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  1. It is more than uterine fibroids: Incidental discovery of adenoma malignum of the cervix
    Abada E
    Malays J Pathol, 2022 Dec;44(3):533-538.
    PMID: 36591722
    Adequate sampling of gross pathology specimens and attention to microscopic details is crucial in establishing the correct diagnosis in a patient, regardless of a benign pre-surgical diagnosis. Adenoma malignum is a rare HPV-negative variant of well-differentiated adenocarcinoma of the endocervix. It is difficult to diagnose in surgical pathology specimens due to its deceptively-benign appearance. This was a case of a 43-year-old woman with a history of menorrhagia and metrorrhagia and radiology interpretation of degenerating uterine fibroids. Pre-operative Pap testing and hysteroscopic dilatation and curettage were non-contributory. Following surgery, microscopic examination of the cervix revealed well-spaced, deeply-invasive, variably-sized glands with irregular outlines/haphazard arrangements, lined by cells showing mild to moderate cytologic atypia. These cells were positive for p53 and CK7 on Immunohistochemistry and Ki-67 showed a high proliferative index. Monoclonal CEA, calretinin, CD10, and P16 were all negative. A diagnosis of adenoma malignum stage pT1b2 was made. The patient was subsequently placed on platinum-based chemotherapy and is doing well 2 years after her diagnosis. Cases such as this, underscore the importance of adequately sampling surgical resection specimens, with careful attention to microscopic details as incidental pathologies may be unearthed which could have significant implications on a patient's clinical outcome.
    Matched MeSH terms: Cervix Uteri/pathology
  2. Fulltext Evaluating Nuclear Membrane Irregularity for the Classification of Cervical Squamous Epithelial Cells
    Tang JR, Mat Isa NA, Ch'ng ES
    PLoS One, 2016;11(10):e0164389.
    PMID: 27741266 DOI: 10.1371/journal.pone.0164389
    Pap test involves searching of morphological changes in cervical squamous epithelial cells by pathologists or cytotechnologists to identify potential cancerous cells in the cervix. Nuclear membrane irregularity is one of the morphological changes of malignancy. This paper proposes two novel techniques for the evaluation of nuclear membrane irregularity. The first technique, namely, penalty-driven smoothing analysis, introduces different penalty values for nuclear membrane contour with different degrees of irregularity. The second technique, which can be subdivided into mean- or median-type residual-based analysis, computes the number of points of nuclear membrane contour that deviates from the mean or median of the nuclear membrane contour. Performance of the proposed techniques was compared to three state-of-the-art techniques, namely, radial asymmetric, shape factor, and rim difference. Friedman and post hoc tests using Holm, Shaffer, and Bergmann procedures returned significant differences for all the three classes, i.e., negative for intraepithelial lesion or malignancy (NILM) versus low grade squamous intraepithelial lesion (LSIL), NILM versus high grade squamous intraepithelial lesion (HSIL), and LSIL versus HSIL when the span value equaled 3 was employed with linear penalty function. When span values equaled 5, 7, and 9, NILM versus LSIL and HSIL showed significant differences regardless of the penalty functions. In addition, the results of penalty-driven smoothing analysis were comparable with those of other state-of-the-art techniques. Residual-based analysis returned significant differences for the comparison among the three diagnostic classes. Findings of this study proved the significance of nuclear membrane irregularity as one of the features to differentiate the different diagnostic classes of cervical squamous epithelial cells.
    Matched MeSH terms: Cervix Uteri/pathology
  3. Squamous cell carcinoma cervix stage IIIB metastatic to oral cavity: A case report and literature review
    Purbadi S, Saspriyana KY, Rustamadji P
    Med J Malaysia, 2020 07;75(4):450-451.
    PMID: 32724016
    Metastatic cervical cancers to the oral cavity are uncommon. These metastases most commonly present as lesions of the jaw bones and the mandible. A 57-year-old female patient complained of mass lesion in her oral cavity after definitive treatment for squamous cell carcinoma of the cervix stage IIIB. On examination a swelling of 3cm in size was found on the left side of buccal vestibule adjacent to the lower canine tooth. Wide local excision was performed, and histopathology results showed a squamous cell carcinoma of moderate differentiation. She was continued with segmental mandibulectomy, supraomohyoid neck dissection and plate-screw reconstruction. Radiotherapy was given as an adjuvant therapy.
