UNIT 10 Flashcards
Due to the enlargement of nuclei and the most important criteria of malignancy.
ALTERED NUCLEAR-CYTOPLASMIC RATIOS
Benign in certain tissues, e.g. endocervical and renal pelvic cells.
ALTERED NUCLEAR-CYTOPLASMIC RATIOS
Frequently seen in reactive pleural and peritoneal
mesothelial cells, in histiocytes and in any tissue
undergoing active repair and benign growths.
increased mitotic activity
Triple or quantiple spindles are highly
suspicious and important signs of
malignancy.
atypical mitoses
Irregular hyperchromatic or bizarre nuclei
multinucleated giant cells
Considerable variation in nuclear size and
shape is common in malignant.
anisokaryosis
common in malignant (especially in
thyroids of older women and less in the
adrenal cortex and hyperactive islets of
Langerhans.)
polyploidy
In vaginal smears, they may result from
pregnancy as well as malignancy.
polyploidy
nuclear changes
ALTERED NUCLEAR-CYTOPLASMIC RATIOS
HYPERCHROMASIA
INCREASED MITOTIC ACTIVITY
ATYPICAL MITOSES
MULTINUCLEATED GIANT CELLS
ANISOKARYOSIS
POLYPLOIDY
Cells of epidermoid carcinomas frequently show a tendency to cytoplasmic _______
eosinophilia
cells may enclose PMNs, (eg. endometrial andcolonic cancers)
adenocarcinoma
_____ is common in adenocarcinoma cells, but may be also be seen in endometrial cells following cutterage.
cytoplasmic vacuolation
Examine for the small groups or clusters of cells:
● Obvious growth patterns.
cell pattern
cell pattern in adenocarcinoma arising in glandular tissues.
acini
cell pattern in neuroblastomas and ependymoma
rosettes
cell pattern in squamous epithelial growths.
stratification
responsive to sex steroids, particularly _______, and undergoes predictable changes through the cycle in response to changes in blood concentrations
vaginal epithelium ; estrogen
Rising levels of estrogen cause the vaginal epithelium to become ________
- the surface cells become large and flattened, with small (pyknotic) or absent
nuclei.
cornified
vaginal cytology is a type of
endocrine assay
Tracking changes in the morphology of desquamated vaginal epithelial cells provides a convenient means of assaying
changes in estrogen levels.
TRUE
Vaginal smears may be taken regularly and often
TRUE
Hormonal changes are best mirrored in the
upper third of the vagina.
Can also be taken from the _________ because this is more accessible and less likely to be contaminated by cellular debris or discharge
lateral walls
Large(30-60u)
superficial cells
Medium-sized
(20-30u)
INTERMEDIATE CELLS
Smaller than
intermediates
(15-25u)
PARABASAL CELLS
Polyhedral flat cells
predominant in estrogen
effect
superficial cells
Polyhedral or elongated
intermediate
Round or oval to oval
“boat” shaped cells
(navicular cells,
“pregnancy cells)
glycogen rich in intermediate cells
Occurs in groups “picket
fence” enface view,
mosaic, monolayered
sheet
intermediate
Boat-shaped
intermediate cells with a
strong tendency to fold
and curl at the edges.
intermediate
Round to oval cells
parabasal cells
Tall columnar cylindrical
cells, basal oriented
nuclei
Occurs in groups “picket
fence” enface view,
mosaic, monolayered
sheets
endocervical cells
Glandular cells: slightly
larger forms acini.
Nucleus: small and
Basophilic and maybe
vacuolated -
endometrial cells
Acidophilic or may be
basophilic.
superficial cells
Basophilic with vacuoles.
Elongated cytoplasm
intermediate cells
Translucent basophilic
cytoplasm (due to
glycogen accumulation).
glycogen rich in intermediate cells
Cytoplasm stains deep
blue or blue green + cell membrane = a “double
cell wall” appearance
glycogen rich in intermediate cells
Thick cytoplasm,
“sunny-side up fried
egg” appearance;
monolayer sheets.
parabasal cells
Strong basophilic
cytoplasm
parabasal
Pale basophilia,
vacuolated
endocervical
Basophilic and maybe
vacuolated
endometrial cells
Vesicular: 6-9u
intermediate and parabasal
Pyknotic:
● Presence of
small dark
pyknotic
nuclei (less
than 6u).
superficial only
● Expression of the combined exaggerated
progesterone effect.
● Found in the latter half of menstrual cycle, during
pregnancy, perimenopause.
● May also be found as a result of abnormal
androgen stimulation, either endogenous or
exogenous
intermediate
Anucleate cells are abnormal (may be derived from):
● Smear contamination by the cells from the vulva.
● Epidermization of the vagina or cervix resulting
from prolapse.
● Leukoplakia of the cervix.
● Ruptured membranes in pregnant women.
● Marked hyper-estrinism.
superficial
Found from 2 weeks of age to puberty, after
childbirth, abortion or miscarriages, and after
menopause (atrophy).
parabasal
Found during menstruation period (in groups) and
4-10 days after LMP, endometrial hyperplasia,
endometrial adenocarcinoma.
endometrial
Percentage of cells that stain
pink-orange to red with Pap’s
and red in Shorr method.
● Refers to Acidophilic cytoplasm.
AI
“Karyo-pyknotic index”; percentage of
cells having shrunken, dark, small (less than
6μ) structures nuclei
○ Refers to the pyknotic nuclei.
PI
Percentage proportion of cells from the three layers of the vaginal epithelium
MATURATION INDEX CHMI
○ Percentage between Parabasal cells (left Value), Intermediate
(Midzone), Superficial (right)
CHMI = CytoHormonal Maturation Index
0 / 5/ 95
estrogen effect
0 / 80 / 20
progesterone effect
100 / 0 / 0
atrophy
30/50/20
unfit