Cervical Smear Findings Research Articles

EVALUATION OF PAP SMEARS BY CONVENTIONAL CYTOLOGY AND CORRELATION WITH CLINICAL AND HISTOPATHOLOGICAL FINDINGS

Introduction: Cervical cancer is considered preventable, as majority of cancers are preceded by a long-standing precancerous lesion. This lesion may exist in the non-invasive stage for years and shed abnormal cells that can be detected on cytological examination.
 Aims: The study was carried out with aim to evaluate cervical smears for epithelial abnormalities and study the relationship of cervical smear findings with clinical features like age, parity, vaginal discharge, lower abdominal pain, backache, postcoital bleeding, infertility, postmenopausal bleeding and also Correlate cervical smear findings with cervical biopsy. Material and methods: All the pap smears received from the gynecology department from 2013 to 2015 were included in the study. In each case, personal information and clinical history were recorded. Correlation with histopathological findings was done in cases where cervical biopsy was available.
 Results: The mean age of the women was 31 years. Normal pap smear was reported in 8.33%. The most common finding reported was inflammatory pap smear.(75%) Highest incidence of premalignant lesion (LSIL) was noted in women with parity 5 and above. The most common presenting complaint was discharge per vaginum which was present in 54 (39.13%) cases. Of the total 60 biopsies, 45 were reported as chronic cervicitis and 11 as LSIL, 2 as HSIL and 2 were normal. Conclusion: This study establishes the importance of conventional cervical Pap smear test in cervical cancer screening for diagnosis of precancerous and cancerous lesions of cervix especially in India where majority of population is rural-based and belong to low socioeconomic group.

Cervical Cytological Findings among Women Attending a Tertiary Care Hospital in Sana’a, Yemen

Objective: To determine the frequency and pattern of abnormal cervical smear findings among women attending the University of Science and Technology Hospital (USTH) in Sana'a city.
 Methods: This study is a retrospective, cross-sectional study. Records of women examined by conventional Pap smears in the Histopathology Laboratory of USTH over a 4-year period (from January 2013 to December 2016) were retrieved and analyzed for abnormalities according to the Bethesda system.
 Results: Of 688 cases, 599 with satisfactory records were analyzed. The mean age of the cases was 39.18±10.23 years (range: 19–75). Epithelial cell abnormalities (ECAs) were found in 47 cases (7.8%), and these were categorized as follows: ASCUS in 4.5% (27/599) of cases followed by atypical glandular cells (AGC) (2.2%; 13/599) and LSIL (0.5%; 3/599), while ASCH and HSIL abnormalities were equally observed among 0.3% (2/599 each) of cases. Of patients positive Pap smear findings, ASCUS was the most frequent type of ECA (57.4%; 27/47) followed by AGC (27.7%; 13/47) and LSIL (6.4%; 3/47), while ASCH and HSIL were the least frequent ECAs among Yemeni patients. ECAs were significantly more prevalent among women aged >40 years (10.8%) compared with those aged <40 years (5.5%).
 Conclusions: Cervical cytological abnormalities are not uncommon among women in Yemen, where the AGC is frequent among about a third of women with abnormal Pap smear findings and affects women of different ages. This requires more attention and training of doctors to master good sample taking, preparation and diagnosis with a focus on glandular changes.

Cervical Cytological Findings among Women Attending a Tertiary Care Hospital in Sana’a, Yemen

Objective: To determine the frequency and pattern of abnormal cervical smear findings among women attending the University of Science and Technology Hospital (USTH) in Sana'a city.
 Methods: This study is a retrospective, cross-sectional study. Records of women examined by conventional Pap smears in the Histopathology Laboratory of USTH over a 4-year period (from January 2013 to December 2016) were retrieved and analyzed for abnormalities according to the Bethesda system.
 Results: Of 688 cases, 599 with satisfactory records were analyzed. The mean age of the cases was 39.18±10.23 years (range: 19–75). Epithelial cell abnormalities (ECAs) were found in 47 cases (7.8%), and these were categorized as follows: ASCUS in 4.5% (27/599) of cases followed by atypical glandular cells (AGC) (2.2%; 13/599) and LSIL (0.5%; 3/599), while ASCH and HSIL abnormalities were equally observed among 0.3% (2/599 each) of cases. Of patients positive Pap smear findings, ASCUS was the most frequent type of ECA (57.4%; 27/47) followed by AGC (27.7%; 13/47) and LSIL (6.4%; 3/47), while ASCH and HSIL were the least frequent ECAs among Yemeni patients. ECAs were significantly more prevalent among women aged >40 years (10.8%) compared with those aged <40 years (5.5%).
 Conclusions: Cervical cytological abnormalities are not uncommon among women in Yemen, where the AGC is frequent among about a third of women with abnormal Pap smear findings and affects women of different ages. This requires more attention and training of doctors to master good sample taking, preparation and diagnosis with a focus on glandular changes.

