Journal of Pathology and Translational Medicine

Original Article

Comparison of Cytologic Characteristics between Adenoid Cystic Carcinoma and Adenoid Basal Carcinoma in the Uterine Cervix: Juhyeon Jeong, Seung Yeon Ha, Hyun Yee Cho, Dong Hae Chung, Jungsuk An; J Pathol Transl Med. 2015;49(5):396-402. Published online August 17, 2015; DOI: https://doi.org/10.4132/jptm.2015.07.08

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Background
Adenoid cystic carcinoma (ACC) and adenoid basal carcinoma (ABC) are rare in the uterine cervix. ACC is more aggressive than ABC, thus accurate differential diagnosis is important. In this study, we identified cytologic features useful in distinguishing these two tumors for diagnosis. Methods: Three cases of ACC and five cases of ABC were selected for this study. Cervicovaginal smear slides were reviewed retrospectively, and the area, circumference, major axis, and minor axis of nuclei were measured using an image analyzer. Results: ACC displayed three-dimensional clusters with a small acini pattern. ABC displayed peripheral palisading without an acini pattern. The nuclei of ACC were more irregular and angulated than those of ABC, and the former showed a coarsely granular chromatin pattern. The nucleic area, circumference, major axis, and minor axis were 18.556±8.665 µm², 23.320±11.412 µm, 5.664±1.537 µm, and 4.127±1.107 µm in ACC and 11.017±4.440 µm², 15.920±5.664 µm, 4.612±1.025 µm, and 3.088±0.762 µm in the cases of ABC. All measured values showed statistically significant difference (p < .001). Conclusions: Although the nuclei of both of these tumor types were oval shaped, inferred from the ratio of minor axis to major axis (0.728 in ACC and 0.669 in ABC), the area of nuclei was approximately 1.7 times larger in ACC than in ABC. Distinguishing nucleic features, including area, morphology, and chromatin pattern, may be helpful in making a correct diagnosis.

Citations

Citations to this article as recorded by

Adenoid basal carcinoma of the uterine cervix
Anas Mohamed, Tesfalem Korga, Ahlam Ali, Javier Laurini
International Journal of Gynecological Cancer.2025; : 101873. CrossRef
Adenoid Basal Carcinoma of the Uterine Cervix: A Case Report
Tatsuya Kanuma, Keiko Kigure, Tosio Nishimura, Yuji Ibuki, Shigeru Tsuchida, Harumi Kamiyama, Misa Iijima, Kazuto Nakamura
The KITAKANTO Medical Journal.2016; 66(1): 11. CrossRef

Brief Case Reports

The Limitations of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology in the Diagnosis of Pancreatic Serous Cystadenoma: A Brief Case Report: Heae Surng Park, Sun Och Yoon, Beom Jin Lim, Joo Hee Kim, Soon Won Hong; Korean J Pathol. 2014;48(5):405-408. Published online October 27, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.5.405

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Detection of Human Papillomavirus Type 39 in a Seborrheic Inclusion Cyst of the Buttock: Dae Hyun Song, Sang-Guk Lee, Dong Chul Kim, Jeong Hee Lee, Gyung Hyuck Ko, Jong Sil Lee; Korean J Pathol. 2014;48(5):398-400. Published online October 27, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.5.398

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Case Study

Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis: A Case Study and Review of the Literature: Seyda Erdogan, Arbil Acikalin, Handan Zeren, Gulfılız Gonlusen, Suzan Zorludemir, Volkan Izol; Korean J Pathol. 2014;48(3):225-228. Published online June 26, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.3.225

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Abstract PDF

Well-differentiated papillary mesothelioma is an uncommon tumor of the testes that usually presents as a hydrocele. Here, we present the case of one patient who did not have a history of asbestos exposure. The tumor was localized in the tunica vaginalis and was composed of three pedunculated masses macroscopically. Microscopically, branching papillary structures with focal coagulative necrosis were present. In addition to immunohistochemistry, simian virus 40 DNA was also tested by polymerase chain reaction. This report presents one case of this rare entity, its clinical and macroscopic features, and follow-up results.

Citations

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Testicular/paratesticular mesothelial tumours: Uncommon histopathologic entities in a very complex anatomical site
Francesca Pagliuca, Stefano Lucà, Marco De Sio, Davide Arcaniolo, Gaetano Facchini, Marco De Martino, Francesco Esposito, Ferdinando DE Vita, Paolo Chieffi, Renato Franco
Pathology - Research and Practice.2024; 253: 155069. CrossRef
Well-differentiated Papillary Mesothelial Tumour of the Tunica Vaginalis Testis – A Rare Lesion, but one Pathologists Should Know About Two Patient Reports and a Review of the Literature
Johannes Kläger, Felicitas Oberndorfer, Cristophe Brunel, Julian Veser, Eva Compérat
International Journal of Surgical Pathology.2023; 31(6): 1126. CrossRef
A diagnostic approach to paratesticular lesions with tubulopapillary architecture: a series of 16 serous borderline tumors/low-grade serous carcinoma and 14 well-differentiated papillary mesothelial tumors and mesothelioma
Rabia Zafar, Lacey J. Schrader, John C. Cheville, J. Kenneth Schoolmeester, Anja C. Roden, Marie-Christine Aubry, Eunhee S. Yi, Aditya Raghunathan, Loren Herrera-Hernandez, R. Houston Thompson, Stephen A. Boorjian, Bradley C. Leibovich, Gary L. Keeney, Ra
Human Pathology.2022; 128: 31. CrossRef
Mesothelioma subtypes of the tunica vaginalis: a rare case report and review of histological criteria
Cutts Rebecca, Martin J Connor, Luxi Sun, Thomas Johnston, Rachel Gooch, John McLoughlin
Journal of Surgical Case Reports.2019;[Epub] CrossRef
Well‐differentiated papillary mesothelioma of tunica vaginalis testis of unknown malignant potential: Sonographic appearance
K.W.S. Ko, K.S. Tse, K.W. Shek, M.N. Hau, S.H. Ting
Journal of Clinical Ultrasound.2018; 46(5): 364. CrossRef
Tunica Vaginalis Thickening, Hemorrhagic Infiltration and Inflammatory Changes in 8 Children with Primary Hydrocele; Reactive Mesothelial Hyperplasia? A Prospective Clinical Study
Ioannis Patoulias, Evangelia Rachmani, Maria Kalogirou, Kyriakos Chatzopoulos, Dimitrios Patoulias
Acta Medica (Hradec Kralove, Czech Republic).2018; 61(2): 41. CrossRef
A 45-year-old man presenting with chest pain
Sheetu Singh, Arpita Jindal
Lung India.2018; 35(2): 171. CrossRef
Two Case Reports of Benign Testicular Mesothelioma and Review of the Literature
Cristobal Ramirez Sevilla, Carme Admella Salvador, Josep Feliu Canaleta, Juan Llopis Manzanera, Miguel Angel Barranco Sanz, Juan Antoni Romero Martin, Sergi Bernal Salguero, Francesco A. Mauri
Case Reports in Oncological Medicine.2017;[Epub] CrossRef
Well-differentiated Papillary Mesothelioma of the Tunica Vaginalis
Wei Keith Tan, Mae-Yen Tan, Hui Meng Tan, Rajadurai Pathmanathan, Wei Phin Tan
Urology.2016; 90: e7. CrossRef
Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis: Case Report and Systematic Review of Literature
Wei Keith Tan, Mae-Yen Tan, Wei Shen Tan, Soon Ching Gan, Rajadurai Pathmanathan, Hui Meng Tan, Wei Phin Tan
Clinical Genitourinary Cancer.2016; 14(4): e435. CrossRef
The legacy of the F344 rat as a cancer bioassay model (a retrospective summary of three common F344 rat neoplasms)
Robert R. Maronpot, Abraham Nyska, Jennifer E. Foreman, Yuval Ramot
Critical Reviews in Toxicology.2016; 46(8): 641. CrossRef
Malignant Mesothelioma of the Tunica Vaginalis: A Rare Neoplasm—Case Report and Literature Review
Manuel Segura-González, Jorge Urias-Rocha, Jorge Castelán-Pedraza
Clinical Genitourinary Cancer.2015; 13(6): e401. CrossRef
In vivo Optical Coherence Tomography Imaging of the Mesothelium Using Developed Window Models
Yeh-Chan Ahn, Yu-Gyeong Chae, Sang Seok Hwang, Bong-Kwon Chun, Maan Hong Jung, Sung Jin Nam, Hae-Young Lee, Jae Min Chung, Chulho Oak, Eun-Kee Park
Journal of the Optical Society of Korea.2015; 19(1): 69. CrossRef

