Dysplasia of the Uterine Cervix

In order to evaluate the significance of dysplasia lesions ofthe uterine cervix, 6,587 cervical biopsies in the five yearsfrom 1974 to 1978 were reviewed. The average age at the timeof diagnosis was: dysplasia, 44.4 years; carcinoma in situ,48.7 years; microinvasive carcinoma, 50.9 years; invasive carcinoma,56.6 years. This group consisted of 653 cases of dysplasia,194 of carcinoma in situ, 75 of microinvasive carcinoma, and536 of invasive carcinoma. On the basis of follow-up studiesof 166 dysplasia patients, the lesions of nine (5.4%) of thesepatients progressed to in situ carcinoma. These nine patientswere kept under observation for periods varying between 12 and41 months. These findings, in addition to the similar distributionof dysplasia and carcinoma in situ on the cervix, suggest thatdysplasia is a stepping stone to carcinoma.     

A Case Report of Mixed Mesodermal Tumor of the Uterine Cervix (Mixed, Heterologous and Homologous Sarcoma of the Uterine Cervix)

A case of mixed sarcoma of the uterine cervix in a 17-year-oldgirl is reported. The tumor showed polypoid features resemblingsarcoma botryoides, and was histologically composed of chondrosarcomaas a heterologous element and stromal sarcoma as a homologousone. Leiomyosarcoma was also found in the tumor,but striatedrhabdomyoblasts were not present. No epithelial component wasdetected. After a total hysterectomy, the patient was givenchemotherapy and is in good condition.     

Primary Uterine NK-Cell Lymphoma,Nasal-Type: A Unique Malignancy of a Prominent Cell Type of the Endometrium

Natural killer (NK) cells host in the human endometrium with dedicated role in reproductive physiology. Interestingly, malignant transformation of these specialized cells has not been presented thus far. Here we report a primary endometrial NK-cell lymphoma of a 48 year-old patient presenting with irregular bleeding. The endometrial curetting showed a dense lymphomatous infiltrate demonstrating highly infiltrative aggressive features with characteristic angiocentric, partially angiodestructive growth pattern and accompanying focal necroses. The lymphoma cells displayed a CD3ε/CD56/TIA-1/granzyme-B-positive and CD5/CD4/CD8/TCRγδ-negative immunophenotype, proved to be positive for Epstein-Barr virus by EBER in situ hybridization, and revealed no clonal T-cell receptor gene rearrangement. The diagnosis of uterine extranodal NK-cell lymphoma, nasal-type was made. Clinically, the disease was limited to the uterus at diagnosis, but progressed rapidly, and the patient died within 5 months due disseminated lymphoma, irrespective of intensive chemotherapy. Genuine NK-cell lymphomas occurring in the uterus as primary site seem to be rare making the therapeutic decisions extremely complicated.     

子宫颈淋巴瘤1例报道

患者女性 ,３８岁 ,因“阴道流淡血水２年 ,阴道流血２个月”于２００２年２月２６日入我院。患者２年前无明显诱因出现阴道流淡血水 ,量时多时少 ,偶有腹痛 ,无性交后阴道流血 ,不伴畏寒发热和恶心呕吐。２个月前出现阴道大出血 ,血顺腿流 ,伴头晕乏力。当地医院抗炎后流血渐止。查体 :生命体征平稳 ,中度贫血貌。全身浅表淋巴结未扪及肿大。心肺 (- )。腹平软 ,无压痛 ,肝脾未及。妇科检查 :阴道被增大的宫颈填塞 ,穹窿不能查及 ,后壁僵硬中１／３受累。宫颈肥大 ,约８ｃｍ直径 ,质脆 ,触血 ,糜烂状 ,子宫约３个月孕大 ,固定 ,宫旁增厚 ,…     

Primary Non-Hodgkin’s Lymphoma of the thyroid with lymphocytic thyroiditis

Primary Lymphoma of the thyroid is one of the very rare entities accounting to less than 2% of thyroid malignancies. We present a case of primary Non-Hodgkin’s Lymphoma of the thyroid with lymphocytic thyroiditis in a 60 year old woman. The patient presented with a rapidly growing nodular mass in the thyroid. The histological and immune marker features of the tumour were consistent with Primary Non-Hodgkin’s Lymphoma of the thyroid with associated thyroiditis.     

