Granülomatöz servisit: Servikovajinal sitoloji ile tanı konan iki olgu
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Date
2012-06-18
Authors
Küçük, Şirin
Dağlı, A. Ferda
Cihangiroğlu, Gülçin
Akpolat, Nusret
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Granülomatöz servisitler serviksi ender tutan, hem enfektif hem de enfeksiyöz etkenler dışında nedenlerle oluşabilen lezyonlardır. Granülomatöz servisitlerin dünyada bildirilen en sık sebebi tüberkülozdur. Enfeksiyon etkenlerinin çoğu antimikrobiyal ajanlara duyarlı olduğundan genellikle tanı için servikal biyopsi yapılmaz. Bu nedenle granülomatöz servisitin hem histolojik hem de sitolojik bulgularıyla ilgili bilgilerimiz kısıtlıdır. Birinci olgu; karın ağrısı, dispepsi ve vajinal akıntı şikayetleriyle kliniğe başvuran 52 yaşında kadın hasta. İkinci olgu; sekonder infertilite, adet düzensizliği ve dismenore şikayetleriyle kliniğe başvuran 29 yaşında kadın hasta. Her iki olgunun jinekolojik muaynesinde servikal erozyon görülerek servikal smear alındı. Servikal yaymaların sitopatolojik incelemesinde çok sayıda yer yer multinükleer dev hücre oluşturmuş histiyosit gruplarına rastlandı. Bazı alanlarda ise epiteloid histiyositlerden meydana gelen granülom yapıları dikkati çekti. Bu bulgular ışığında her iki olguya da granülomatöz servisit tanısı verildi. Serviksin granülomatöz enfeksiyonlarının ender görülmesi ve bu konuyla ilgili bilgilerimizin kısıtlılığı yanlış pozitif ve negatif sonuçlar vermemize neden olabilir. Bu nedenle, özellikle multinükleer dev hücrelerin varlığı granülomatöz servisit için uyarıcı olmalıdır.
Granulomatous cervicitis consists of lesions which rarely involve the cervix and which mayarise from infective as well as non-infective causes. The most commonly reported cause of granulomatous cervicitis is tuberculosis. Since most infective agents are susceptible to antimicrobials, cervical biopsy is not usually conducted for diagnosis. Therefore, we have limited information on histological and cytological signs of granulomatous cervicitis. The first case was a 52-year-old female patient who presented at the clinic complaining from abdominal pain, dyspepsia and vaginal flow. The second case was a 29-year-old female patient who presented at the clinic complaining from secondary infertility, irregular menses and dysmenorrhea. Cervical smears were collected from both patients upon observation of cervical erosion during gynecological examination. Cytopathological examination of cervical smears showed groups of histiocytes, which occasionally formed multi-nuclear giant cells in large numbers. Granuloma structures composed of epitheloid histiocytes were noted in some areas. Both cases were diagnosed as granulomatous cervicitis upon these findings. The fact that granulomatous infections of the cervix are rare and our knowledge on this topic is limited may produce false positive and false negative results. Therefore, presence of multi-nuclear giant cells should be considered as an alarming sign for granulomatous infections.
Granulomatous cervicitis consists of lesions which rarely involve the cervix and which mayarise from infective as well as non-infective causes. The most commonly reported cause of granulomatous cervicitis is tuberculosis. Since most infective agents are susceptible to antimicrobials, cervical biopsy is not usually conducted for diagnosis. Therefore, we have limited information on histological and cytological signs of granulomatous cervicitis. The first case was a 52-year-old female patient who presented at the clinic complaining from abdominal pain, dyspepsia and vaginal flow. The second case was a 29-year-old female patient who presented at the clinic complaining from secondary infertility, irregular menses and dysmenorrhea. Cervical smears were collected from both patients upon observation of cervical erosion during gynecological examination. Cytopathological examination of cervical smears showed groups of histiocytes, which occasionally formed multi-nuclear giant cells in large numbers. Granuloma structures composed of epitheloid histiocytes were noted in some areas. Both cases were diagnosed as granulomatous cervicitis upon these findings. The fact that granulomatous infections of the cervix are rare and our knowledge on this topic is limited may produce false positive and false negative results. Therefore, presence of multi-nuclear giant cells should be considered as an alarming sign for granulomatous infections.
Description
IV. Ulusal Sitopatoloji Kongresi’nde poster olarak sunulmuş ve 3.'lük ödülü almıştır.
Keywords
Granülomatöz servisit, Servikovajinal, Sitoloji, Granulomatous cervicitis, Cervicovaginal, Cytology
Citation
Küçük, Ş. vd. (2012). "Granülomatöz servisit: servikovajinal sitoloji ile tanı konan iki olgu". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 38(2), 153-156.