Original Article

Cytological Evaluation and REBA HPV-ID HPV Testing of Newly Developed Liquid-Based Cytology, EASYPREP: Comparison with SurePath: Youn Soo Lee, Gyungyub Gong, Jin Hee Sohn, Ki Sung Ryu, Jung Hun Lee, Shin Kwang Khang, Kyung-Ja Cho, Yong-Man Kim, Chang Suk Kang; Korean J Pathol. 2013;47(3):265-274. Published online June 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.265

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Abstract PDF

Background

The objective of this study was to evaluate a newly-developed EASYPREP liquid-based cytology method in cervicovaginal specimens and compare it with SurePath.

Methods

Cervicovaginal specimens were prospectively collected from 1,000 patients with EASYPREP and SurePath. The specimens were first collected by brushing for SurePath and second for EASYPREP. The specimens of both methods were diagnosed according to the Bethesda System. Additionally, we performed to REBA HPV-ID genotyping and sequencing analysis for human papillomavirus (HPV) on 249 specimens.

Results

EASYPREP and SurePath showed even distribution of cells and were equal in cellularity and staining quality. The diagnostic agreement between the two methods was 96.5%. Based on the standard of SurePath, the sensitivity, specificity, positive predictive value, and negative predictive value of EASYPREP were 90.7%, 99.2%, 94.8%, and 98.5%, respectively. The positivity of REBA HPV-ID was 49.4% and 95.1% in normal and abnormal cytological samples, respectively. The result of REBA HPV-ID had high concordance with sequencing analysis.

Conclusions

EASYPREP provided comparable results to SurePath in the diagnosis and staining quality of cytology examinations and in HPV testing with REBA HPV-ID. EASYPREP could be another LBC method choice for the cervicovaginal specimens. Additionally, REBA HPV-ID may be a useful method for HPV genotyping.

Citations

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Virome capture sequencing for comprehensive HPV genotyping in cervical samples
Thanayod Sasivimolrattana, Sasiprapa Liewchalermwong, Wasun Chantratita, Insee Sensorn, Arkom Chaiwongkot, Parvapan Bhattarakosol
Science Progress.2025;[Epub] CrossRef
High-Risk Human Papillomavirus Detection via Cobas® 4800 and REBA HPV-ID® Assays
Sasiprapa Liewchalermwong, Shina Oranratanaphan, Wichai Termrungruanglert, Surang Triratanachat, Patou Tantbirojn, Nakarin Kitkumthorn, Parvapan Bhattarakosol, Arkom Chaiwongkot
Viruses.2022; 14(12): 2713. CrossRef
Evaluation of nuclear chromatin using grayscale intensity and thresholded percentage area in liquid‐based cervical cytology
Hyekyung Lee, Myungein Han, Taejo Yoo, Chanho Jung, Hyun‐Jin Son, Migyung Cho
Diagnostic Cytopathology.2018; 46(5): 384. CrossRef
Comparison of EASYPREP® and SurePath® in thyroid fine‐needle aspiration
Yosep Chong, Ki Hyun Baek, Jee Young Kim, Tae‐Jung Kim, Eun Jung Lee, Chang Suk Kang
Diagnostic Cytopathology.2016; 44(4): 283. CrossRef

Case Report

Cellular Pseudosarcomatous Fibroepithelial Stromal Polyp of the Vagina during Pregnancy: A Lesion That Is Overdiagnosed as a Malignant Tumor: Joon Seon Song, Dong Eun Song, Kyu-Rae Kim, Jae Y. Ro; Korean J Pathol. 2012;46(5):494-498. Published online October 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.5.494

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Abstract PDF

Fibroepithelial stromal polyp (FSP) is a benign lesion that can occur at various sites, including the lower female genital tract. In rare cases, however, it may exhibit hypercellularity, bizarre cytomorphological features, and atypical mitoses resulting in an overdiagnosis as a malignant tumor despite its benign clinical course. Recently, we experienced one case of a 30-year-old pregnant woman with cellular pseudosarcomatous FSP that was initially diagnosed as a malignant fibrous histiocytoma at a primary clinic. In addition to describing the rare features of this case, we wish to increase awareness about this benign lesion which will be essential for avoiding unnecessary radical surgery or chemoradiation treatment.

