Neovaginal cytology after total pelvic exenteration for gynecological malignancies.
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.
Selvaggi
S M
SM
Department of Pathology and Obstetrics and Gynecology, University of Michigan Medical Center, Ann Arbor, USA.
Haefner
H K
HK
Lelle
R J
RJ
Pearl
M L
ML
Roberts
J A
JA
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