Papillary tissue fragments in cervicovaginal (Pap) smears: cytomorphologic characteristics and clinicopathologic significance.
Papillary epithelial fragments (PEFs) are a rarely described architectural feature in cervicovaginal (Pap) smears. Morphologically, PEFs often consist of small, finely branching glandular tissue fragments with varying cytomorphology. This study identified 21 Pap smears (1978-2009) containing PEFs to determine the clinicopathologic significance of such findings. Patients ranged in age from 36 to 81 years (mean, 54 years). The Pap smear diagnoses consisted of 48% overt malignant neoplasms, 24% atypical fragments, and 28% benign entities. The papillary fragments featured a range of cytomorphologies consisting of benign features, mild to marked atypia, and overt malignancy. PEFs were more commonly found (57%) in specimens from patients with significant pathologic outcomes. Hence, the presence of PEFs in a Pap smear should raise concern for a neoplastic process. In smears displaying atypical to malignant cytomorphologic features recommendations for further clinical work-up and/or tissue studies should be made.
Stoll
Lisa M
LM
Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
Johnson
Michael W
MW
Ali
Syed Z
SZ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D053144:Cell Nucleus Shape; D048430:Cell Shape; D002843:Chromatin / Q000473:pathology; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D014626:Vaginal Smears
D002843:Chromatin