April 2016
Authors: Preetha Alath, MD, Hussain Makki Al Juma Centre for Specialized Surgery, Kuwait
Kusum Kapila, MD, FRCPath, FIAC
Department of Pathology, Faculty of Medicine, Kuwait University

Reviewer: Christopher J VandenBussche MD PhD, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Clinical History

A 53 year old post-menopausal woman with insulin dependent diabetes and hypertension was seen in the Kuwait Cancer Centre with irregular bleeding per vagina. She gave history of having had a total abdominal hysterectomy with bilateral salpingo-oopherectomy two years ago in a different hospital. At that time MRI showed a mass lesion in the endometrial cavity merging into the fundal and anterior myometrium. All serum tumor markers were normal. A conventional Pap smear from the vault was obtained.

Fig. 1

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Based on the cytomorphology (Figures 1-4) what is the most likely diagnosis?