J Korean Med Sci.  2005 Feb;20(1):93-97. 10.3346/jkms.2005.20.1.93.

Cytologic Findings of Cervicovaginal Smears in Women with Uterine Papillary Serous Carcinoma

• Park JY
• Kim HS
• Hong SR
• Chun YK

• KMID: 1781733
• DOI: http://doi.org/10.3346/jkms.2005.20.1.93

Abstract

The goal of this study was to evaluate the cytomorphologic features of histologically confirmed uterine papillary serous carcinomas (UPSC) of the endometrium. We reviewed cervicovaginal smears from 12 patients with UPSC who had done their cervical smears at six months to a year earlier before the time of diagnosis; nine smears (75%) were diagnosed as positive for malignancy and three smears (25%) were diagnosed as negative. The cervical smears of patients with UPSC revealed frequent papillary clusters that were composed of large pleomorphic tumor cells with prominent nucleoli in a background of necrosis. Other findings revealed from the tests were relatively frequent single malignant cells and bare nuclei. Although the Pap smear is not a sensitive screening test for endometrial carcinoma, we could depend on it to reveal the cytologic features of UPSC which are fairly characteristic and reliable for a preoperative diagnosis of UPSC. Preoperative identification of this poor prognostic variant of endometrial carcinoma may influence the surgical management of these cases and the choice of adjuvant therapy.

Keyword

Endometrial Neoplasms; Carcinoma, Papillary; Vaginal Smears

MeSH Terms

Adenocarcinoma/diagnosis/pathology
Adult
Aged
Carcinoma
Carcinoma, Squamous Cell/diagnosis/pathology
Cystadenocarcinoma, Papillary/*diagnosis/*pathology
Cystadenocarcinoma, Serous/*diagnosis/*pathology
Diagnosis, Differential
Female
Humans
Middle Aged
Necrosis
Prognosis
Uterine Neoplasms/*diagnosis/*pathology
*Vaginal Smears

Figure

• 

  Fig. 1 Cervical smear of uterine papillary carcinoma shows papillary fragment of tumor cells with irregular outline and acute inflammatory cells in background (Papanicolaou stain, ×400).

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  Fig. 2 Tumor cells of uterine papillary serous carcinoma have large nuclei with irregularly distributed chromatin, distinct nucleoli, irregular nuclear margins and indistinct cytoplasmic borders (Papanicolaou stain, ×1,000).

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  Fig. 3 Cervicovaginal smear of uterine papillary carcinoma shows a papillary cluster and single scattered malignant cells in background of tumor diathesis and lysed blood (Papanicolaou stain, ×400).

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  Fig. 4 Histology of uterine papillary serous carcinoma shows short and dense papillae. The cells covering the papillae and lining glands form small papillary tufts or floating clusters (H&E stain, ×100). Tumor cells reveal dense eosinophilic cytoplasm with high grade nulclear atypia (inset, H&E stain, ×400).

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