Covell J L, Frierson H F
Department of Pathology, University of Virginia Health Sciences Center, Charlottesville 22908.
Diagn Cytopathol. 1992;8(1):18-22. doi: 10.1002/dc.2840080105.
The interpretation of endocervical brush specimens requires familiarity with the various benign, atypical, dysplastic, and invasive neoplastic changes in cells located in the endocervical canal. There are several pitfalls in the cytologic evaluation of brush specimens that may result in diagnostic difficulty and error. We report seven cases of high-grade squamous intraepithelial lesions that were sampled by endocervical brushing and confirmed by cone biopsy or hysterectomy in which the cytologic changes in the Papanicolaou smears mimicked those of microinvasive squamous-cell carcinoma. The cells in the smears were compared with those in the tissue sections to determine their sites of origin. Results of this study indicate that cells with features fulfilling the criteria for microinvasive carcinoma were found primarily in brushing smears and corresponded with the features of cells involving the endocervical glands rather than those in the surface epithelium. We conclude that the criteria that have been promulgated for the cytologic diagnosis of microinvasive squamous-cell carcinoma have limited value in the examination of endocervical brush specimens.
对宫颈管刷片标本的解读需要熟悉宫颈管内细胞的各种良性、非典型、发育异常和浸润性肿瘤性变化。在刷片标本的细胞学评估中存在一些陷阱，可能导致诊断困难和错误。我们报告了7例高级别鳞状上皮内病变，这些病例通过宫颈管刷取取样，并经锥形活检或子宫切除术确诊，其中巴氏涂片的细胞学变化类似于微浸润性鳞状细胞癌。将涂片细胞与组织切片细胞进行比较，以确定其起源部位。本研究结果表明，具有符合微浸润癌标准特征的细胞主要见于刷片涂片，且与累及宫颈管腺体的细胞特征相符，而非表面上皮细胞的特征。我们得出结论，已公布的微浸润性鳞状细胞癌的细胞学诊断标准在宫颈管刷片标本检查中的价值有限。
