Patients younger than 71 years, with a good performance status and slowly growing tumours confined to the thyroid, and without distant metastases, had the best prognosis.
Fine needle aspiration biopsies (FNA) of 47 Warthin's tumours confirmed by histology were re-evaluated for cytomorphological findings. The majority of aspirates (37/47) contained a typical background with proteinaceous substance and cell debris, along with cellular elements represented by oncocytic, lymphoid, and mast cells with degranulated cytoplasm. Uncommon cellular findings were true squamous cells (1/47), atypical cells with vacuoles (1/47), osteoclastic giant cells (1/47), epithelioid cells (1/47), mast cells with preserved granules in cytoplasm (3/47), and siderophages (4/47). Uncommon findings in the background were corpora amylacea-like structures and homogeneous bright red droplets. Squamous cells and atypical cells with vacuoles caused diagnostic difficulties in distinguishing a Warthin's tumour from a squamous cell or mucoepidermoid carcinoma. However, other unusual cellular and background findings were not worrying; therefore, they are merely regarded as a curiosity in the cytomorphological appearance of the tumour.
Background
The COVID-19 pandemic threatens the impact of cervical cancer screening and global cervical cancer elimination goals. As cervical cancer screening programmes were adjusting to the new situation, we evaluated the intensity, quality, and outcomes of cervical cancer screening in Slovenia in the first seven months of the pandemic.
Methods
Historical observational study on data from a population-based cervical cancer screening registry. Number of cervical cytopathology (screening and follow-up), histopathology (diagnostic procedures, invasive procedures and number of newly diagnosed CIN2+ cases) and HPV test results from the entire Slovenian women population between January 1st and September 30th 2020 were compared to a three-year average of the years 2017–19.
Findings
A two-month screening lock-down between March 12th and May 8th 2020 resulted in an epidemic deficit of screening (-92%), follow-up (-70%), and HPV triage tests (-68%), as well as invasive diagnostic (-47%) and treatment (-15%) of cervical lesions. Time to diagnosis and treatment did not increase; times to laboratory results fluctuated but stayed within standards. Slovenia has entered the second epidemic intending to add as little as possible to the pandemic deficit of screening smears (-23%) and yearly CIN2+ cases (-10%). Women aged 30–39 were most affected, with the highest pandemic deficit of screening smears (-26%) and yearly CIN2+ cases (-19%).
Interpretation
The pandemic has deeply affected all levels of our lives. New vulnerable groups and inequalities have emerged that require recognition and action. To prevent long-term increases in the cervical cancer burden due to the COVID-19 pandemic, it is crucial that organised screening is maintained and monitored in settings where it can be safely and comprehensively provided.
Funding
None.
TIC is a simple, quick, and sensitive method of intraoperative SLNs evaluation for the presence of the macrometastases. TIC has a very limited value in detecting micrometastases and no value in detecting ITC. TIC may not be indicated in T1a + b tumors.
The aim of this study was to evaluate the ability of axillary ultrasound (US) and US-guided fine-needle aspiration biopsy (FNAB) to detect axillary LN metastases. Between January 2001 and September 2003, axillary US was performed in 165 patients with cytologically or histologically proven breast cancer and clinically non-palpable axillary LNs. In patients with US suspicious LNs, US-guided FNAB was performed and patients with cytologically proven malignant LNs proceeded directly to the ALND. In 49/90 patients with US suspicious LNs, US-guided FNAB was performed. It was positive in 33/49 patients. Definitive histology report revealed LN metastases in 65/165 patients. The sensitivity, specificity, positive and negative predictive value of the US-FNAB, were 84, 91, 97 and 62%. Axillary US in a combination with US-FNAB is a valuable method in preoperative staging of patients with breast cancer. Almost 50% of patients with LN metastases can be spared the second operation. However, it is very much operator-dependent and equipment-dependent.
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