Eight cases of malignant mixed müllerian tumor (carcinosarcoma) of the uterus: Findings in surepath™ cervical cytology

Malignant mixed Müllerian tumor (MMMT)/carcinosarcoma is a rare neoplasm of the female genital tract characterized by a mixture of epithelial and mesenchymal components. There are published reports of conventional cervical smear findings in uterine MMMT, but to the best of our knowledge the cytomorphology of MMMT in SurePath™ liquid-based cytology samples has not been described. We present a series of eight cases of uterine MMMT in SurePath™ cervical samples. The mean age of the women was 65.5 years (range, 60-82 years) and the most common presenting symptom was postmenopausal bleeding. Three out of the eight cases had both epithelial and sarcomatous elements in highly cellular cervical samples. In two cases, abnormal glandular cell clusters were closely associated with the mesenchymal component. The glandular component was usually represented by three-dimensional clusters of malignant glandular cells and a dispersed population of large, round to oval malignant epithelial cells with single prominent nucleoli. Necrosis or tumor diathesis was not seen in any cases. Six out of the eight cases were initially reported as adenocarcinoma, endometrial type, and two cases as normal. Five cases had an atrophic background and tiny atypical glandular clusters that could easily be overlooked. Although cervical sample is not the method of choice for primary uterine carcinosarcoma screening, the possibility of the same should be kept in mind, when reporting a cervical sample from a woman with postmenopausal vaginal bleeding.

A Clinical Study of Cervical Dysplasia in Long-Term Survivors of Allogeneic Stem Cell Transplantation

This retrospective study examined the prevalence of and risk factors for cervical dysplasia and genital human papillomavirus (HPV) infection in 89 female recipients of allogeneic stem cell transplantation (allo-SCT) between 1985 and 2005 who survived for more than 5 years after transplantation. All patients underwent regular gynecologic examination and cervical cytological testing. The incidence rates of cervical cytological abnormalities and HPV infection were calculated. Various clinical parameters were evaluated for association with cytological high-grade squamous intraepithelial lesion (HSIL) posttransplantation to identify risk factors for cervical dysplasia. Multivariate analysis with logistic regression was used to identify independent risk factors for cervical dysplasia after adjusting for confounding factors. Sixty-one of the 89 patients (68.5%) had cervical cytological abnormalities of varying grades, including atypical squamous cells of undetermined significance (ASC-US; 31.5%; 28 of 89), low-grade squamous intraepithelial lesion (LSIL; 10.1%; 9 of 89), and HSIL (27%; 24 of 89). HPV status was available for 43 patients, 12 of whom (27.9%) were HPV-positive. Among the 69 patients with normal cytological cervical smear findings pretransplantation, the incidence of cytological HSIL was 23.2% (16 of 69) posttransplantation. After adjusting for confounding factors, only unrelated HLA-matched donor and the presence of vulvovaginal chronic graft-versus-host disease (cGVHD) were independent risk factors for cervical cytology HSIL after transplantation, with the highest risk among patients with vulvovaginal cGVHD (adjusted odds ratio, 31.97). We conclude that long-term survivors of allogeneic stem cell transplantation are at high risk for cervical cytological abnormalities. Vulvovaginal cGVHD and unrelated HLA-matched donor were the only independent risk factors for cervical cytological HSIL in patients with normal cervical cytology before transplantation. Regular surveillance by gynecologic examination, including cervical cytological testing, in these patients allows for early diagnosis and effective management of cervical abnormality and decreases the burden of this potentially fatal, but treatable, condition.

