You answered: Non-keratinizing squamous cell carcinoma
     Sorry, that is INCORRECT

The correct diagnosis is: Endometrial adenocarcinoma

CYTOPATHOLOGY:

• The smear contains atypical cells with increased N/C ratio and hyperchromatic nuclei in loosely cohesive sheet and glandular-like groups. (Images 1,2)
• The cells are enlarged and of variable size, with predominantly round to oval nuclei, and slightly irregular nuclear membranes.
• The cytoplasm is wispy and indistinct.
• A few of the groups of cells suggest acinar formation (Images 3,4)
• The background contains atrophic squamous cells, inflammation and a watery diathesis
• These cytologic features are suggestive of a recurrent endometrial adenocarcinoma

DISCUSSION:

• The biopsy reveals malignant endometrial cells and atrophic squamous mucosa.
• This tumour is positive for both cytokeratin and vimentin and is negative for CK20 (usually positive in colorectal carcinoma).
• The sheets of tumour cells in the smear suggest squamous differentiation, but acinar formation within some groups and ill-defined cell borders are more consistent with a glandular lesion.
• Malignant endometrial cells tend to have a more rounded nuclear shape, instead of the columnar shape of malignant endocervical cells.

BACK TO IMAGES                                       HISTOLOGY

REFERENCES:

Bonfiglio TA, Erozan YS.  Gynecologic Cytopathology. Philadelphia: Lipincott-Raven 1997: 138-139.

Kini SR. Color Atlas of Differential Diagnosis in Exfoliative and Aspiration Cytopathology. Baltimore: Williams & Wilkins 1999: 79-80.

DeMay RM. The Art & Science of Cytopathology. Chicago: ASCP Press, 1996: 126.