Case In Point | General
To avoid under-diagnosis of cervical intraepithelial neoplasia (CIN) or malignancy, liberal (all 4 quadrant) colposcopic biopsies are recommended. However, pain and traumatic bleeding are powerful demotivators to both the clinician and the patient in...
Case In Point | General
HPV types 16 and 18 cause 60-70% of cervical cancers worldwide, with the remaining high risk HPV types causing essentially all remaining cases. With the need for stratifying HPV-positive (cytology negative) patients, genotyping for HPV types 16 and 18 has...
Case In Point | General
One of the greatest challenges in cervical cancer screening is the sensitivity of the Pap test. The addition of high risk HPV to the Pap greatly improves sensitivity, at the cost of specificity. As described in this issue, an attempt at isolating patients at...
Case In Point | General
The management of atypical, or malignant endometrial cells in a Pap test is obvious; immediate tissue sampling in the form of biopsy or curettage. However, what is the relevance of normal endometrial cells (NEMCs) in a premenopausal patient? NEMCs are...
Case In Point | General
Historically, the presence of an endocervical/transformation (EC/TZ) component was considered a measurement of quality of the Pap test, implying that the transformation zone was adequately sampled, which indirectly represents the competence of the individual...
Case In Point | General
Maternal infections are associated with Intellectual Disability/Mental Retardation (ID/MR) in children.1 2 What began as a broad analysis of maternal genitourinary infections and pregnancy/child outcomes soon led to the discovery that Trichomoniasis also has...
Case In Point | General
We have just discussed how cotesting has greater sensitivity and specificity than using the HPV or Pap tests independently. However, does the type of HPV test affect sensitivity and specificity in cervical cancer screening? We believe so; at PathAdvantage, we...
Case In Point | General
In the US, Trichomonas vaginalis (TV) infections are not reportable to state agencies and therefore actual prevalence data is limited. In addition, as many as 85% of infected women1 are asymptomatic and therefore do not even undergo testing. Also, in those...
Case In Point | General
We have just described how all patients should be followed up equally after a LEEP, regardless of the presence of squamous dysplasia within the excision specimen. However, are there other factors which might identify patients who are more likely to experience...
Case In Point | General
Answering the above question may not be easy; you may have asked this yourself. For both the operating clinician and the examining pathologist, it is very satisfying to find a high grade squamous lesion within a cervical LEEP, which confirms the original...