    Matched MeSH terms: Cervix Uteri/pathology*
  4. Fulltext Unusual finding of endocervical-like mucinous epithelium in continuity with urothelium in endocervicosis of the urinary bladder
    Cheah PL, Looi LM, Lee GE, Teoh KH, Mun KS, Nazarina AR
    Diagn Pathol, 2011;6:56.
    PMID: 21699710 DOI: 10.1186/1746-1596-6-56
    Endocervicosis in the urinary bladder is a rare benign condition. We present a case in a 37-year-old woman with classical clinical and pathological features of endocervicosis. The unusual observation of endocervical-like mucinous epithelium in continuity with the urothelium in addition to fully developed endocervicosis prompted immunohistochemical profiling of the case using antibodies to cytokeratins (AE1/AE3, CK19, CK7, CK5/6, CK20), HBME-1, estrogen receptor (ER) and progesterone receptor (PR) to assess the relationship of the surface mucinous and endocervicosis glandular epithelia. The surface mucinous epithelium, urothelium and endocervicosis glands were immunopositive for AE1/AE3, CK7 and CK19 while CK20 was only expressed by few urothelial umbrella cells. The surface mucinous epithelium was CK5/6 and HBME-1 immunonegative but showed presence of ER and PR. This was in contrast to the urothelium's expression of CK5/6 but not ER and PR. In comparison, endocervicosis glands expressed HBME-1, unlike the surface mucinous epithelium. The endocervicosis epithelium also demonstrated the expected presence of ER and PR and CK5/6 immunonegativity. The slightly differing immunohistochemical phenotypes of the surface mucinous and morphologically similar endocervicosis glandular epithelium is interesting and requires further clarification to its actual nature. The patient has remained well and without evidence of disease 18-months following transurethral resection of the lesion.
    Matched MeSH terms: Cervix Uteri/pathology*
  5. Endometrial and endocervical secretion: the search for histochemical differentiation
    Nieuwenhuizen L, Khalil MK, Venkatesh N, Othman NH
    Anal. Quant. Cytol. Histol., 2006 Apr;28(2):87-96.
    PMID: 16637511
    To determine the ideal histochemical stain to differentiate between non-neoplastic and neoplastic endocervix and endometrium.
    Matched MeSH terms: Cervix Uteri/pathology
  6. Fulltext Evaluation of PathTezt™, a Liquid-Based Cytology System
    Mohd Nafis NS, Mat Zin AA
    Asian Pac J Cancer Prev, 2021 Oct 01;22(10):3261-3266.
    PMID: 34711003 DOI: 10.31557/APJCP.2021.22.10.3261
    Liquid-based preparation (LBP) cytology is commonly used in most laboratories these days due to its convenience and reliable results for the cervical cancer screening program. The PathTezt™ Liquid-based Pap smear is a second-generation LBP, which uses a filter-based concentration technique in processing the sample.

    OBJECTIVE: This study was done to evaluate the cellular fixation, morphology, quality of smear in gynae cytology, and diagnostic interpretation of cervical cytological smears produced by the PathTezt liquid-based processor.

    MATERIALS AND METHODS: A total of 400 pap smear samples were taken and processed using the PathTezt 2000 processor. The slides were evaluated in terms of sample adequacy, percentage of the circle covered by epithelial cells, cellular distribution, obscuring factors, and cell fixation.

    RESULTS: About 95.25% (381) of the samples were satisfactory for the evaluation. In 19 (4.75%) of the samples, epithelial cells covered less than 50% of the circle. A sample with good cellular distribution was seen in 92% of the cases, while 354 (88.5%) samples showed minimal inflammatory background. Almost all the smears (95.75%) had no erythrocytes in the background. All smears showed good quality fixation features toward nuclear, cytoplasm, and microorganisms. The total performance rate was 99%.

