- Email: [email protected]
Pathological diagnosis of choriocarcinoma from endometrial scraping
Selected abstracts 399
Volume 80 Number 2
Journal of the Philippine Medical Association Vol. 35, December, 1959. *Sta. Cruz, J. Z.: The Pathological Diagnosis of Choriocarcinoma From Endometrial Scraping, p. 805. Sta. Cruz: Pathological Diagnosis of Chorio· carcinoma From Endometrial Scraping,
p. 805. The author reviewed 3,802 endometrial scrapings obtained during the 10 year period 1945-1955. The incidence of chorioma was 183 cases ( 4.8 per cent), of which 93 were hydatidiform mole, 57 were chorioadenoma destruens, and 33 were choriocarcinoma. The percentage of error in diagnosis from endometrial scrapings was as follows: 5 cases which were diagnosed as hydatidiform mole on curettings were found to be chorioadenoma destruens at hysterectomy-an error of 5.3 per cent. Six cases diagnosed as chorioadenoma on curettings were choriocarcinomas on hysterectomy, an error of 10.5 per cent. Two cases diagnosed as chorioadenoma on curettings werr later found to be syncytial endometritis, an error of 2.2 per cent. The author states the morphologic appearance of the cells themselves remains his main criterion for malignancy. In chorioadenoma destruens he looks for an irregularity of the trophoblastic layer in the periphery of the villus but, irrespective of the malignancy of the trophoblasts, the presence of intact chorionic villi makes the diagnosis chorioadenoma destruens or malignant mole. His criterion for diagnosis of chorionepithelioma in endometrial scrapings is the finding of anaplastic reaction of the trophoblastic cells with all the pleomorphic and mitotic nuclear changes. Richard J. Calame
Lancet Vol. 2, Sept. 5, 1959. *Nilsson, I. M., Bergman, S., Reitalu, J., and W aldenstrom, J.: Hemophilia A in a "Girl" With Male Sex-Chromatin Pattern, p. 264. *MacRae, D. J.: Monitoring the Heart of the Fetus and the Newborn, p. 266. Nilsson et al.: Hemophilia A in a "Girl" With Male Sex-Chromatin Pattern, p. 264. Although hemophilia ( antihemophiliac globulin deficiency) is transmitted by a sex-linked recessive gene, four instances of homozygous hemo-
philia resulting from the marriage of a hemophilic man to a woman who carried the disease have been reported. Also, the homozygous female dog has been found to have hemophilia. However, additional instances of apparently classical hemophilia have been reported previously in a girl of 2 years who had an unknown family history and in a girl of 11 years who had a negative family history. These latter seeming exceptions to strict sex-linkage have not been explained although Quick and Hussey (Lancet 1: 1294, 1958) suggested a possible mutation. The present report is concerned with a female child of 16 months who had always bruised easily and who had developed large hematomas which on one occasion caused the hemoglobin to fall from 11.2 Gm. per 100 mi. to 4.6 Gm. The child's mother was a known carrier of hemophilia A whose anti-hemophilic globulin activity (AHG) was 25 per cent. The child's father was normal ( AHG 115 per cent) without any family history of hemophilia. The child's coagulation time was prolonged to 120 minutes. The plasma AHG activity as determined by the recalcification method on hemophilia A plasma was 0.1 per cent. The hemophilia B factor content of the plasma was 60 per cent. These and other laboratory findings were identical with those obtainable in severe hemophilia A in males. Sex determination by means of studies of blood films and resting cells from skin were thought to indicate a male chromosomal pattern. Tissue cultures of skin showed 46 chromosomes and a probable XY sex chromosomal constitution. Inasmuch as none of the evidences of Turner's syndrome, such as digital abnormalities, webbed neck, heart disease, etc., were present in the patient, the genetic constitution XO seemed unlikely. It is possible, therefore, that seeming exceptions from sex-linked inheritance may in reality conform to the genetic pattern that would be expected.
