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Papillary tissue fragments in cervicovaginal (Pap) smears: Cytomorphologic characteristics and clinicopathologic significance
Author(s) -
Stoll Lisa M.,
Johnson Michael W.,
Ali Syed Z.
Publication year - 2011
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.21443
Subject(s) - medicine , atypia , pathology , malignancy , clinical significance , cytopathology , cytology
Papillary epithelial fragments (PEFs) are a rarely described architectural feature in cervicovaginal (Pap) smears. Morphologically, PEFs often consist of small, finely branching glandular tissue fragments with varying cytomorphology. This study identified 21 Pap smears (1978–2009) containing PEFs to determine the clinicopathologic significance of such findings. Patients ranged in age from 36 to 81 years (mean, 54 years). The Pap smear diagnoses consisted of 48% overt malignant neoplasms, 24% atypical fragments, and 28% benign entities. The papillary fragments featured a range of cytomorphologies consisting of benign features, mild to marked atypia, and overt malignancy. PEFs were more commonly found (57%) in specimens from patients with significant pathologic outcomes. Hence, the presence of PEFs in a Pap smear should raise concern for a neoplastic process. In smears displaying atypical to malignant cytomorphologic features recommendations for further clinical work‐up and/or tissue studies should be made. Diagn. Cytopathol. 2010. © 2010 Wiley‐Liss, Inc.