    CONCLUSION: Although the PathTezt liquid-based processor is still new compared to other first-generation LBP, the smears produced by this method were of high quality and it was cost-effective.

    Matched MeSH terms: Cervix Uteri/pathology*
  7. Fulltext Clear cell adenocarcinoma of the cervix in a ten-year-old girl without prenatal diethylstilbestrol exposure
    Andi Asri AA, Lim BK, Lim YK, A Latiff L
    Singapore Med J, 2016 Aug;57(8):470.
    PMID: 27549741 DOI: 10.11622/smedj.2016138
    Matched MeSH terms: Cervix Uteri/pathology
  8. The prevalence and significance of high-risk human papillomavirus DNA test in southern Malaysia and Singapore
    Tay SK, Tay YK
    Aust N Z J Obstet Gynaecol, 2009 Jun;49(3):323-7.
    PMID: 19566569 DOI: 10.1111/j.1479-828X.2009.01000.x
    To investigate the prevalence of high-risk human papillomavirus (HPV) and its associated cytological abnormalities among women attending cervical screening clinics in southern Malaysia and Singapore.
    Matched MeSH terms: Cervix Uteri/pathology*
  9. Expression of p53, bcl-2 and Ki-67 in cervical intraepithelial neoplasia and invasive squamous cell carcinoma of the uterine cervix
    Looi ML, Dali AZ, Ali SA, Ngah WZ, Yusof YA
    Anal. Quant. Cytol. Histol., 2008 Apr;30(2):63-70.
    PMID: 18561741
    To assess the expression of p53, bcl-2 and Ki-67 in the progression of cervical neoplasia.
    Matched MeSH terms: Cervix Uteri/pathology
  10. Responses of female reproductive hormones and histopathology in the reproductive organs and associated lymph nodes of Boer does challenged with Corynebacterium pseudotuberculosis and its immunogenic corynomycolic acid extract
    Jesse FFA, Odhah MN, Abba Y, Garba B, Mahmood Z, Hambali IU, et al.
    Microb Pathog, 2020 Feb;139:103852.
    PMID: 31730998 DOI: 10.1016/j.micpath.2019.103852
    BACKGROUND: Corynebacterium pseudotuberculosis biotype ovis is a bacterium that causes caseous lymphadenitis (CLA), a chronic disease of sheep and goats characterized by the formation of suppurative abscesses in superficial and visceral lymph nodes and internal organs of small ruminants. This study was designed to evaluate the reproductive hormonal changes (estrogen and progesterone) and histopathology in the reproductive organs and associated lymph nodes of does challenged with C. pseudotuberculosis biotype ovis and its immunogen; corynomycolic acid. A total of 12 healthy non-pregnant female goats were grouped into three: A, B and C consisting of four does each. Group A was intradermally inoculated with 2 mL of sterile phosphate buffered saline (PBS) pH 7 (negative control group); group B was intradermally inoculated with 2 mL of corynomycolic acid extract (CMAs), while group C was intradermally inoculated with 2 mL of 10⁹ colony-forming unit (cfu) of live C. pseudotuberculosis. Blood samples were also collected at predetermined intervals for estrogen and progesterone hormonal assays. The does were euthanized 90 days post challenge and tissue samples of the uterus, ovaries, fallopian tubes, cervix and associated lymph nodes were collected and fixed in 10% neutral buffered formalin for histopathological processing. The result showed various degrees of histopathological changes (hemorrhage, congestion, degeneration, necrosis, edema, leucocytic infiltrations) in the reproductive organs and associated lymph nodes of both inoculation groups. Increases in estrogen hormone concentration were observed in both inoculation groups in comparison to the control group. However, progesterone concentration was only increased in group C. This study highlighted that corynomycolic acid extract from C. pseudotuberculosis biotype ovis resulted in significant histopathology in the reproductive organs and associated lymph nodes of does and increase estrogen concentration.
    Matched MeSH terms: Cervix Uteri/pathology
  11. Fulltext Gold-Hybridized Zinc Oxide Nanorods as Real-Time Low-Cost NanoBiosensors for Detection of virulent DNA signature of HPV-16 in Cervical Carcinoma
    Ramesh T, Foo KL, R H, Sam AJ, Solayappan M
    Sci Rep, 2019 Nov 19;9(1):17039.
