Summary Background Men who have sex with men (MSM) are at greatly increased risk of human papillomavirus (HPV)-associated anal cancer. Screening for the presumed cancer precursor, high-grade anal intraepithelial neoplasia (AIN), followed by treatment in a manner analogous to cervical screening, has been proposed. We aimed to assess available data for anal HPV disease that can inform pre-cancer screening programmes. Methods We searched PubMed, OVID Medline, and Embase for all studies published before Nov 1, 2011, that reported prevalence and incidence of anal HPV detection, AIN, and anal cancer in MSM. We calculated summary estimates using random-effects meta-analysis. Findings 53 studies met the inclusion criteria, including 31 estimates of HPV prevalence, 19 estimates of cytological abnormalities, eight estimates of histological abnormalities, and nine estimates of anal cancer incidence. Data for incident HPV and high-grade AIN were scarce. In HIV-positive men, the pooled prevalence of anal HPV-16 was 35·4% (95% CI 32·9–37·9). In the only published estimate, incidence of anal HPV-16 was 13·0% (9·6–17·6), and clearance occurred in 14·6% (10·2–21·2) of men per year. The pooled prevalence of histological high-grade AIN was 29·1% (22·8–35·4) with incidences of 8·5% (6·9–10·4) and 15·4% (11·8–19·8) per year in two estimates. The pooled anal cancer incidence was 45·9 per 100 000 men (31·2–60·3). In HIV-negative men, the pooled prevalence of anal HPV-16 was 12·5% (9·8–15·4). Incidence of HPV-16 was 11·8% (9·2–14·9) and 5·8% (1·9–13·5) of men per year in two estimates. The pooled prevalence of histological high-grade AIN was 21·5% (13·7–29·3), with incidence of 3·3% (2·2–4·7) and 6·0% (4·2–8·1) per year in two estimates. Anal cancer incidence was 5·1 per 100 000 men (0–11·5; based on two estimates). There were no published estimates of high-grade AIN regression. Interpretation Anal HPV and anal cancer precursors were very common in MSM. However, on the basis of restricted data, rates of progression to cancer seem to be substantially lower than they are for cervical pre-cancerous lesions. Large, good-quality prospective studies are needed to inform the development of anal cancer screening guidelines for MSM. Funding Australian Government Department of Health and Ageing.

https://www.thelancet.com/pdfs/journals/lanonc/PIIS1470-2045(12)70080-3.pdf

Anal human papillomavirus infection and associated neoplastic lesions in men who have sex with men: a systematic review and meta-analysis

Digital imaging in pathology has undergone an exponential period of growth and expansion catalyzed by changes in imaging hardware and gains in computational processing. Today, digitization of entire glass slides at near the optical resolution limits of light can occur in 60 s. Whole slides can be imaged in fluorescence or by use of multispectral imaging systems. Computational algorithms have been developed for cytometric analysis of cells and proteins in subcellular locations by use of multiplexed antibody staining protocols. Digital imaging is unlocking the potential to integrate primary image features into high-dimensional genomic assays by moving microscopic analysis into the digital age. This review highlights the emerging field of digital pathology and explores the methods and analytic approaches being developed for the application and use of these methods in clinical care and research settings.

/pdf/digital-imaging-in-pathology-whole-slide-imaging-and-beyond-4ermw42cxi.pdf

Digital imaging in pathology: whole-slide imaging and beyond.

