Slide Atlas

Gynecology
   Normal

Clean background(A few neutrophils are seen)

Superficial cell – pyknotic nucleus,featureless chromatin

Defined polygonal sharp cytoplasm

Intermediate cell  vesicular with finely granular chromatin nucleus

Polyhedral thin flat or folded,

Pale cyanophilic cytoplasm

   Secretory phase

Intermediate cell of crowding, folded

Increase döderlein bacilli

Appearance naked nucleus

Increase neutrophils

Clean background

   Endocervical cell

Sheets and some clusters

Honeycomb pattern

Abundant clear or lacy cytoplasm

Large vacuoles common

Nuclei round, central

Vasicular chromatin

Minimal nuclear molding

Usually appear in sufficient smears

   Endometrial cell

Disorganized clusters, fewer sheets

Less defined cell borders

Minimal dense cytoplasm

Few cells with small vacuoles

Triangular, oval, or indented nuclei

Granular darker chromatin

Prominent tight nuclear molding

Frequently degenerated in smears

   Atrophy

Piknotic or fragmented nuclei

Tendency to from syncytia

Nuclei are dark and homogeneous without clearly defined chromatin pattern and enlarged, streaked nuclei degenerating background.

   Benign cellular change

Marked leukocytosis

Leukophagocytosis

Change of epithelial cells

We can find pathogenic microorganism

Increased the maturation of squamous epithelium

   Squamous metaplasia

Thick cytoplasm

Polygonal

Pseudopod

Spider cell

Double cytoplasm(ectoplasm, endoplasm)

   Gardnerella vaginalis

Haemophilus vaginitis, Corynebacterium

Pleomorphic gram(+) coccobacilli, no senile

Nonspecific vulvovaginitis is caused

Cloudy cytoplasm

We called it “Clue cell”

   Candida albicans

Vulvovaginitis is caused

Pseudohyphae

Round or oval spore

In cytoplasm perispore halo

Eosinophilic staining

   Trichomonas vaginalis

Ill-defined body

No flagella in cytologic smear

Anisocytosis

 pear shape

Ill-defined nucleus

Well defined eosinophilic granules

   Herpes simplex

Stage I : Multinucleation, Chromatin granularity

Stage II : ground glass, chromatin margination, nuclear molding

Stage III : intranuclear eosinophilic inclusion

   ASCUS

Nuclear enlargement

(two and a half to three times than that of a normal intermediate)

Most often, ASCUS involves nuclear enlargement in squamous cells with mature superficial, intermediate type cytoplasm

Atypical metaplasia and atypical repair are included in this category

The differential diagnosis is between a benign reactive change versus LSIL

   Human papilloma virus

Koilocytosis

Parakeratosis

Condylomatous parabasal cell

Smudge nuclei

Giant cell

   LSIL (HPV)

Few isolated cells

Polygonal intermediate or superficial

with cytoplasmic cavity.

Large nucleus with uniform finely granular chromatin.

   HSIL

Isolated or sheets

Predominantly intermediate cell

Some less mature cells with dense cytoplasm

High N/C ratio

   HSIL

Many abnormal cells in syncytium

Small round cells with the highest N/C ratio

& indistinct cells border.

Marked irregularity of nuclear envelope

Monotonous on low power

Nuclear pleomorphism on high power.

Lost polarity, coarse granular chromatin, round or oval nuclei shape

 

 

 

   Squamous cell carcinoma (keratinising)

Bizarre pleomorphism

Pyknosis, hyperchromatic coarse chromatin

Elongate nuclei

High N/C ratio

Irregular indentation nuclear membrane

Tadpole, spindle cell

Tumor diathesis

   Squamous cell carcinoma

Anisocytosis, anisokaryosis

Potato shaped nuclei

Coarse, clearing clumping chromatin

Macronucleoli

Moderately high N/C ratio

Ill defined cytoplasm

Naked nuclei