تقييم وبائي لموجودات مسحات عنق الرحم في الضفة الغربية/ فلسطين : دراسة استرجاعية

Pap test is widely used both as a screening test in asymptomatic population and in the follow-up of patients with cervical carcinomas. The objective of the study was to evaluate cervical smear findings in the West Bank and to assess the need for cervical screening program in Palestine. Methods: This retrospective study was performed at two private laboratories in Nablus and Ramallah, in the West Bank/ Palestine. Cervical smears over a period of 5 years (2003-2007) taken from 239 women referred either for a check-up or with vaginal discharge were reviewed at two Pathology laboratories in the West Bank. All smears were fixed with 96% alcohol, stained with Papanicolaou stain and screened microscopically by a pathologist. Bethesda system definition of morphology was used. Results: Of the 239 smears, the majority of cases (59%) showed non- specific inflammation while cervical dysplastic changes were uncommon; 11 cases (4.60%) were classified as Atypical Squamous Cells of Undetermined Significance (ASCUS), 1 case (0.42%) was Low-grade Squamous Intraepithelial Lesion (LGSIL), however High-grade Squamous Intraepithelial Lesion (HGSIL) and cervical carcinoma were not found. Conclusion: Our findings are in agreement with Jordanian study which reveals low incidence of cervical precursor lesions, there aggressive screening program is not a priority or recommended in Palestine at this time. We should concentrate on education and awareness of Palestinian women to risk factors for cervical cancer. تستخدم فحوصات عنق الرحم بشكل واسع كاختبار مسحي عند النساء اللواتي لا يشكين أية أعراض وكذلك لمتابعة المرضى اللواتي تم تشخيص وجود سرطان عنق الرحم لديهن. الهدف من الدراسة كان لتقييم الموجودات المرضية في مسحات عنق الرحم في الضفة الغربية وتحديد الحاجة لإجراء برامج الكشف المسحي لعنق الرحم في فلسطين.

“Fruiting body” Penicillium species: Papanicolaou stained conventional cervical smear findings

Diagnostic CytopathologyVolume 38, Issue 1 p. 34-35 Images in Cytology “Fruiting body” Penicillium species: Papanicolaou stained conventional cervical smear findings Balaiah Donta M.Sc., Ph.D., Balaiah Donta M.Sc., Ph.D. Division of Biostatistics, National Institute for Research in Reproductive Health, Parel, Mumbai 400 012, India The authors have no connection to any companies or products mentioned in this letter.Search for more papers by this authorD. D. Naik M.A., M.P.S., D.P.M., D. D. Naik M.A., M.P.S., D.P.M. Division of Biostatistics, National Institute for Research in Reproductive Health, Parel, Mumbai 400 012, India The authors have no connection to any companies or products mentioned in this letter.Search for more papers by this authorB. N. Mali M.Sc., Ph.D., Corresponding Author B. N. Mali M.Sc., Ph.D. bnmali@rediffmail.com Division of Biostatistics, National Institute for Research in Reproductive Health, Parel, Mumbai 400 012, India The authors have no connection to any companies or products mentioned in this letter.Consulting Cytopathologist, Division of Biostatistics, National Institute for Research in Reproductive Health (ICMR), Jehangir Merwanji Street, Parel, Mumbai 400 012, IndiaSearch for more papers by this authorAnil Bandiwadekar M.B.B.S., D.P.H., D.H.A., Anil Bandiwadekar M.B.B.S., D.P.H., D.H.A. Municipal Corporation of Greater Mumbai, Public Health Department, Maternal and Child Health, Parel, Mumbai 400 012, India The authors have no connection to any companies or products mentioned in this letter.Search for more papers by this authorKavita Ramnath M.D., Kavita Ramnath M.D. Municipal Corporation of Greater Mumbai, Public Health Department, Maternal and Child Health, Parel, Mumbai 400 012, India The authors have no connection to any companies or products mentioned in this letter.Search for more papers by this authorMeenakshi Rao M.D., Meenakshi Rao M.D. Municipal Corporation of Greater Mumbai, Public Health Department, Maternal and Child Health, Parel, Mumbai 400 012, India The authors have no connection to any companies or products mentioned in this letter.Search for more papers by this author Balaiah Donta M.Sc., Ph.D., Balaiah Donta M.Sc., Ph.D. Division of Biostatistics, National Institute for Research in Reproductive Health, Parel, Mumbai 400 012, India The authors have no connection to any companies or products mentioned in this letter.Search for more papers by this authorD. D. Naik M.A., M.P.S., D.P.M., D. D. Naik M.A., M.P.S., D.P.M. Division of Biostatistics, National Institute for Research in Reproductive Health, Parel, Mumbai 400 012, India The authors have no connection to any companies or products mentioned in this letter.Search for more papers by this authorB. N. Mali M.Sc., Ph.D., Corresponding Author B. N. Mali M.Sc., Ph.D. bnmali@rediffmail.com Division of Biostatistics, National Institute for Research in Reproductive Health, Parel, Mumbai 400 012, India The authors have no connection to any companies or products mentioned in this letter.Consulting Cytopathologist, Division of Biostatistics, National Institute for Research in Reproductive Health (ICMR), Jehangir Merwanji Street, Parel, Mumbai 400 012, IndiaSearch for more papers by this authorAnil Bandiwadekar M.B.B.S., D.P.H., D.H.A., Anil Bandiwadekar M.B.B.S., D.P.H., D.H.A. Municipal Corporation of Greater Mumbai, Public Health Department, Maternal and Child Health, Parel, Mumbai 400 012, India The authors have no connection to any companies or products mentioned in this letter.Search for more papers by this authorKavita Ramnath M.D., Kavita Ramnath M.D. Municipal Corporation of Greater Mumbai, Public Health Department, Maternal and Child Health, Parel, Mumbai 400 012, India The authors have no connection to any companies or products mentioned in this letter.Search for more papers by this authorMeenakshi Rao M.D., Meenakshi Rao M.D. Municipal Corporation of Greater Mumbai, Public Health Department, Maternal and Child Health, Parel, Mumbai 400 012, India The authors have no connection to any companies or products mentioned in this letter.Search for more papers by this author First published: 13 February 2009 https://doi.org/10.1002/dc.21034Citations: 2 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume38, Issue1January 2010Pages 34-35 RelatedInformation

