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Significance of histiocytes in cervical smears from peri/postmenopausal women
Author(s) -
Tambouret Rosemary,
Bell Debra A.,
Centeno Barbara A.
Publication year - 2001
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.1058
Subject(s) - medicine , vaginal bleeding , endometrial hyperplasia , hyperplasia , gynecology , histiocyte , biopsy , adenocarcinoma , endometrial biopsy , cytology , vaginal smear , atypical hyperplasia , pathology , clinical significance , endometrium , obstetrics , cancer , pregnancy , genetics , estrous cycle , biology
Abstract Histiocytes in cervicovaginal smears from peri‐ or postmenopausal women have been viewed as a potential indicator of endometrial neoplasia, but recent studies have refuted that view. This study further defines the clinical significance of such findings. All cervical smears were selected from women (≥50 yr) in whom the presence of histiocytes was mentioned; pertinent clinical history, follow‐up information, and selected slides were reviewed. Among 105,225 total cervicovaginal smears from a 3.5‐yr period, 106 smears from 103 women were identified. Forty‐two patients (41%) were on hormone replacement therapy (2 on tamoxifen), and 23 (22.3%) patients experienced vaginal bleeding, all of whom had biopsy or cytology follow‐up. Ten (9.6%) patients had no follow‐up, 35 (32%) had repeat smears only, and 58 (56.3%) had endometrial/endocervical sampling. In 28 patients, the index smear was categorized as other than within normal limits or benign cellular changes; of these, 24 had subsequent tissue sampling and 4 had cytology follow‐up. Of the patients with tissue sampling, 51 (84%) had benign findings (including polyps), 2 (3.5%) had hyperplasia, and 5 (10%) had adenocarcinoma. All 5 patients with adenocarcinoma had endometrial glandular cells on the smear, and 4 had vaginal bleeding. One patient with hyperplasia had vaginal bleeding, and the other was on tamoxifen and had endometrial glandular cells on the smear. None of the patients having only histiocytes on their smears and no clinical symptoms or risk factors had endometrial adenocarcinoma or hyperplasia. These findings support the conclusion that the presence of histiocytes alone on cervicovaginal smears from peri‐ or postmenopausal women is nonspecific and of no major clinical significance in the absence of other clinical or cytologic findings. Diagn. Cytopathol. 24:271–275, 2001. © 2001 Wiley‐Liss, Inc.