Abnormal cervicovaginal smears due to endometriosis: A continuing problem

Lundeen SJ, Sarah J. Lundeen, Horwitz CA, Charles A. Horwitz, Carol J. Larson, Larson CJ, Michael W. Stanley, Stanley MW
Diagnostic cytopathology · 2002 · vol. 26(1) , pp. 35–40 · doi:10.1002/dc.10038 · PMID:11782085 · W2129630685
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Cervical endometriosis on cervicovaginal smears can mimic high-grade squamous intraepithelial lesions or glandular abnormalities, leading to misdiagnosis and unnecessary procedures.

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Abstract

Endometriosis may be challenging when identified on cervicovaginal smears (CVS), leading to an incorrect interpretation of high-grade squamous intraepithelial lesion (HSIL), or atypical glandular cells of undetermined significance (AGUS) including adenocarcinoma in situ (AIS). Awareness of cervical endometriosis, particularly in predisposed patients, is crucial for a correct diagnosis. While cervical endometriosis has been reported to be a diagnostic pitfall of glandular abnormalities, its characteristic features are still not well-established. This may partially be attributed to the varied cytomorphologic features endometriosis shows, depending on menstrual cycle hormonal changes. We describe our experience with three examples where CVS were interpreted as either AGUS or HSIL, which led to a hysterectomy in 2 of 3 patients. Cervical endometriosis needs to be considered with other well-known benign conditions that mimic glandular abnormalities, including cervicitis, tubal metaplasia, lower uterine segment sampling, and microglandular hyperplasia. Published series and our own experience lead us to suggest that these smears will continue to present diagnostic difficulties.

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Condition tags

endometriosis

MeSH descriptors

Carcinoma in Situ Endometriosis Uterine Cervical Dysplasia Uterine Cervical Neoplasms Adult Carcinoma in Situ Carcinoma in Situ Carcinoma in Situ Cervix Uteri Cervix Uteri Diagnosis, Differential Endometriosis Endometriosis Endometriosis Fallopian Tube Diseases Fallopian Tube Diseases Female Humans Hyperplasia Hyperplasia

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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Cited by (19)

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