In comparison with the available literature data, the presented case is the first to describe the association of hemangioma and dysplastic changes in the endocervical epithelium. Hemangioma was incidentally discovered in the histological sections of the material after the conization in a postmenopausal women.
Hysteroscopy is a safe, highly sensitive, precise diagnostic and operative endoscopic procedure. Our experiences and dilemmas open a field for discussion and offer salutations to everyday problems. The introduction of this procedure into out-patients conditions has contributed to the efficiency of the treatment of vaginal pathological processes, thus enabling that the method has become available to all gynecologists. This fact requires further study and new results.
Background / Aim: Functional imaging, including diffusion-weighted magnetic
resonance imaging (DWI MRI) and ADC map, provides promising results in
discrimination benign from malignant pelvic and inguinal lymph nodes in
patients with gynecological malignancies. Aim of the study was to assess
diagnostic performances of DWI in differentiation between benign and
malignant pelvic and inguinal lymph nodes in patients with gynecological
malignancies. Methods: The prospective clinical study was conducted at
Clinical Center of Vojvodina from 2013 to 2016, comprising 80 patients with
malignant gynecological tumors. Preoperatively, all patients underwent MRI
examination, followed by standard surgical treatment with complete pelvic
and/or inguinal lymphadenectomy. Histopathological examination of surgically
removed material and lymph nodes separated in pelvic and inguinal anatomic
groups was performed after the surgery. Results: The total of 2320 of lymph
nodes were mapped and histopathologically examined in 80 patients included
in the study. Metastases in lymph nodes were histopathologically confirmed
in 28 patients (35%). Measured ADC values were significantly lower in
metastatic (mean ? SD, ADC: 0.8725 x 10-3 mm2/s ? 0.0125) than benign lymph
nodes (mean ? SD, ADC: 1.116 x 10-3 mm2/s ? 0.1848; P=0.001). If ADC value
of 0.860 x 10- 3 mm2 / s is determined as a cut off value for discrimination
between benign and malignant lymph nodes, DWI sensitivity was 89%,
specificity 85% and overall accuracy was 86%. Combination of ADC value
criteria and size-based criteria yields MRI the following diagnostic
performances in discrimination between benign and malignant lymph nodes:
sensitivity 95%, specificity 92%, overall accuracy 92.5%, positive
predictive value 46% and negative predictive value 99.6%. Conclusion: DWI
MRI sequence is fast, simple, noninvasive method which aids significantly to
MRI diagnostic performances in discrimination between benign and malignant
pelvic and inguinal lymph nodes.
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