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Acta Cytologica 2012;56:55–61

p16INK4a and ProEx C Immunostains Facilitate Differential Diagnosis of Hyperchromatic Crowded Groups in Liquid-Based Papanicolaou Tests with Menstrual Contamination

Ge Y.a, b · Mody D.R.a, b · Smith D.a · Anton R.a, b

Author affiliations

aDepartment of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Tex., and bWeill Cornell Medical College, Cornell University, New York, N.Y., USA

Corresponding Author

Correspondence to: Dr. Yimin Ge

Department of Pathology and Laboratory Medicine, Methodist Hospital

6565 Fannin Street, Suite M227

Houston, TX 77030 (USA)

Tel. +1 713 441 2283, E-Mail yge@tmhs.org

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Objective: Evaluation of hyperchromatic crowded groups in Papanicolaou (Pap) tests from women during menstruation can be a diagnostic pitfall due to similar morphological appearances with significant cervical lesions. We studied the results of p16INK4a and ProEx C on cell blocks from Pap tests during menstruation in an attempt to facilitate the differentiation. Study Design: Immunohistochemical stains for p16INK4a and ProEx C were performed on 25 cell blocks prepared from residual liquid-based cervical material with menstrual contamination. Results: Strong, diffuse, and full thickness staining pattern for p16INK4a and ProEx C was observed in cases of high-grade squamous intraepithelial lesion (HSIL) and small cell carcinoma of the cervix. The low-grade squamous intraepithelial lesion cases and cases negative for intraepithelial lesion or malignancy were negative for ProEx C, with focal staining for p16INK4a. The benign endometrial cells had either negative or focal patchy staining, which is often associated with tubal metaplasia. Conclusion: p16INK4a and ProEx C are sensitive markers for identifying significant lesions in Pap test specimens with menstrual contamination. Patchy/mosaic staining may be seen in benign endometrial tissue with tubal metaplasia, but strong, diffuse staining likely indicates HSIL or carcinoma. These findings can be helpful in interpreting hyperchromatic crowded groups in menstrual Pap specimens. Further study may be prudent, being aware of the small study group.

© 2012 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Gynecologic Cytopathology

Received: August 09, 2011
Accepted: September 12, 2011
Published online: January 04, 2012

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 1

ISSN: 0001-5547 (Print)
eISSN: 1938-2650 (Online)

For additional information: https://www.karger.com/ACY