Concise Reporting of Benign Endometrial Biopsies is an Acceptable Alternative to Descriptive Reporting

In the United Kingdom, endometrial biopsy reports traditionally consist of a morphologic description followed by a conclusion. Recently published consensus guidelines for reporting benign endometrial biopsies advocate the use of standardized terminology. In this project we aimed to assess the acceptability and benefits of this simplified "diagnosis only" format for reporting non-neoplastic endometrial biopsies. Two consultants reported consecutive endometrial biopsies using 1 of 3 possible formats: (i) diagnosis only, (ii) diagnosis plus an accompanying comment, and (iii) the traditional descriptive format. Service users were asked to provide feedback on this approach via an anonymized online survey. The reproducibility of this system was assessed on a set of 53 endometrial biopsies among consultants and senior histopathology trainees. Of 370 consecutive benign endometrial biopsies, 245 (66%) were reported as diagnosis only, 101 (27%) as diagnosis plus a brief comment, and 24 (7%) as diagnosis following a morphologic description. Of the 43 survey respondents (28 gynecologists, 11 pathologists, and 4 clinical nurse specialists), 40 (93%) preferred a diagnosis only, with 3 (7%) being against/uncertain about a diagnosis only report. Among 3 histopathology consultants and 4 senior trainees there was majority agreement on the reporting format in 53/53 (100%) and 52/53 (98%) biopsies. In summary, we found that reporting benign specimens within standardized, well-understood diagnostic categories is an acceptable alternative to traditional descriptive reporting, with the latter reserved for the minority of cases that do not fit into specific categories. This revised approach has the potential to improve reporting uniformity and reproducibility

Psammocarcinoma of ovary with serous cystadenofibroma of contralateral ovary: a case report

<p>Abstract</p> <p>Introduction</p> <p>Psammocarcinoma of ovary is a rare serous neoplasm characterized by extensive formation of psammoma bodies, invasion of ovarian stroma, peritoneum or intraperitoneal viscera, and moderate cytological atypia. Extensive medlar search showed presence of only 28 cases of psammocarcinoma of ovary reported till date.</p> <p>Case presentation</p> <p>We herein report a case of psammocarcinoma of ovary with serous cystadenofibroma of contralateral ovary in a 55 year old Asian Indian female.</p> <p>Conclusion</p> <p>To the best of author's knowledge, ours is the rare case describing coexistence of this very rare malignant serous epithelial tumor with a benign serous cystadenofibroma of contralateral ovary.</p

Persistence of Fimbrial Tissue on the Ovarian Surface Following Salpingectomy

BACKGROUND: Salpingectomy is recommended as a risk-reducing strategy for epithelial tubo-ovarian cancer. The gold standard procedure is complete tubal excision. OBJECTIVE: To assess the presence of residual fimbrial/tubal tissue on ovarian surfaces following salpingectomy. DESIGN: Prospective analysis of patients undergoing salpingo-oophorectomy +/- hysterectomy for benign indications, early cervical cancer or low risk endometrial cancer at a UK National Health Service Trust. Salpingectomy +/- hysterectomy was performed initially, followed by oophorectomy within the same operation. Separately retrieved tubes and ovaries were serially sectioned and completely examined histologically. The main outcome measure was histologically identified fimbrial/ tubal tissue on ovarian surface. Chi-square/Fisher's exact tests evaluated categorical variables (SPSS-23). RESULTS: 25 consecutive cases (mean age= 54.8 years (SD=5.0), comprising 41 adnexae (9= unilateral, 16= bilateral) were analysed. 17 (68.0%), 5 (20.0%) and 3 (12.0%), procedures were performed by consultant gynaecologists, subspecialty/specialist trainees and consultant gynaecological oncologists respectively. 12/25 (48.0%) were laparoscopic and 13/25 (52.0%) involved laparotomy. 4/25 (16.0%, CI: 4.5%, 36.1%) patients or 4/41 (9.8%, CI: 2.7%, 23.1%) adnexae showed residual microscopic fimbrial tissue on the ovarian surface. Tubes/ ovaries were free of adhesions in 23 cases. Two cases had dense adnexal adhesions but neither had residual fimbrial tissue on the ovary. Residual fimbrial tissue was not significantly associated with surgical route or experience; (consultant= 3/20 (15%), trainee= 1/5 (20%), p=1.0). CONCLUSION: Residual fimbrial tissue remains on the ovary following salpingectomy in a significant proportion of cases and could impact the level of risk-reduction obtained