You answered: Atypical squamous cells, recommend stilbestrol
Sorry, that is INCORRECT
The correct diagnosis is: Endometrial adenocarcinoma
- 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.
- 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
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.