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Continuing Medical Education (CME): The American Society of Cytopathology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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Clinical History

A 30 year old female presented for her annual GYN examination with complaint of dysmenorrhea. She denied any complaint of abdominal pain or abnormal discharge. Her past medical history was significant for endometriotic cyst of ovary 15 years ago (Status post ovarian cystectomy) and numerous colonic polyps. She was then referred for colonoscopy. Flexible sigmoidoscopy showed a large 7 cm sub-epithelial lesions at the rectal sigmoid colon and an irregular-shaped hypoechoic lesion with cystic components arising from the muscularis propria. Subsequently, fine need aspirate (FNA) was performed.

Cytopathology Features

The cells of interest form sheets in a honeycomb arrangement, and tubular structures, in a relatively clean background. The nuclei are small and round, and devoid of cytological atypia. There is minimal nuclear overlap and nuclear palisading at the edge of the sheets. In addition to this, there are glandular cells forming tight three-dimensional clusters. The glandular cells have indistinct cell borders, scant cytoplasm, small round to oval nuclei, and inconspicuous nucleoli. In the background, there are rare histiocytes.

Figure 1. Lesional Cells, 20x, Papanicolaou stain

Figure 2. Lesional Cells, 20x, Diff-Quik stain


Sean M. Hacking, MB, BCh, BAO and Seema D. Khutti, MD
Zucker School of Medicine at Hofstra/Northwell Health,
Lake Success, NY

 

 

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