Citations

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Giant hypopharyngeal fibroepithelial polyp: A case report and literature review
Muhammad Nour Alabdullah, Nagham Halaweek, Yasser Al Ghabra, Mohammad Hamdi, Mhd Ayham Abo Trab, Faysal Hajjar
Ear, Nose & Throat Journal.2025;[Epub] CrossRef
A Rare Case of A Pseudosarcomatous Stromal Tumor: A Unique Benign Ampullary Tumor
Jacob C. Jones, Penelope I. Quiles, John G. Quiles, Jerome G. Edelson
ACG Case Reports Journal.2025; 12(7): e01767. CrossRef
Fibroepithelial Polyp of the Vagina With Torsion: A Difficult Diagnosis Based on Clinical and Morphological Findings of the Vaginal Lesion
Efthymia Thanasa, Anna Thanasa, Gerasimos Kontogeorgis, Ektoras-Evangelos Gerokostas, Ioannis-Rafail Antoniou, Athanasios Chasiotis, Emmanouil M Xydias, Apostolos C Ziogas, Evangelos Kamaretsos, Ioannis Thanasas
Cureus.2024;[Epub] CrossRef
Recurrent fibroepithelial vaginal polyp in a 2-year-old girl: a case report and review of the literature
Mohammad Hakam Shehadeh, Ahmad M. Abualrub, Waleed M. Malhes, Amar Msarweh, Wael Amro
Annals of Medicine & Surgery.2024; 86(4): 2335. CrossRef
A vaginal fibroepithelial stromal polyp: a case report with magnetic resonance images
Naoko Ogura, Mieko Inagaki, Ritsuko Yasuda, Shigeki Yoshida, Tetsuo Maeda
BJR|case reports.2022;[Epub] CrossRef
Fast-growing fibroepithelial stromal vaginal polyp
Ana Marta Pinto, Maria Boia Martins, Isabel Ferreira, Clara Moreira
BMJ Case Reports.2022; 15(6): e250076. CrossRef
Mesenchymal lesions of the vulva
David B. Chapel, Nicole A. Cipriani, Jennifer A. Bennett
Seminars in Diagnostic Pathology.2021; 38(1): 85. CrossRef
Giant Fibroepithelial Stromal Polyp of the Vulva: Diffusion-Weighted and Conventional Magnetic Resonance Imaging Features and Pathologic Correlation
Joonghyun Yoo, Bo-Kyung Je, Suk Keu Yeom, Ye Sul Park, Kyung-Jin Min, Joo Han Lee
Journal of Pediatric and Adolescent Gynecology.2019; 32(1): 93. CrossRef
Cellular Pseudosarcomatous Fibroepithelial Stromal Polyp of the Cervix: A Lesion Mimicking as Sarcoma
Ruquiya Afrose
Advances in Cytology & Pathology.2018;[Epub] CrossRef
Pseudosarcomatous Vaginal Polyp
Alexis Heller, Adanna Ukazu, Qing Wang
International Journal of Surgical Pathology.2017; 25(1): 54. CrossRef

Original Article

Primary Non-clear-cell Adenocarcinoma of the Vagina: Report of a Case.: M K Jee, Y J Choi, K W Yang, B K Kim, S M Kim; J Pathol Transl Med. 1990;1(1):103-110.

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Abstract PDF: A case of primary non-clear-cell adenocarcinoma of the vagina is reported occurring in a 65-year-old woman without exposure to diethylstilbestrol(DES) in utero. The adenocarcinoma did not appear to be associated with vaginal adenosis. It lacked clear cell component and interestingly composed of columnar epithelial cells of endocervical-type Cytologically round to oval unclei revealed one or more small nucleoli and fine granular chromatin pattern. Cytoplasm was pulmp, faintly basophilic and homogeneously stained. Histologically well differentiated columnar epithelial cells were arranged in trabecular pattern mainly, and also occasional glandular lumina and small solid sheets were found. Mitoses were hardly found.

Case Report

Spindle Cell Epithelioma, a So-called Benign Mixed Tumor of the Vagina: A Case Report.: Mee Hye Oh, Eun Ah Jung, Ji Hye Lee, Hyun Deuk Cho, Seung Ha Yang, Jeong Ja Kwak; Korean J Pathol. 2010;44(6):670-674.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.670

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Abstract PDF: We report a case of spindle cell epithelioma, a so-called benign mixed tumor of the vagina. The patient was a 35-year-old nulliparous woman who presented with a polypoid mass in the posterior wall of the lower vagina just above the hymenal ring. The tumor was relatively well-defined with an expansile margin and composed of stromal-type spindle cells with a myxoid stroma arranged in short fascicles and an irregular cord-like or reticular pattern. A few glandular structures lined by cuboidal cells with squamous metaplasia were also noted. Cellular atypia was not conspicuous and mitosis was not found. We examined this tumor immunohistochemically to identify the histogenesis. The coexpression of epithelial and mesenchymal markers in stromal-type spindle cells suggested a multipotential cell origin for this tumor. The patient has been well with no signs of recurrence during the 12 months after surgery.

Original Article

Evaluation of Low-Grade Squamous Intraepithelial Lesions, Cannot Exclude High-Grade Squamous Intraepithelial Lesions on Cervical Smear.: Sung Ran Hong, Bock Man Kim, Hye Sun Kim, Yi Kyeong Chun, Hy Sook Kim; Korean J Pathol. 2010;44(5):528-535.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.528

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Abstract PDF

BACKGROUND
We examined cervicovaginal smears that contained definite low-grade squamous intraepithelial lesion (LSIL) cells and rare atypical cells suggestive of high-grade SIL (HSIL) (ASC-H) or contained borderline dysplastic cells between LSIL and HSIL. Such lesions were classified as LSIL-H. This study aimed to investigate the cytologic and histologic characteristics of LSIL-H category and we evaluated the associated clinical risk.
METHODS
The histologic outcomes of LSIL-H were compared with those of LSIL and ASC-H. Both the cytologic and histologic findings of LSIL-H that were confirmed as cervical intraepithelial neoplasia 2 (CIN2) or greater (CIN2+) were investigated.
RESULTS
LSIL-H accounted for 0.09% of the Pap tests. On the follow-up histology, the most frequent outcome was CIN2, and the risk of CIN2+ was higher than that for ASC-H. In the cases of LSIL-H that was histologically confirmed as CIN2+, most of the atypical cells suggestive of HSIL were cytologically similar to those of CIN2, and the corresponding cervical tissues were characterized by small CIN2+ lesions in a large background of flat condyloma/CIN1. The LSIL-H cases not confirmed on initial colposcopically-directed biopsy required further follow-up.
CONCLUSIONS
LSIL-H may be a valid diagnostic category with distinctive features that are different from LSIL or ASC-H. LSIL-H needs further follow-up for the proper management.

Citations

Citations to this article as recorded by

The Clinical Significance of “Squamous Intraepithelial Lesion of Indeterminate Grade” as a Distinct Cytologic Category
Dorothy Wong, Crystal Teschendorf, Grace Y. Lin, Farnaz Hasteh
American Journal of Clinical Pathology.2012; 137(5): 753. CrossRef

Case Reports

Enterobius vermicularis Ova in a Vaginal Smear.: Seung Kyu Choi, Eun Kyung Kim, Young Ok Hong, Ho Jung Lee, Won Mi Lee, Sook Kyung Ko, Jong Eun Joo; Korean J Pathol. 2010;44(3):341-342.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.341

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Abstract PDF

Enterobius vermicularis is one of the most common parasites found in the intestine of humans. The gravid female worms migrate outside the anus to release eggs on the perianal skin. Rarely, they migrate to the genitourinary tract in female patients. We present a case in which pinworm eggs were found in a cervicovaginal smear of a 37-year-old woman. The eggs were elongated oval shaped and flattened on one side. The thick, double contoured birefringent shell stained bright yellow or orange. Some coarsely granular embryos or curved larvae were enclosed in the refractile shell. Empty eggs or wrinkled shells with clumped granular material were also present. Although pinworm eggs are easily identified because of their characteristic morphologic appearance, careful screening is needed due to the frequent masking by inflammatory cells.

