This report describes a rare case of uterine cervical stromal sarcoma in a virgin 22 years old girl before sexual experience. She admitted for recurrent pyelonephritis and pelvic mass (vaginal origin). Pathologic exam revealed myoma with low mitosis. The mass recurred after a year and the pathological diagnosis was low grade spindle cell sarcoma. Immunohistochemical staining showed stromal sarcoma. Hysterectomy was carried out. In a 30 months follow up after the primary diagnosis, the patient showed recurrence of pelvic symptoms.

Introduction: Today, cancer of the CERVIX has been considered a preventable cancer due to its long pre- invasive state, availability of cervical cytology screening programs, and effectiveness of the treatment of preinvasive lesions. Due to slow progression of cervical cancer lesions, Pap smear is an efficient procedure for cancer detection and decreases mortality.Objective: The objective of this study is to compare the quality of Papsmear before and after cervical cleaning in females referred to Alzahra Hospital.Materials and Methods: This is a before – after clinical trial. Subjects were sampled by nonprobability convenience method. Inclusion criteria were absence of vaginal bleeding, infection, pregnancy, coitus and vaginal douching during past 48 hrs. After obtaining informed consent, two cytologic smears were taken by cytobrush (Cervex-Brush) before and after cervical cleaning by sterile cotton. Both smears were fixed, Coded and send to a special laboratory immediately. They were taken by a resident and were reported by a pathologist. After data collection analysis carried out with X2, X2 Mantel Hanszell, statistical software SPSS.10 was used.Results: In this study, 152 patients had met inclusion criteria .The mean age of women was 39.6±11.2yrs (range 17-65 yr). Before cleaning, there were 39 (25.7%) satisfactory versus 101 (66.4%) after cleaning (P<0.0001). There were 22 (14.5%) unsatisfactory smears before cleaning versus 10 (6.6%) after it (P=0.0025). Before cleaning 15 (9.9%) of smears were poor cellular although 4 (2.6%) of smears was poor cellular after procedure (P= 0.009). Before cleaning, we had 1 (0.7%) smear with epithelial abnormality, which were increased by 7 (4.6%) after (5 ASCUS-1 AGUS-1 CIN-I) (P=0.032).Conclusion: Pap smear sampling after cervical cleaning increases the quality of smears and is recommended. Due to similar standard results in other sites of the world, we advocate this procedure for accuracy improvement.

Introduction: The preinvasive cervical lesions are increased appreciately in recent years. Early diagnosis and management of abnormal pap test has an effective role in prevention of invasive cervical carcinoma and its related mortality. The aim of this study was to assess the prevalence of intraepithelial dysplasia and to compare colposcopic- histologic results in patients with minimally abnormal papanicolaou smears (ASCUS, nuclear enlargement, low-grade SIL and atypical metaplasia). Objective: The aim of this study was to assess the prevalence of intraepithelial dysplasia and compare colposcopic-histologic results in patients with minimally abnormal papanicolaou smears (ASCUS, nuclear enlargement, low-grade SIL and atypical metaplasia). Materials and Methods: This research was a cross-sectional study that evaluated patients presenting with minimally abnormal pap test to Gynecology Clinic in Alzahra Hospital (Rasht) from June 1998 to December 1999. All patients underwent colposcopy and biopsy due to suspicious lesions immediately. The results were analyzed with X2 test to calculate differences between the two reports of colposcopy and pap test. Results: Out of a research sample consisting of 70 people, 49 patients (70%) had histologic SIL (LSIL and HSIL. Histologic intraepithelial lesions were found in 14 patients out of 21 cases (66.6%) of ASCUS group. Among them, one patient was with HSIL and 13 patients were with LSIL. In a total of 18 patients with a positive result of nuclear enlargement pap test, 12 cases (66.6%) were with intraepithelial lesions (2 patients with HSIL and 10 patients with LSIL. In a total of 19 patients with a positive result of intramenopausal and atypical metaplasia in pap smear test, 12 cases (63.2%) had LSIL. Out of 12 patients with positive pap smear result of LSIL, 10 cases (83.3%) were with intraepithelial lesions (3 with HSIL, 7 with LSIL). Conclusion: Considering the observation of histologic intraepithelial lesions with a high grade in patients with pap smear result of LSIL and nuclear enlargement profile at the age of 30 and above and with regard to ASCUS at the ages below 30, colposcopy and biopsy are suggested when there is a well-equipped center.

