{"id":6192,"date":"2023-03-17T08:43:03","date_gmt":"2023-03-17T08:43:03","guid":{"rendered":"https:\/\/www.eurocytology.eu\/course\/revisao-da-citologia-na-reuniao-da-emd\/"},"modified":"2023-04-26T08:11:52","modified_gmt":"2023-04-26T08:11:52","slug":"revisao-da-citologia-na-reuniao-da-emd","status":"publish","type":"course","link":"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/12-citologia-em-um-contexto-multidisciplinar\/revisao-da-citologia-na-reuniao-da-emd\/","title":{"rendered":"Revis\u00e3o da citologia na reuni\u00e3o da EMD"},"content":{"rendered":"<div data-object_id=\"6192\" class=\"cbxwpbkmarkwrap cbxwpbkmarkwrap_guest cbxwpbkmarkwrap_user_cat cbxwpbkmarkwrap-course \"><a  data-redirect-url=\"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course\/6192\/\"  data-display-label=\"1\" data-show-count=\"1\" data-bookmark-label=\"Bookmark\"  data-bookmarked-label=\"Bookmarked\"  data-loggedin=\"0\" data-type=\"course\" data-object_id=\"6192\" class=\"cbxwpbkmarktrig  cbxwpbkmarktrig-button-addto\" title=\"Bookmark This\" href=\"#\"><span class=\"cbxwpbkmarktrig-label\" >Bookmark (<i class=\"cbxwpbkmarktrig-count\">0<\/i>)<\/span><\/a> <div  data-type=\"course\" data-object_id=\"6192\" class=\"cbxwpbkmarkguestwrap\" id=\"cbxwpbkmarkguestwrap-6192\"><div class=\"cbxwpbkmarkguest-message\"><a href=\"#\" class=\"cbxwpbkmarkguesttrig_close\"><\/a><h3 class=\"cbxwpbookmark-title cbxwpbookmark-title-login\">Please login to bookmark<\/h3><form name=\"loginform\" id=\"loginform\" action=\"https:\/\/www.eurocytology.eu\/wp-login.php\" method=\"post\"><p class=\"login-username\">\n\t\t\t\t<label for=\"user_login\">Nome de utilizador ou endere\u00e7o de email<\/label>\n\t\t\t\t<input type=\"text\" name=\"log\" id=\"user_login\" autocomplete=\"username\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-password\">\n\t\t\t\t<label for=\"user_pass\">Senha<\/label>\n\t\t\t\t<input type=\"password\" name=\"pwd\" id=\"user_pass\" autocomplete=\"current-password\" spellcheck=\"false\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-remember\"><label><input name=\"rememberme\" type=\"checkbox\" id=\"rememberme\" value=\"forever\" \/> Manter sess\u00e3o<\/label><\/p><p class=\"login-submit\">\n\t\t\t\t<input type=\"submit\" name=\"wp-submit\" id=\"wp-submit\" class=\"button button-primary\" value=\"Iniciar sess\u00e3o\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course\/6192\/\" \/>\n\t\t\t<\/p><\/form><p class=\"cbxwpbookmark-guest-register\">No account yet? <a href=\"https:\/\/www.eurocytology.eu\/pt-pt\/register\/?redirect_to=https%3A%2F%2Fwww.eurocytology.eu%2Fpt-pt%2Fwp-json%2Fwp%2Fv2%2Fcourse%2F6192%2F\">Register<\/a><\/p><\/div><\/div><\/div><p>Seja qual for o cen\u00e1rio, a convic\u00e7\u00e3o do colposcopista ou do ginecologista e sua confian\u00e7a no relat\u00f3rio de citologia dependem da sensibilidade e valor preditivo positivo (VPP) nesse laborat\u00f3rio e seu controle de qualidade.<\/p>\n<ul>\n<li>Cytology slide review allows potential false positive features to be recognised before treatment is carried out.<\/li>\n<li>Equivocal cytology reports may be given more definitive reports on review allowing the correct treatment to be carried out.<\/li>\n<li>Definitive cytological features may be presented and confirmed at MDT meetings allowing treatment to be planned even when the lesion cannot be seen at colposcopy.<\/li>\n<li>False negative cytology may be presented and discussed during the historical review of slides reported before a diagnosis of cervical cancer.<\/li>\n<li>Review of equivocal cases and recognised pitfalls provides colposcopists and other professional groups with insight into difficult areas of cytology.<\/li>\n<li>High-risk HPV positivity may support a diagnosis of HSIL or CIN but does not confirm it; nor does high-risk HPV negativity refute it.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Figure 12.1.