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Abnormal cervicovaginal smears due to endometriosis: a continuing problem
Sarah J Lundeen1, Charles A Horwitz, Carol J Larson
1Department of Pathology, Hennepin County Medical Center, Minneapolis, Minnesota 55415, USA. lunde007@gold.tc.umn.edu
Diagnostic Cytopathology
|January 10, 2002
Summary
Cervical endometriosis on cervicovaginal smears (CVS) can be misdiagnosed as high-grade squamous intraepithelial lesion (HSIL) or atypical glandular cells (AGUS). Increased awareness is crucial for accurate diagnosis and to prevent unnecessary procedures.
Area of Science:
- Gynecologic Pathology
- Cytopathology
Background:
- Cervical endometriosis is a rare condition that can mimic glandular abnormalities on cervicovaginal smears (CVS).
- Accurate identification of cervical endometriosis is essential to avoid misdiagnosis as high-grade squamous intraepithelial lesion (HSIL) or atypical glandular cells of undetermined significance (AGUS).
Observation:
- Three cases are presented where cervical endometriosis on CVS was misinterpreted as AGUS or HSIL.
- Two of the three patients underwent hysterectomy due to misdiagnosis.
Findings:
- Endometriosis exhibits varied cytomorphologic features influenced by hormonal changes during the menstrual cycle, complicating diagnosis.
- Characteristic features of cervical endometriosis on CVS are not well-established, contributing to diagnostic challenges.
Implications:
- Cervical endometriosis should be considered in the differential diagnosis of glandular abnormalities on CVS, alongside conditions like cervicitis and microglandular hyperplasia.
- Enhanced awareness and understanding of endometriosis cytomorphology are needed to improve diagnostic accuracy and patient management, potentially reducing overtreatment.