Cervical cytology of recurrent psammoma bodies with atypical cells in a postmenopausal woman: a case report.
BACKGROUND
Psammoma bodies (PBs) are an unusual finding in cervical cytology preparations. They have been identified in association with a wide range of benign and malignant conditions within the female genital tract. Portents of a significant underlying pathology include their occurrence in postmenopausal patients, the presence of unexplained vaginal bleeding and their occurrence in association with atypical cells.


METHODS
PBs associated with atypical cells were detected in repeated cervical cytology smears of an asymptomatic, 55-year-old postmenopausal woman over a 4-year period. She was extensively investigated, and, in the absence of a bleeding) have definitive cause, she underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histologic examination of the specimen demonstrated the presence of bilateral benign ovarian serous cystadenofibromas with large numbers of PBs. Focally the PBs were closely apposed to the serosal surface and invested in a blanket of mesothelial cells.


CONCLUSIONS
Caution is required when assessing the significance of PBs associated with atypical cells in a cervical cytology specimen. Our case demonstrates the presence of ovarian mesothelial cells mimicking atypical glandular cells.
Malcolm
Paul
P
Department of Obstetrics and Gynecology, Royal Cornwall Hospital, Truro, Cornwall, UK.
St John
Alison
A
Oladipo
Abiodun
A
Mathew
Joseph
J
D022082:Cellular Structures / Q000473:pathology*; D002584:Cervix Uteri / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010053:Ovary / Q000473:pathology; D017698:Postmenopause