Type of Preparation: Conventional Magnification: High Clinical History: 42 year old perimenopausal woman presents with irregular bleeding and an enlarged uterus Interpretation: Other Malignant Neoplasms: Sarcoma Cytomorphologic Criteria: This single giant cells with malignant nuclear features is present in a bloody background. Explanatory Notes: Uterine sarcomas exfoliate scant cellular material in cervical cytology samples. Although malignant giant cells may be seen in high grade carcinomas, their association with a spindle cell component point towards a sarcomatous differentiation. The differential diagnosis may include choriocarcinoma. Follow-up: High grade sarcoma (hysterectomy)