Effects of dietary boron on cervical cytopathology and on micronucleus frequency in exfoliated buccal cells

Recent evidence indicates that boron and borates may have anticarcinogenic properties. In this study, we have investigated the incidence of adverse cytological findings in cervical smears and the micronucleus (MN) frequency in women living in boron-rich and boron-poor regions. Cervical smears were prepared from 1059 women with low socioeconomic status; 472 of the women lived in relatively boron-rich rural areas, while 587 lived in relatively boron-poor regions. The average and standard deviation values for the age of the women screened with the cervical Pap smear test were 41.55 +/- 8.38. The mean dietary intake of boron was 8.41 mg/day for women from the boron-rich regions, and 1.26 mg/day for women living in the boron-poor regions (P < 0.0001). Women from the boron-rich regions had no cytopathological indications of cervical cancer, while there were cytopathological findings for 15 women from the boron-poor areas (chi(2) = 10.473, P < 0.05). Sixty women, 30 from each region, were chosen for evaluating MN frequencies in exfoliated buccal cells. MN frequencies for women from the boron-rich and boron-poor regions were not significantly different (t = -0.294, P > 0.05). Also, there were no significant correlations between age and MN frequency for women from both the boron-rich (r = 0.133, P = 0.48, P > 0.05) and boron-poor (r = -0.033, P = 0.861, P > 0.05) regions. The results suggest that ingestion of boron in the drinking water decreases the incidence of cervical cancer-related histopathological findings. There was no correlation between the pathological findings from the cervical smears and buccal cell MN frequency suggesting that the two study populations were exposed equally to gentotoxic agents. Nonetheless, cervical cancer-related histopathological findings should be validated by other researchers.

Cytologic findings in cervical smears in patients using intramuscular medroxyprogesterone acetate (Depo‐Provera) for contraception

The purpose of the present study was to assess the findings in cervical smears associated with intramuscular depot medroxyprogesterone acetate (Depo-Provera) contraception. Seventy-four cervical smears of reproductive-age patients on Depo-Provera were reviewed for cytologic abnormalities, predominant cell type, and intermediate cell glycogenation (extensive (EGly) = navicular cells / glycogenation in 10 or more high-powered fields (hpf); moderate (MGly) = 5–10 hpf; and focal (FGly) = less than 5 hpf). A control group of 38 nonpregnant patients without hormonal therapy was reviewed. Study group patients' (SGP) age ranged from 16–44 years (average 28.1); control group patients (CGP) from 17–42 years (average 29.4). Time since last menstrual period (LMP) for the SGP was 16.9 months (range 1–96); LMP for CGP was 18.2 days (range 5–33). Four (5.4%) SGP had squamous intraepithelial lesions (SIL), four (5.4%) atypical squamous cells of undetermined significance (ASCUS), and one (1.4%) atypical repair. No CGP had SIL or ASCUS. Seventy-three (98.6%) SGP had intermediate cell (IC) predominance; one had parabasal cell predominance. Of the CGP, 28 (73.7%) had IC predominance, nine (23.7%) superficial cell (SC) predominance and one (2.6%) had near equal IC and SC. EGly was seen in 22 (29.7%) SGP; two (5.3%) in CGP (chi-square 7.53; 0.95 = 3.84). MGly was seen in 29 (39.2%) SGP; 10 (26.3%) in CG. FGly was seen in 17 (22.9%) SGP; 14 (36.8%) in CGP. No glycogenation was seen in six (8.1%) SGP; 12 (31.6%) in CGP. Time since LMP was inversely proportional to glycogenation in SGP: EGly-LMP 11.6 months; MGly-LMP 14.9 months; FGly-LMP 15.0 months; and no glycogenation-LMP 22.5 months. Glycogenation of IC appears inversely proportional to Depo-Provera effect. EGly due to recent Depo-Provera administration mimics changes associated with pregnancy. Diagn. Cytopathol. 2000;23:161–164. © 2000 Wiley-Liss, Inc.

