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ThinPrep Pap test of endocervical adenocarcinoma with lymph node metastasis: Report of a case in a 17‐year‐old woman
Author(s) -
Wagner David G.,
Weisensel Joseph,
Mentrikoski Mark J.,
Leo Sharon D.,
Bonfiglio Thomas A.,
Hoda Rana S.
Publication year - 2010
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.21257
Subject(s) - medicine , adenocarcinoma , papanicolaou test , cervical cancer , malignancy , cytology , metastasis , pap test , lymph node , papanicolaou stain , stage (stratigraphy) , dysplasia , gynecology , pathology , cancer , cervical cancer screening , paleontology , biology
Endocervical adenocarcinoma is an uncommon malignancy that is composed of multiple subtypes and accounts for ∼15% of all cervical cancers. In this article, we describe the cytomorphology and differential diagnosis of an AJCC clinical stage IIIb, FIGO IB2 endocervical adenocarcinoma in a 17‐year‐old woman in a ThinPrep Pap test. The patient was a 17‐year‐old G0P0 white woman with no significant past medical history and no prior history of cervical dysplasia. She presented to her physician with a putrid vaginal discharge. A sample was sent to cytology that was interpreted as atypical endocervical cells, favor neoplasia. A subsequent cervical biopsy was diagnosed as endocervical adenocarcinoma with villoglandular features and ultimately, a hysterectomy with lymph node dissection was performed. The final diagnosis was endocervical adenocarcinoma with metastasis to three pelvic lymph nodes. The cytomorphology of endocervical adenocarcinoma on ThinPrep Pap test is similar to that described for conventionally‐processed Pap smears. This difficult diagnosis should be considered on a ThinPrep Pap test, regardless of age when the characteristic cytomorphology is observed. On a cytology sample, it is advisable to state atypical endocervical cells, adenocarcinoma in situ, or endocervical adenocarcinoma without providing a specific subtype even if there is a predominance of features for a particular subtype. Diagn. Cytopathol. 2010;38:633–638. © 2009 Wiley‐Liss, Inc.