Introduction: Despite the significant relationship between human papillomavirus 16 and 18 subtypes and severe cases of cervical cancer, the assessing the frequency of high-grade cervical intraepithelial NEOPLASMS in the patients infected with high-risk human papillomavirus other than 16 and 18 has been less studied in Iranian population. Methods: In this cross-sectional study, the patients referred to Oncology Clinic of Shahid Beheshti Hospital in Isfahan, Iran were selected by positive HPV-typing test through Cobas HPV test and high-risk papilloma virus in 2018 by convenience sampling method. Pap smear was first taken from the patients in the usual way, then they underwent colposcopy, and a biopsy was performed on the lesion during colposcopy. If colposcopy was normal, biopsies were randomly taken from 4 quadrants (12, 3, 9, 6 hours) and, if necessary, endocervical curettage was performed. Samplings were taken by the pathologist of the study center and the prevalence of CIN2 and CIN3 was reported. ANOVA test was performed to compare quantitative variables. Chi-square test was used to compare qualitative variables. SPSS version 17 software was used for statistical analysis of data. Significance level was considered less than 0. 05. Results: In this study, 105 individuals with high-risk HPV other than 16 and 18 were evaluated. In the biopsy performed according to the standard diagnostic method, the prevalence of severe form of precancerous lesions (CIN 2, 3) was 9. 6% and the most common types of HPV in the patients with CIN 2, 3 were 52 with a frequency of 40% and type 58 with a frequency 30%. Conclusion: Due to the significant prevalence of severe (precancerous) lesions in these patients, it is necessary to review the current protocols.

Introduction: HPV types 16 and 18 cause 70% of cervical cancer around the world. Approximately, in 70-50% of women HPV 16 and 18 antibodies are produced after-acquired infection. These antibodies remain for at least 4-5 years.Objective: This study aimed to determine antibody levels in the serum of patients with cervical cancer, CIN I,II,III in pap smears and its association with cervical abnormalities in sexually active women with no history of cervical abnormalities, respectively.Materials and Methods: In this case-control study, 70 patients referred to the clinic of gynecological oncology in Al-Zahra hospital from 2007 to 2014 were enrolled. They were divided into 3 groups. The first group of patients have biopsy of cervical cancer, the second group who have Pap smear with CIN I,II,III results and in fact with premalignant lesions. The third group had normal Pap smear for malignant or premalignant lesions. From all of the groups, 5 cc blood samples were taken. Using ELISA kit for HPV-16 and HPV-18, the level of antibodies against HPV high-risk was measured. Demographic data including age, marital status, smoking, family history of cancer, age at menarche, menopausal status, parity, contraceptive method, Parity, history of sexually transmitted infections and history of contraceptive pills consumption for more than a year were recorded.Results: Patients with cervical cancer and pre-malignant disease had a mean age of 30.8±6.45 years. The mean age of healthy patients was 45.6±8.30 y/o. The difference between the three groups’ HPV18 antibody levels in healthy individuals, patients with biopsy results CIN I,II,III and cervical cancer patients was statistically significant (P=0.047). HPV18 antibody levels between the two groups of patients with cervical cancer, and biopsy results in patients with CIN I,II,III, was not statistically significant. But the difference between healthy subjects and patients with cervical cancer was statistically significant (P=0.034). The mean level of HPV16 antibodies in patients with biopsy results CIN I,II,III and cervical cancer patients was statistically significant (P=0.046). The difference between two groups of healthy individuals and patients with biopsy results CIN I,II,III was on the borderline (p=0.043). Also, there was no statistically significant difference between the mean level of HPV 16 antibodies in patients with cervical cancer and patients with biopsy results CIN I,II,III (P=0.476).Conclusion: The study showed that antibodies against HPV 16 and less HPV18 produced following the acquisition of infection, reduces the risk of cervical cancer and abnormalities.

Papanicolau test (smear), is a simple, painless test most commonly to detect cancer of uterus and CERVIX; often called Pap test or smear. The present research is a quasi-experimental study conducted for the purpose of studying the effect of teaching pap smear procedures by midwives working in health centers in Semnan province. The number of smears before and after education of Pap smear procedure has been 950 and 900 sample respectively. Two questionnaires were used the first one included demographic characteristics of midwives and the second consisted of two, one for history of those refered for pap smear and the other part for quality of obtained sample. The findings showed that there is significant difference between unsatisfactory results in before and after the education (P<0.001). The ratio of "Inadequate" results before education were 19.58 percent and after education were 5.78 percent (P<0.001). The Ratio of "Bad fixation" results before education were 9.68 percent and after education were 3.22 (P<0.001). The Ratio of "obscuring" results before education were 3.9 percent and after education were 1.22 (P<0.001). Finally it is concluded that unsatisfactory cervical cytologic smear remarkably declines with education of Pap smear procedure.