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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Cervical polyps often show no symptoms. Where there are symptoms, they include intermenstrual bleeding, abnormally heavy menstrual bleeding (menorrhagia), vaginal bleeding in post-menopausal women, bleeding after sex and thick white vaginal or yellowish discharge (leukorrhoea).
Cervical intraepithelial neoplasia (CIN), also known as cervical dysplasia, is the potentially premalignant transformation and abnormal growth (dysplasia) of squamous cells on the surface of the cervix. Cervical intraepithelial neoplasia most commonly occurs on the cervix at the squamo-columnar junction, but can also occur in vaginal walls and vulvar epthelium. The New Bethesda System reports all gynecologic abnormalities termed "SIL" squamous intraepithelial lesions, arising from all areas of female genital tract, and anal canal of both men and women. Like other intraepithelial neoplasias, CIN or [SIL] is not cancer, and it is usually curable. Most cases of CIN remain stable, or are eliminated by the host's immune system without intervention. However a small percentage of cases progress to become cervical cancer, usually cervical squamous cell carcinoma (SCC), if left untreated. The major cause of CIN is chronic infection of the cervix with the sexually transmitted human papillomavirus (HPV), especially the high-risk HPV types 16 or 18. Over 100 types of HPV have been identified. About a dozen of these types appear to cause cervical dysplasia and may lead to the development of cervical cancer. Other types cause warts.
The earliest microscopic change corresponding to CIN is dysplasia of the epithelial or surface lining of the cervix, which is essentially undetectable by the woman. Cellular changes associated with HPV infection, such as koilocytes, are also commonly seen in CIN. CIN is usually discovered by a screening test, the Papanicolau or "Pap" smear. The purpose of this test is to detect potentially precancerous changes. Pap smear results may be reported using the Bethesda System. An abnormal Pap smear result may lead to a recommendation for colposcopy of the cervix, during which the cervix is examined under magnification. A biopsy is taken of any abnormal appearing areas. Cervical dysplasia can be diagnosed by biopsy. A test for Human Papilloma Virus called the Digene HPV test is highly accurate and serves as both a direct diagnosis and adjuvant to the all important pap test which is a screening device and not the final answer in detecting all types of female genital cancers. Endocervical brush sampling at time of pap smear to detect adenocarcinoma and its precursors is necessary along with doctor/patient vigilance on abdominal symptoms associated with uterine and ovarian carcinoma.
A cervical polyp is a common benign polyp or tumour on the surface of the cervical canal. They can cause irregular menstrual bleeding but often show no symptoms. Treatment consists of simple removal of the polyp and prognosis is generally good. About 1% of cervical polyps will show neoplastic change which may lead to cancer. They are most common in post-menarche, pre-menopausal women who have been pregnant.
"Cervical ectropion" (or cervical eversion) is a condition in which the cells from the ‘inside’ of the cervical canal known as glandular cells (or columnar epithelium), are present on the ‘outside’ of the vaginal portion of the cervix. The cells on the ‘outside’ of the cervix are called squamous epithelial cells. Where the two cells meet is called the transformation zone also known as the stratified squamous epithelium. Although having this condition is not an abnormality, it is indistinguishable from early cervical cancer. When at a routine check up, it can be seen by the nurse when a cervical screening test (or smear test) is done. The area may look red because the glandular cells are red. While many women are born with cervical ectropion, it can be caused by a number of reasons, such as:
- Hormonal changes, so meaning it can be common in young women.
- Taking “the pill” to protect from pregnancy
- Pregnancy
Cervical ectropion can be associated with excessive but non-purulent vaginal discharge due to the increased surface area of columnar epithelium containing mucus-secreting glands. It may also give rise to post-coital bleeding, as fine blood vessels present within the columnar epithelium are easily traumatised.
The signs and symptoms are similar to other cervical cancers and may include post-coital bleeding and/or pain during intercourse (dyspareunia). Early lesions may be completely asymptomatic.
Depending on several factors and the location of the infection, CIN can start in any of the three stage, and can either progress, or regress. The grade of squamous intraepithelial lesion can vary.
CIN is classified in grades:
Nabothian cysts appear most often as firm bumps on the cervix's surface. A woman may notice the cyst when inserting a diaphragm or cervical cap, or when checking the cervix as part of fertility awareness. A health care provider may notice the cysts during a pelvic exam.
A benign papillomatous tumor is derived from epithelium, with cauliflower-like projections that arise from the mucosal surface.
It may appear white or normal colored. It may be pedunculated or sessile. The average size is between 1–5 cm.
Neither sex is significantly more likely to develop them. The most common site is the palate-uvula area followed by tongue and lips. Durations range from weeks to 10 years.
Inverted papillomas are definitively diagnosed by histologic examination. However, Magnetic Resonanace Imaging (MRI) may show a characteristic feature described as a Convoluted Cerebriform Pattern (CCP). A retrospective study published in the American Journal of Neuroradiology concluded that identification of CCP by MRI in a patient with a nasal tumor made the diagnosis of Inverted papilloma quite likely. The study reported the sensitivity and specificity to be 100% and 87% respectively. CCP can be associated with other malignant tumors as well.
Villoglandular adenocarcinoma of the cervix, also villoglandular papillary adenocarcinoma, papillary villoglandular adenocarcinoma and well-differentiated villoglandular adenocarcinoma, abbreviated VGA, is a rare type of cervical cancer that, in relation to other cervical cancers, is typically found in younger women and has a better prognosis.
A similar lesion, "villoglandular adenocarcinoma of the endometrium", may arise from the inner lining of the uterus, the endometrium.