    PMID: 31745139 DOI: 10.1038/s41598-019-53476-9
    Detection of host integrated viral oncogenes are critical for early and point-of-care molecular diagnostics of virus-induced carcinoma. However, available diagnostic approaches are incapable of combining both cost-efficient medical diagnosis and high analytical performances. To circumvent this, we have developed an improved IDE-based nanobiosensor for biorecognition of HPV-16 infected cervical cancer cells through electrochemical impedance spectroscopy. The system is fabricated by coating gold (Au) doped zinc oxide (ZnO) nanorods interfaced with HPV-16 viral DNA bioreceptors on top of the Interdigitated Electrode (IDE) chips surface. Due to the concurrently improved sensitivity and biocompatibility of the designed nanohybrid film, Au decorated ZnO-Nanorod biosensors demonstrate exceptional detection of HPV-16 E6 oncogene, the cancer biomarker for HPV infected cervical cancers. This sensor displayed high levels of sensitivity by detecting as low as 1fM of viral E6 gene target. The sensor also exhibited a stable functional life span of more than 5 weeks, good reproducibility and high discriminatory properties against HPV-16. Sensor current responses are obtained from cultured cervical cancer cells which are close to clinical cancer samples. Hence, the developed sensor is an adaptable tool with high potential for clinical diagnosis especially useful for economically challenged countries/regions.
    Matched MeSH terms: Cervix Uteri/pathology
  12. Fulltext Expression of P16 in high-risk human papillomavirus related lesions of the uterine cervix in a government hospital, Malaysia
    Krishnappa P, Mohamad IB, Lin YJ, Barua A
    Diagn Pathol, 2014;9:202.
    PMID: 25361681 DOI: 10.1186/s13000-014-0202-z
    Cervical cancer is one of the most common cancers affecting women worldwide. It is well established that human papilloma virus (HPV) infection is the prime risk factor in the development of cervical cancer. The current screening and diagnostic tests have limitations in identifying the range of lesions caused by HPV. The current study aims to evaluate the diagnostic value of p16 immunohistochemical (IHC) investigation in high-risk human papillomavirus (HR-HPV) related lesions of the uterine cervix in Hospital Tuanku Jaafar, Seremban, Malaysia.
    Matched MeSH terms: Cervix Uteri/pathology
  13. The road to cervical cancer elimination in Malaysia: Evaluation of the impact and cost-effectiveness of human papillomavirus screening with self-collection and digital registry support
    Keane A, Ng CW, Simms KT, Nguyen D, Woo YL, Saville M, et al.
    Int J Cancer, 2021 12 15;149(12):1997-2009.
    PMID: 34363620 DOI: 10.1002/ijc.33759
    The WHO has launched a global strategy to eliminate cervical cancer through the scale-up of human papillomavirus (HPV) vaccination, cervical screening, and cervical cancer treatment. Malaysia has achieved high-coverage HPV vaccination since 2010, but coverage of the existing cytology-based program remains low. Pilot studies found HPV self-sampling was acceptable and effective, with high follow-up rates when a digital registry was used, and recently the Malaysian Government announced plans for a national HPV-based screening program. We therefore evaluated the impact of primary HPV screening with self-collection in Malaysia in the context of Malaysia's existing vaccination program. We used the "Policy1-Cervix" modeling platform to assess health outcomes, cost-effectiveness, resource use and cervical cancer elimination timing (the year when cervical cancer rates reach four cases per 100 000 women) of implementing primary HPV testing with self-collection, assuming 70% routine-screening coverage could be achieved. Based on available data, we assumed that compliance with follow-up was 90% when a digital registry was used, but that compliance with follow-up would be 50-75% without the use of a digital registry. We found that the current vaccination program would prevent 27 000 to 32 200 cervical cancer cases and 11 700 to 14 000 deaths by 2070. HPV testing with a digital registry was cost-effective (CER = $US 6953-7549 
    Matched MeSH terms: Cervix Uteri/pathology
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