Abstract
Background : Vaginal stump fallopian tube prolapse (VSFTP) is a rare complication after a hysterectomy. The vaginal stump smear contains mature squamous cells and large clusters of small columnar cells accompanied by a leukocytic infiltration in an inflammatory background. These clusters are thought to be fallopian tubal epithelium, but no ciliated cells exist in many cases.
Case : A 38-year-old woman who underwent an abdominal hysterectomy 4 months prior sought evaluation for a brown discharge, and the vaginal stump showed a granulation tissue-like tumor. A vaginal stump scraping smear contained mature squamous cells and clusters of small non-ciliated columnar cells in an inflammatory background. An excision was performed, and a diagnosis of VSFTP was made. To determine why ciliated cells were not detected in the scraping cytopreparation, we observed an imprint and a scraping cytopreparation from the fallopian tubes of another patient. Ciliated cells were noted in the imprint cytopreparation ; however, these cells were absent in the scraping cytopreparation.
Conclusion : We conclude that the reason why most of the ciliated cells are not seen in a scraping cytopreparation in VSFTP cases is that cilia come off during scraping. The cytologic diagnosis of VSFTP is easy to establish if a sampling method is used which does not involve scraping.