Citations

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High case enterobiasis in school children and potential eggs distribution on the bed
Didik Sumanto, Sayono E, Wulandari Meikawati, Tri Dewi Kristini, Wahyu Handoyo, Aris Sugiharto
Journal of Microbiology & Experimentation.2022; 10(1): 33. CrossRef
Enterobius vermicularis larvae in urine sample of female student: The first case report in Indonesia
Didik Sumanto, Sayono Sayono, Puji Lestari Mudawamah
Journal of Microbiology & Experimentation.2021; 9(1): 1. CrossRef
Vaginal Enterobius vermicularis diagnosed on liquid‐based cytology during Papanicolaou test cervical cancer screening: A report of two cases and a review of the literature
Chun‐Yi Tsai, Rachel Junod, Martine Jacot‐Guillarmod, Charles Beniere, Sonia Ziadi, Massimo Bongiovanni
Diagnostic Cytopathology.2018; 46(2): 179. CrossRef
Recurrent paediatric pinworm infection of the vagina as a potential reservoir for Enterobius vermicularis
B. Kashyap, J.C. Samantray, S. Kumar, R. Jhamb, A.K. Singh, I.R. Kaur
Journal of Helminthology.2014; 88(3): 381. CrossRef

Cytologic Findings of Malakoplakia of the Uterine Cervix and the Vagina: A Case Report.: Yi Kyeong Chun, Sung Ran Hong, Hye Sun Kim, Ji Young Kim, Bok Man Kim, Hy Sook Kim; J Pathol Transl Med. 2008;19(2):164-167.; DOI: https://doi.org/10.3338/kjc.2008.19.2.164

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Abstract PDF: Malakoplakia is an uncommon chronic granulomatous inflammation that usually involves the urinary and gastrointestinal tracts, but rarely affects the female genital tract. We experienced a case of malakoplakia in a cervicovaginal smear in a 54-year-old woman. Colposcopic examination showed a friable, easily bleeding tissue in the uterine cervix and the vaginal fornix. The cervicovaginal smear consisted of numerous isolated histiocytes, polymorphonuclear leukocytes, lymphocytes, and plasma cells. The histiocytes had an abundant, granular, and degenerated cytoplasm with inflammatory cell debris. Michaelis-Gutmann bodies were readily identified.

Original Articles

The Usefulness of Cervicovaginal Cytology as a Primary Screening Test.: Jae Hong Park, Seung Yeon Ha, Hyun Yee Cho, Dong Hae Chung, Na Rae Kim, Sanghui Park; J Pathol Transl Med. 2008;19(2):107-110.; DOI: https://doi.org/10.3338/kjc.2008.19.2.107

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Abstract PDF

We evaluated the usefulness of cervicovaginal cytology as a primary screening test by analyzing the cytologic and histological diagnoses of 2,254 women. Cervicovaginal cytology had 93.0% sensitivity, 86.1% specificity, 88.2% positive predictive value, and 91.7% of negative predictive value. Cervicovaginal cytology as a primary screening test showed much higher specificity but slightly lower sensitivity than HPV DNA testing. However, the sensitivity of cervicovaginal cytology will be improved continuously due to the development of liquid-based cytology. We regard cervicovaginal cytology as a good primary screening test for cervical intraepithelial neoplasia or carcinoma.

Citations

Citations to this article as recorded by

Working Conditions that Impact the Workload of Cytotechnologists: A Study Calculating the Actual Man Power Required
Soo Il Jee, Yong Ho Ahn, Hwa-Jeong Ha, Jeong Eun Kang, Jun Ho Won
The Korean Journal of Clinical Laboratory Science.2021; 53(2): 174. CrossRef

Comparison of Qualified Diagnosis of "Atypical Squamous Cells of Undetermined Significance" with Subsequent Biopsy .: Jae Soo Koh, Jin Haeng Chung, Seung Sook Lee, Kyung Ja Cho; J Pathol Transl Med. 1999;10(1):1-5.

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Abstract PDF: To evaluate whether different qualifications of a cytologic diagnosis of "atypical squamous cells of undetermined significance(ASCUS)" predict a greater or lesser likelihood of tissue diagnosis of uterine cervix, we compared different cytologic qualifications of ASCUS with the tissue diagnosis. One hundred twenty-two con secutive Papanicolaou smears showing ASCUS in women who had undergone cervical biopsy within nearest 30 days were collected. The 122 smears were qualified as "favor reactive"(25%), "favor low grade squamous intraepithelial lesion (LSIL)"(24%), "favor squamous intraepithelial lesion(SIL)"(16%), "favor high grade squa mous intraepithelial lesion(HSIL)"(16%), and "not otherwise specified"(19%). Squamous intraepithelial or invasive lesion was pathologically confirmed by cervical biopsy in 13% of the "favor reactive", 27% in "favor LSIL", 70% in "favor SIL", 75% in "favor HSIL", and 35% in "not otherwise specified" smears. There were significant asso ciations between the favor reactive smear and the benign biopsy finding and between the favor SIL smear and the biopsy showing a squamous intraepithelial or more severe lesion. Nevertheless, most of favor LSIL smears exhibit reactive process in tissue biopsy. Conclusively, qualified ASCUS stratifies women into different risk groups for SIL. The cytopathologist should make the cytologic diagnosis of "ASCUS, favor LSIL" circumspectly.

Cytologic Features of Endometral Papillary Serous Carchinoma.: Gu Kong, Eun Kyoung Hong, Jung Dal Lee; J Pathol Transl Med. 1990;1(2):121-128.

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Abstract PDF: Endometrial papillary serous carcinoma (EPSC) is a distinct variant of endometrial adenocarcinoma that histologically resembles ovarian serous papillary adenocarcinoma and has an aggressive clinical course. Usually, the tumor is diagnosed at the advanced stage. The tumor has well confused with metastatic ovarian tumor of identical histology. Diagnosis of EPSC should be considered when the cervico-vaginal smear reveals numerous papillary clusters of tumor cells with macronucleoli and psammoma bodies. Recently, we have experienced two cases of EPSC diagnosed on cervico-vaginal smears, which revealed characteristic cytologic features including numerous papillary clusters of tumor cells with macronucleoli. The cytologic diagnoses were confirmed on histologic sections.

Curschmann's spirals in cervico-vaginal smears.: In Ae Park, Eui Keun Ham; J Pathol Transl Med. 1991;2(1):56-61.

