Research

Prevalence and significance of psammoma bodies in cervicovaginal smears in a cervical cancer screening program with emphasis on a case of primary bilateral ovarian psammocarcinoma

Teresa Pusiol¹, Anna M Parolari², Irene Piscioli³, Luca Morelli¹, Franca Del Nonno⁴ and Stefano Licci⁴

¹Department of Pathology, "S. Maria del Carmine" Hospital, Rovereto (TN), Italy

²Department of Gynecology, New Hospital of Arco (TN), Italy

³Department of Radiology, Civil Hospital of Budrio (BO), Italy

⁴Department of Pathology, "National Institute for Infectious Diseases – L. Spallanzani" IRCCS, Rome, Italy

CytoJournal 2008, 5:7doi:10.1186/1742-6413-5-7

Published:	16 April 2008

Abstract

Background

The purpose of our study was to determine the prevalence and significance of psammoma bodies (PBs) in the cervicovaginal smears of the screening population of Trento district (Italy), with the description of the cytological presentation of an asymptomatic bilateral ovarian psammocarcinoma.

Methods

From 1993 to 2006, women with PBs detected on consecutively screened cervical smears were identified from the computerized pathology database of Rovereto Hospital. The follow-up period was set from the time of cytological diagnosis to May 31^st, 2007. Clinical information was obtained from retrospective review of women's medical records. The source of PBs was identified with adequate diagnostic procedures.

Results

PBs were found in six of the 201,231 Papanicolaou screening smears (0.0029%). Benign conditions (intrauterine device, inclusion ovarian cysts and ovarian cystoadenofibroma with PBs) were found in four patients. In two cases, PBs were associated with malignant cells; a bilateral ovarian malignancy was diagnosed in both cases, a serous adenocarcinoma and a psammocarcinoma.

Conclusion

PBs in the cervicovaginal smears are a rare finding, associated more often with benign conditions than with malignancies. Moreover, to our knowledge, our case of primary ovarian psammocarcinoma is the first report in which the presence of malignant cells and PBs in the cervicovaginal and endometrial smears represents the first manifestation of disease.