Cervical stenosis means that the opening in the cervix (the endocervical canal) is more narrow than is typical. In some cases, the endocervical canal may be completely closed. A stenosis is any passage in the body that is more narrow than it should typically be.
The term Vulvar intraepithelial neoplasia (VIN) refers to particular changes that can occur in the skin that covers the vulva. VIN is not cancer, and in some women it disappears without treatment. If the changes become more severe, there is a chance that cancer might develop after many years, and so it is referred to as a precancerous condition.
An inverted papilloma is a type of tumor in which surface epithelial cells grow downward into the underlying supportive tissue. It may occur in the nose and/or sinuses or in the urinary tract (bladder, renal pelvis, ureter, urethra). When it occurs in the nose or sinuses, it may cause symptoms similar to those caused by sinusitis, such as nasal congestion. When it occurs in the urinary tract, it may cause blood in the urine.
Nabothian cysts are considered harmless and usually disappear on their own, although some will persist indefinitely. Some women notice they appear and disappear in relation to their menstrual cycle. If a woman is not sure the anomaly she has found on her cervix is a nabothian cyst, a visit to a doctor is recommended to rule out other conditions.
Rarely, nabothian cysts have a correlation with chronic cervicitis, an inflammatory infection of the cervix.
Nabothian cysts are not considered problematic unless they grow very large and present secondary symptoms. A physician may wish to perform a colposcopy or biopsy on a nabothian cyst to check for cancer or other problems. Two methods for removing these cysts include electrocautery and cryofreezing, although new cysts may form after the procedure.
Nipple adenomas may be felt as a lump under the nipple or areola. They may come to attention because of nipple pain, ulceration, swelling or discharge.
Symptoms depend on whether the cervical canal is partially or completely obstructed and on the patient's menopausal status. Pre-menopausal patients may have a build up of blood inside the uterus which may cause infection, sporadic bleeding, or pelvic pain. Patients also have an increased risk of infertility and endometriosis.
A papilloma (plural papillomas or papillomata) ("" + "") is a benign epithelial tumor growing exophytically (outwardly projecting) in nipple-like and often finger-like fronds. In this context refers to the projection created by the tumor, not a tumor on an already existing papilla (such as the nipple).
When used without context, it frequently refers to infections (squamous cell papilloma) caused by human papillomavirus (HPV), such as warts. Human papillomavirus infection is a major cause of cervical cancer, although most HPV infections do not cause cancer. There are, however, a number of other conditions that cause papilloma, as well as many cases in which there is no known cause.
Medically speaking, the term denotes a squamous intraepithelial lesion of the vulva that shows dysplasia with varying degrees of atypia. The epithelial basement membrane is intact and the lesion is thus not invasive but has invasive potential.
The terminology of VIN evolved over several decades. In 1989 the Committee on Terminology, International Society for the Study of Vulvar Disease (ISSVD) replaced older terminology such as vulvar , Bowen's disease, and Kraurosis vulvae by a new classification system for "Epithelial Vulvar Disease":
- Nonneoplastic epithelial disorders of vulva and mucosa:
- Lichen sclerosus
- Squamous hyperplasia
- Other dermatoses
- Mixed neoplastic and nonneoplastic disorders
- Intraepithelial neoplasia
- Squamous vulvar intraepithelial neoplasia (VIN)
- VIN I, mildest form
- VIN II, intermediate
- VIN III, most severe form including carcinoma in situ of the vulva
- Non-squamous intraepithelial neoplasia
- Extramammary Paget's disease
- Tumors of melanocytes, noninvasive
- Invasive disease (vulvar carcinoma)
The ISSVD further revised this classification in 2004, replacing the three-grade system with a single-grade system in which only the high-grade disease is classified as VIN.
VIN is subdivided into: (Robbins Pathological Basis of Disease, 9th Ed)
Classic vulvular intraepithelial neoplasia: associated with developing into the warty and basaloid type carcinoma. This is associated with carcinogenic genotypes of HPV and/or HPV persistence factors such as cigarette smoking or immunocompromised states.
Differentiated vulvar intraepithelial neoplasia also known as VIN Simplex: is associated with vulvar dermatoses such as lichen sclerosus. It is associated with atypia of the squamous epithelium.
Most patients present clinically with progressive, one sided hearing loss, much more often of the sensorineural rather than conductive type. Patients may also experience tinnitus, vertigo, and loss of vestibular function (ataxia). Symptoms are usually present for a long time, which supports the slow growth of these tumors. Patients may also present with other symptoms related to von Hippel-Lindau syndrome in other anatomic sites, which will result in imaging evaluation of the head.
Nipple adenomas most commonly occur in 30- to 40-year-old women, but can also occur in men. They can also occur at any age, including in the elderly, in adolescence, and in infants.
Patients with cervical agenesis typically present in early adolescence, around the time of menarche, with amenorrhea and cyclic pelvic pain caused by the obstruction of menstrual flow from the uterus.
A squamous cell papilloma is a generally benign papilloma that arises from the stratified squamous epithelium of the skin, lip, oral cavity, tongue, pharynx, larynx, esophagus, cervix, vagina or anal canal. Squamous cell papillomas are a result of infection with human papillomavirus (HPV).
Signs of the tumor resulting from increased intracranial pressure are present in 91% of patients, with vomiting, homonymous visual field defects and headache being the most common symptoms.
Other symptoms are ear ringing and dizziness.
The general presentation is of a skin-covered nodule, papule, or nodule of the skin surface, usually immediately anterior to the auricle. However, it may be anywhere within the periauricular tissues. Bilateral presentation can be seen.