Case Of The Month - April 2005

Introduction

Every month we will try to present an interesting case. We need your participation to make this work!! This month's case has been kindly put together by Erin Retter of DML. There are six images and the 'answer' (with histology and 2 more images) is at the bottom of the page

You are invited to submit comments to the members' froum about this case.
Click here for the NZSC forum

Clinical Details

Female
52 years of age
Vault smear
Has had regular smears

Images

Image 1

Image 2

Image 3

Image 4

Image 5

Smear Diagnosis

The specimen is satisfactory containing abundant normal squamous cells.
Endometrial cells are seen.
The endometrial cells are interpreted as representing vault endometriosis.
There is no cytological atypia.
Continue normal screening programme.

Histology - Biopsy Vaginal Vault

(See images 7 and 8 below)
MICROSCOPY:Sections show fragments of endometrial glands and stroma with focal surface erosion. The endometrial glands are lined by endometrial epithelial cells showing pseudostratification and mitotic activity. Glands show focal crowding with little intervening stroma. Occasional cystically dilated glands are also present. The stroma contains inflammatory cell infiltrates including numbers of neutrophils and plasma cells. There is no evidence of malignancy but the focal glandular crowding suggests a degree of endometrial hyperplasia.

DIAGNOSIS:
ENDOMETRIOSIS,
FOCAL GLANDULAR CROWDING SUGGESTING ENDOMETRIAL HYPERPLASIA.

Image 7

Image 8

Thanks to Erin and the DML team for submitting this case