Cytology of vaginal and uterine sarcomas.
OBJECTIVE
To retrospectively review, based on cytologic and histopathologic findings, the diagnoses of 13 patients with uterine sarcoma and 1 with vaginal sarcoma.


METHODS
There were 8 cases of uterine carcinosarcoma (CS), 2 of leiomyosarcoma, 2 of endometrial stromal sarcoma (ESS), 1 of endocervical stromal sarcoma (ECSS) and 1 of malignant fibrous histiocytoma (MFH) of the vagina. The presence of sarcomatous components was retrospectively investigated by microscopic observation of preoperative specimens from the endocervical canal and endometrial cells. Characteristic features of sarcomatous cells were then investigated by cytodiagnostic micrometry of malignant cells.


RESULTS
Of the 14 patients, 1 with low grade ESS and 1 with homologous CS were diagnosed as negative for sarcomatous components. One case of high grade ESS had been overlooked, as were 4 cases of CS. Thus, 7 cases (50%) were diagnosed as positive for sarcomatous cells by preoperative cytologic observation. Based on these findings, 12 of the 14 cases (85.7%) were positive for sarcomatous elements on retrospective reexamination of the specimens.


CONCLUSIONS
Careful attention should be paid to small sarcomatous cells since cases of ESS or ECSS with such cells show morphologic characteristics similar to those of stromatous cells. Furthermore, careful microscopic observation of an entire specimen is required to avoid misdiagnosis as carcinoma since it is easy to overlook sarcomatous elements in smears with carcinosarcoma if there are only a few sarcomatous cells.
Department of Obstetrics and Gynecology, Sapporo Medical University, School of Medicine, Hokkaido, Japan.
Eiki
E
Ito
Tsuyoshi
T
Saito
Takahiro
T
Suzuki
Miho
M
Fujii
Ryuichi
R
Kudo
D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D002296:Carcinosarcoma / Q000473:pathology; D002467:Cell Nucleus / Q000473:pathology; D048429:Cell Size / Q000502:physiology; D002813:Chondrosarcoma / Q000473:pathology; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control; D004717:Endometrium / Q000473:pathology; D005260:Female; D018219:Histiocytoma, Benign Fibrous / Q000473:pathology*; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology; D008875:Middle Aged; D032389:Myocytes, Smooth Muscle / Q000473:pathology; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology*; D017154:Stromal Cells / Q000473:pathology; D014594:Uterine Neoplasms / Q000473:pathology*; D014625:Vaginal Neoplasms / Q000473:pathology*