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

1. Bonfiglio, T.A. & Erozan, Y.S. (1997). Gynecologic Cytopathology. Philadelphia: Lipincott-Raven: 138-139.
2. Kini, S.R. (1999). Color Atlas of Differential Diagnosis in Exfoliative and Aspiration Cytopathology. Baltimore: Williams & Wilkins: 79-80.
3. DeMay, R.M. (1996). The Art & Science of Cytopathology. Chicago: ASCP Press: 126.

You answered: Atypical squamous cells, recommend stilbestrol.

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

1. Bonfiglio, T.A. & Erozan, Y.S. (1997). Gynecologic Cytopathology. Philadelphia: Lipincott-Raven: 138-139.
2. Kini, S.R. (1999). Color Atlas of Differential Diagnosis in Exfoliative and Aspiration Cytopathology. Baltimore: Williams & Wilkins: 79-80.
3. DeMay, R.M. (1996). The Art & Science of Cytopathology. Chicago: ASCP Press: 126.
   

You answered: Endocervical adenocarcinoma.

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

1. Bonfiglio, T.A. & Erozan, Y.S. (1997). Gynecologic Cytopathology. Philadelphia: Lipincott-Raven: 138-139.
2. Kini, S.R. (1999). Color Atlas of Differential Diagnosis in Exfoliative and Aspiration Cytopathology. Baltimore: Williams & Wilkins: 79-80.
3. DeMay, R.M. (1996). The Art & Science of Cytopathology. Chicago: ASCP Press: 126.​
   

You answered: Endometrial adenocarcinoma.

That is correct!

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

1. Bonfiglio, T.A. & Erozan, Y.S. (1997). Gynecologic Cytopathology. Philadelphia: Lipincott-Raven: 138-139.
2. Kini, S.R. (1999). Color Atlas of Differential Diagnosis in Exfoliative and Aspiration Cytopathology. Baltimore: Williams & Wilkins: 79-80.
3. DeMay, R.M. (1996). The Art & Science of Cytopathology. Chicago: ASCP Press: 126.