LBC Diagnosis of Clear Cell Adenocarcinoma of Vagina: An Interesting Case Report

Clear cell Adenocarcinoma (CCA) of vagina is a rare malignancy, reported at early ages in daughters of mothers exposed to diethylstilbestrol (DES) in utero. Histological features are well established, however cytological findings and moreover Liquid Based Cytology (LBC) morphology is not well characterized. We report a case of primary vaginal CCA first time picked up on LBC smear examination, confirmed by further histopathology and immunohistochemistry. In this case LBC smear from a 27-year-old lady (with no maternal history suggestive of DES exposure) displayed multiple three-dimensional groups of atypical cells with abundant foamy to vacuolated cytoplasm with focal acinar formations. Subsequent histologic features from the polypoidal lesion from vagina were consistent with CCA confirmed by immunohistochemistry. This case emphasizes the role of LBC in detection of the lesion and stresses on the unique features of CCA.