Innervation of internal female genital organs in the pig during prenatal development

This study investigated the innervation of internal genital organs in 5‐, 7‐ and 10‐week‐old female pig foetuses using single and double‐labelling immunofluorescence methods. The structure and topography of the organs was examined using a scanning electron microscope (SEM). The investigations revealed differences in the innervation between the three developmental periods. Immunostaining for protein gene product 9.5 (PGP; general neural marker) disclosed solitary nerve fibres in the external part of the gonadal ridge and just outside of the mesenchyme surrounding mesonephric ducts in 5‐week‐old foetuses. Double‐labelling immunohistochemistry revealed that nerve fibres associated with the ridge expressed dopamine β‐hydroxylase (DβH; adrenergic marker) or vesicular acetylcholine transporter (VAChT; cholinergic marker). In 7‐week‐old foetuses, the PGP‐positive nerve terminals were absent from the gonad but some of them ran outside and along, and sometimes penetrated into the mesenchyme surrounding the tubal and uterine segments of the paramesonephric ducts and uterovaginal canal. Few axons penetrated into the mesenchyme. DβH‐positive fibres were found in single nerve strands or bundles distributed at the edge of the mesenchyme. VAChT‐positive nerve terminals formed delicate bundles located at the edge of the mesenchyme, and the single nerves penetrated into the mesenchyme. DβH was also expressed by neurons which formed cell clusters comprising also DβH‐ or VAChT‐positive nerve fibres. In 10‐week‐old foetuses, PGP‐positive nerve fibres were still absent from the ovary but some were distributed in the mesenchyme associated with the uterovaginal canal and uterine and a tubal segment of the paramesonephric ducts, respectively. DβH‐ or VAChT‐positive nerve fibres were distributed at the periphery of the mesenchyme associated with the uterovaginal canal. Some DβH‐ and many VAChT‐positive nerve fibres were evenly distributed throughout the mesenchyme. The clusters of nerve cells comprised DβH‐positive perikarya and DβH‐ or VAChT‐positive nerve fibres. The investigations revealed no DβH/VAChT‐positive nerve fibres or neurons as well as no nerve structures stained for calcitonin gene‐related peptide and/or substance P (sensory markers) associated with the genital organs in the studied prenatal periods.     

Sclerosing variant of perivascular epithelioid cell tumor in the female genital organs

Perivascular epithelioid cell tumor (PEComas), other than angiomyolipoma, clear cell 'sugar' tumor of the lung, and lymphangioleiomyomatosis, is an uncommon mesenchymal neoplasm that arises in the soft tissue and visceral organs. We report herein two cases of sclerosing PEComa; a distinctive variant of PEComa, which is characterized by extensive stromal hyalinization, occurring in the uterus and broad ligament. The patients were 34- and 51-year-old females with no family history of tuberous sclerosis complex. Macroscopically, the tumors had white to gray cut surfaces and were microscopically composed of predominantly spindle- to polygon-shaped cells with clear to slightly eosinophilic cytoplasm and pleomorphic nuclei focally arranged in a perivascular pattern, accompanied by marked stromal hyalinization. These tumor cells were immunohistochemically positive for HMB45 and α-smooth muscle actin. Although this variant of PEComa is very rare, this entity should be considered as a potential primary neoplasm of the female genital organs.     

Pain sensitivity of and pain radiation from the internal female genital organs

The aim of this study was to determine the sensitivity and the localization of pain from the internal female genital organs. In 28 women undergoing a ring sterilization, the internal genital organs were pinched with a 3 mm forceps and the pain sensitivity and localization were recorded. Pain localization was vague, and pinching of the medial and distal end of the oviduct, or of the anterior, posterior or left or right uterosacral ligament could not be discriminated. The sensitivity of the pouch of Douglas and of the uterosacrals was greater than of the oviduct, uterus or ovaries. Small typical endometriotic lesions were specifically more painful. The pain from the uterus was felt mainly in the hypogastric region. The oviducts and ovaries radiated mainly to the iliac fossa, whereas pain stimulation of the uterosacrals and pouch of Douglas was felt predominantly in the perineal-perivulvar-perianal region. Radiation to the lower back was rare and never occurred in isolation.      

Clinical evaluation of precipitin tests for genital actinomycosis

A precipitin test system for antibodies against Actinomyces israelii, comprising a combination of counterimmunoelectrophoretic and crossed immunoelectrophoretic gel techniques, was evaluated for its clinical usefulness in diagnosing genital actinomycosis. A total of 263 serum samples from healthy women and women with proven actinomycosis, A. israelii-associated salpingitis, other gynecological infections, or miscellaneous gynecological diseases were analyzed. Six different precipitins could be detected. Five precipitins were defined as specific for actinomycosis, whereas one was found to occur nonspecifically in women with gynecological infections. The specificity of the test system for the detection of cases of genital actinomycosis was 98%, and the sensitivity was 83%. The accuracy was 100% for negative prediction and 45% for positive prediction. Thus, the test was shown to be valuable for a noninvasive diagnosis of genital actinomycosis.     

Expression of E-cadherin in normal, benign, and malignant tissues of female genital organs.

The expression of human E-cadherin in normal tissues and in benign and malignant tumors of female genital organs was examined immunohistochemically with a monoclonal antibody, HECD-1, specific for human E-cadherin. The normal tissues included the ovary, fallopian tube, uterine endometrium, uterine cervix, and vagina. E-cadherin was detected clearly in the cell-to-cell boundaries of both normal glandular and squamous epithelia obtained from those tissues. The tumor tissues consisted of 9 ovarian, 7 endometrial, and 4 cervical adenocarcinomas, 12 squamous cell carcinomas of the cervix, including 3 cervical intraepithelial neoplasms, and 5 mesenchymal tumors. E-cadherin also was detected in the cell-to-cell borders of all the epithelial tumors tested, with some reactivity in the cytoplasm of malignant cells, whereas mesenchymal tumors showed no expression. It is noteworthy that poorly differentiated areas of both the adenocarcinomas and squamous cell carcinomas showed less expression of E-cadherin. No difference in the expression of E-cadherin between the primary and metastatic lesions was detected in 10 sets of malignant tumors. E-cadherin may be an important factor among a variety of biologic events that occur during the process of metastasis. However, further studies are needed to clarify this.     

乳腺癌女性生殖道转移二例

例1,患者女,47岁,因右乳腺浸润性导管癌行乳腺癌保乳区段切除术,化疗至第2个疗程约半年前出现闭经,阴道出血35d,于2005年3月来我院门诊断性诊刮。     

Enteric tumours of the lower female genital tract: a report of three cases

Three enteric-type neoplasms of the lower female genital tract are described; an enteric adenocarcinoma of the cervix, an enteric adenocarcinoma of the vagina and a tubulo-villous adenoma of the vagina. The two adenocarcinomas were characterized by the presence of columnar cells with a prominent brush border and an abundance of goblet cells. The tubulovillous adenoma was identical to similar lesions found in the large intestine. The criteria for diagnosis of an enteric adenocarcinoma of the female genital tract are discussed and it is concluded that the histochemical demonstration of o-acetylated sialomucin is the most specific marker of intestinal differentiation. It is suggested that enteric tumours of the cervix arise from foci of gastrointestinal metaplasia. Enteric tumours of the vagina are more likely to develop from cloacal remnants.