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Abstract: Curschmann' spirals morphologically similar to those seen in sputum were found in cervico-vaginal smears of six patients ranged from 28 to 40 years of age, during 18 months from January. 1985 to June. 1986. The prevalence was 1 in 2147 smears in that period. All of them had gynecologic disorders without systemic effect such as chronic cervictis in three, leiomyoma in one, pelvic inflammatory disorder in one, and primary infertility in one. The Curshmann' spirals in the smear showed varying degrees of maturation from wavy incipient ones to highly coiled mature ones, admixed with thick mucinous background, suggesting of their production in the uterine cervix itself. Also the recent history of undergone cryocautery, electrocautery or parturition suggest its production in the endocervical gland due to mechanical obstruction and/or change in biochemical composition of mucus.

Case Report

Superficial Endometriosis of the Uterine Cervix as a Source of Atypical Glandular Cells of Undetermined Significance in the Cervicovaginal Smear: A Report of Two Cases.: Hye Jeong Choi, Seung Koo Lee, Kyu Rae Kim; Korean J Pathol. 2001;35(3):263-266.

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Abstract PDF: Superficial endometriosis of the uterine cervix refers to a lesion in which endometrial stroma and/or gland is located immediately subjacent to the surface epithelium. The cells on the cervicovaginal smear shed from the lesion can be a significant source of atypical glandular cells of undetermined significance (AGUS), or can be easily mistaken for glandular dysplasia or adenocarcinoma in situ. Not infrequently it occurs at the conization site for cervical neoplasia. We describe the cytologic and histologic features of 2 cases of superficial endometriosis of the uterine cervix, which were discovered during an evaluation for AGUS detected on the cervicovaginal smears, with an emphasis on the utility of trichrome and reticulin staining for the diagnosis of superficial endometriosis. The cervicovaginal smears show sheets and clusters of glandular cells having mild to moderately pleomorphic oval nuclei with inconspicuous nucleoli and indistinct cytoplasmic border. Single cells or tumor diathesis were not present. Diagnostic histologic findings were the absence of thick or abundant collagen bundles, the encasement of individual stromal cells by a fine reticulin network and thick reticulin fibers around the spiral arterioles within the endometriotic foci. Therefore, superficial endometriosis should be considered as a potential source of AGUS, especially during follow-up after conization for cervical intraepithelial neoplasia.

Editorial

The Bethedsa System 2001 Workshop Report.: Eun Kyung Hong, Jong Hee Nam, Moon Hyang Park; J Pathol Transl Med. 2001;12(1):1-15.

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Abstract PDF: The Bethesda System (TBS) was first developed in 1988 for the need to enhance the communication of the cytopathologic findings to the referring physician in unambiguous diagnostic terms. The terminology used in this reporting system should reflect current understanding of the pathogenesis of cervical/vaginal disease, so the framework of the reporting system should be flexible enough to accommodate advances in medicine, including virology, molecular biology, and pathology. Three years after the introduction of TBS, the second Bethesda workshop was held to set or amend diagnostic criteria for each categories of TBS. TBS 1991 is now widely used. The third Bethesda workshop, The Bethesda System 2001 Workshop, was held in National Cancer Institute, Bethesda, Maryland from April 30 to May 2, 2001. Again, the goals of this workshop were to promote effective communication and to clarify in reporting cervical cytopathology results to clinicians and to provide with the information to make appropriate decisions about diagnosis and treatment. Nine forum groups were made and there were Web-based bulletin board discussions between October, 2000 and the first week of April, 2001. On the basis of bulletin board comments and discussions, the forum moderators recommended revised terminologies in the Workshop. Hot discussions were followed after the presentation by forum moderators during the workshop. Terminologies confusing clinicians and providing no additional informations regarding patient management were deleted in the workshop to clarify the cervicovaginal cytology results. Any informations related to the patient management were encouraged to add. So 'Satisfactory for evaluation but limited by' of 'Specimen Adequacy' catergory was deleted. Terminology of 'Unsatisfactory' was further specified as 'Specimen rejected' and 'Specimen processed and examined, but unsatisfactory'. Terminologies of 'Benign Cellular Change' and 'Within Normal Limits' were combined and terminology was changed to 'Negative for intraepithelial lesion

Original Article

The Cytologic Analysis of Microinvasive Squamous Cell Carcinoma of the Uterine Cervix on Cervical Smear .: Hyun Joo Choi, In Ae Park; J Pathol Transl Med. 2001;12(1):31-37.

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Abstract PDF: While cytologic characteristics of squamous dysplasia, carcinoma in situ, and invasive squamous cell carcinoma of the uterine cervix are well documented, relatively few studies have dealt with the cellular features of microinvasive carcinoma. In order to describe the cellular characteristics of microinvasive squamous cell carcinoma, we retrospectively reviewed 45 cervovaginal smears(15 carcinoma in situ, 15 microinvasive cancer, 15 invasive cancer) which were confirmed by histologic examination of specimens obtained by hysterectomy at the Seoul National University Hospital during 5 years from 1995 to 1999. The cytologic features about tumor diathesis, inflammatory background, cell arrangement, anisonucleosis, nuclear membrane irregularity, nuclear chromatin pattern, and nucleoli were observed. The cytologic characteristics of microinvasive squamous cell carcinoma of the uterine cervix are syncytial pattern, mild tumor diathesis, the irregularity of nuclear membrane, irregularly distributed nuclear chromatin, and occurrence of micronucleoli. But, correlation between the depth of invasion and the cytologic feature had limited value.

Case Report

Exfoliation of endometrial cells on cervicovaginal smears.: Miseon Kang, Hye Kyoung Yoon; J Pathol Transl Med. 2001;12(2):97-103.

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Abstract PDF: The significance of endometrial cells on cervicovaginal smears is underestimated. The aim of this study is to evaluate the detection rate of endometrial cells on cervicovaginal smears. The materials consisted of two groups. Group I was 701 cervicovaginal smears from patients with no gynecological problems. Group II was 208 cervicovaginal smears from patients with abnormal uterine bleeding followed by endometrial curettage; 31 cases of endometrial adenocarcinoma(CA), 19 cases of endometrial hyperplasia(HP), 83 cases of dysfunctional uterine bleeding(DUB), and 75 cases of normal endometrium. Cervicovaginal smears was reviewed according to the criteria of The Bethesda System. Endometrial cells were identified in 15 of 701 cases(2.1%) in group I and 64 of 208 cases(30.8%) in group II. Among group II, detection rate of endometrial cells was the highest in CA (51.6%) compared to HP(26.3%), DUB(41.0%), and normal endometrium(12.0%) (p<0.05). Cytologic atypia of endometrial cells was not found in group I, but was more frequently identified in CA(87.5%) than in HP(10.5%) or DUB(14.7%) (p<0.05). Exfoliation of endometrial cells might be related to abnormal endometrial lesion, and reporting of endometrial cells in the cervicovaginal smear may increase a chance to detect endometrial lesions especially in patients with abnormal uterine bleeding.

Original Articles

Exfoliation of Endometrial Cells on Cervicovaginal Smears.: Miseon Kang, Hye Kyoung Yoon; J Pathol Transl Med. 2002;13(1):1-7.

