Keratin bodies and pseudokeratin bodies endometrial adenoacanthoma versus "ligneous" vaginitis
Becker, S.N.
Acta Cytologica 20(5): 486-488
1976
ISSN/ISBN: 0001-5547 PMID: 185870 Document Number: 102987
Shortly after a report in this journal describing keratin bodies as a unique and useful clue in the cytologic diagnosis of endometrial adenoacanthoma, 2 cases were observed, both of which demonstrated apparent keratin bodies. In 1 case these bodies permitted correct prediction of endometrial adenoacanthoma from the cervical-vaginal smears. In the 2nd case, although the bodies were remarkably refractile and orangeophilic, they represented not keratin but rather acellular hyalinized material from an unusual chronic inflammation of the vagina and cervix. The identical inflammatory process also involved the patient's conjunctivae and there was called ligneous conjunctivitis. These cases are reported to substantiate the usefulness of apparent keratin bodies in the cytologic detection of endometrial adenoacanthoma and adenosquamous carcinoma yet also to indicate at least 1 rare condition in which they may be a diagnostic pitfall. Although "pseudokeratin bodies" were remarkably similar to keratin bodies in the smears, the 2 cases differed in 2 important aspects. In the case of adenoacanthoma the clinical history was classical for endometrial carcinoma, and there were malignant adenocarcinoma cells in the smears. Keratin bodies can be considered suggestive in a few cases of endometrial carcinoma; but malignant cells, whether they be columnar, squamous, or both, must be present for cervicovaginal smears to be diagnostic of any malignancy.