Two women, ages 42 and 46, each had a cervical mass that clinically was grossly compatible with invasive carcinoma. Colposcopy supported the clinical impression. Weeks after the women were examined, it was determined that the masses represented syphilitic cervicitis. This entity has received almost no attention in the cytology literature, and is not discussed in major cytopathology texts. Accordingly, the cervicovaginal smears that were obtained in these cases are of interest. The smear pattern, which included lymphocytes, plasma cells, histiocytes, and debris, is described. Although in contrast, the histopathology of syphilitic cervicitis is well-characterized, diagnostic evidence of syphilis was missed in the initial interpretation of several of the biopsies. Syphilis recently has reemerged as a public health problem. Although the cases reported here represent rare events, pathologists should be aware that syphilitic cervicitis may clinically and colposcopically simulate a primary advanced cervical cancer. When interpreting cervical biopsies and cervicovaginal smears, they should be alert to patterns that suggest that syphilis is present.
Adult Diagnosis, Differential