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Abstract PDF: The significance of endometrial cells on cervicovaginal smears is underestimated. The aim of this study is to evaluate the detection rate of endometrial cells on cervicovaginal smears. The materials consisted of two groups. Group I was 701 cervicovaginal smears from patients with no gynecological problems. Group II was 208 cervicovaginal smears from patients with abnormal uterine bleeding followed by endometrial curettage; 31 cases of endometrial adenocarcinoma(CA), 19 cases of endometrial hyperplasia(HP), 83 cases of dysfunctional uterine bleeding(DUB), and 75 cases of normal endometrium. Cervicovaginal smears were reviewed according to the criteria of The Bethesda System. Endometrial cells were identified in 15 of 701 cases(2.1%) in group I and 64 of 208 cases(30.8%) in group II. Among group II, detection rate of endometrial cells was the highest in CA (51.6%) compared to HP(26.3%), DUB(41.0%), and normal endometrium(12.0%) ( p<0.05). Cytologic atypia of endometrial cells was not found in group I, but was more frequently identified in CA(87.5%) than in HP(10.5%) or DUB(14.7%) ( p<0.05). Exfoliation of endometrial cells might be related to abnormal endometrial lesion, and reporting of endometrial cells in the cervicovaginal smear may increase a chance to detect endometrial lesions especially in patients with abnormal uterine bleeding.

A Comparision of AutoCyte PREP with Matched Conventional Smear in Cervicovaginal Cytology.: Jaejung Jang, Jungsun Kim, Kyung Ja Cho, Shin Kwang Khang, Joo Hyun Nam, Gyungyub Gong; J Pathol Transl Med. 2002;13(1):8-13.

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Abstract PDF: This study was designed to compare the performance of liquid-based preparation from the AutoCyte PREP with the conventional cervicovaginal smear in masked split-samples. In randomly selected 840 cases, the conventional smear was always prepared first, and the AutoCyte PREP used the residual cells on the collecting device. Parallel AutoCyte PREP slides and matched conventional smears were screened in a blind fashion. All abnormals and 10% random normal cases were reviewed by two pathologists in a blind fashion. The Bethesda System was used for reporting the diagnosis and specimen adequacy. The diagnoses from the two methods were agreed exactly in 767(91.3%) of 840 cases. The AutoCyte PREP demonstrated a 25% overall improvement in the detection of squamous intraepithelial lesion(SIL). The ratio of ASCUS to SIL was decreased as 0.45 compared with 1.00 of conventional smear. The AutoCyte PREP produced excellent cellular preservation and superior sensitivity for detection of atypical cells as compared to the conventional smear. It makes us to be able to subclassify ASCUS into from WNL to HSIL. We thought that the AutoCyte PREP method might contribute to increase the detection rate of abnormal cells than conventional methods.

Case Report

Cytologic Features of Signet Ring Cell Carcinoma of the Uterine Cervix: A Report of Two Cases.: Hyun Yee Cho, Seung Yeon Ha, Jaegul Chung, Young Ha Oh, Dong Hae Chung, Na Rae Kim, Jong Min Lee, Eui Don Lee; J Pathol Transl Med. 2003;14(2):66-70.

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Abstract PDF: Signet ring cell carcinoma is a rare type of mucinous adenocarcinoma of the uterine cervix. To the best of our knowledge, there is no report on cytologic findings of primary signet ring cell carcinoma of the uterine cervix in the literature. Recently, we experienced two cases of signet ring cell carcinoma of the uterine cervix. The finding of characteristic signet ring cells on cervicovaginal smear led to the diagnosis of signet ring cell carcinoma. However, primary signet ring cell carcinoma could not be cytologically distinguished from more common metastatic tumor. Therefore, diagnosis rests upon the recognition of signet ring cells and the absence of signet ring cell carcinoma elsewhere.

Original Articles

Immunocytochemical Staining for p16 of Atypical Squamous Cells in Cervicovaginal Smear.: Hwal Woong Kim, Jong Sil Lee, Jeong Hee Lee, Gyung Hyuck Ko; J Pathol Transl Med. 2004;15(1):28-32.

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Abstract PDF: It was reported that the main cause of intraepithelial neoplasm and squamous cell carcinoma of the uterine cervix is human papilloma virus infection, and that the expression of p16 is increased in cells infected by human papilloma virus. We performed an immunocytochemical staining for protein p16 in 17 cases of cervocovaginal smears initially diagnosed as atypical squamous cells of undetermined significance, to know whether the staining could help the differentiation of neoplastic cells from reactive atypical cells. Of 17 smears, 6 were diagnosed finally as high grade intraepithelial neoplasm or invasive squamous cell carcinoma by follow-up biopsy and smear, and 5 of the 6 were positive for p16. Three were diagnosed as koilocytosis, and one of them was weakly positive for p16. Eight were diagnosed as reactive atypical cells, and all of them were negative for p16. We thought that immunocytochemical staining of p16 in cervocovaginal smears could help the differentiation of neoplastic cells from reactive atypical cells.

Liquid-Based Cytology Using MonoPrep2(TM) System in Cervicovaginal Cytology: Comparative Study with Conventional Pap Smear and Histology.: Yoon Kyung Jeon, Ok Ran Kim, Ki Wha Park, Soon Beom Kang, In Ae Park; J Pathol Transl Med. 2004;15(1):33-39.

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Abstract PDF: We compared the diagnostic accuracy of liquid-based cervicovaginal cytology using MonoPrep2(TM) system (Monogen, Herndon, Virginia, USA), a manual system based on membrane filtration method, with conventional Pap smear. Study population included 92 patients visiting the gynecologic department under the suspicion of uterine cervical disease. In thirty of them, surgical biopsy was performed. MonoPrep2(TM) system provided well-preserved monolayer specimen with good nuclear morphology. However, about 19% of specimens were inadequate to interpret due to low cellularity. The detection rate of abnormal cells more than ASCUS (atypical squamous cells of unknown significance) was 23.9% and higher than 19.4 % of conventional Pap smear. Diagnostic concordance rate with conventional Pap smear was 81%, and severe discordance rate influencing on the management of patient was 7.6 %. Among these seven cases, MonoPrep2(TM) system was more diagnostic only in four. In comparison with histology, the sensitivity of diagnosis of MonoPrep2(TM) system was 78.9% and slightly higher than 73.5% of conventional Pap smear. However, the specificity was 81.1% and lower than 90.9% of Pap smear. In conclusion, MonoPrep2(TM) system provided diagnostic accuracies similar to the conventional Pap smear. The inexpertness of slide preparation and the low cellularity were considered to endow a limitation in more accurate evaluation.

Pregnancy-Related Cytologic Changes In Cervicovaginal Smears.: Yi Kyeong Chun, Hoi Sook Jang, Hye Sun Kim, Sung Ran Hong, Jong Sun Choi, Ji Young Park, Jung Sook Cho, Seok Ju Seong, Jae Hyug Yang, Hy Sook Kim; J Pathol Transl Med. 2004;15(2):92-100.