Cytologic findings in cervical smears in patients using intramuscular medroxyprogesterone acetate (Depo-provera) for contraception.

The purpose of the present study was to assess the findings in cervical smears associated with intramuscular depot medroxyprogesterone acetate (Depo-Provera) contraception. Seventy-four cervical smears of reproductive-age patients on Depo-Provera were reviewed for cytologic abnormalities, predominant cell type, and intermediate cell glycogenation (extensive (EGly) = navicular cells / glycogenation in 10 or more high-powered fields (hpf); moderate (MGly) = 5-10 hpf; and focal (FGly) = less than 5 hpf). A control group of 38 nonpregnant patients without hormonal therapy was reviewed. Study group patients' (SGP) age ranged from 16-44 years (average 28.1); control group patients (CGP) from 17-42 years (average 29.4). Time since last menstrual period (LMP) for the SGP was 16.9 months (range 1-96); LMP for CGP was 18.2 days (range 5-33). Four (5.4%) SGP had squamous intraepithelial lesions (SIL), four (5.4%) atypical squamous cells of undetermined significance (ASCUS), and one (1.4%) atypical repair. No CGP had SIL or ASCUS. Seventy-three (98.6%) SGP had intermediate cell (IC) predominance; one had parabasal cell predominance. Of the CGP, 28 (73.7%) had IC predominance, nine (23.7%) superficial cell (SC) predominance and one (2.6%) had near equal IC and SC. EGly was seen in 22 (29.7%) SGP; two (5.3%) in CGP (chi-square 7.53; 0.95 = 3.84). MGly was seen in 29 (39.2%) SGP; 10 (26.3%) in CG. FGly was seen in 17 (22.9%) SGP; 14 (36.8%) in CGP. No glycogenation was seen in six (8.1%) SGP; 12 (31.6%) in CGP. Time since LMP was inversely proportional to glycogenation in SGP: EGly-LMP 11.6 months; MGly-LMP 14.9 months; FGly-LMP 15.0 months; and no glycogenation-LMP 22.5 months. Glycogenation of IC appears inversely proportional to Depo-Provera effect. EGly due to recent Depo-Provera administration mimics changes associated with pregnancy.

Inflammatory smears in cervicovaginal cytology. A finding meaning infection?

Inflammatory changes are relatively frequent findings in cervical smears and are generally believed to be a consequence of genital infection. However, clinical signs of infection are frequently absent and no consensus exists on the management of these patients. The objective of this study was to assess whether or not inflammatory smears are exclusively a consequence of genital infection. For this purpose, the prevalence of genital infection in a group of women with inflammatory cells in the cervical smear and a control group with normal smears was compared. Sixty-two regularly menstruating women aged 17 to 48 years, attending the outpatient Gynaecology sector of S. João Hospital, were prospectively evaluated. Cervical smears were analysed by the same cytologist who chose 10 inflammatory cells per high power field (400x) as the cut-off value for normality. Infection by Candida spp., Trichomonas vaginalis, Neisseria gonorrhoeae, Mycoplasma hominis, Ureaplasma urealyticum, Chlamydia trachomatis and bacterial vaginosis was investigated. Human Papillomavirus infection was evaluated by colposcopy and biopsy of abnormal colposcopic findings. Thirty-four women and inflammatory cells on their cervical smear and 15 of these (44%) had a genital infection. Of the 28 women with normal smears, 12 (43%) had a genital infection. No statistically significant difference in the prevalence of infection was found between the two groups. Our results suggest that the presence of inflammatory cells in cervical smears is not necessarily due to infection and other causes may be responsible for their appearance.