Gyne Cytopathology: Practice Question
Question
What is the most likely diagnosis of this cervical Papanicolaou stained specimen?
Question images
Cervical cytology specimen.
Answer Choices
- Tubal metaplasia
- Creola body
- Squamous cell carcinoma
- Herpes simplex virus infection
- Endocervical adenocarcinoma
Show Answer and Explanations
Tubal metaplasia — Correct answer
Correct. Tubal metaplasia or endosalpingiosis shows ciliated cells that can be disorganized and crowded.
Creola body
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.
Squamous cell carcinoma
Incorrect. Squamous cell carcinoma shows hyperchromasia, irregular arrangement of cells and overall greater atypia with abnormal forms such as "tadpole cells" or abnormal mitoses.
Herpes simplex virus infection
Incorrect. Herpes causes nuclear molding, multinucleation and margination of the chromatin along the edge of the nuclear membrane.
Endocervical adenocarcinoma
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.
Summary
Summary: On cervicovaginal PAP smear, the clue to tubal metaplasia or endosalpingiosis is cilia. Be careful, look closely.Free account required. No subscription needed.