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Abstract PDF: Due to insufficient clinical information, most cervicovaginal smears from pregnant or postpartum women have been screened without regard to pregnancy-related cytological changes. Here, we have reviewed 116 abnormal cervicovaginal smears from 103 pregnant and postpartum women. Initial cytological diagnoses revealed the following: 9 cases of high-grade squamous intraepithelial lesions (HSIL), 8 cases of low-grade squamous intraepithelial lesions (LSIL), 85 cases of atypical squamous cells of undetermined significance (ASCUS), and 14 cases involving atypical glandular cells of undetermined significance (AGUS). 31 cases, upon review, involved pregnancy-related cytological changes, comprising 25 cases of decidua cells, 4 cases of Arias-Stella reaction, and 2 cases of decidual cells coupled with Arias-Stella reaction. Interpretation errors were detected in 14 cases: 13 cases of decidual cells interpreted as either ASCUS favor reactive or ASCUS ruled out HSIL, and one case of Arias-Stella reaction was interpreted as ASCUS ruled out HSIL. Decidual cells and degenerated glandular cells with Arias-Stella reaction can result in diagnostic mistakes. In order to avoid misdiagnosis and unnecessary surgeries, both clinicians and pathologists must be aware of the pregnancy-related cytological changes. The clinician should also always inform the pathologist on the pregnancy status of the patient.

Case Reports

Cytology of the Uterine Cervico-vaginal Smear of Clear Cell Adenocarcinoma in Uterine Cervix: Report of a Case.: Leeso Maeng, Kyoung Mee Kim, Anhi Lee, Chang Suk Kang; J Pathol Transl Med. 2004;15(2):116-119.

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Abstract PDF: Primary clear cell adenocarcinoma of uterine cervix is rare and cytomorphology in the vaginal smear have not been previously described in Korean literatures. The cytologic characteristics of clear cell adenocarcinoma of the uterine cervix include : malignant cells with abundant, finely vacuolated cytoplasm ; hobnail appearance ; and distinctive basement membrane-like hyaline materials within cellular aggregates. A 36-year-old woman presented with vaginal bleeding. Cytologic examination of vaginal smear and histopathologic examination of a radical hysterectomy specimen allowed the diagnosis of hemorrhagic tumor in the uterine cervix as a clear cell adenocarcinoma. Cytologic findings were very characteristic. The tumor cells had abundant, pale, finely vacuolated cytoplasm with indistinct cytoplasmic membrane. The nuclei were round to oval with finely dispersed chromatin. Extracellular basement membrane-like hyaline substance, which stained a light green color in Papanicolaou's preparation, was frequently observed within the cancer cell clusters.

Cytologic Features of Malignant Lymphoma of the Uterine Cervix: A case report.: Nam Hoon Kim, Chan Kum Park, Young Hyeh Ko, Moon Hyang Park, Jung Dal Lee; J Pathol Transl Med. 1995;6(1):76-79.

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Abstract PDF: The uterine cervix is an uncommon site of primary non-Hodgkin's lymphoma (NHL). Although the cytologic findings of NHLs are well known, most cervicovaginal smear of uterine NHLs give lower diagnostic yield than common epithelial malignancy because abnormal cells do not appear in the sample in the absence of surface ulceration. Herein, we describe cytologic findings of a case of uterine cervical NHL which was initially diagnosed by cervicovaginal smear. The tumor cells were relatively uniform, isolated, large-sized with scanty cytoplasm and round or indented nuclei. The nuclei had stippled chromatin and small nucleoli. Histologically and immunohistochemically the tumor was proven to be large cell lymphoma of T-cell lineage.

Original Article

The Bethesda System(TBS): A New Reporting System of Cervicovaginal Smear.: Hy Sook Kim; J Pathol Transl Med. 1995;6(2):85-98.

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Abstract PDF: In 1989, the Bethesda System(TBS) was introduced as an attempt to standardize cervical/vaginal reporting systems. TBS nomenclature was created for reporting cytologic diagnoses to replace the currently used Cervical Intraepithelial Neoplasia(CIN) and Papanicolaou Class System which are deemed less reproducible. The name for preinvasive squamous lesions was changed to squamous intraepithelial lesion(SIL), subdivided into low-grade and high-grade type. TBS recommends a specific format for cytologic report, starting with explicit statement on the adequacy of the specimen, followed by general categorization and descriptive diagnosis. Pathologic and epidemiologic studies performed over last 10 years have provided evidence that human, papillomavirus(HPV) plays a significant role in the development of cervical neoplasia. TBS corresponds not only to currently held views of the behavior of preinvasive lesions and their HPV distribution, but also to the current guidelines for clinical management.

Case Report

Cytologic Features of Papnicolaou Smears of Malignant Melanoma Arising in Vagina: A Cese Report.: Myung Suk Kang, Bohng Hee Kim, Jae Hoon Park, Youn Wha Kim, Yong Koo Park, Ju Hie Lee, Moon Ho Yang; J Pathol Transl Med. 1995;6(2):209-214.

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Abstract PDF: Primary malignant melanoma of vagina is a rare tumor which is easily misinterpretated in routine cytologic examination. We lately experienced a case of primary malignant melanoma of the vagina with direct cervical extension diagnosed by Pap smear. The cervicovaginal smear showed variable sized clusters of epithelial cells or singly scattered abnormal epithelial cells. Most of the tumor cells had round hyperchromatic nuclei with prominent nucleoli and brownish pigments in cytoplasm. The cytologic findings are compared with histologic features of resected specimen.

Original Articles

A Comparision of Surepath(TM) Liquid-Based Smear with a Conventional Smear for Cervicovaginal Cytology-with Reference to a Histological Diagnosis.: Kyung Chul Lee, Chan Kwon Jung, Ahwon Lee, Eun Sun Jung, Yeong Jin Choi, Jong Sup Park, Kyo Young Lee; J Pathol Transl Med. 2007;18(1):20-28.

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Abstract PDF: This study was performed to compare Surepath(TM) liquid-based smear and a conventional cervicovaginal smear with reference to a histological diagnosis. A hybrid capture test (HCII) was also performed and analyzed. We collected matched cases for cervicovaginal cytology- histology: 207 cases for conventional cytology (CC) and 199 cases for liquid-based cytology (LBC). HCII was performed in 254 patients. When a cytological diagnosis of ASCUS or above (ASCUS+) is classified as positive and a histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for LBC was 91.7% and 75.9%, respectively and the sensitivity and specificity for CC was 62.6% and 96.1%, respectively. When a cytological and histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for LBC was 77.5 and 96.6%, respectively and the sensitivity and specificity for CC was 49.7% and 100%, respectively. When a histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for HCII was 78.9% and 78.1%, respectively. The concordance ratio between the cytological and histological diagnosis was 80.4% (kappa=76.0) for LBC and 56.5% (kappa=55.1) for CC. LBC is more sensitive and less specific then CC, as a cytological cutoff level of ASCUS, but more sensitive and equally specific, as a cytological cutoff level LSIL or HSIL. LBC is more reliable with a high concordance ratio between the cytological and histological diagnosis.

