of erosive vulvitis with a characteristic clinical and histologic appearance.

Adult↗
PubMed1992

Organ weight/bodyweight ratios: growth rates of fetal organs in the latter half of pregnancy with a simple method for calculating mean organ weights.

Ratios for major organ weights compared with bodyweights of 1023 stillborn and liveborn babies who lived less than 72 h are presented. The ratios were calculated for 2 week increments of gestational age from 20 to 43 weeks and clearly depict the relative growth of fetal organs during the last half of pregnancy. The ratios for heart and for kidneys were virtually constant for the whole period of gestation examined. The ratios for thymus and spleen increased between 20 and 30 weeks gestation and then became constant, although the ratio for the spleen dropped slightly during the last 6 weeks. The ratios for liver, lungs and adrenals decreased between 20 and 30 weeks gestation, and then steadied. The ratio for brain declined very slowly throughout the period examined. An observation of practical importance was that all organ weight/bodyweight ratios were virtually constant after 30 weeks gestation. Approximate mean organ weight/bodyweight ratios between 30 and 43 weeks gestation were: heart 0.007, lungs 0.02, spleen 0.003, liver 0.04, kidneys 0.01, adrenals 0.003, thymus 0.004 and brain 0.13. By multiplying the mean ratio by the total bodyweight, the approximate mean weight for a particular fetal organ can be calculated in situations where charts of normal organ weights are not at hand.

Body Weight↗
PubMed1992

Tachyarrhythmia, cardiac rhabdomyomata and fetal hydrops in a premature infant with tuberous sclerosis.

An hydropic infant was delivered at 32 weeks gestation by emergency Caesarean section for acute polyhydramnios. A diagnosis of cardiac rhabdomyomata was made on echocardiography. The baby survived 10 days, during which time repeated episodes of supraventricular tachycardia occurred. She eventually died of cardiac failure following an episode of septicaemia, convulsions and aspiration pneumonia. Necropsy showed multiple cardiac rhabdomyomata and numerous cerebral germinal layer and periventricular white matter nodules. This case stresses the importance of clinical investigations and perinatal necropsy in non-immune hydrops fetalis (NIHF) in determining the causes of clinical presentation and the underlying pathology.

Female↗
PubMed1992

Survey of congenital tumors in perinatal necropsies.

In an audit of 17,417 necropsies from 1939 to 1989 at the Royal Women's Hospital, Melbourne, Victoria, 46 congenital tumors comprising 24 teratomas, 8 vascular tumors, 6 neuroblastomas, three rhabdomyomas, two mesoblastic nephromas, one thyroid adenoma, one hepatic adenoma and one cerebellar medulloblastoma were found. The teratomas were generally large tumors and, because of their size and location, incompatible with extrauterine life. Ten teratomas were associated with polyhydramnios, three with obstructed labour, five of the fetuses were hydropic and four had malformations at sites distant to the tumor. Twenty teratomas occurred in stillbirths, half of whom were macerated. The vascular tumors were associated with polyhydramnios in three cases and hydrops fetalis in two. The neuroblastomas were all incidental findings. Four were intra-adrenal, one was an adrenal tumor which had metastasized to the liver and the remaining case was a small paravertebral lesion. Two of the three rhabdomyomas were multiple and one of these occurred in a case of tuberous sclerosis. One of the mesoblastic nephromas occurred in a hydropic fetus who had the Arnold-Chiari malformation. The thyroid and hepatic adenomas were small incidental lesions. The cerebellar medulloblastoma had led to marked hydrocephalus. Congenital tumors have different incidence, presentation and behaviour than those in childhood or adult life. The association of congenital tumors with congenital malformations and hydrops fetalis should always be remembered.

Female↗
PubMed1992

Viruses in anogenital cancer.

