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Clinical significance of histiocytes found on cervical cytology
1Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Jefferson Medical College, Philadelphia, PA.
Insights
The presence of histiocytes on cervical cytology is rarely linked to significant pathology, especially when no symptoms are present. Further investigation is warranted if clinical signs suggest disease.
Area of Science:
- Gynecologic Pathology
- Cytopathology
- Oncology
Background:
- Histiocytes are occasionally identified in cervical cytology reports.
- The clinical significance of histiocytes in cervical cytology requires further elucidation.
Purpose of the Study:
- To determine the incidence of cervical and endometrial pathology associated with histiocyte diagnosis on cervical cytology.
- To assess the correlation between histiocytes in cervical cytology and subsequent neoplastic or cancerous findings.
Main Methods:
- Retrospective review of cervical cytology reports from 1993-1995 identifying histiocytes.
- Chart review and 2-year follow-up for all identified patients.
Main Results:
- Histiocytes were diagnosed in 0.27% of cytology reports.
- Follow-up revealed normal pathology in 169 cases; neoplastic findings included polyps, hyperplasia, and 5 cases of endometrial cancer.
- All endometrial cancer cases presented with clinical signs and symptoms.
Conclusions:
- Histiocyte diagnosis on cervical cytology is associated with neoplasia (7.8%) or cancer (2.6%) in a minority of cases.
- Significant neoplasia or carcinoma was linked to clinical signs and symptoms.
- Histiocytes without concurrent symptoms appear to have minimal association with significant pathology.
Objective:
Our aim was to determine the incidence of cervical and endometrial pathology associated with the diagnosis of histiocytes on cervical cytology.
Materials And Methods:
A retrospective review was conducted from 1993 to 1995 of cervical cytology reports in which histiocytes were named in the descriptive diagnosis. Charts were reviewed and follow-up was performed on all patients for an additional 2 years.
Results:
Histiocytes were diagnosed in 226 of 82,018 (0.27%) cytology reports. Histiocytes alone (110), histiocytes and endometrial cells (40), and histiocytes and inflammation (45) were reported in the patients with complete follow-up. Final pathological findings after 2 years of follow-up were normal in 169 cases; other findings included polyps (6), simple hyperplasia (10), complex hyperplasia (1), previously treated cervical cancer (4), and endometrial cancer (5). All patients with endometrial cancer had clinical signs and symptoms of disease.
Conclusion:
The diagnosis of histiocytes on cervical cytology is associated with neoplasia (7.8%) or cancer (2.6%) in some cases. However, significant neoplasia (i.e., carcinoma or atypical hyperplasia) was associated with clinical signs and symptoms. On cytological workup, the finding of histiocytes in the absence of symptoms appears not to be associated with significant pathology.