David M. Kydd MacRae: Monitoring the Heart of Fetus and Newborn, p. 266. A device consisting of a sensitive small microphone that can be strapped to the abdomen of a pregnant woman and a selecting and amplifying soniscope is described. The impulses may be made to activate a loud-speaker, earphones, a flashing light, or a recording device. Continuous monitoring of the fetal heartbeat has proved useful in providing early evidence of fetal dis-
Volume 80 Number 2
Journal of the Philippine Medical Association Vol. 35, December, 1959. *Sta. Cruz, J. Z.: The Pathological Diagnosis of Choriocarcinoma From Endometrial Scraping, p. 805. Sta. Cruz: Pathological Diagnosis of Chorio· carcinoma From Endometrial Scraping,
p. 805. The author reviewed 3,802 endometrial scrapings obtained during the 10 year period 1945-1955. The incidence of chorioma was 183 cases ( 4.8 per cent), of which 93 were hydatidiform mole, 57 were chorioadenoma destruens, and 33 were choriocarcinoma. The percentage of error in diagnosis from endometrial scrapings was as follows: 5 cases which were diagnosed as hydatidiform mole on curettings were found to be chorioadenoma destruens at hysterectomy-an error of 5.3 per cent. Six cases diagnosed as chorioadenoma on curettings were choriocarcinomas on hysterectomy, an error of 10.5 per cent. Two cases diagnosed as chorioadenoma on curettings werr later found to be syncytial endometritis, an error of 2.2 per cent. The author states the morphologic appearance of the cells themselves remains his main criterion for malignancy. In chorioadenoma destruens he looks for an irregularity of the trophoblastic layer in the periphery of the villus but, irrespective of the malignancy of the trophoblasts, the presence of intact chorionic villi makes the diagnosis chorioadenoma destruens or malignant mole. His criterion for diagnosis of chorionepithelioma in endometrial scrapings is the finding of anaplastic reaction of the trophoblastic cells with all the pleomorphic and mitotic nuclear changes. Richard J. Calame
Lancet Vol. 2, Sept. 5, 1959. *Nilsson, I. M., Bergman, S., Reitalu, J., and W aldenstrom, J.: Hemophilia A in a "Girl" With Male Sex-Chromatin Pattern, p. 264. *MacRae, D. J.: Monitoring the Heart of the Fetus and the Newborn, p. 266. Nilsson et al.: Hemophilia A in a "Girl" With Male Sex-Chromatin Pattern, p. 264. Although hemophilia ( antihemophiliac globulin deficiency) is transmitted by a sex-linked recessive gene, four instances of homozygous hemo-
philia resulting from the marriage of a hemophilic man to a woman who carried the disease have been reported. Also, the homozygous female dog has been found to have hemophilia. However, additional instances of apparently classical hemophilia have been reported previously in a girl of 2 years who had an unknown family history and in a girl of 11 years who had a negative family history. These latter seeming exceptions to strict sex-linkage have not been explained although Quick and Hussey (Lancet 1: 1294, 1958) suggested a possible mutation. The present report is concerned with a female child of 16 months who had always bruised easily and who had developed large hematomas which on one occasion caused the hemoglobin to fall from 11.2 Gm. per 100 mi. to 4.6 Gm. The child's mother was a known carrier of hemophilia A whose anti-hemophilic globulin activity (AHG) was 25 per cent. The child's father was normal ( AHG 115 per cent) without any family history of hemophilia. The child's coagulation time was prolonged to 120 minutes. The plasma AHG activity as determined by the recalcification method on hemophilia A plasma was 0.1 per cent. The hemophilia B factor content of the plasma was 60 per cent. These and other laboratory findings were identical with those obtainable in severe hemophilia A in males. Sex determination by means of studies of blood films and resting cells from skin were thought to indicate a male chromosomal pattern. Tissue cultures of skin showed 46 chromosomes and a probable XY sex chromosomal constitution. Inasmuch as none of the evidences of Turner's syndrome, such as digital abnormalities, webbed neck, heart disease, etc., were present in the patient, the genetic constitution XO seemed unlikely. It is possible, therefore, that seeming exceptions from sex-linked inheritance may in reality conform to the genetic pattern that would be expected.
David M. Kydd MacRae: Monitoring the Heart of Fetus and Newborn, p. 266. A device consisting of a sensitive small microphone that can be strapped to the abdomen of a pregnant woman and a selecting and amplifying soniscope is described. The impulses may be made to activate a loud-speaker, earphones, a flashing light, or a recording device. Continuous monitoring of the fetal heartbeat has proved useful in providing early evidence of fetal dis-