Objective: To evaluate the cytologic features of villoglandular adenocarcinoma of the cervix in cervical smears.
Study design: Eleven cervical smears from six patients with histologically proven villoglandular adenocarcinoma were reviewed.
Results: All smears were positive for tumor upon retrospective evaluation and revealed similar cytologic features. The tumor cells were abundant and were shed in sheets, tight clusters and tissue fragments. Papillary projections, clusters with smooth borders and flattened cells at the periphery, strips with peripheral nuclear palisading and pseudostratification, and rosettes were present. Nuclear crowding and overlapping were prominent. The nuclei were small, ovoid and hyperchromatic. The chromatin was granular and evenly distributed. Nucleoli were absent or inconspicuous. Mitoses were present.
Conclusion: VGA may cause diagnostic difficulty because it shares some morphologic similarities with adenocarcinoma in situ, squamous cell carcinoma in situ involving endocervical glands, endometrial cells directly sampled with the Cytobrush and reactive endocervical cells. However, the above constellation of features should permit a cytologic diagnosis.