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. 2008 Apr 16:5:7.
doi: 10.1186/1742-6413-5-7.

Prevalence and significance of psammoma bodies in cervicovaginal smears in a cervical cancer screening program with emphasis on a case of primary bilateral ovarian psammocarcinoma

Teresa Pusiol  1 , Anna M Parolari, Irene Piscioli, Luca Morelli, Franca Del Nonno, Stefano Licci
Affiliations

Prevalence and significance of psammoma bodies in cervicovaginal smears in a cervical cancer screening program with emphasis on a case of primary bilateral ovarian psammocarcinoma

Teresa Pusiol et al. Cytojournal. .

Abstract

Background: The purpose of our study was to determine the prevalence and significance of psammoma bodies (PBs) in the cervicovaginal smears of the screening population of Trento district (Italy), with the description of the cytological presentation of an asymptomatic bilateral ovarian psammocarcinoma.

Methods: From 1993 to 2006, women with PBs detected on consecutively screened cervical smears were identified from the computerized pathology database of Rovereto Hospital. The follow-up period was set from the time of cytological diagnosis to May 31st, 2007. Clinical information was obtained from retrospective review of women's medical records. The source of PBs was identified with adequate diagnostic procedures.

Results: PBs were found in six of the 201,231 Papanicolaou screening smears (0.0029%). Benign conditions (intrauterine device, inclusion ovarian cysts and ovarian cystoadenofibroma with PBs) were found in four patients. In two cases, PBs were associated with malignant cells; a bilateral ovarian malignancy was diagnosed in both cases, a serous adenocarcinoma and a psammocarcinoma.

Conclusion: PBs in the cervicovaginal smears are a rare finding, associated more often with benign conditions than with malignancies. Moreover, to our knowledge, our case of primary ovarian psammocarcinoma is the first report in which the presence of malignant cells and PBs in the cervicovaginal and endometrial smears represents the first manifestation of disease.

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Figures

Figure 1
Figure 1
a) Presence of a psammoma body in absence of atypical cells in cervicovaginal smear (Papanicolaou stain, 200×); b) Serous ovarian cystoadenofibroma with parietal psammoma bodies (Hematoxylin and Eosin, 100×).
Figure 2
Figure 2
a) Psammoma body surrounded by atypical cells (arrows) in cervicovaginal smear (Papanicolaou stain, 200×); b) Psammoma body surrounded by atypical cells (arrows) in endometrial aspiration smear (Papanicolaou stain, 200×).
Figure 3
Figure 3
a) Moderately differentiated ovarian adenocarcinoma with psammoma bodies infiltrating the stroma (Hematoxylin and Eosin, 100×); b) Psammocarcinoma localized on the ovarian surface with invasion of the underlying stroma (Hematoxylin and Eosin, 100×); c) Omental metastasis of psammocarcinoma (Hematoxylin and Eosin, 100×); d) Presence of psammocarcinoma in the tubaric lumen (Hematoxylin and Eosin, 100×).
See this image and copyright information in PMC

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