Radiation-Induced Changes in Cervico-vagical Smears of Uterine Cervical Cancer Patients.: Sung Hye Park, In Sun Kim, Seung Yong Paik, Hyo Sook Park, No Won Park; Korean J Pathol. 1988;22(3):268-276.

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Abstract PDF: Nowday, ionizing radiation is one of the methods eradicating the uterine cervical malignancy. However radiation alone or in combination with surgery have an effect on normal tissue as well as the malignant cells, and their changes have been well described in other countries. Unfortunately, the history of radiation modality for cancer treatment is relatively short and the reports about radiation induced changes are limited in our country. We evaluated the radiation-induced changes in cervico-vaginal smears of 107 uterine cervical cancer patients obtained from March, 1985 to October, 1987. Most patients had been received 5,400 Rads of external radiation and intracavitary radiation. Patient's age ranged from 30 to 67 years old. Of 107 cases, 24 cases were normal, 72 cases showed benign radiation changes, 7 cases revealed radiation dysplasia, and residual and recurrent carcinomas found in one and 3 cases, respectively. Cytoplasmic and nuclear enlargement were the most common and noted in 57 and 38 cases, respectively. Vacuolization and polychromasia of the cytoplasm were identified in 43 and 30 cases, respectively. The most common histiocytic change was multinucleation, which was found in about one third. The radiation changes of the cytoplasm and nuclear enlargement persisted for a long time after completion of radiation, however, nuclear degeneration and multinucleation gradually disappeared after 6 months. The inflammation in background prolonged for a long time but degeneration disappeared after 6 months. The biologic significance of post-radiation dysplasia could not evaluated because of short follow up period.

Case Report

Fibroepithelial Polyp of Vagina with Atypical Stromal Cells: A case report.: Mi Ok Park, Yong Jin Kim, Jae Bok Park; Korean J Pathol. 1998;32(8):619-921.

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Abstract: A case of fibroepithelial polyp with stromal atypia in a 25-year-old female is described. The tumor arose from the vaginal wall and measured 3.5 cm in maximal diameter. It was composed of hypercellular connective tissue stroma and focal myxoid area containing numerous atypical mono- and multinucleated stromal cells. These cells may mislead to make a diagnosis of sarcoma, particulary of botryoid rhabdomyosarcoma.

Original Articles

Clinical Experience and Sensitivity of the AutoPap 300 QC System in Cervicovaginal Cytology.: Sung Ran Hong, Jong Sook Park, Hoi Sook Jang, Yee Jeong Kim, Hy Sook Kim, Chong Taik Park, In Sou Park; J Pathol Transl Med. 1998;9(1):37-44.

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Abstract PDF: OBJECTIVE: False negatives of cervical smears due to screening errors pose a significant and persistent problem. AutoPap 300 QC System, an automated screening device, is designed to rescreen conventionally prepared Pap smears initially screened by cytotechnologists as normal. Clinical experience and sensitivity of the AutoPap 300 QC System were assessed and compared with current 10% random quality control technique. MATERIALS AND METHODS: In clinical practice, a total of 18,592 "within normal limits" or "benign cellular changes" cases classified by The Bethesda System were rescreened by the AutoPap System. In study for sensitivity of The AutoPap System to detect false negatives, a total of 1,680 "within normal limits" or "benign cellular changes" cases were rescreened both manually and by the AutoPap System. The sensitivity of the AutoPap System to these false negatives was assessed at 10% review rate to compare 10% random manual rescreen.
RESULTS
In clinical practice, 38 false negatives were identified by the AutoPap System and we had achieved 0.2% reduction in the false negative rate of screening error. In study for sensitivity, 37 false negatives were identified by manual rescreening, and 23 cases(62.2%) of the abnormal squamous cytology were detected by the AutoPap System at 10% review rate. CONCLUSONS: The AutoPap 300 QC System is a sensitive automated rescreening device that can detect potential false negatives prior to reporting and can reduce false negative rates in the laboratory. The device is confirmed to be about eight times superior to the 10% random rescreen in detecting false negatives.

Sensitivity and Scoring of AutoPap 300 QC System for Abnormal Cervicovaginal Cytology .: Sung Ran Hong; J Pathol Transl Med. 1998;9(2):139-146.

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Abstract PDF: The AutoPap 300 QC System is an automated device for the analysis and classification of conventional cervical cytology slides for quality control purpose. These studies evaluated the sensitivity of the AutoPap 300 QC System, and estimated morphologic features other than epithelial abnormality to identify a high quality control(QC) score with the AutoPap 300 QC System. The sensitivity of the AutoPap 300 QC System at 10% review rate for 210 cases of cervicovaginal cytology with low grade squamous intraepithelial lesion(LSIL) and higher grade lesion was assessed, and compared with a 10% random rescreening. The morphologic features, such as presence of endocervical component, dirty background, atrophy, abnormal cell size, and cellularity of single atypical cells were estimated in 45 cases of no review and 30 cases of QC review cases. The AutoPap 300 QC System identified 119(56.7%) out of 210 cases with LSIL and higher grade lesion at 10% review rate. It was more sensitive to squamous cell lesions(50-62%) than to glandular lesions(10%). The dirty background and the scanty cellularity of single atypical cells were significantly related to low QC score. Conclusively, AutoPap 300 QC System is superior to human random rescreen for the identification of false negative smears. The upgrading of this device is required to enhance the detection of glandular lesion and certain inadequate conditions of the slides.

Cytologic Analysis of Adenocarcinoma of the Cervicovaginal Smears .: Jung Yeon Kim, Hye Jae Cho, Kyung Ja Cho, Hong Kyoon Lee; J Pathol Transl Med. 1998;9(2):147-154.

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Abstract PDF: We have investigated the cervicovaginal smears in order to define the cytologic features of uterine adenocarcinomas. Total 22 cases were reviewed(12 cases from the Sanggye Paik hospital, Inje university and 10 cases from the Korea Cancer Center Hospital) from January 1992 to December 1997. Five cases were endometrial adenocarcinomas and the remaining 17 cases were cervical adenocarcinomas. Se venteen cases of cervical adenocarcinomas were divided into endometrioid(6 cases), endocervical(7 cases), mixed endometrioid and endocervical(1 case), papillary (2 cases), and adenosquamous(1 case) carcinomas. The background of endocervical adenocarcinoma was hemorrhagic or inflammatory. The tumor diathesis was less prominent than that of the squamous cell carcinoma. The prominent features of the endocervical type adenocarcinomas were large and loose clusters, large intra cytoplasmic vacuoles, and prominent overlapping and peripheral palisading of nuclei. In contrast, the endometrioid adenocarcinomas showed small and compact clusters, and small intracytoplasmic vacuoles. The detection rate of endometrial adeno carcinoma was lower than that of the endocervical adenocarcinoma.

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