Abstract
Objective: To clarify the factors responsible for misdiagnosis of cervical adenocarcinoma on cytology.
Study Design: A total of 59 cases of cervical adenocarcinoma were reviewed to clarify the cytological findings, and compared with squamous cell carcinoma with respect to the frequency of tumor diatheses in cytological specimens and necrosis on histopathologic examinaition.
Results: 1. Some cases of invasive adenocarcinoma were difficult to diagnose by cytology. 2. All smears did not reveal overlapping clusters of cells and atypia of nuclei. The more frequent abnormal findings were irregular arrangement, nuclear enlargement and anisonucleosis. 3. The frequency of tumor diatheses in cytological specimens of cervical adenocarcinoma was statistically significantly lower than that in stage I b and II b squamous cell carcinoma. It would seem that tumor cells in cases of cervical adenocarcinoma are often not detected in spite of the observation of necrosis on histopathological examination.
Conclusion: It is suggested that one cause of misdiagnosis of cervical adenocarcinoma on cytology is the cytological characteristics of the tumor, in which cellular and structure atypia is ofter mild, and in some cases, smears do not reveal tumor diatheses even in the presence of invasive carcinoma. Thus, in cases in whom irregular arrangement, nuclear enlargement and anisonucleosis are detected on cytology, but no tumor cells, punch biopsy or conization should be performed to exclude invasive carcinoma.
