P20.03: The value of puncture biopsy guided by transvaginal ultrasound in the diagnosis of cervical diseases

To evaluate the value of puncture biopsy guided by transvaginal ultrasound in the diagnosis of cervical diseases. During Feb. 2004 to Jan. 2013, twenty-one patients aged from 32 to 67(mean 48), have received puncture biopsy by transvaginal ultrasound guidance owing to unclear diagnosis of cervix lesion. Three patients underwent cervical carcinoma operation 2.5 years, 1.5 years or 5 months ago and one hysterectomy 15 years ago, occurred undetermined lumps in the pelvic cavity or on the stump of vagina. Ultrasound examination found cervical lesions or lumps on the stump of vagina in all patients. The diagnosis were endometriosis, endometrial carcinoma infiltrated cervix, malignant tumor of cervix and right ovary, tumor relapse, cervix malignant tumor, undetermined. TCT, colposcopy and cervical biopsy were negative or indefinitive. In all patients 2–5 (average 3) specimens were obtained from diseased region successfully. All patients got definite diagnosis. There were two cases of endometriosis, ten squamous carcinoma(one was endocervical endogenetic), four adenocarcinoma (one infiltrated rectum), three tumor relapse (one was adenocarcinoma), one endometrial adenocarcinoma infiltrated the cervix and one diffuse large B cell lymphoma. The diagnosis after surgery was confirmed in one patient to be well-differentiated endometrioid carcinoma of superior cervix and poorly differentiated transitional cell carcinoma of the right ovary (bis-carcinoma). Cervical carcinoma has a high incidence in gynecological diseases, getting a definite diagnosis in time is important for treatment. TCT, colposcopy and cervical biopsy are routine examinations for diagnosis, but they might lead to false negative results. If ultrasound thought to be malignancy of cervix uteri but routine examinations got negative results, or clinical examinations considered to be cervical carcinoma but ultrasound thought to be endometriosis, puncture biopsy guided by transvaginal ultrasound should be taken for definite diagnosis.