title: The significance of psammoma bodies in screening cervical cytologic smears.
abstract: OBJECTIVE
  Although the presence of psammoma bodies in cervical cytologic smears has been associated previously with gynecologic malignancies, the clinical significance of this finding in asymptomatic women who undergo routine cervical cytologic screening has not been well defined.
  
  
  METHODS
  For this retrospective clinicopathologic study, a search of the Virginia Mason Medical Center computerized cytology registry from 1993 through March 2002 identified 25 evaluable cervical cytologic smears that contained psammomatous calcifications. Slides were reviewed, and clinical information was obtained from medical records.
  
  
  RESULTS
  The median patient age was 36 years (range, 22-72 years). Nine women were postmenopausal. All cytologic smears were obtained for routine screening, and no abnormal cells that were diagnostic of malignancy were identified. Possible explanations for the psammoma bodies was determined for 11 women, including foci of calcifications in benign endometrial or endocervical tissue (4 women), polyps (3 women), marked atrophy (3 women), postpartum (2 women), and follicular cervicitis (1 woman). None of the 25 women had cancer. After excluding 1 woman who was to lost to follow-up, the remaining 24 women were followed up for a median of 3 years (range, 6 months-7 years) without the subsequent detection of cancer.
  
  
  CONCLUSIONS
  Cancers that were reported in previous studies usually were diagnosed in women with malignant background cytology or abnormal symptoms, such as postmenopausal bleeding. In contrast, our study suggests that the presence of psammoma bodies in normal cytologic smears of asymptomatic women is an incidental finding.
authors.affiliation: Gynecology and Gynecologic Oncology Section, Department of Surgery, Virginia Mason Medical Center, Seattle, WA 98111-0900, USA. Howard.Muntz@vmmc.org
authors.forename: Howard G
authors.initials: HG
authors.lastname: Muntz
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Goff
authors.forename: Kathryn
authors.initials: K
authors.lastname: McGonigle
authors.forename: Christina
authors.initials: C
authors.lastname: Isacson
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005833:Genital Neoplasms, Female / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology; D012042:Registries; D012189:Retrospective Studies; D014626:Vaginal Smears / Q000379:methods*; D014768:Virginia / Q000453:epidemiology