Test Revision Flashcards
Small cells that give rise to squamous cells Rarely recognised in a Pap smear Seen in short rows Sparse green cytoplasm Oval nuclei High N/C ratio Fine granular chromatin pattern Small chromocenters
Basal cells
Round to oval cells Dense green (cyanophilic cytoplasm) May stain pink (orangeophilic) if not well preserved Nucleus occupies ½ of cell Fine chromatin pattern May present in sheets, singly Commonly found in post menopausal women/post partum Indicates oestrogen deficiency
Parabasal cells
If these cells found in cervical smear may indicate:
- the smear was taken in the distal 1/3 of the vagina
- the specimen was taken from an ectocervix that contained an area of leucoplakia (hyperkeratosis)
- the specimen was taken from a pregnant patient whose fetal membranes had ruptured with secretions containing said cells
Anucleate squamous cells
Found in the superficial stroma and deep stroma
Central core of stromal cells, peripheral rim of epithelial cells
Appear in 3 dimensional clusters or singly
Cell ball pattern with moulding
Often show degenerative changes
Cytoplasmic vacuoles with neutrophils
Hyperchromatic nuclei
May appear no larger than an inflammatory cell
Presence of endometrial cells after 12 day of cycle is considered abnormal
Noted on sample to make sure they are not confused with lesions
Endometrial cells
What kind of change in cytoplasm do these relate to?
- Perinuclear halos
- Vacuolation
- Altered staining pattern
- Abnormal keratinisation
- Cytolysis
- Engulfed polymorphism
Inflammatory
What kind of change in nucleus do these relate to?
- Pyknosis, karyorrhexis and karyolysis
- Swelling - due to fluid absorption
- Wrinkling of the nuclear membranes
- Enlargement
- Hyperchromasia
- Multinucleation/binucleation
- Chromatin degeneration
- Nuclear symmetry is maintained
Inflammatory
What kind of change in cell architecture do these relate to?
- Cohesive flat sheets of very active cells
- Cell polarity is maintained (nuclei oriented in the same direction)
- Equality in cell and nuclear size, distribution of chromatin and number of nucleoli
- The cells remain cohesive, have distinct cell borders and single cells are rarely seen
- Streaming (toffee-pull effect/spinous projections
Reparative
What kind of change in nucleus do these relate to?
- Prominent nucleoli
- Smooth nuclear membranes
- Size may vary but shape remains round or oval
- Nuclear enlargement
- Hyperchromasia
- Chromatin may be coarsely granular
- Mitotic activity
- Binucleation or multinucleation
Reparative
What kind of change in cytoplasm do these relate to?
- Large with tails and distinct borders
- Retains evidence of squamous or glandular differentiation
- Changes in staining reaction (polychromasia)
- +/- engulfed polymorphs
Reparative
How to Distinguish Reparative from Malignant Cells?
Uniformity of cell nuclei within flat sheets and lack of single cells distinguishes reparative from malignant cells
What infection is this?
- Streaks of small and large lymphocytes
- Macrophages
- Multinucleated histiocytes
- Plasma cells ‘clock face pattern’
- Lymphocytes on their own can’t be reported as [blank] without the presence of tingible body macrophages
- Common in post meno women
Follicular cervicitis
What infection is this?
- Clue cells
- Common cause of DC in younger women
- thin milky d/c and foul fishy odour
- Shift from lactobacilli to coccobacilli
- Considered venereal disease (STD)
- Uncommon in Pmeno women, except those on HRT
- Risk factors includes multiple sexual partners, IUCD, prior pregnancy, spermicides and smoking
- Increases vaginal pH (> 4.5)
Gardnerella vaginalis
Reported as Profuse Coccoid Flora
What infection is this?
- Suspect if ulcerative lesion seen on cervix
- Venereal infection common in women in the tropical climates
- Indicates granulomatous inflammation with caseous necrosis mainly of the skin and external genitalia
- Skin scrapings show predominance of histiocytes with vacuoles containing straight and curved dumbbell shaped rods
- Stain pos with Warthin Starry method
Klebsiella granulomatis
What infection is this?
- Bacteria capable of forming large colonies
- Usually seen in associated with IUCD
- Saprophytic organism with no clinical symptoms
- Colonies on filamentous organism
- Staining dark blue in central area
- Thin radiating filament
- Variable inflammatory exudate
- Variable inflammatory changes in squamous epithelium
- If left can lead to pelvic inflammatory disease => infertility
Actinomyces
What infection is this?
- Unicellular, grey pear shaped, with oval eccentric hypochromic nucleus and eosinophilic granules in cytoplasm
- Considered venereal disease
- Symptoms produce frothy +/- white/yellow d/c, vaginal dryness, postcoital or intermenstrual bleeding
- Punctate haemorrhagic spots may develop on the mucosa of vaginal cavity known as ‘strawberry vagina’
Trichomonas vaginalis
What stage of the menstrual cycle is this?
- Desquamated endometrial cells
- Blood
- Polymorphonuclear leukocytes
- Predominantly intermediate cells in clumps and folded cytoplasm
Menstrual phase
