Psammoma bodies in cervicovaginal cytology specimens: a clinicopathological analysis of 31 cases.
BACKGROUND
Psammoma bodies in cervicovaginal cytology specimens are associated with malignant and benign conditions. Few studies have evaluated which features distinguish patients with underlying malignancy from those with benign conditions.


METHODS
Pathology files were searched for cervicovaginal specimens having psammoma bodies. The cytology specimen was assessed for the background, glandular atypia, squamous atypia, and presence of non-psammomatous calcifications. Clinical data was obtained from chart review.


RESULTS
Nineteen women (mean age 42.7 years) had benign outcomes. None had signs or symptoms suggesting malignancy. None had highly atypical or malignant appearing glandular cells. Twelve women had malignant neoplasms (mean age 56 years), including 6 with recurrent disease. Four women without prior malignancy had worrisome signs including bleeding or mass. All six women with prior malignancy had signs of recurrent disease. All specimens contained highly atypical or malignant glandular cells.


CONCLUSIONS
The only cytologic feature predictive of outcome was the presence of highly atypical glandular cells in the specimen (P = 0.001), but these cells may be few. Women with underlying malignancy were older than those with benign outcome (P = 0.014) and more likely to be postmenopausal (P = 0.05). Women with malignancy had signs that warranted additional investigation whereas those with benign outcome were usually asymptomatic (P = 0.001).
Misdraji
Joseph
J
Department of Pathology and Cytopathology Laboratory, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA. jmisdraji@partners.org
Vaidya
Ami
A
Tambouret
Rosemary H
RH
Duska
Linda
L
Bell
Debra A
DA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002584:Cervix Uteri / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000473:pathology*; D006801:Humans; D002479:Inclusion Bodies / Q000473:pathology; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology*; D011237:Predictive Value of Tests; D014626:Vaginal Smears