Objective: To determine the significance of the presence of foamy histiocytes (FH) in postmenopausal cervicovaginal smears for the detection of endometrial carcinomas (EC). Study Design: Endometrial sampling was performed over 6 months in 53 of 102 cases that presented with postmenopausal FH, benign endometrial cells (BEC), FH with BEC (FH + BEC), and atypical endometrial cells (AEC), resulting in a total of 41,150 cervicovaginal smears. The control group consisted of 58 cases with a cytologic diagnosis of a normal smear (NS). Results: There were 0 (0%), 1 (4.54%), 2 (13.33%), 2 (33.33%), and 5 (50.00%) cases of EC diagnosed on histopathologic evaluation in patients with NS (n = 58), BEC (n = 22), FH (n = 15), FH + BEC (n = 6), and AEC (n = 10), respectively. The sensitivities and specificities of the cytologic diagnoses of FH, FH + BEC, and AEC for the detection of EC were 81.7 and 100%, 93.6 and 100%, and 92.1 and 100%, respectively. Conclusion: The cytologic diagnoses of FH and FH + BEC had reasonably high sensitivities and specificities for the diagnosis of EC by cervicovaginal smear. Additional studies are needed.

Keywords:
Foamy histiocytes, Papanicolaou smear, Benign endometrial cells, Atypical endometrial cells
1.
Ellenson LH, Ronnett BM, Kurman RJ: Precursor lesions of endometrial carcinoma; in Ellenson LH, Ronnett BM, Kurman RJ (eds): Blaustein's Pathology of the Female Genital Tract, ed 6. New York, Springer, 2011, pp 359-391.
2.
Nassar A, Fleisher SR, Nasuti JF: Value of histiocyte detection in Pap smears for predicting endometrial pathology: an institutional experience. Acta Cytol 2003;47:762-767.
3.
Wen P, Abramovich CM, Wang N, Knop N, Mansbacher S, et al: Significance of histiocytes on otherwise-normal cervical smears from postmenopausal women: a retrospective study of 108 cases. Acta Cytol 2003;47:135-140.
4.
Ivazzo C, Kalmantis K, Ntziora F, Balakitsas N, Paschalinopoulos D: Detection of large histiocytes in Pap smears: role in the prediction of endometrial pathology? Bratisl Lek Listy 2008;109:497-498.
5.
Tambouret R, Bell DA, Centeno BA: Significance of histiocytes in cervical smear from postmenopausal women. Diagn Cytopathol 2001;24:271-275.
6.
Nguyen TN, Bourdeu JL, Ferenczy A, Franco EL: Clinical significance of histiocytes in the detection of endometrial adenocarcinoma and hyperplasia. Diagn Cytopathol 1998;19:89-93.
7.
Fadare O, Ghofrani M, Chacho MS, Vinita P: The significance of benign endometrial cells in cervicovaginal smears. Adv Anat Pathol 2005;12:274-287.
8.
Moriarty AT, Cibas ES: Endometrial cells: the how and when of reporting; in Solomon D, Nayar R (eds): The Bethesda System for Reporting Cervical Cytology, ed 2. New York, Springer, 2004, pp 57-66.
9.
Covell JL, Wilbur DC, Guidos B, Lee KR, Chhieng DC, Mody DR: Epithelial abnormalities: glandular; in Solomon D, Nayar R (eds): The Bethesda System for Reporting Cervical Cytology, ed 2. New York, Springer, 2004, pp 123-156.
10.
Brogi E, Tambouret R, Bell DA: Classification of benign endometrial glandular cells in cervical smears from postmenopausal women. Cancer Cytopathol 2002;96:60-66.
11.
Saad RE, Takei H, Liu YL, Silverman JE, Lipscomb JT, Ruitz B: Clinical significance of a cytologic diagnosis of atypical glandular cells, favor endometrial origin, in Pap smears. Acta Cytol 2006;50:48-54.
12.
Zhao C, Austin RM, Pan J, Barr N, Martin SE, Raza A, Cobb C: Clinical significance of atypical glandular cells in conventional Pap smears in a large, high-risk US west coast minority population. Acta Cytol 2009;53:153-159.
13.
Zhou J, Tomashefski JF Jr, Sawady J, Ferrer H, Khiyami A: The diagnostic value of the ThinPrep Pap test in endometrial carcinoma: a prospective study with histological follow-up. Diagn Pathol 2013;41:408-412.
14.
Wright TC Jr, Massad LS, Dunton CJ, Spitzer M, Wilkinson EJ, Solomon D: 2006 consensus guidelines for the management of women with abnormal cervical cancer screening tests. Am J Obstet Gynecol 2007;197:346-355.
15.
Zarcone R, Cardone G, Voto RI, Longo M, Cardone A: The role of histiocytes in the cytodiagnosis of endometrial adenocarcinoma. Minerva Ginecol 1992;44:83-86.
16.
Schroeter L, Louw M, Michelow P, Wright C: Application of cytomorphologic features and immunohistochemistry to cervicovaginal smears: a scoring system to distinguish between endometrial and endocervical adenocarcinoma. Acta Cytol 2009;6:630-636.
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2013
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