Review of the current state of whole slide imaging in pathology

Sun, 30 Dec 2018 10:47:00 GMT bethesda system for reporting cervical pdf This book offers clear, up-to-date guidance on how to report cytologic findings in cervical, vaginal and anal samples in accordance with the 2014 Bethesda System Update. Sun, 30 Dec 2018 08:23:00 GMT The Bethesda System for Reporting Cervical Cytology ... May 2015â€”The value of standardized terminology for reporting cytology and histopathologyhas been essential in our work and important for patient care. The Bethesda System for Reporting Cervical Cytology, put forward in 1988 thanks to the pioneering work of Diane Solomon, MD, and Robert Kurman, MD,1 saw unprecedented adoption around the world. Wed, 26 Dec 2018 19:05:00 GMT Cytopathology and More | Inside the 2014 Bethesda System ... The Bethesda system (TBS) is a system for reporting cervical or vaginal cytologic diagnoses, used for reporting Pap smear results. It was introduced in 1988 and revised in 1991 , 2001, and 2014. The name comes from the location (Bethesda, Maryland) of the conference that established the system.Additionally, the Bethesda system is used for cytopathology of thyroid nodules Tue, 01 Jan 2019 06:48:00 GMT Bethesda system Wikipedia CONSENSUS STATEMENT The 2001 Bethesda System Terminology for Reporting Results of Cervical Cytology Diane Solomon, MD Diane Davey, MD Robert Kurman, MD Tue, 01 Jan 2019 13:36:00 GMT The 2001 Bethesda System: Terminology for Reporting ... The Cancer. The Bethesda System for Reporting Thyroid Cytopathology. Cancer. Thyroid. Thu, 27 Dec 2018 18:28:00 GMT The Bethesda System for Reporting Thyroid Cytopathology System Bethesda (ang. The Bethesda System, TBS) â€“ klasyfikacja obrazÃ3w cytologicznych uzyskanych rozmazÃ3w z pochwowej czÄTMÅ›ci szyjki macicy. KlasyfikacjÄTM zaproponowano w 1988 roku, nastÄTMpnie modyfikowano w 1991 i 2001 roku.. W klasyfikacji Bethesda obraz cytologiczny klasyfikuje siÄTM jako: Sun, 30 Dec 2018 15:54:00 GMT System Bethesda â€“ Wikipedia, wolna encyklopedia HKCOG GUIDELINES NUMBER 3 (revised November 2016) 4 the Bethesda System for Reporting Cervical Cytology. This has proven to be more reproducible and divides patients into two managerial subgroups [17-19]. Tue, 01 Jan 2019 18:01:00 GMT HKCOG Guidelines Number 4 Revised November 2016 Historically, abnormal changes of cervical epithelial cells were described as mild, moderate, or severe dysplasia. In 1988 the National Cancer Institute developed "The Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses." Sat, 29 Dec 2018 21:18:00 GMT Cervical intraepithelial neoplasia Wikipedia Coding for Path and Lab Screenings â€¢ 88141-88158 â€¢ Cervical or vaginal â€¢ Differ by screening method(s) used. â€¢ Methods â€“ Thin layer â€“ Slides Sun, 30 Dec 2018 01:21:00 GMT Coding for Obstetrics and Gynecology AAPC Bats and Rabies What you need to know about bats and rabies to keep you and your family safe. Annual Water Testing Test your well water once a year for bacteria and nitrates, and every 5 years for arsenic, fluoride, uranium, radon, lead, and manganese. Tickborne Diseases Learn the facts about tickborne diseases and the steps you can take to prevent them. Tue, 24 Dec 2013 23:58:00 GMT Maine Center for Disease Control & Prevention: DHHS Maine Role of NYS Primary Care Providers. For patients with HIV infection, primary care clinicians, including mid-level care providers, have a major role in the screening, diagnosis, and treatment of gynecologic comorbidities and especially cervical dysplasia and cervical

The Bethesda System for Reporting Cervical Cytology

Individuals with human immunodeficiency virus (HIV) infection are at increased risk for human papillomavirus-related squamous cell cancer of the anus. Screening HIV-infected patients for squamous cell cancer of the anus and human papillomavirus-related anal dysplasia may prevent excess morbidity and mortality. We have conducted a systematic review of the indirect evidence in the literature regarding the utility of anal Papanicolau (Pap) smear screening of HIV-infected individuals in the highly active antiretroviral therapy era. Although there are no published studies evaluating the efficacy of anal Pap smear screening for preventing squamous cell cancer of the anus or anal intraepithelial neoplasia, we reviewed data regarding the burden of disease, anal Pap smear sensitivity and specificity, the prevalence of anal dysplasia, and 1 cost effectiveness study. The available evidence demonstrates that HIV-infected individuals have an increased risk for squamous cell cancer of the anus and anal intraepithelial neoplasia. This review identifies important areas for further study before routine anal Pap smear screening can be recommended.

