Authors

Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background & Objectives: Tumor diathesis (TD) is defined as granular proteinaceous precipitates on slide surface of cytologic smears. It is found in the background of smears of invasive carcinoma but not in all cases. The aim of present study was to determine the prevalence of TD in cervicovaginal smears from patients with uterine cervix carcinoma.
Methods: Cytological smears and histological slides from the Department of Pathology, Women Hospital, Tehran, Iran, of forty six patients histologically confirmed carcinoma of uterine cervix from 1995 to 2003 were reviewed for presence of TD, red blood cells, and neutrophils on cytological smears as well as depth of invasion, histologic types and grade of differentiation of tumor.
Results: TD was detected in 28 of the 46 smears (60.9%); in 18 patients with squamous cell carcinoma (62.1%), 7 adenocarcinoma (58.3%), 2 adenosquamous carcinoma (66.7%) and one endometrial carcinoma which involved uterine cervix. TD was seen in 4 (33.3%) uterine cervix carcinoma with 5mm depth of invasion and 17 (65.4%) uterine cervix carcinoma with ≥ 5mm depth of invasion. There was a positive correlation between the presence of TD and the depth of invasion. Although an important criterion of malignancy, TD, was absent in some cases of carcinoma, particularly those that had < 5mm depth of invasion.
Conclusion: Increasing in depth of invasion and decreasing in differentiation of the tumor were associated with increasing in frequency of TD in cytological smears. A definite distinction between an intraepithelial lesion and a shallow invasive cancer may not be possible on cervicovaginal smears.

Keywords

Rushing L, Cibas E. Frequency of tumor diathesis in smears from women with squamous cell carcinoma of the cervix. Acta Cytologica 1997; 41 : 781-5.

  • Selvaggi SM. Atrophic Vaginitis Versus Inrasive Squamous Cell Carcinoma on ThinPrep cytology: Can the Background be Reliably Distinguished? Diag Cytopathol 2002; 27(6):362-64.

  • Ramzy I. Clinical cytopathology and aspiration biopsy. 2nd ed. New York: Mcgraw-Hill Press; 2001.

  • Vooijs P. Comprehensive cytopathology. 2nd ed. Philadelphia:Saunders; 1997.

  • Chirstin W.  Diagnostic cytopathology. 2nd ed. London:Churchill Livigstone; 2003.

  • Clark S B, Dawson A E. Invasive Squamous-Cell Carcinoma in ThinPrep Specimens: Diagnostic Clues in the Cellular Pattern. Diag Cytopathol  2002; 26(1):1-4.

  • Selvaggi SM. Background Features of Endometrial Carcinoma on ThinPrep Cytology. Diag Cytopathol 2005; 33(3):162-5.

  • Robboy SJ, Mutter GL, Prat J, Bentley RC, Russel P, Anderson MC. Robboys Pathology of Female Reproductive Tract. 2nded. London:Churchill Livingstone;2009.

  • Schorge JO, Hossein Saboorian M, Hynan L, Ashfaq R. ThinPrep detection of cervical and endometrial adenocarcinoma: a retrospective cohort study. Cancer 2002;96(6):338-43.

  • Schoolland M, Allpress S, Sterrett GF. Adenocarcinoma of cervix. Cancer 2002; 96(6):5-13.

  • Renshaw AA, Dubray-Benstein B, Cobb CJ, Lozano RL, Neal MH, Prey M, et al. Cytologic features of squamous cell carcinoma in ThinPrep slides: evaluation of cases that performed poorly versus those that performed well in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology.  Arch Pathol Lab Med 2004; 128(7):403-5.