What is the most likely diagnosis of this cervical Papanicolaou stained specimen?

  • Incorrect. A creola body looks similar, but is from the airway, and is associated with asthma. They are a benign mimicker of malignancy. Creola bodies are malignant looking clusters of cells which have cilia on close inspection. Malignant cells do not have cilia.

  • Incorrect. Endocervical adenocarcinoma would show malignant features such as irregular nuclear contours and a greater degree of pleomorphism. Other hints may include squamous dysplasia, a history of dysplasia (LSIL/HSIL) and a relatively young age, which can also help to distinguish the lesion from endometrial adenocarcinoma, which tends to occur in older patients.

  • Incorrect. Herpes causes nuclear molding, multinucleation and margination of the chromatin along the edge of the nuclear membrane.

  • Correct. Tubal metaplasia or endosalpingiosis shows ciliated cells that can be disorganized and crowded.

  • Incorrect. Squamous cell carcinoma shows hyperchromasia, irregular arrangement of cells and overall greater atypia with abnormal forms such as “tadpole cells” or abnormal mitoses.