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Connolly Hospital Dublin
St. Luke’s Radiation Oncology Network Dublin (3)
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Banville, N
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Gavin K
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OBJECTIVES: Recent National Health Service Cervical Screening Programme (NHSCSP) guidelines suggest referral for colposcopy following an initial result of mild dyskaryosis. The aim of this study was to investigate if the number of dyskaryotic cells counted on an initial ThinPrep cervical sample showing mild dyskaryosis has predictive value. METHODS: Cases of mild dyskaryosis on ThinPrep cervical samples from 2002 were retrieved from the cytology department records of St Luke's Hospital. A total of 123 sequential cases with a first-time result of mild dyskaryosis on ThinPrep slides with follow-up cytology available in the same institution were identified. While blinded to outcome, the number of dyskaryotic cells was counted in each case. Follow-up colposcopy/histology information was retrieved where indicated. The number of dyskaryotic cells counted on each slide was collated with outcome data. RESULTS: Of the 123 cases, six women were lost to follow-up. Seventy-three had a negative outcome, 27 had a low-grade outcome and 17 had a high-grade outcome. Only one of 17 high-grade outcome cases had < or = 15 dyskaryotic cells on the initial slide. The distribution of women with a negative/low-grade outcome and those with a high-grade outcome with >15 and < or = 15 dyskaryotic cells on the initial slide was tested using a chi-square test (P = 0.008). The negative predictive value for a high-grade outcome when < or = 15 dyskaryotic cells were present on the initial slide was 97.7. CONCLUSION: The number of dyskaryotic cells on ThinPrep slides showing mild cervical dyskaryosis has predictive value. The number of dyskaryotic cells may be used to select women suitable for cytological rather than colposcopic follow-up (1)
We present two examples of Liesegang rings occurring in association with duct ectasia. Liesegang rings are a rare phenomenon usually found in association with cystic or inflammatory lesions, and may be mistaken for parasites. ""The first patient, a 52 year old woman, had a radiological code 4 mass lesion on screening mammography. Needle core biopsy (NCB) showed breast tissue infiltrated by sheets of single cells, with abundant foamy cytoplasm and slightly eccentric nuclei. Cytological atypia was minimal and there was no significant mitotic activity. The cells were admixed with lymphocytes, plasma cells, and neutrophil polymorphs. Immunohistochemical studies showed that the lesional cells were strongly CD68 positive and cytokeratin negative, confirming the haematoxylin and eosin impression of an inflammatory process, and excluding histiocytoid carcinoma. The aetiology of the inflammatory process was not apparent on NCB and, in view of the radiological suspicion of malignancy, the patient proceeded to excisional biopsy (1)
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1)
The number of dyskaryotic cells on an initial ThinPrep cervical sample showing mild dyskaryosis has predictive value
Author
Banville, N
Publisher
Staff Publications- Magee, Derek
Pub. Date
2005
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2)
Micrococcus tetragenus: an unusual commensal in a cervical smear
Author
Banville, N
Publisher
Staff Publications
Pub. Date
2005
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3)
Liesegang rings in inflammatory breast lesions
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Gavin K
Pub. Date
2005
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