title: Neovaginal cytology after total pelvic exenteration for gynecological malignancies.
abstract: Vaginal reconstruction has become an established method to restore sexual function in women who have undergone ultraradical surgery and/or irradiation for the treatment of gynecologic malignancies. Cytologic evaluation of the neovagina serves a major role in the detection of recurrent disease. The purpose of this retrospective 6-yr study (January 1987-December 1993) was to evaluate the cytologic features of vaginal smear specimens from neovaginas constructed utilizing split-thickness skin grafts. Thirty-four vaginal smears were obtained at regular intervals from nine women (mean age: 51 yr) who underwent total pelvic exenteration with vaginal reconstruction for recurrent malignancies of the vagina and the cervix. Anucleated, keratinizing squames were a constant finding in each smear. Over a 4-mo-6-yr postoperative period, superficial and intermediate squamous cells were present in the majority of the smears and the maturation index showed a shift to the right. In two cases, a squamous cell carcinoma of the cervix recurred within the neovagina. Knowledge of the cytologic features associated with neovaginas is important in order to distinguish normal changes from neoplastic lesions.
authors.affiliation: Department of Pathology and Obstetrics and Gynecology, University of Michigan Medical Center, Ann Arbor, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Selvaggi
authors.forename: H K
authors.initials: HK
authors.lastname: Haefner
authors.forename: R J
authors.initials: RJ
authors.lastname: Lelle
authors.forename: M L
authors.initials: ML
authors.lastname: Pearl
authors.forename: J A
authors.initials: JA
authors.lastname: Roberts
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D010385:Pelvic Exenteration; D011183:Postoperative Complications / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D014625:Vaginal Neoplasms / Q000473:pathology / Q000601:surgery*; D014626:Vaginal Smears