The cytomorphology of papillary serous carcinoma of the endometrium in cervical smears

BACKGROUND. An investigation into the determination of cytomorphologic crit eria that may distinguish papillary serous carcinoma of the endometrium (PS C) from typical endometrioid carcinoma (TEC) in cervical smears was underta ken. Preoperative identification of this poor prognostic variant of endomet rial carcinoma may influence the surgical management of these cases and the choice of adjuvant therapy. METHODS. The cervical smears of 12 cases of histologically confirmed PSC; 1 2 cases of TEC, including 2 villoglandular/papillary variants, and 6 cases of mixed PSC and papillary endometrioid carcinoma were reviewed. In all cas es an initial diagnosis of malignancy had been made on the cervical smears. Twenty-seven criteria were evaluated and the relation between the cytologi c characteristics and the type of adenocarcinoma, the degree of association , and the intergroup homogeneity were tested. RESULTS, Features strongly associated with PSC were hypercellular smears wi th a background tumor diathesis, papillae, bare nuclei, and cells with larg e pleomorphic nuclei and bulky dense cytoplasm. In contrast, TEC showed a r elatively monomorphic population of cells with moderately enlarged oval nuc lei and delicate cytoplasm. In the mixed tumors, the features were similar to those of PSC, suggesting preferential exfoliation of the PSC component o f the tumor. CONCLUSIONS, Assessment of the cytomorphology of PSC and TEC of the endomet rium in Papanicolaou stained cervical smears is possible using statisticall y significant diagnostic criteria. Cancer (Cancer Cytopathol) 1999;87:12-8. (C) 1999 American Cancer Society.