A new case report was published in Volume 12 of Oncosciencetitled “Deciphering Radiation Effects in Swabs: A Case Report and Overview of Challenges.”
In this report, Gunvanti Rathod, Monica Mishra, Alisha Khan and Mishu Mangla from AIIMS Bibinagar took up the case of a 44-year-old woman who was previously treated for advanced cervical cancer.
A follow-up Papanicolaou (Pap) Pap smear revealed abnormal cells that looked suspicious of cancer recurrence, but were ultimately identified as benign changes.
The case highlights the importance of recognizing changes after treatment to avoid misdiagnosis and unnecessary medical procedures.
Cervical cancer is one of the most common cancers in women, especially in resource-poor settings, and the Pap smear remains an essential tool for both early detection and post-treatment monitoring.
In advanced cases, therapy often includes surgery, chemotherapy, and radiation, and while effective, long-term radiation can cause cellular changes that closely resemble malignancy on microscopic examination.
In this case, the patient had undergone a hysterectomy followed by radiation and chemotherapy.
She returned one year later for routine follow-up.
Although she had no symptoms and no visible signs of disease, her smear showed enlarged nuclei, cytoplasmic changes, and multinucleation, features often associated with cancer.
However, these were determined to be radiation-induced effects and the patient remained stable and symptom-free during her 12-month evaluation.
“Numerous squamous epithelial cells showed: nuclear enlargement with preserved N:C ratio, cytoplasmic vacuolation and granularity, mild hyperchromasia with patchy chromatin, binucleation and multinucleation, degenerative nuclear changes such as nuclear pallor, irregular membranes and chromatin wrinkling, occasional bizarrely shaped cells and inflammatory background with atrophy,” the study read.
This case contributes to clinical knowledge by demonstrating how radiation therapy can mimic disease in cytology and highlights the importance of training and awareness among pathologists to ensure accurate diagnoses and avoid misdiagnoses.
