Small cells in cervical-vaginal smears of patients treated with tamoxifen

Opjorden, SL Caudill, JL Humphrey, SK Salomao, DR

Sl. Opjorden et al., Small cells in cervical-vaginal smears of patients treated with tamoxifen, CANC CYTOP, 93(1), 2001, pp. 23-28

28

INGLESE

Article

Oncology,"Onconogenesis & Cancer Research

CANCER CYTOPATHOLOGY

0008-543X → ACNP

93

1

2001

23 - 28

ISI

0008-543X(20010225)93:1<23:SCICSO>2.0.ZU;2-1

BACKGROUND. "Small cells" have been described in the cervical-vaginal (Papa nicolaou [Pap]) smears of patients receiving tamoxifen. The current study d etermined the frequency of this finding and its implications for the differ ential diagnosis. METHODS. A computer-based search of the cytopathology files from January 19 94 to December 1998 was performed for Pap smears from patients with a histo ry of tamoxifen treatment. All smears were reviewed for the presence of "sm all cells" and endometrial cells. Pap smears from an age-matched control gr oup that was not treated with tamoxifen also were screened for "small cells ." RESULTS. Five hundred forty-eight Pap smears were identified from 425 patie nts (mean age, 62 years; average duration of treatment, 43 months). Cluster s of these "small cells" were present in 104 Pap smears from 86 patients (1 9%). The background pattern was proliferative in the majority of the Pap sm ears (83%). In five Pap smears (5%), these "small cells" were interpreted o riginally as endometrial cells. In the remaining Pap smears, no reference t o the presence of the cells was made in the original report. "Small cells" were identified in 79 Pap smears (18%) in the control group (n = 443 smears ). CONCLUSIONS. The incidence of "small cells" is similar in the Pap smears of patients with or without a history of tamoxifen treatment. These cells are similar to reserve cells noted in atrophic smears. However, as a result of the proliferative effect of tamoxifen in the cervical epithelium, these ce lls are prominent when admired with superficial and intermediate cells in p atients treated with tamoxifen. These cells need to be differentiated from endometrial cells to avoid unnecessary follow-up procedures. Cancer (Cancer Cytopathol) 2001;93:23-28, (C) 2001 American Cancer Society.