Pemphigus vulgaris of the cervix: Diagnostic difficulties associated with the Pap test
- 26 February 2015
- journal article
- case report
- Published by Wiley in Diagnostic Cytopathology
- Vol. 43 (8), 635-637
- https://doi.org/10.1002/dc.23269
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 responsible for false positive diagnoses of cervical neoplasia. However, a suspected diagnosis of PV is possible if the cytological findings are carefully correlated with the clinical data. Diagn. Cytopathol. 2015.Keywords
This publication has 11 references indexed in Scilit:
- Incidência do pênfigo vulgar ultrapassa a do pênfigo foliáceo em região endêmica para pênfigo foliáceo: análise de série histórica de 21 anosAnais Brasileiros de Dermatologia, 2011
- Cervicovaginal involvement in pemphigus vulgaris: a clinical study of 77 casesBritish Journal of Dermatology, 2007
- HR-HPV DNA to differentiate between cervical pemphigus and CIN: a case reportArchiv für Gynäkologie, 2007
- Involvement of the Female Genital Tract in Pemphigus VulgarisObstetrics & Gynecology, 2005
- Pemphigus vulgaris of the cervixDiagnostic Cytopathology, 2005
- Acantholytic Cells Exfoliated from Pemphigus Vulgaris of the Uterine CervixActa Cytologica, 2003
- Antibodies against keratinocyte antigens other than desmogleins 1 and 3 can induce pemphigus vulgaris–like lesionsJCI Insight, 2000
- Pemphigus vulgaris: the other half of the storyJCI Insight, 2000
- Pemphigus vulgaris of the uterine cervix revisited: Case report and review of the literatureDiagnostic Cytopathology, 2000
- Nikolsky sign on cervix uteri in pemphigusBritish Journal of Dermatology, 1974