Re: GYN: Atypical Endocervical Cells--followup
From: art fougner, md (evsono@pipeline.com)
Tue May 11 18:30:40 1999
come to think of it, just do HPV typing at next visit and see - if lo
risk, can simply repeat paps periodically.
Art
At Tue, 11 May 1999, Garry E. Siegel, M.D. wrote:
>
>I left the original posts below as a reminder.
>
>In the OR, her h-scope revealed a 1-2 cm object literally hanging from a
>thread on the anterior uterine wall that looked like an embryo that had
>halted development; it had what looked like a yolk sac, and my partner
>came in to look.
>
>Well, I did a pregnancy test on the spot (she had gotten Depo 1.5 months
>earlier, and hadn't menstruated since) which was negative (*note to
>others--if you are in a tight, get urine and have the office run over an
>office UCG--results in 10 minutes, not 30 like the hospital lab*).
>
>I went to change from the diagnotic h-scope to the operative one to
>retrieve it, and it was gone.
>
>The uterine cavity and endocervical canals were otherwise normal. I did
>endo curettings, then a "top hat" LEEP, and an ECC.
>
>The endo was negative, the ECC just clot, and the LEEP had adenoCa in
>situ, with a postive endocervical margin (and I went as deeply as I
>could).
>
>The gyn onc is having the slides reviewed for invasion, as he says
>sometimes it is missed. If in situ, I'll re-LEEP in 6 weeks.
>
>Garry
>
>At Mon, 26 Apr 1999, Garry E. Siegel, M.D. wrote:
>>
>>I am now at the office, and here are the reports:
>>
>>Referring pap, 2/99--abnormal smear, suspicious for endocervical
>>adenocarcinoma in situ.
>>
>>Pap by me 4/99--atypical endocervical cells of undetermined signficance.
>>
>>ECC--rare benign endocervical glands and many fragmented pieces of
>>endometrium. In areas the endometrial glands are arranged in small
>>papillary structures. The papillary structures are lined by epithelial
>>cells showing stratification. No nuclear atypia is seen. The patern is
>>suspicious for endometrial hyperplasia with papillary metaplasia. A
>>complete D and C and endocervical curettings are recommended.
>>
>>The original post is below.
>>
>>Garry
>>
>>At Sat, 24 Apr 1999, Garry E. Siegel, M.D. wrote:
>>>
>>>I don't have the info in front of me, but I've been meaning to post this
>>>for opinions; I may not have the exact wording just right (sorry):
>>>
>>>26 YO P0 referred from FP MD with a pap with atypical endocervical
>>>cells, suggestive of endocervical CIS (or something to that effect).
>>>
>>>Well, her colposcopy was adequate, no lesion; her ECC came back with
>>>endocervical cells and endometrial cells with atypia, and the
>>>pathologist recommended further endometrial and endocervical sampling.
>>>
>>>I plan to hysteroscope, D and C (ECC and endometrial), and then LEEP her
>>>cervix. What do ya'll think? Do I need to do the LEEP?
>>>
>>>Garry
>>>
>>>--
>>>Garry E. Siegel, M.D., FACOG
>>>Private Practice
>>>Roswell, Ga.
>>>
>>--
>>Garry E. Siegel, M.D., FACOG
>>Private Practice
>>Roswell, Ga.
>>
>--
>Garry E. Siegel, M.D., FACOG
>Private Practice
>Roswell, Ga.
>
--
art fougner, md
SonoScan/Genetic Sciences
forest hills, ny
evsono@pipeline.com
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