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Prevalence of psammoma bodies in Papanicolaou-stained cervicovaginal smears
1Medical Arts Laboratory, Oklahoma City, Oklahoma.
Abstract:
Reports from sequential series of 234,318 cervicovaginal smears from a period of three years were reviewed to ascertain the prevalence and significance of psammoma bodies. Seven smears contained psammoma bodies. Three of the seven were associated with benign conditions and four were associated with a cancer (two serous papillary endometrial adenocarcinomas, one ovarian serous cystadenocarcinoma and one serous papillary carcinoma of the peritoneum). The prevalence of psammoma bodies in benign cases was much higher than reported in previous studies, in which most findings of psammoma bodies were associated with malignancy, particularly ovarian carcinoma. A consistent and useful feature in distinguishing psammoma bodies associated with benign or malignant disease was the presence of a few adherent small bland-appearing glandular cells in benign disorders and adherent malignant glandular cells in cases of carcinoma. A more conservative work-up may be merited in young women with clearly benign cells associated with psamoma bodies in a cervicovaginal smear and an otherwise negative physical examination and noncontributory endometrial sampling.
Insights
Psammoma bodies in cervicovaginal smears are not always malignant. Differentiating benign from malignant psammoma bodies involves examining attached glandular cells, potentially altering diagnostic work-ups.
Area of Science:
- Gynecologic Pathology
- Cytopathology
Background:
- Psammoma bodies are calcified structures often associated with malignancy, particularly ovarian and endometrial cancers.
- Previous studies indicated a strong correlation between psammoma bodies and malignant conditions.
Observation:
- A review of 234,318 cervicovaginal smears identified psammoma bodies in seven cases.
- Three cases were linked to benign conditions, while four were associated with various cancers.
Findings:
- The prevalence of psammoma bodies in benign conditions was higher than previously reported.
- Distinguishing feature: benign cases had bland glandular cells, malignant cases had cancerous cells attached.
Implications:
- A more conservative diagnostic approach may be suitable for young women with benign-appearing psammoma bodies and negative clinical findings.
- This study refines the interpretation of psammoma bodies in cervicovaginal cytology, impacting patient management.