Medicinski Glasnik

Prevalence of cervical cytology abnormalities and its correlation with HPV infection among different age groups: Single institution five-year experience

<p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Aim </strong>to investigate the prevalence of cervical cytology abnormalities over five years and to correlate it with patient’s age and presence/absence of HPV infection.</p> <p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Methods</strong> Pap findings of 614 women with documented cervical abnormalities and Pap findings of HPV-positive women (regardless of whether the Pap test showed an intraepithelial abnormality) were included in this study.</p> <p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Results </strong>The majority of women included in the study (36.5%) were aged 30-39 years. The most common abnormalities included atypical squamous cells-ASC (47.4%) and low-grade intraepithelial lesions (LSIL)-15.1%. Out of 614 women, 270 (43.9%) were positive for HPV. HR HPV positivity was found in 256 (41.7%). The proportion of HPV infection positivity decreases with age, especially in the two oldest age groups (women older than 60), <em>p</em>=0.03. The analysis showed a higher ratio of Pap smear abnormalities in groups of patients older than 40 years of age (<em>p</em>=0.02). The youngest age group (patients younger than 20 years of age) showed no other lesions than ASC, while women younger than 40 had no SCC on Pap smear. (<em>p</em><0.01). Out of 256 HR HPV- positive women 42.2% (n=108) showed Pap abnormalities. HR HPV-positive women more commonly had HSIL lesions, but without statistical significance (<em>p</em>>0.05).</p> <p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Conclusion</strong> The results obtained contribute to the knowledge about HPV prevalence and the incidence of squamous cell abnormalities and confirm the necessity for further implementation of HPV vaccination and organized cervical cancer screening program on national level.</p> <p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Keywords:</strong> cervical dysplasia, Pap smear, screening</p>

Peritoneal and upper genital tract tuberculosis

<p><strong>Aim<br /></strong> To present diagnostic and therapeutic possibilities for genital and peritoneal tuberculosis, mimicking to other pathological conditions, mainly, ovarian cancer. <br /><strong>Methods <br /></strong>Transabdominal and transvaginal ultrasound, computerized tomography, Ca125 and HE 4, ROMA-index (Risk of Ovarian Maligancy Algorithm index) and diagnostic laparoscopy were performed in order to diagnose genital tuberculosis in a female patient. <br /><strong>Results:<br /></strong> A 23-year-old woman from Morocco presented with intermitting abdominal pain, unintentional weight loss and primary infertility. There was no positive family history for breast or ovarian cancer and no history of previous tuberculosis (TB). Elevated CA-125 level, HE 4 normal, ROMA-Index of 13.2 % suggested high risk for epithelial ovarian cancer (EOC). Ultrasound revealed free fluid, dilated fallopian tubes and a cystic mass near the right ovary. Suspecting fallopian tube or ovarian cancer, we performed exploratory laparoscopy, revealing adhesions, multiple miliary nodes and dilated fallopian tubes. Histological investigation revealed granulomatous abscessing salpingitis with suspicion of genital TB, so antituberculous therapy was administered with success. <br /><strong>Conclusion<br /></strong> Female genital tuberculosis is very rare but important in differential diagnosis and should be kept in mind regarding suspected fallopian tube or ovarian carcinoma to prevent women from extensive surgery. An algorithm for possible differentiation between peritoneal/female genital TB and EOC may be helpful in clinical setting.</p>