Pap smear shows three dimensional balls of cells with smooth outlines. It is difficult to visualize the nuclei in such clusters.
The Pap smear is also extremely cellular and composed of glandular cells with a spectrum of nuclear atypia and enlargement.
The corresponding resection shows invasive endometrioid adenocarcinoma invading through most of the myometrial wall.
Close to the surface are nearly confluent areas of solid growth of malignant cells.
Nest of invasive cells in the myometrial wall frequently disclosed central coagulative necrosis.
The cells show the same prominent irregular nucleoli, nuclear enlargement, and degree of atypia as appreciated on the pap smear.
Transitions between a limited area of gland forming neoplasia to solid growth can sometimes be abrupt.
Although this tumor did show a fair amount of glandular differentiation, the grade was increased from FIGO 2 to FIGO 3 based on severe nuclear pleomorphism.