Pemphigus vulgaris of the cervix: diagnostic difficulties associated with the Pap test

Diagnostic Cytopathology
Karina Munhoz de Paula Alves CoelhoHercílio Fronza Júnior

Abstract

Pemphigus vulgaris (PV) is a rare mucocutaneous disease caused by the abnormal production of antibodies against epithelial cell surface glycoproteins, resulting in loss of cell adhesion and intraepithelial blister formation. Cervical involvement in PV has been poorly reported, and there is little information regarding the criteria about consequential cytological changes identified in a Papanicolaou-stained cervicovaginal smear (Pap smear). Here, we report a case of PV manifesting in the cervix as well as the difficulty associated with the cytomorphological identification and interpretation of acantholytic cells. This case involved a 40-year-old patient with no history of Pap test abnormalities and no prior diagnosis of PV. In the cytological assessment, cells were identified both in isolation and in clusters that exhibited round nuclei of increased volume, inconspicuous nucleoli, and perinuclear halos. The patient underwent a cervical biopsy that revealed vesiculobullous lesions and morphological pattern consistent with PV. A skin biopsy confirmed this diagnosis. We concluded that knowledge of PV cytomorphology is important because difficulties associated with the identification and interpretation of acantholytic cells might be...Continue Reading

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Citations

Jun 2, 2016·Archives of Dermatological Research·Leena ChularojanamontriPuan Suthipinittharm
Aug 12, 2017·Diagnostic Cytopathology·Seiji KondoToshihiro Kikuta
Dec 17, 2020·International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists·Stephen M SmithVinita Parkash

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