Maja Krašević

Transvaginal sonography and hysteroscopy in women with postmenopausal bleeding.

Objective: To make a prospective comparison between endometrial thickness determined by transvaginal sonography (TVS) and hysteroscopic findings in women with postmenopausal bleeding with histologic findings obtained by dilatation and curettage (D&C). Methods: Eighty‐one patients who had not received hormonal replacement therapy were scanned by transvaginal probe, and double‐layer endometrial thickness was measured 1 day before hysteroscopy and D&C. Results: The histologic diagnosis was atrophy in 12 cases, irregular proliferative changes in 21, endometrial polyps in 16, hyperplasia in 16 and endometrial carcinoma in 16. TVS detected 46 of 48 pathologic conditions, including all cases of endometrial carcinoma if the endometrial thickness (both layers) was ≥ 5 mm (sensitivity 95.8%, specificity 45.5%). Hysteroscopy also detected the endometrial pathology in 46 of 48 cases but with a higher specificity (sensitivity 95.3%, specificity 93.9%). Conclusion: TVS and hysteroscopy are complementary diagnostic methods and could be accurately used to discriminate between normal and pathologic conditions in patients with postmenopausal bleeding.

Chromosomal Anomalies in Abnormal Human Pregnancies

Objective: The aim of this study was to describe the cytogenetic observations on abnormal human pregnancies (anembryonic pregnancy, early fetal loss, and hydatidiform moles), and to detect the most frequent or typical chromosomal aberration for anembryonic pregnancy and early fetal loss. Study Design: Abnormal pregnancies were divided into three clinical and morphological groups: (a) anembryonic pregnancy; (b) early fetal loss, and (c) hydatidiform mole. Of the 119 karyotyped tissue samples, 42 (35%) were from anembryonic pregnancies, 64 (54%) from early fetal losses, and 13 (11%) were from hydatidiform moles (6 complete and 7 partial moles). Long-term cultures of chorionic villi and GTG-banding techniques were used for chromosome analysis. Results and Conclusion: The overall frequency of chromosome anomalies among the 119 karyotyped spontaneous abortions was found to be 37.8%. Trisomy (double trisomy included) accounted for 35.6% of all aberrations, followed by polyploidy (33.3%), mosaicism (11.1%), tructural abnormalities (4.4%), and monosomy X (2.2%). Although the difference was not statistically significant, single trisomy was the predominant chromosome abnormality found in anembryonic pregnancies (64.3%) while in cases of early fetal loss, trisomy (double trisomy included) (38.9%) and triploidy (27.8%) were quite frequently present. The frequency of triploidy among all chromosomal abnormalities was 28.9%, and 53.8% of them were found in partial hydatidiform mole. The rest of them were almost exclusively found in early fetal losses. Complete hydatidiform moles (androgenetic in origin) were present in 13.3% of all aberrations, of which 83.3% had a 46,XX, and the rest of them had a 46,XY karyotype.

Intraoperative cytology of clear cell carcinoma of the ovary

Objective:  To describe the cytomorphology of clear cell carcinoma (CCC) of the ovary in intraoperative samples of peritoneal fluid, imprint and scraping samples of the tumour tissue.

Morphometry and digital AgNOR analysis in cytological imprints of benign, borderline and malignant serous ovarian tumours.

Aim:  The aim of the study was to determine values of a quantitative morphometry analysis of nuclear characteristics and argyrophilic nucleolar organizer regions (AgNORs) in differential cytodiagnosis of benign, atypically proliferating (borderline) and malignant serous ovarian tumours.

HPV16 genotype, p16/Ki-67 dual staining and koilocytic morphology as potential predictors of the clinical outcome for cervical low-grade squamous intraepithelial lesions

To evaluate the association of human papillomavirus (HPV) 16 and non‐16 genotype, p16/Ki‐67 dual staining and koilocytosis and their role in the prediction of the clinical outcome of low‐grade squamous intraepithelial lesion (LSIL) cytology.

Serous borderline tumor of the fallopian tube presented as hematosalpinx: a case report

BackgroundCompared with their ovarian counterparts, serous borderline tumors of the fallopian tube are uncommon, with limited experience about their clinical behaviour. We present a case of serous borderline tumor of the fallopian tube with unusual presentation and summarise all the published cases to date.Case presentationA case of serous borderline tumor of the fallopian tube in a 34-year old patient is presented, incidentally found during routine gynecologic examination. At laparoscopy the tumor was unusualy presented as hematosalpinx and was treated by salpingectomy. Cell-cycle analysis of the tumor tissue revealed a diploid DNA content and a low S-phase fraction. There was no evidence of the disease during the follow-up period of 4.6 years.ConclusionThe current case and review of the literature suggest salpingectomy as the optimal treatment for patients with serous borderline tumor of the fallopian tube.

Frequency and distribution of lymph node metastases in epithelial ovarian cancer : Significance of Serous Histology

Background: The aim of this retrospective study was to evaluate the incidence and distribution of nodal metastases in relation to the serous versus nonserous histological subtypes of epithelial ovarian cancer. Methods: Patients were treated primarily with upfront surgery, including pelvic and para-aortic systematic lymphadenectomy, up to the level of the left renal vein, before any kind of chemotherapy administration. Patients were classified according the tumor histology into 2 groups: serous (including the cases of mixed histology with a serous component) and nonserous group. Results: A total of 173 patients fulfilled the inclusion criteria; 76 and 97 patients had serous and nonserous ovarian carcinoma, respectively. Positive lymph nodes were found in 59.3% (45/76) and 14.4% (14/97) of patients in the serous and nonserous histology groups, respectively. There was no difference in positive node distribution in 3 regions (pelvic and para-aortic regions, below and above the inferior mesenteric artery) between these 2 groups. Early spread including 1 or 2 positive lymph nodes was predominantly found in the para-aortic region in both groups, serous and nonserous, whereas distribution of positive nodes in patients with 3 or more lymph nodes shows equal presence in pelvic and para-aortic regions. Conclusions: Serous ovarian carcinomas are much more prone to metastasize to lymph nodes than nonserous histological types. However, the pattern of lymph node distribution did not differ between these 2 groups and was similar in the pelvic and para-aortic regions.

Treatment and outcome of stage Ia1 squamous cell carcinoma of the uterine cervix

To evaluate the treatment and clinical outcome of patients with FIGO stage IA1 cervical squamous cell carcinoma (SCC).

Novi model patogeneze karcinoma jajnika

Sažetak. Karcinom jajnika je vodeci uzrok smrti među zlocudnim novotvorinama ženskog spolnog sustava. Usprkos pokusajima razvoja programa probira s ciljem ranog otkrivanja bolesti, kao i novim terapijskim pristupima, mortalitet nije znacajno smanjen. Jedan od razloga ovog neuspjeha bio je slabo razumijevanje patogeneze karcinoma jajnika koji je smatran jedinstvenom bolescu. Nove spoznaje pokazuju da je karcinom jajnika vrlo heterogena bolest, koja se na temelju klinickopatoloskih karakteristika te molekularnih i genetickih promjena može podijeliti u dvije skupine: tip 1 i tip 2 tumori. Ovaj novi model patogeneze karcinoma jajnika danas ima važan klinicki i terapijski znacaj.

Procjena citomorfologije, HPV statusa i HPV 16 genotipa u predikciji ishoda bolesti kod pacijentica s citološkim nalazom ASCUS i LSIL

Cilj: Istražiti međusobnu povezanost i prognosticki znacaj HPV statusa (humani papiloma-virus), HPV 16 genotipa i citomorfologije kod pacijentica