<\/strong> <strong>Potential pitfalls to be reviewed at MDT meeting&nbsp;<\/strong><\/p>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img fetchpriority=\"high\" decoding=\"async\" alt=\"\" height=\"469\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2073_1425657152.png?itok=oifm0gQl\" width=\"720\" \/><\/a><figcaption>(a) Reported as moderate dyskaryosis (HSIL) on cytology.<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img decoding=\"async\" alt=\"\" height=\"390\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2074_1425657275.png?itok=yFjImsXc\" width=\"563\" \/><\/a><figcaption>\n<div>(b) Histology from the same case reported as CIN2.<\/div>\n<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>However, the diagnosis of CIN2 was doubted when this case was reviewed as a teaching case several years later and most likely represents immature metaplasia. It would now be resolved by p16\/Ki67 staining (see below).<\/p>\n<p>A decision to carry out a LLETZ was based on colposcopic appearances as well as the cytology report and is typical of cases requiring multidisciplinary discussion.<\/p>\n<h4>\nHyperchromatic crowded cell groups<\/h4>\n<p>The diagnosis of HSIL in Figure 12.2 was confirmed as CIN3 but represents a difficult diagnosis warranting MDT discussion alongside full slide review and presentation of other findings.&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img decoding=\"async\" alt=\"\" height=\"389\" src=\"http:\/\/www.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2623_1449747442.png?itok=kUet7rtg\" width=\"597\" \/><\/a><figcaption>Figure 12.2&nbsp;&nbsp;&nbsp;This image is reproduced from the BSCC Terminology Conference 2002 and is also shown in&nbsp;Chapter 10 &#8211; Pitfalls in cytology&nbsp;as an example of HSIL seen in a hyperchromatic crowded cell of groups.&nbsp; Less than half of the respondents recognised this image as HSIL.&nbsp;<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>Alternatively, such changes could be seen when previous negative or atypical slides are reviewed from a patient who subsequently develops HSIL or cancer.&nbsp;<\/p>\n<p>Hyperchromatic crowded cell groups are known to be at risk for a false negative diagnosis in conventional smears and liquid-based preparations (Demay 2000; Gupta <em>et al<\/em>. 2013).&nbsp;<\/p>\n<p>This cell group could be misinterpreted as a cluster of endocervical cells &#8211; but close review shows severely dyskaryotic cells at the edge of the group of cells; similar cells are likely to be found on careful search of the rest of the slide.<\/p>\n<h4>&nbsp;<\/h4>\n<h4>Definitive cytological diagnoses confirmed at MDT meeting<\/h4>\n<p>Classic appearances of HSIL and AIS respectively may have been well represented on the cytology slides even if not widespread, reported unequivocally and confirmed on review.&nbsp;<\/p>\n<p>Colposcopy may be negative in such cases, particularly if the lesion is high in the endocervical canal: a biopsy may be inadequate or negative.&nbsp; Glandular abnormalities are known to be difficult to identify and sample at colposcopy.<\/p>\n<p>Diagnostic LLETZ may be considered in such cases even if a punch biopsy does not identify the lesion.<\/p>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"697\" src=\"http:\/\/www.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2624_1449747469.png?itok=p4LUv-xk\" width=\"927\" \/><\/a><figcaption>Figure 12.3. (a) Unequivocal HSIL.<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"667\" src=\"http:\/\/www.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2625_1449747490.png?itok=apF2-76t\" width=\"892\" \/><\/a><figcaption>Figure 12.3. (b) Typical AIS<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<table border=\"3\" cellpadding=\"1\" cellspacing=\"1\" style=\"width: 500px;\">\n<tbody>\n<tr>\n<td>\n<h3>Revis\u00e3o de citologia para reuni\u00f5es da EMD<\/h3>\n<ul>\n<li>Revis\u00e3o de l\u00e2minas por citologistas experientes e apresenta\u00e7\u00e3o de resultados em uma reuni\u00e3o de EMD permite que um caso de apresenta\u00e7\u00e3o citol\u00f3gica dif\u00edcil seja reavaliada e confirmada ou revisada<\/li>\n<li>As armadilhas diagn\u00f3sticas conhecidas devem ser reavaliadas \u00e0 luz de outros