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British Association for Cytopathology June 2025 Case Study

Persistent High Grade Dyskaryosis in cytology with Low Grade Histology in a Patient with Vaginal Adenosis and Unusual Cervical Gastric Metaplasia: A Long Term Diagnostic Challenge

Dr. Supriya Dhar, Locum Consultant Cytopathologist Manchester University NHS Foundation Trust

  • We present a complex case involving both a likely DES associated glandular
    abnormality and persistent cytology histology discordance, necessitating
    multidisciplinary evaluation over a long period of time.
  • A woman in her mid fifties, with probable maternal DES exposure, has been under
    gynaecological follow up for 17 years.
  • Vaginal biopsies confirmed vaginal adenosis.
  • A hysterectomy specimen also showed features in keeping with vaginal adenosis.
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