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Pemphigus vulgaris of the cervix: Diagnostic difficulties associated with the P ap test
Author(s) -
Munhoz de Paula Alves Coelho Karina,
Stall Jaqueline,
Henrique Condeixa de França Paulo,
Cristina de Carvalho Tavares Lara,
Stefanello Bublitz Giuliano,
Loos Beliza,
Carvalho Costa Luciana,
Fronza Júnior Hercílio
Publication year - 2015
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.23269
Subject(s) - medicine , pemphigus vulgaris , pathology , papanicolaou stain , cervix , biopsy , cervical intraepithelial neoplasia , pap test , papanicolaou test , dermatology , cervical cancer , cervical cancer screening , cancer
Pemphigus vulgaris (PV) is a rare mucocutaneous disease caused by the abnormal production of antibodies against epithelial cell surface glycoproteins, resulting in loss of cell adhesion and intraepithelial blister formation. Cervical involvement in PV has been poorly reported, and there is little information regarding the criteria about consequential cytological changes identified in a Papanicolaou‐stained cervicovaginal smear (Pap smear). Here, we report a case of PV manifesting in the cervix as well as the difficulty associated with the cytomorphological identification and interpretation of acantholytic cells. This case involved a 40‐year‐old patient with no history of Pap test abnormalities and no prior diagnosis of PV. In the cytological assessment, cells were identified both in isolation and in clusters that exhibited round nuclei of increased volume, inconspicuous nucleoli, and perinuclear halos. The patient underwent a cervical biopsy that revealed vesiculobullous lesions and morphological pattern consistent with PV. A skin biopsy confirmed this diagnosis. We concluded that knowledge of PV cytomorphology is important because difficulties associated with the identification and interpretation of acantholytic cells might be responsible for false positive diagnoses of cervical neoplasia. However, a suspected diagnosis of PV is possible if the cytological findings are carefully correlated with the clinical data. Diagn. Cytopathol. 2015;43:635–637. © 2015 Wiley Periodicals, Inc.