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Genital Bleeding (genital + bleeding)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Primary relapse of acute lymphoblastic leukemia in a cervical smear: A case report

DIAGNOSTIC CYTOPATHOLOGY, Issue 7 2006
Akiko Ikuta M.D.
Abstract Uterine cervix and corpus are rarely the initial site of relapse in leukemia or lymphoma. We report herein a case of uterine cervical relapse with B-cell acute lymphoblastic leukemia (ALL). The patient, a 60-yr-old woman, had a history of ALL that had been in remission for 2 yr after chemotherapy. She presented with a chief complaint of genital bleeding. In a routine cervico-vaginal Papanicolau smear, abundant atypical lymphoid cells with round-to-oval nuclei, scant cytoplasm, and high nuclear to cytoplasmic ratios was observed. The nuclei of these cells had fine and dark chromatin and thickened nuclear membranes, with one or several nucleoli being visible. Biopsy under colposcope was performed, and a diagnosis of relapse of ALL was confirmed. The ongoing genital bleeding presented a problem with clinical management of the patient. It was decided to proceed with hysterectomy to end that problem and thereafter proceed with therapy directed against the leukemia. Our results suggest that in patients with known extrauterine cancer, the presence of malignancy in uterine cellular samples provides information regarding the extent of the neoplasm. Diagn. Cytopathol. 2006;34:499,502. © 2006 Wiley-Liss, Inc. [source]

Successful management of uterine arteriovenous malformation by ligation of feeding artery after unsuccessful uterine artery embolization

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2009
Daisaku Yokomine
Abstract Uterine arteriovenous malformation (AVM) is a rare and potentially life-threatening disease. The present report describes a postmenopausal patient with uterine AVM manifesting recurrent, massive genital bleeding. Uterine artery embolization (UAE) was scheduled before hysterectomy, but UAE was unsuccessful due to the dilated, tortuous internal iliac arteries, and extremely rapid arterial blood flow. Hysterectomy appeared to carry a potential risk of massive blood loss due to multiple dilated vessels around the uterine corpus and cervix. Therefore, six arteries feeding the uterus were surgically ligated. At 10 months after the operation there have been no episodes of atypical genital bleeding. [source]

Malignant transformation of atypical endometrial hyperplasia after progesterone therapy showing germ-cell tumor-like differentiation

PATHOLOGY INTERNATIONAL, Issue 6 2004
Masanori Yasuda
A 31-year-old woman was treated for atypical endometrial hyperplasia (AEH) with high-dose medroxyprogesterone acetate (MPA) therapy to preserve fertility. The AEH was found by repeated cytologic and histologic examinations to have completely disappeared with the therapy, but 3 years after her last follow up she required emergency surgery to treat severe genital bleeding. The hysterectomied uterus consisted mostly of poorly differentiated adenocarcinoma, G3 endometrioid type. Minor AEH was present in the exophytic area, in which some glands were cystically dilated. Part of the AEH had transformed into other histologic features with germ-cell-like differentiation, demonstrated by immunohistochemical positive reaction of placental alkaline phosphatase, alpha-fetoprotein, and human chorionic gonadotrophin. Recurrent AEH had undergone malignant transformation, resulting in the development of well- and poorly differentiated adenocarcinoma and tumor exhibiting germ-cell-like differentiation. The patient died of a massive tumor extension 7 months after surgery. The AEH before MPA therapy and the recurrent tumors had genetically different characteristics based on evidence of a loss of heterozygosity, detected at D8S1132 (chromosomal locus, 8q22.1) in the latter but not in the former, by analysis of genetic alterations using microsatellite markers. [source]

Accumulation of IL-17-Positive Cells in Decidua of Inevitable Abortion Cases

AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 1 2010
Akitoshi Nakashima
Citation Nakashima A, Ito M, Shima T, Bac ND, Hidaka T, Saito S. Accumulation of IL-17-positive cells in decidua of inevitable abortion cases. Am J Reprod Immunol 2010 Problem, Th17 cells, a new subset of helper T cells, have been focused on as a producer pro-inflammatory cytokines. It is, however, still unknown how Th17 cells affect pregnancy outcome. We investigated the expression of IL-17-producing cells in human spontaneous abortion. Method of study, IL-17 expression was analyzed in decidual tissues among normal pregnancy, missed abortion, and inevitable abortion cases by immunohistochemistry and flow cytometry. Results, IL-17+ cells were accumulated in decidua and were detected in decidual CD4+ T cells and few decidual CD8+ T cells in spontaneous abortion cases. The number of decidual IL-17+ cells in inevitable abortion cases involving active genital bleeding was significantly higher than that in normal pregnancy cases (P < 0.05). On the other hand, there were no significant differences in the numbers of decidual IL-17+ cells between missed abortion cases and normal pregnancy subjects. Furthermore, the number of IL-17+ cells was positively correlated with the number of neutrophils in spontaneous abortion cases. Conclusion, IL-17+ cells might be involved in the induction of inflammation in the late stage of abortion, but not in the early stage of abortion. [source]

Synchronous granular cell tumor of the bladder, endometrial carcinoma and endometrial stromal sarcoma

ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 1 2006
Yasuhiko KIYOZUKA
Abstract We describe a very rare case of synchronous granular cell tumor of the bladder, endometrial carcinoma and endometrial stromal sarcoma. A 55-year-old woman with a 4-month history of genital bleeding was cytologically diagnosed with endometrial carcinoma. Imaging studies suggested concomitant bladder tumor with the possibility of direct invasion from endometrial carcinoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy and transurethral resection of bladder tumor was performed. The bladder tumor comprised polygonal cells with abundant eosinophilic, finely granular cytoplasm, separated by collagenous tissue. Neither nuclear pleomorphism nor tumor necrosis was found. Immunohistochemical expression of neural markers of neuron-specific enolase and S-100 allowed the diagnosis of granular cell tumor (GCT) of the bladder. Microscopic examination of endometrium revealed endometrioid adenocarcinoma with squamous differentiation (EAC). Ill-defined nodular lesion comprising endometrial stromal sarcoma (ESS) was accidentally found in myometrium. Postoperatively, the patient underwent radiotherapy. This is the first well-documented case of synchronous triple tumors comprising GCT of the bladder, uterine EAC and ESS. [source]