Tehran University Medical Journal

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It this prospective cross sectional study out-patient endometrial biopsy by PIPELLE was compared with diagnostic curretage (D&C) in patients suffering of Abnormal Uterine bleeding (AUB). Diagnostic accuracy, sufficient tissue sampling, intensity of pain and effective factors in biopsy results were the evaluated parameters in this study. In 70 patients with complaint of AUB (20 of them were post-menoupsal age admitted in hospital for D&C) endometrial biopsy was conducted by PIPELLE before operation and the results were compared. 96% of total patients (67) and 91% of patients with post menopause age had tolerance of undergoing out-patient PIPELLE biopsy of endometrium. 79% of these individuals complained of mild pain and 21% of moderate pain. Endometrium biopsy by PIPELLE in 77% of patients had similar accurate diagnostic results as compared to D&C. PIPELLE in 34% of patients (24) could not be conducted with the same accuracy of D&C patients, although in 14 (20%) of them, notissue samples could be collected by D&C. In none of these methods endometrial hyperplasia or endometrial cancer were detected. This study showed that in 77% of the total patients, the extra cost and general anesthetical risk of D&C could have been eliminated, by utilization of out-patient biopsy with PIPELLE

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Nodules in the thyroid have always commanded a great deal of attention because of the fear of their being cancerous. The estimated incidence of thyroid nodules in children and young adults is about 0.22 to 1.8 percent. According to different epidemiological data, about 10 to 35 percent of thyroid cancers occur in the first two decades. The present study based on microscopic review of tissue slides obtained from thyroid nodules in cancer institute during 24 years focusing on malignant lesions in the mentioned age group revealed the following results: The average age of patients was 16.5. The female to male ratio is about 3.3/1 (76.7 percent female and 23.3 percent male). About 84 percent of thyroid nodules were benign with the following incidence of different morphologic features: nodular goiter 78.6 percent, follicular adenoma 1.96 percent, 16 percent of thyroid nodules were malignant with the following incidence of different morphologic variants: papillary CA 91.3 percent, follicular CA 3.5 percent and medullary CA 5.2 percent. Papillary carcinoma as the predominant from of thyroid cancer was accompanied by unilateral cervical lymph node metastasis in 53.8 percent of cases and distant metastasis (to lung) just in one case. According to major variation of papillary carcinoma, we found the classic type in 33 cases, the follicular variant in 18 cases and micro carcinoma in one case. Based on the above results once again we reach this belief that every thyroid nodule especially in children and young adults demands careful appraisal.

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Background: The aim of this investigation is to evaluate the histologic results of biopsy in women with atypical squamous cells of undetermined significance (ASCUS) cytologic diagnosis.

Materials and Methods: We reviewed a series of cases with ASCUS pap smears from March 1999 to Feb 2002 in Imam Khomeini Hospital (n= 104), Who had cervical biopsy indirected colposcopy (103) and in Onec endocervical biopsy obtained without colposcopy. In 60 patients before colposcopy and biopsy repeat pap smear was tabled.

Results: Biopsy revealed 28.8% SIL (14 LSIL and 16 HSIL), 1 invasive carcinoma and 1 endometrial carcinoma. Pap smear repeated for 60 women before colposcopy examination, which 7 (11.7%) of them were normal. ASCUS persisted in 45 cases (75%) and 8 cases (13.3%) turned out to be SIL (6 LSIL, 2 HSIL) of 7 normal repeat smear, 2 marked as LSIL by biopsy. In colposcopic examination 22 of 103 (21.4%) had normal view which one of them was LSIL histologically.

Conclusion: Based on these findings, it seems immediate colposcopy and directed biopsy are appropriate procedures for management of ASCUS and to detect underlying SIL.