Papillary tissue fragments in cervicovaginal (Pap) smears: Cytomorphologic characteristics and clinicopathologic significance

Lisa M. Stoll, Michael W. Johnson, Syed Z. Ali

Research output: Contribution to journalArticlepeer-review

Abstract

Papillary epithelial fragments (PEFs) are a rarely described architectural feature in cervicovaginal (Pap) smears. Morphologically, PEFs often consist of small, finely branching glandular tissue fragments with varying cytomorphology. This study identified 21 Pap smears (1978-2009) containing PEFs to determine the clinicopathologic significance of such findings. Patients ranged in age from 36 to 81 years (mean, 54 years). The Pap smear diagnoses consisted of 48% overt malignant neoplasms, 24% atypical fragments, and 28% benign entities. The papillary fragments featured a range of cytomorphologies consisting of benign features, mild to marked atypia, and overt malignancy. PEFs were more commonly found (57%) in specimens from patients with significant pathologic outcomes. Hence, the presence of PEFs in a Pap smear should raise concern for a neoplastic process. In smears displaying atypical to malignant cytomorphologic features recommendations for further clinical work-up and/or tissue studies should be made.

Original languageEnglish (US)
Pages (from-to)657-662
Number of pages6
JournalDiagnostic cytopathology
Volume39
Issue number9
DOIs
StatePublished - Sep 2011

Keywords

  • Pap
  • adenocarcinoma
  • cytology
  • papillary epithelial fragments

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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