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Re: abnormal pap From: Gail Waldby (gwaldby@willinet.net) Mon Oct 7 16:12:14 2002 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: RModugno@aol.com: "Re: abnormal pap" Previous message: Dr. Ainsworth: "abnormal pap" In reply to: Dr. Ainsworth: "abnormal pap" Next in thread: Dr. Ainsworth: "Re: abnormal pap" Reply: Dr. Ainsworth: "Re: abnormal pap" Cone or LEEP at hospital with at least IV sedation Sonography if not done already to look at Fallopian tubes Gail Waldby, MD Huron Clinic SD 10/7/2002 4:06:03 PM, ainsron@sbcglobal.net (Dr. Ainsworth) wrote: >74 yo lady with PMB, on HRT for over two years. Sonogram showed a >thickened endometrium, hysteroscopy showed benign polyps, w/squamous >metaplasia and simple hyperplasia, ecc was negative. Pap done at the >time of her preop exam returned two weeks later, showed abnormal cells, >suspicious for adenocarcinoma. Colposcopy was negative, except for >small, benign appearing polypoid growth on the cervix that was >pathologically benign. The ECC was negative. When the pathologist >reviewed all of the slides and paps at the same time, he felt the >abnormal pathology originated in the polyp that was removed at the time >of the hysteroscopy and was therefore there was no evidence of >malignancy. Never one to leave "well enough alone," I repeated the pap >at the time of the last colposcopy, of course it returned with the >comment, abnormal cells, appear to be glandular, suspect adenocarcinoma. > >Now what to do? This lady is a train wreck, severe COPD on oxygen >therapy 24/7, not a very good candidate for surgery, although she did >well with the hysteroscopy. She is not a good candidate for office >LEEP, her cervix is very difficult to visualize, even for a colpo, the >upper vagina tunnels in and it does not descend well at all. I'm >thinking that I should probably do a cone biopsy in the hospital, but >what if that is not diagnostic either? Who would vote for going directly >to TAH/BSO? Currently I'm waiting to hear back from a couple of gyn >oncs. > Next message: RModugno@aol.com: "Re: abnormal pap" Previous message: Dr. Ainsworth: "abnormal pap" In reply to: Dr. Ainsworth: "abnormal pap" Next in thread: Dr. Ainsworth: "Re: abnormal pap" Reply: Dr. Ainsworth: "Re: abnormal pap"

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