par\u00e2metros, com os membros da equipe compreendendo os dilemas e as dificuldades<\/li>\n<li>Os diagn\u00f3sticos confirmados de LIEEAG &#8211; <em>HSIL<\/em> (favorecendo NIC3) ou AIS \/ Adenocarcinoma podem ser aceitos na aus\u00eancia de les\u00f5es vis\u00edveis na colposcopia, especialmente se for confirmado em m\u00faltiplas c\u00e9lulas ou grupos celulares<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<div data-object_id=\"6192\" class=\"cbxwpbkmarkwrap cbxwpbkmarkwrap_guest cbxwpbkmarkwrap_user_cat cbxwpbkmarkwrap-course \"><a  data-redirect-url=\"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course\/6192\/\"  data-display-label=\"1\" data-show-count=\"1\" data-bookmark-label=\"Bookmark\"  data-bookmarked-label=\"Bookmarked\"  data-loggedin=\"0\" data-type=\"course\" data-object_id=\"6192\" class=\"cbxwpbkmarktrig  cbxwpbkmarktrig-button-addto\" title=\"Bookmark This\" href=\"#\"><span class=\"cbxwpbkmarktrig-label\" >Bookmark (<i class=\"cbxwpbkmarktrig-count\">0<\/i>)<\/span><\/a> <div  data-type=\"course\" data-object_id=\"6192\" class=\"cbxwpbkmarkguestwrap\" id=\"cbxwpbkmarkguestwrap-6192\"><div class=\"cbxwpbkmarkguest-message\"><a href=\"#\" class=\"cbxwpbkmarkguesttrig_close\"><\/a><h3 class=\"cbxwpbookmark-title cbxwpbookmark-title-login\">Please login to bookmark<\/h3><form name=\"loginform\" id=\"loginform\" action=\"https:\/\/www.eurocytology.eu\/wp-login.php\" method=\"post\"><p class=\"login-username\">\n\t\t\t\t<label for=\"user_login\">Nome de utilizador ou endere\u00e7o de email<\/label>\n\t\t\t\t<input type=\"text\" name=\"log\" id=\"user_login\" autocomplete=\"username\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-password\">\n\t\t\t\t<label for=\"user_pass\">Senha<\/label>\n\t\t\t\t<input type=\"password\" name=\"pwd\" id=\"user_pass\" autocomplete=\"current-password\" spellcheck=\"false\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-remember\"><label><input name=\"rememberme\" type=\"checkbox\" id=\"rememberme\" value=\"forever\" \/> Manter sess\u00e3o<\/label><\/p><p class=\"login-submit\">\n\t\t\t\t<input type=\"submit\" name=\"wp-submit\" id=\"wp-submit\" class=\"button button-primary\" value=\"Iniciar sess\u00e3o\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/www.eurocytology.eu\/pt-pt\/wp-json\/wp\/v2\/course\/6192\/\" \/>\n\t\t\t<\/p><\/form><p class=\"cbxwpbookmark-guest-register\">No account yet? <a href=\"https:\/\/www.eurocytology.eu\/pt-pt\/register\/?redirect_to=https%3A%2F%2Fwww.eurocytology.eu%2Fpt-pt%2Fwp-json%2Fwp%2Fv2%2Fcourse%2F6192%2F\">Register<\/a><\/p><\/div><\/div><\/div><p>Seja qual for o cen\u00e1rio, a convic\u00e7\u00e3o do colposcopista ou do ginecologista e sua confian\u00e7a no relat\u00f3rio de citologia dependem da sensibilidade e valor preditivo positivo (VPP) nesse laborat\u00f3rio e seu controle de qualidade. Cytology slide review allows potential false positive features to be recognised before treatment is carried out. Equivocal cytology reports may be [&hellip;]<\/p>\n","protected":false},"featured_media":0,"parent":6191,"menu_order":0,"template":"","meta":[],"tags":[],"course_area":[121],"authors":[],"class_list":["post-6192","course","type-course","status-publish","hentry","course_area-citologia-cervical"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Revis\u00e3o da citologia na reuni\u00e3o da EMD - Eurocytology<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.eurocytology.eu\/pt-pt\/course\/citologia-cervical\/12-citologia-em-um-contexto-multidisciplinar\/revisao-da-citologia-na-reuniao-da-emd\/\" \/>\n<meta property=\"og:locale\" content=\"pt_PT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Revis\u00e3o da citologia na reuni\u00e3o da EMD - Eurocytology\" \/>\n<meta property=\"og:description\" content=\"Seja qual for o cen\u00e1rio, a convic\u00e7\u00e3o do colposcopista ou do ginecologista e sua confian\u00e7a no relat\u00f3rio de citologia dependem da sensibilidade e valor preditivo positivo (VPP) nesse laborat\u00f3rio e seu controle de qualidade. 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