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Re: abnormal pap From: Efrain Ramirez (eramirezt@coqui.net) Mon Oct 7 18:09:45 2002 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Kathi Wilson: "Re: OB: PROM at term**outcome" Previous message: Garry E. Siegel, M.D.: "Re: OB: PROM at term**outcome" In reply to: Dr. Ainsworth: "abnormal pap" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: abnormal pap" Cone biopsy - AND very good point by Gail -- >At Mon, 7 Oct 2002, 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. -- "Life is neither the notes nor the silence between the notes, but the music that arises out of sound and silence felt as a living whole. Stop choosing...between chaos and order, and live at the boundary between them, where rest and action move together..." David Whyte Next message: Kathi Wilson: "Re: OB: PROM at term**outcome" Previous message: Garry E. Siegel, M.D.: "Re: OB: PROM at term**outcome" In reply to: Dr. Ainsworth: "abnormal pap" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: abnormal pap"

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