Psammoma bodies in cervicovaginal smears

Objective: To estimate the prevalence of psammoma bodies in routine cervica l cytology specimens and describe clinical diagnoses associated with them i n pre- and postmenopausal women. Methods: We identified all reports that contained psammoma bodies from a re trospective review of 34,816 cytology reports over 4 consecutive years from the computerized pathology database at Yale New-Haven Medical Center. Slid es were reviewed to confirm and qualify psammoma bodies. Medical records of women with psammoma bodies were reviewed and information on follow-up was collected. Results: We identified 18 women with psammoma bodies on their Papanicolaou smears. The median age was 49.5 years [range 17-78 years). Seven of eight p ostmenopausal women had gynecologic malignancies. Five presented with postm enopausal bleeding and had uterine serous or clear-cell carcinomas. One pre sented with a pelvic mass that was ovarian serous carcinoma. Another had a serous carcinoma of the fallopian tube with only psammoma bodies on Papanic olaou smears. Only one of the remaining 11 nonmalignant cases was a postmen opausal woman. Conclusion: The prevalence of psammoma bodies in consecutively screened Pap anicolaou smears was 18 of 34,816. Psammoma bodies on Papanicolaou smears a re ominous in postmenopausal women. Their presence in asymptomatic premenop ausal women warrants further evaluation, but not necessarily surgical explo ration. (Obstet Gynecol 2001;97: 693-5. (C) 2001 by The American College of Obstetricians and Gynecologists.).