Population-based survivorship research using cancer registries: a study of non-Hodgkin’s Lymphoma survivors

Introduction Several recent reports have recommended use of population-based cancer registries for evaluating the long-term health outcomes of cancer survivors. Drawing upon experiences from a study of survivors of non-Hodgkin’s Lymphoma (NHL), we discuss conceptual and methodological challenges to and opportunities for conducting population-based survivorship research using cancer registries. Materials and methods Survivors of aggressive NHL diagnosed between June 1998 and August 2001, 2–5 years prior to the study, were sampled from the Los Angeles Surveillance Epidemiology and End Results (SEER) registry. A conceptual framework was developed to systematically evaluate the association of sociodemographic, clinical, social, psychological, and behavioral factors with survivors’ health-related quality of life. Data were collected primarily by a mailed questionnaire; medical records were also abstracted. Results Of 744 eligible survivors identified from the registry, 181 (24.3%) were lost to follow-up; 408 responded to the questionnaire (54.8%); 155 (20.8%) refused. Those lost to follow-up included a significantly higher proportion of younger, male, and Hispanic survivors compared to the other two groups (P ≤ 0.01). There were no sociodemographic or clinical differences among the questionnaire respondents and survivors who refused study participation. Medical records were abstracted for 59.8% of the respondents. A high percentage of agreement was seen between survivors’ self-report and medical record documentation of key treatments and disease status (≥95% for survivors with complete records). Conclusions The cancer registry served as a valuable resource for recruiting one of the largest population-based samples of NHL survivors. The methodology and example of a conceptual framework utilized in this study provide a model for future population-based cancer survivorship research.     

Primary gastrointestinal non-Hodgkin’s lymphoma: clinicopathological and prognostic analysis

The objective is to investigate the association between pathological type and clinical features, response to treatment and prognosis of primary gastrointestinal Non-Hodgkin’s lymphoma (PGINHL). The clinicopathologic features, response to treatment and survival of 124 patients with PGINHL, were investigated retrospectively. Ninety-one patients were treated with surgery, most of which included combined therapy, while 32 patients received chemotherapy alone. Survival analysis was performed by Kaplan–Meier and Cox regression method. The most common immunophenotype was B-cell subtype. In 115 (92.7%) patients of B-cell lymphoma, mucosa-associated lymphoid tissue lymphoma (MALToma) and diffuse large B-cell lymphoma (DLBCL) were 55 and 50 patients, respectively. The patients of two pathological types had different clinical features including stage, B symptoms, sites of tumor, distant involvement, International Prognosis Index Score, size of tumor, and response to treatment. Both overall survival curve and multiple Cox regression analysis indicated that pathological type was statistically significant. The pathological subtype of PGINHL was an important prognostic factor. The patients with MALToma appear to have more favorable prognosis than those with DLBCL.     

41例宫颈粘液腺癌临床分析

目的：探讨宫颈粘液腺癌的临床特点及其治疗方法。方法：本文对1958年至1990年我院收治的41例宫颈粘液腺癌的临床资料进行回顾性分析。结果：宫颈粘液腺癌占同期宫颈腺癌的19．16（41／214）。平均年龄为50．89岁，阴道白带增多为临床突出症状，按FIGO分期，Ⅱ期占34．14％（14／41），Ⅲ期占56．09％（23／41），Ⅳ期占9．76％（4／41）。采用单纯放疗26例，综合治疗15例。总5年生存率为13．20％，其中Ⅱ期33.30％，Ⅲ期2．17％，Ⅳ期0.宫颈直径≤3cm和＞3cm5年生存率分别为9．09％和12.80％（P＞0．05）。结论：本资料表明宫颈粘液腺癌的预后比宫颈鳞癌以及其他类型的宫颈腺癌差，与临床分期有关，但与宫颈肿瘤大小无关。     

Line-1 Hypomethylation in Multistage Carcinogenesis of the Uterine Cervix

Objective: To evaluate characteristics of global hypomethylation in evolution of cervical cancer. Materialsand Methods: Eight cases of squamous cell carcinoma (SCC) and seven cases of carcinoma in situ (CIS) werestudied. Each of the SCC samples contained CIS, and all SCC and CIS samples contained normal ectocervicalepithelium. Microdissection was performed to separate normal epithelium, CIS and SCC prior to DNA extraction.Hypomethylation levels of long interspersed nuclear elements (LINE-1 or L1) were measured with a combinedbisulfite restriction analysis (COBRA) PCR (polymerase chain reaction) protocol. The percentage of L1hypomethylation for SCC, CIS and normal epithelium was compared. Results: In the SCC cohort, the L1hypomethylation level showed progressive increase comparing normal epithelium (59.4 ± 8.86%) to CIS (64.37± 7.32%) and SCC (66.3 ± 7.26%) (repeated measurement ANOVA, P = 0.005). A significantly greater L1hypomethylation level was found in CIS (62.06 ± 3.44 %) compared to normal epithelium (60.03 ± 3.69 %)(paired t-Test, P = 0.03). No significant difference in L1 hypomethylation level was noted between CIS of the twosample groups (unpaired t-Test, P = 0.2). Conclusions: In our study, there was a significant correlation betweenthe degree of hypomethylation and progression from normal ectocervical mucosa to CIS and invasive cancer.Laboratory assessment of biopsies for this molecular event may have clinical significance.