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Cytologic findings in lichen sclerosus
K H van Hoeven1, G A Randleman, R L Artymyshyn
1Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, USA.
Acta Cytologica
|March 1, 1997
Summary
Gynecologic smears from patients with lichen sclerosus commonly show parakeratosis, hyperkeratosis, and small parabasal cells. Squamous atypia may be present but does not always indicate pre-cancerous changes.
Area of Science:
- Gynecologic Pathology
- Cytopathology
- Dermatopathology
Background:
- Lichen sclerosus is a chronic inflammatory skin condition affecting the vulva, vagina, and perineum.
- Understanding the cytologic findings in gynecologic smears is crucial for accurate diagnosis and management.
Purpose of the Study:
- To characterize the cytologic features observed in gynecologic smears from patients diagnosed with lichen sclerosus.
- To correlate these findings with biopsy-proven diagnoses.
Main Methods:
- Retrospective review of gynecologic smears from 29 patients with biopsy-proven lichen sclerosus (1989-1992).
- Analysis of cytologic findings including parakeratosis, hyperkeratosis, cell size and shape, and squamous atypia.
- Comparison of cytologic findings with histologic biopsy results.
Main Results:
- Parakeratosis (48%) and hyperkeratosis (62%) were frequent findings.
- Small, elongated parabasal cells were identified in 59% of smears and were morphologically similar to disorganized squamous cells in biopsies.
- Squamous atypia was noted in 41% of smears; frank dysplasia was rare, seen only in a patient with a history of vulvar carcinoma.
Conclusions:
- Common cytologic features in smears from lichen sclerosus patients include parakeratosis, hyperkeratosis, and small, elongated parabasal cells.
- Focal squamous atypia can occur and may not represent a preneoplastic condition.
- These cytologic findings warrant correlation with clinical and histologic diagnoses for comprehensive patient care.