Journal of Mid-life Health Journal of Mid-life Health
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Year : 2018  |  Volume : 9  |  Issue : 3  |  Page : 162-164

Retained fetal bones: An unusual cause of granulomatous reaction on papanicolaou smear

1 Department of Pathology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
2 Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research, New Delhi, India

Correspondence Address:
Sujata Jetley
Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi - 110 062
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmh.JMH_65_18

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Granulomas are a rare finding on Papanicolaou (Pap) smear which if encountered are usually attributed to tuberculosis, especially in an endemic country like India. Here, we report an interesting case of a 40-year-old female presenting with blood-stained discharge and chronic pelvic pain for 8 years. She was advised Pap smear which showed granulomatous inflammation suggestive of tuberculosis. The patient was worked up for tuberculosis which was noncontributory. Dilatation and curettage was done which revealed multiple small bones and bony chips in the endometrial cavity. Following the removal of bones, the patient showed considerable symptomatic improvement. Repeat Pap smear did not reveal any evidence of granuloma. Even after extensive search of literature, we did not come across any such case report in which intrauterine retention of fetal bones evoked a granulomatous response in cervical smears though the presence of uterine granulomas in response to foreign body has been well documented.

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