The association between sexual activity and cancer, first described in carcinoma of the cervix, has been expanded to include the majority of anogenital squamous epithelial carcinomas. Current evidence suggests that human papillomavirus (HPV) may be of great importance in the development of these tumours, whilst herpes simplex type 2 virus (HSV-2) and human immunodeficiency virus (HIV) may play minor roles. Certain types of HPV DNA, including types 16, 18, 31, 33 and 39 are found in most but not all anogenital cancers and pre-invasive neoplastic conditions. Viral genes E6 and E7 of HPV 16 and 18 are regularly expressed in HPV-positive tumours. In vitro, E6 and E7 genes have transforming properties which correlate with their ability to bind naturally occurring growth regulation proteins p53 and pRB. It has, however, become apparent that HPV alone does not provide the full aetiological explanation of sexually related carcinomas. The finding of latent, non-sexually-acquired HPV in a sizable proportion of the community, including children, has confounded simple theories of HPV transmission and cancer. Furthermore, in vitro experiments suggest that other factors may potentiate the effects of HPV. HSV-2 may possibly function as cofactor as it can synergize with HPV to cause transformation in vitro, and can transactivate HPV gene expression. HIV is associated with an increased rate of anogenital malignancies, particularly of the anus. Tumours in HIV-positive patients appear to have a worse prognosis, even before the onset of AIDS.

Anus Neoplasms↗
PubMed1991

Unusual variants of vaginal adenosis: a challenge for diagnosis and treatment.

Two unusual cases of vaginal adenosis in non-diethylstilbestrol (DES)-exposed patients are presented. These cases created an initial difficulty in histological classification and exclusion of the diagnosis of adenocarcinoma. The first case presented a problem of atypical columnar epithelium with simple gland architecture, while the second showed a pseudoinfiltrative pattern of small glands, but without cytological atypia. A diagnosis of glandular dysplasia (atypical columnar epithelium) was finally made in the first case and vaginal adenosis with unusual architectural features in the second. The first patient was treated by excision and the second expectantly. Subsquently, neither patient has developed carcinoma. The spectrum of glandular changes in vaginal adenosis appears analogous to that of the cervix. Until the natural history of sufficient numbers of these variants of vaginal adenosis have been studied, the analogous cervical condition may serve as a guide to prognosis. The diagnosis of invasive adenocarcinoma should be made cautiously unless there are both architectural and cytological features of malignancy.

Adenocarcinoma↗
PubMed1991

Topical mercurials.

Explore the source record for details and available documents.

Administration, Cutaneous↗
PubMed1990

Leiomyosarcoma arising in a lipoleiomyoma.

A leiomyosarcoma arising in a uterine lipoleiomyoma is described in a 70-year-old woman. The tumor measured 11 cm and was located in the corpus uteri. It was composed of a mixture of firm, pale tan, whorled tissue and soft, white or hemorrhagic areas. Histologically, the firm tissue was a mixture of bland smooth muscle, fat and fibrous tissue, whereas the soft areas showed a malignant spindle cell tumor with smooth muscle differentiation. Pure sarcoma similar to the malignant portion of the lipoleiomyoma had metastasized to the vaginal wall.

Aged↗
PubMed1990

Generalised eruptive syringoma--a papular dermatosis.

Generalized eruptive syringoma is a rare condition characterised by multiple papules over the anterior trunk, sometimes extending on to the flexural aspects of the arms and thighs. A 22 year old Ethiopian woman with this disorder is presented.

Adenoma, Sweat Gland↗
PubMed1990

Ganglion cells in colonic mucosa.

Intramucosal ganglion cells are commonly believed not to occur in normal colon and to be found only in the chronic bowel motility disorder, neuronal intestinal dysplasia. After chance observations of two intramucosal ganglion cells in endoscopic biopsies in two patients without neuronal intestinal dysplasia, a retrospective study was undertaken to determine how frequently ganglion cells are present in colonic mucosa. Excluding the index cases, three intramucosal ganglion cells were found in 169 consecutive colonic biopsies. The nature of the ganglion cells was confirmed by positive neurone specific enolase staining by the peroxidase-antiperoxidase technique in all cases. None of the patients had neuronal intestinal dysplasia. The diagnosis of neuronal intestinal dysplasia should rely on a constellation of clinicopathological features. Rare intramucosal ganglion cells are a normal histological finding.

Adolescent↗