Frequency of Tumor Diathesis in Pap Smears of Women with Carcinoma of Uterine Cervix in Women Hospital (1995- 2003)

Background & Objectives: Tumor diathesis (TD) is defined as granular proteinaceous precipitates on slide surface of cytologic smears. It is found in the background of smears of invasive carcinoma but not in all cases. The aim of present study was to determine the prevalence of TD in cervicovaginal smears from patients with uterine cervix carcinoma. Methods: Cytological smears and histological slides from the Department of Pathology, Women Hospital, Tehran, Iran, of forty six patients histologically confirmed carcinoma of uterine cervix from 1995 to 2003 were reviewed for presence of TD, red blood cells, and neutrophils on cytological smears as well as depth of invasion, histologic types and grade of differentiation of tumor. Results: TD was detected in 28 of the 46 smears (60.9%); in 18 patients with squamous cell carcinoma (62.1%), 7 adenocarcinoma (58.3%), 2 adenosquamous carcinoma (66.7%) and one endometrial carcinoma which involved uterine cervix. TD was seen in 4 (33.3%) uterine cervix carcinoma with 5mm depth of invasion and 17 (65.4%) uterine cervix carcinoma with ≥ 5mm depth of invasion. There was a positive correlation between the presence of TD and the depth of invasion. Although an important criterion of malignancy, TD, was absent in some cases of carcinoma, particularly those that had < 5mm depth of invasion. Conclusion: Increasing in depth of invasion and decreasing in differentiation of the tumor were associated with increasing in frequency of TD in cytological smears. A definite distinction between an intraepithelial lesion and a shallow invasive cancer may not be possible on cervicovaginal smears.