Screening HIV-infected individuals for anal cancer precursor lesions: a systematic review.

Anal smears are increasingly being used as a screening test for anal squamous intraepithelial lesions (ASILs). This study was undertaken to assess the usefulness and limitations of anal smears in screening for ASILs.

The Anal Pap Smear: Cytomorphology of squamous intraepithelial lesions.

Context.—ScanScope software can digitize entire cytology slides. Objective.—To test the feasibility of using virtual microscopy methods and “virtual Papanicolaou tests” for proficiency tes...

The use of virtual microscopy for proficiency testing in gynecologic cytopathology: a feasibility study using ScanScope.

Background.—Modern digital cameras can acquire images from cytologic slides at sufficient resolution to allow for digital enlargement and scrolling on a video monitor, allowing for the simulation of microscopy using a computer. Objective.—The purpose of this study was to develop a tool for proficiency testing in cytopathology using multiple digital images of Papanicolaou tests. Methods.—Nine images were photographed from each of 10 Papanicolaou tests at ×100 optical magnification, 3400 × 2300-pixel resolution, using a light microscope and a digital camera. All images from each case were tiled in a single canvas with Photoshop 4.0 software. Two cytopathologists and 3 cytotechnologists interpreted these “virtual slides” using a computer and graded diagnostic codes (PAP program, College of American Pathologists). Subjects were retested a year later using the glass slides from the same cases and routine microscopy. Both test results, by diagnostic code, were compared with the McNemar test of symmetry...

Virtual microscopy as a tool for proficiency testing in cytopathology: a model using multiple digital images of Papanicolaou tests.

There is an increased incidence of anal squamous carcinoma and its precursor lesions (anal intraepithelial neoplasia [AIN]) among persons who engage in anal-receptive sex. Analogous to cervical cancer screening, anal Papanicplaou (Pap) smears currently are used to screen these high-risk populations. Human papilloma virus (HPV) has been implicated in anal carcinoma pathogenesis and this study was performed to assess the potential role of HPV DNA testing as an adjunct to anal cytology. We correlated cytological diagnoses and HPV DNA (Digene Hybrid Capture [HC II] assay) in anal specimens collected in SurePath liquid medium from 118 patients; 54.8% of cases diagnosed as atypical squamous cells of undetermined significance (ASC-US) and 87.8% diagnosed as low-grade squamous intraepithelial lesion (LSIL) or above tested positive for high- risk HPV DNA (B+). High-grade SIL (HSIL) was present in 31 of the 51 patients with follow-up. Although a cytological diagnosis of ASC-US or above was a reliable indicator for AIN, cytology frequently did not accurately predict the grade of SIL in subsequent biopsy. Our findings suggest that reflex HPV DNA testing would be helpful in triaging patients diagnosed with ASC-US. However, patients diagnosed with LSIL or above should go directly to ansocopic biopsy.

Anal cytology: is there a role for reflex HPV DNA testing?

Immunologic studies demonstrate that non-Hodgkin’s lymphomas are derived predominantly from B- or T-lymphoid cells, while node-based tumors of true histiocytic derivation are rare, with few documented cases. This report describes the clinical, histologic, immunohistochemical, and ultrastructural features of two cases of node-based true histiocytic lymphoma. Distinctive ultrastructural features included numerous cytoplasmic lysosomes, surface microvillous processes, and occasional cell junctions, and the cells stained strongly for alpha napthyl acetate esterase and alpha one-antitrypsin. Since there are few specific histologic features, special technics may be essential in confirming the diagnosis of true histiocytic lymphoma, and determining appropriate therapy.

Premi Thomas

Papers

The Anal Pap Smear: Cytomorphology of squamous intraepithelial lesions.

The use of virtual microscopy for proficiency testing in gynecologic cytopathology: a feasibility study using ScanScope.

Virtual microscopy as a tool for proficiency testing in cytopathology: a model using multiple digital images of Papanicolaou tests.

Anal cytology: is there a role for reflex HPV DNA testing?

True Histiocytic Lymphoma: An Immunohistochemical and Ultrastructural Study of Two Cases