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. 2020 Nov;31(6):579-585.
doi: 10.1111/cyt.12899. Epub 2020 Sep 12.

Lesion-targeted cytology to improve cytological sampling for atypical polypoid adenomyomas of the uterus: A case series and review of the literature

Makiko Omori  1 , Masataka Kawai  2 , Tatsuyuki Ogawa  1 , Satoko Sasatsu  1 , Hiroko Fukasawa  1 , Kumiko Nakazawa  2 , Tetsuo Kondo  2 , Shuji Hirata  1
Affiliations

Lesion-targeted cytology to improve cytological sampling for atypical polypoid adenomyomas of the uterus: A case series and review of the literature

Makiko Omori et al. Cytopathology. 2020 Nov.

Abstract

Objective: Atypical polypoid adenomyomas (APAs) are uncommon tumours consisting of atypical endometrioid glands and fibromyomatous stroma. Identifying the biphasic nature of atypical glandular components and spindle mesenchymal components without atypia is crucial for the cytological diagnosis of APA. We investigated the utility of lesion-targeted cytology (LTC) to directly collect firm spindle components.

Methods: We recruited seven consecutive surgical patients who underwent cytological examinations before surgery and were diagnosed with APA on postoperative histological examinations. Cytological smears were obtained by routine sampling in five cases and by targeted sampling using transvaginal ultrasonography, that is, LTC, in two cases. We retrospectively analysed the cytological findings from our cases and compared them to those of APA cases previously reported in the English literature.

Results: Among 5/7 cases that involved routine cytological sampling, normal cytological findings were found in 2 and atypical glandular cells were found in 3, but spindle cells from mesenchymal components were not detected. In contrast, among 2/7 cases in which sampling involved LTC, spindle cells without atypia, in addition to atypical glandular cells were found.

Conclusions: Lesion-targeted cytology is useful to assess mesenchymal components of APAs and may improve the cytological diagnosis of APA.

Keywords: adenocarcinoma; atypical polypoid adenomyoma; cytology; lesion-targeted cytology; spindle cells; uterine neoplasm.

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References

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