You answered: Marked squamous dyskaryosis
Sorry, that is INCORRECT
The correct diagnosis is: Small cell carcinoma
CYTOPATHOLOGY:
- The smear contains numerous groups of loosely cohesive aggregates of small cells with scant cytoplasm.
- The nuclei are hyperchromatic and angular. Nuclear moulding is evident.
- The cytologic features suggest small cell carcinoma.
DISCUSSION:
- Small cell carcinoma is a highly aggressive tumour of neuroendocrine differentiation strongly associated with HPV types 18 and 16.
- The routine cervical smear is a relatively insensitive and nonspecific method of detecting small cell carcinoma. The specific diagnosis on cervical smears is difficult. Small cell carcinoma can mimic follicular cervicitis, endometrial cells, endocervical adenocarcinoma, squamous cell carcinoma of small cell type, and non-Hodgkin's lymphoma. Suspicion should prompt an urgent biopsy to establish the diagnosis and initiate prompt treatment
- Biopsies reveal tumours composed of densely packed small to intermediate sized cells with scant cytoplasm, oval to spindle shaped, hyperchromatic nuclei and usually indistinct nucleoli. Mitoses and apoptotic nuclear debris are frequent.
BACK TO IMAGES
HISTOLOGY
REFERENCES:
Bonfiglio TA, Erozan YS. Gynecologic Cytopathology. Philadelphia: Lipincott-Raven 1997:145
Zhou, C.; Hayes, M. M.; Clement, P. B.; Thomson, T. A. Small cell carcinoma of the uterine cervix: cytologic findings in 13 cases Cancer Cytopathology 1998,85(5), 281-8.
