The present study reported a case of Synchronous Mucinous Metaplasia and Neoplasia of the Female Genital Tract (SMMN-FGT), which occurred in a 47-year-old woman. The patient complained of pelvic mass during a physical examination a month ago. Ultrasound examination found an anechoic spot in the left ovary and several anechoic spots were detected in the cervix. The patient underwent left adnexectomy and the left ovarian frozen section revealed a mucinous borderline tumor. Total abdominal hysterectomy and right salpingo-oophorectomy were subsequently performed. Microscopically, multifocal mucinous lesions were involved in the female genital tract, including bilateral ovarian mucinous borderline tumor, cervical and endometrial mucinous adenocarcinoma and the bilateral fallopian tube epithelium showed mucinous metaplasia. Immunohistochemistry revealed that the tumor cells of the ovary, cervix and endometrium expressed MUC6, exhibiting features of gastric-type differentiation. The Ki-67 proliferative index was ~10-70%. Cumulative evidence established SMMN-FGT as the final histopathological diagnosis with International Federation of Gynecology and Obstetrics stage I. Following surgery, the patient received a course of pelvic radiotherapy and survived for 16 months.
Objective To analyze the Bethesda System reporting rates, histological follow‐up, and HPV genotypes distribution of abnormal cytology in Anhui province of China. Methods According to the Bethesda Reporting System of Cervical Cytology (2014), a retrospective analysis of the cervical liquid‐based cytology (LBC) results, abnormal cytology with concurrent HPV genotype testing, and immediate histological follow‐up. HPV genotype testing was performed for 15 High‐risk types and 6 Low‐risk types. Immediate histological correlation results within 6 months after the LBC and HPV results. Results 6.70% of women with abnormal LBC results, and ASC/SIL was 1.42. The severe histological results in abnormal cytology were ASC‐US (18.58%), ASC‐H (53.76%), LSIL (16.62%), HSIL (82.07%), SCC/ACa (100.00%), AGC (63.77%). The total HPV‐positive rate in abnormal cytology was 70.29%, of which ASC‐US, ASC‐H, LSIL, HSIL, SCC/ACa, and AGC were 60.78%, 80.83%, 83.05%, 84.93%, 84.51%, 33.33%. The top three detected genotypes were HR HPV 16, 52, and 58. The most commonly detected genotype in HSIL and SCC/ACa was HPV 16. Of the 91 AGC patients, 34.78% were cervical lesions, and 42.03% were endometrial lesions. The HPV‐positive rate in the group of AGC‐FN was highest and lowest in the group of AGC‐EM. Conclusion The Bethesda System reporting rates of cervical cytology were all within the benchmark range of the CAP laboratory. HPV 16, 52, and 58 were the most common genotypes in our population, and HPV 16 infection has a higher degree of malignancy of cervical lesions. Among patients with ASC‐US results, HPV positive patients had a higher rate of biopsy‐detected CIN2+ than HPV negative patients.
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