Zusam me nfassu ng Anhand eines eigene n Falles und einer Literaturiibersicht wird das seltene Krankheitsbild des placen tal site tr opho blas tic tumor vorgestellt. Placental Site Tro p hob lastic Tumo r From both an actual case as well as a literature rev iew. the ra re clinica l picture of a placent al site trop ho blastic tumo r is desc ribed. Einleitung Der placent al site tro pho blastic tum or (PSTT) ist c ine se ltene Neoplas ie, die bei Fra ue n im reprodukti ven Alter auftri tt. Erstma ls wu rde er 1976 von Kurmann bcsch rieben (5). Urspriinglich glaubte ma n, es han dle sic h urn einen gutartigen Tumor. doch zeigten Publikat ionen in den letzten Jah ren (2, 4, 7, 9), daB es auch tiidliche Verliiufe dieser Erkrankung gibt. An lIan d eines eigenen Falles mocht en wir dies es doch eh er unbekannte Krankheitshild vorstellen. Fallhericht Die 27jiihrige II. Para-II. Gravida suchte im Juni 1988 wegen eine r Amenorrho von 6 \Vochen einen Gynakologen auf. Da der Schw angerschaftstest im Uri n negativ war. wurde mit eine m Gestagen eine Abbru chblutung ausgelost. Ende Oktober 88 su cht e sie ih n erneut a uf. da eine Arnenorrho von 7 \Vochen aufgetreten war. Das Seru m-HCG betrug 34 IF .!1. Anfan g November 88 trat eine sta rke vag ina le Blutung auf, und da a nliiBlich der gyna kologische n Kontr olle 3 Tage sparer das Seru m-IICG negati v war. ste llte man die Diagnose etn es kompletten Abortes. Anfan g Dezember trat eine leichte vaginal e B1utungauf. die sich in der Paige verstiirkte. \Vegen neu aufgetr etenen Unte rba uchschme rze n meldete sich die Patientin aufunserer Notfallsta tion. Bei der klinisc he n Unte rsuchung fand sich eine leichte vaginaIe Blutung , der Zervlkalka na l war Ge burtsh. u. Fraucn heilk. 51 (9 9 1) 67-69
All practicable applications of fine-needle aspiration cytology (FNAC) for palpable tumors or non-palpable lesions guided with endoscopic and imaging procedures are presented. Multidisciplinary procedures and the technical and biological aspects of FNAC are presented. Indications and diagnostic challenges of FNAC on selected organs and neoplasms are discussed based on personal experience and the literature. Skilled and well-trained cytopathologists, the quality of the aspirate and the cytological preparation as well as supplementary immunocytochemical and molecular genetic analyses are mandatory for reliable diagnostic results. The indications and advantages of liquid-based techniques are discussed.
Operation, retroperitoneal lymphadenectomy, irradiation and chemotherapy may reduce the fertility potential of young male patients suffering from a malignant tumour. Prediction of the reversibility is difficult. Cryopreservation is a possibility to maintain the fertility of such patients. Unfortunately, the quality of the sperm is often reduced beforehand. The sperm motility is noticeably reduced by the freezing process. But the sperm preservation may help to reduce the psychological stress of the patients, thus improving their quality of life. Therefore, we recommend the use of the method liberally, although only few patients will make use of their sperm later. There has been no known teratogenicity to date. We report on our own experience with cryopreservation in 39 patients.
We report on our experience with the induction of labour using 0.5 mg of prostaglandin E2 gel (Cerviprost, Organon) intracervically. Out of 43 cases, 27 were primiparae. Indication for induction was: 10 post-term pregnancies, 9 PROM's > 24h, 12 foetal and 11 maternal indications. Mean Bishop score before induction was 3.1 and 9 hours later or at the beginning of regular contractions 6.7. In 9 of the 43 cases induction was unsuccessful. There were 23 spontaneous vaginal deliveries, 6 forceps and 5 Caesarean sections. Uterine hyperstimulation was found in 6 cases, 5 of which occurred during the first 16 inductions, and only one was seen during the following 27. A possible reason may be unrecognised extra-amniotic application of the gel. Intracervical prostaglandin seems to be an appropriate method not only for cervical ripening but also for induction of labour in cases with a low Bishop score. Although side effects are rare, sufficient monitoring and control of mother and foetus are mandatory.
The ABBI (advanced breast biopsy instrumentation) system has only recently been available for diagnostic excisional biopsy of small, non-palpable lesions of the breast. Between 1.1.1998 and 31.3.1999 this method was utilized in 40 patients with suspicious microcalcifications (n = 25), newly developed densities (n = 11) and a combination of microcalcifications and densities (n = 4). In 12 cases malignancy was diagnosed, in 11 cases a subsequent resection was performed. In every case sufficient tissue for diagnosis was obtained, in not a single case the diagnosis had to be revised in case of subsequent resection. Orientation within the specimen is accurate, the resection margins can be judged unequivocally. Any necessary special examinations can be performed on the resected tissue. In our experience, ABBI is a valuable and elegant tool for diagnosing small suspicious lesions of the breast.
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