CLINICAL APPARATUSES
1. Ayre's spatula: mucoid for hormonal study
2. Laryngeal cannula: endocervical/endometrial
3. Curette (spoon/curved/blunt): vagina, cervix,
placenta, endometrial
4. Endocervical brush: endocervical
5. Vaginal scrape: hysterectomy
6. Lateral vaginal scrape: hormonal evaluation
7. 4 quadrant vaginal scrape: vaginal adenosis
8. Vulvular: herpetic lesions or carcinoma
VAGINAL HORMONAL CYTOLOGY UPPER LATERAL THIRD
OF THE VAGINAL WALL
CELLS FOUND IN CERVICO-VAGINAL SMEARS
A. MATURE SUPERFICIAL CELLS
Dark pyknotic nuclei (dark structures)
and pale-pink cytoplasm; polygonal
squamous cells measures 45-50 um in
diameter
TRUE ACIDOPHILIA: superficial vaginal
cells under estrogen inflammation
PSEUDOACIDOPHILIA: observed due to
drying of smears (infection. chemicals,
prolapse and drying of vaginal
epithelium)
B. INTERMEDIATE CELLS
Medium-sized polyhedral or elongated
cells with basophilic vacuolated
cytoplasm
C. PARABASAL CELLS
Round to oval cells with small dense
basophilic cytoplasm ("fried-egg"
appearance)
Smaller than intermediate cells
Found from two weeks of age of
puberty, after childbirth, with
abortions, and after menopause
D. ENDOMETRIAL CELLS
Resembles like parabasal cells; slightly
cylindrical and less basophilic
1-4 days after menstruation
E. NAVICULAR CELLS
“Boat shaped” with strong tendency to
fold or curl on edges
Combines estrogen-progesterone effect
Found in latter half of the menstrual
cycle and during pregnancy and
menopausal stage
F. PREGNANCY CELLS
Round, oval or boat-shaped cells with
translucent basophilic cytoplasm
(glycogen accumulation)
G. BASAL CELLS
Small, round, & with large nucei
Found before puberty and after
menopausal stage
H. ENDOCERVICAL GLANDULAR CELLS
Pale blue/ gray cytoplasm, finely
vacillated: in distinct cell borders and
nuclei with finely granular chromatin
"Honey-comb" appearance
CRITERIA FOR CYTOLOGIC DIAGNOSIS OF NORMAL
PREGNANCY
1. Marked progesterone effect (absence of
ferning)
FERNING: mucus, on drying exhibits a
"fern"/ "palm-leaf" pattern
(ARBORIZATION) due to formation of
salt crystals in high sodium chloride
2. At least 50% intermediate cells in clusters
3. At least some typical pregnancy cells present
(average 3-7)
4. Less than 30% superficial cells
CLASSES OF CYTOLOGIC EVALUATION (PAP'S
PREPARATION)
I- Absence of atypical or abnormal cells
II- Atypical cytologic picture but no evidence
of malignancy
III- Cytologic picture suggestive but not
conclusive of malignancy
IV- Cytologic picture strongly suggestive of
malignancy
V- Cytologic picture conclusive of malignancy
CLASSES FOR CYTOLOGIC DIAGNOSIS OF NORMAL
PREGNANCY
INFLAMMATION
othe sum of total changes in the living tissues
CARDINAL SIGNS:
1. Rubor (Redness)
2. Tumor (Swelling)
3. Calor (Heat)
4. Dolor (Pain)
5. Functiolaesa (Diminished Function)
TYPES OF INFLAMMATION ACCORDING TO DURATION
1. Acute
osudden onset; refers to an
inflammatory reaction which the
dominant anatomic changes are
vascular and exudative responses
2. Chronic
