GYNAE CYTOLOGY SLIDE

SEMINAR - THE AGATHA

CHRISTIE MYSTERIES

TUESDAY 4TH OCTOBER 2016 14.30-16.00 HALL 3A

CHAIR: DINA R MODY, MD

CO-CHAIR: LUIGI DI BONITO, MD

FORMAT: UNKNOWN CASES WITH AUDIENCE PARTICIPATION

Speakers order

• Dr Mody, Introductions

• Case 1 Dr Mody

• Cases 2, 3 Dr Hoda

• Cases 4,5 Dr Gupta

• Cases 6,7 and summation Dr Di Bonito

CASE 1 DR MODY

• 62 Year old woman, immigrant from South East Asia, seen in our charity clinic. Pap (SurePath) and HPV performed

YOUR DIAGNOSIS FOR CASE 1

• Adenocarcinoma

• Benign/reactive atypia

• High Grade Squamous Intraepithelial Lesion

• Low Grade Squamous Intraepithelial lesion

• Something else...don’t waste my time, just tell me!!

CASE 2 :DR HODA

62-year-old,

Prior Paps: negative

History: Breast cancer, 2004

Medications: Estrogen 5 years until 2002

ThinPrep

ThinPrep

Dr. Rana Hoda, Case 2, Image 1

ThinPrep

Dr. Rana Hoda, Case 2, Image 2

CYTOLOGICAL DIAGNOSIS: CASE 2

A. Reactive endocervical cells

B. Endocervical adenocarcinoma, usual type

C. Atrophy

D. Endometrial adenocarcinoma

E. Minimal deviation endocervical adenocarcinoma

CASE 3 DR HODA

31-year-old

Routine Pap

SurePath

Dr. Rana Hoda, Case 3, Image 1

Dr. Rana Hoda, Case 3, Image 2

CYTOLOGICAL DIAGNOSIS

A. Reactive endocervical cells

B. Endocervical adenocarcinoma in situ

C. HSIL

D. Endocervical adenocarcinoma

E. LSIL

CASE 4 DR GUPTA

• A 34-year-old lady

• Presented with primary infertility

• Cervix- bled on touch

• Liquid-based sample (SurePath® technique) was taken

DIAGNOSIS 1. Atypical glandular cells

2. Follicular cervicitis

3. Inflammatory smear

4. Mild dyskaryosis/ LSIL

5. Moderate dyskaryosis/ HSIL

CASE 5 : DR GUPTA

• A 35-year-old lady

• Presented with primary infertility

• Abnormal bleeding per vaginum x 6 months

• Pain lower abdomen x 6 months

DIAGNOSIS 1. Adenocarcinoma

2. Infection with carcinoma

3. Mild dyskaryosis/ LSIL

4. Reactive endocervical cells

5. Severe dyskaryosis/ HSIL

CASE 6 DR DI BONITO

• 37 YEARS OLD PATIENT

• REGULAR PERIODS, 10TH DAY AT MENSTRUAL CYCLE

• PREVIOUS SCREENING PAP TEST NEGATIVE

NEGATIVE

LG- SIL

HG- SIL

ASC

SQUAMOUS CARCINOMA

AGC

ADENOCARCINOMA IN SITU

ADENOCARCINOMA

How would you report ?

CASE 7 DR DI BONITO

• 35 YEARS OLD PATIENT

• 21TH WEEK OF PREGNANCY

• COLPOSCOPY: POLYPOID DECIDUOSIS

• VAGINAL BLEEDING

Epithelial hypercellular layers

NEGATIVE

LG- SIL

HG- SIL

ASC

SQUAMOUS CARCINOMA

AGC

ADENOCARCINOMA IN SITU

ADENOCARCINOMA

How would you report ?