1
|
Ikegami K, Watanabe G, Kumagai J, Fujii Y, Watanabe H, Oite T. The apparition macrophage and Döderlein bacillus is negatively correlated in class I Papanicolaou smear: A morphological examination. Diagn Cytopathol 2020; 48:1205-1210. [PMID: 32628346 DOI: 10.1002/dc.24538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/26/2020] [Accepted: 06/12/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Nonspecific vaginitis, also known as Bacterial vaginosis, unlike genital candidiasis and trichomoniasis, is caused by microbiome breakdown. Döderlein's bacillus are gram-positive bacillus that form a microbiome, reproduce in the female vagina after gaining sexual maturity, secrete lactic acid, and prevent the growth of other vaginitis-causing bacteria. Clue cell are squamous epithelial cells with Gardnerella sp. attached to their cell surface. The presence of clue cell is one of the diagnostic criteria for nonspecific vaginitis. Additionally, although macrophages are reported to protect against candidal vaginitis, there are no reports of studies examining the association between macrophages and clue cell. MATERIALS AND METHODS After re-staining 300 class I specimens by cervical cancer screening with Papanicolaou staining, the appearance of Döderlein's bacillus, macrophages, and clue cell was observed. RESULT Age group and appearance of Döderlein's bacillus were negatively correlated. The rate of appearance of macrophages was positively correlated with the age group. In people aged 50 years or more, the appearance rate of clue cells was significantly lower in the macrophage appearance group than that in the non-appearance group. CONCLUSION This study suggested that macrophages, and not Döderlein's bacillus, may play an important role in defense against nonspecific vaginitis.
Collapse
Affiliation(s)
- Kikuo Ikegami
- Department of Clinical Engineering and Medical Technology, Niigata University Health and Welfare, Niigata, Japan
| | - Gen Watanabe
- Department of Pathology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Junko Kumagai
- Department of Clinical Engineering and Medical Technology, Niigata University Health and Welfare, Niigata, Japan
| | - Yutaka Fujii
- Department of Clinical Engineering and Medical Technology, Niigata University Health and Welfare, Niigata, Japan
| | - Hiroaki Watanabe
- Department of Clinical Engineering and Medical Technology, Niigata University Health and Welfare, Niigata, Japan
| | - Takashi Oite
- Department of Clinical Engineering and Medical Technology, Niigata University Health and Welfare, Niigata, Japan
| |
Collapse
|
2
|
Carneiro FP, Ferreira VM, Silvestre FA, da Costa FJQ, de Paula von Glehn M, de Vasconcelos Carneiro M, de Resende Oyama CN, Motoyama AB. Aerobic bacteria on cervical cytology. Diagn Cytopathol 2018; 46:547-549. [PMID: 29656562 DOI: 10.1002/dc.23937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 03/17/2018] [Accepted: 03/22/2018] [Indexed: 12/29/2022]
|
3
|
Eleutério J, Eleutério RMN, Martins LA, Giraldo PC, Gonçalves AKS. Inflammatory cells in liquid-based cytology smears classified as bacterial vaginosis. Diagn Cytopathol 2017; 45:1100-1104. [PMID: 28994506 DOI: 10.1002/dc.23830] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 06/14/2017] [Accepted: 09/27/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Bacterial vaginosis (BV) remains an enigmatic question. The term "osis" instead of "itis" is used because commonly, there are no inflammatory process associated with BV. However, leukocytes are often observed in it. METHODS In a transversal study, we evaluated 1178 cases with diagnosis of BV by liquid-based cytology (more than 20% of clue cells), attended in general gynecologic private clinic. Depending of the presence of more than five leukocytes on average per field in immersion objective (1000×), the cases were divided in two groups: few or no leukocytes (< 5 leukocytes per field) (BV) and with leukocytes (≥ 5 leukocytes per field) (BV-L). The Fisher exact and Student t tests was applied to a confidence interval of 95%. The project was approved by the Ethic Committee of Federal University of Ceará, Brazil. RESULTS The age between the groups was the only different socio-demographic variable. The assessment of vaginal discharge aspect had no characteristic aspect. Colposcopy findings suggesting colpitis and ectopy were more frequent in the group of BV-L, 7.1% and 6.9%, respectively. The study of the microbiology demonstrated in the BV-L group, more frequently co-occurrence of Candida sp (15.1%) than in BV group (1.5%) (P < .0001). The cellular atypia was present more frequently in the BV-L (9.6%) than in BV (5.7%) (P = .0116). CONCLUSION The presence of leukocytes in BV (or BV-L) may suggest a mixed infection, ectopy influencing the vaginal milieu and even epithelial atypia.
Collapse
Affiliation(s)
- José Eleutério
- Department of Maternal and Child Health, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil.,Department of Pathology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | | | - Leonardo Arruda Martins
- Department of Pathology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Paulo César Giraldo
- Department of Obstetrics and Gynecology, State University of Campinas, Campinas, Brazil
| | | |
Collapse
|
4
|
Seok JY, An J, Ha SY, Chung DH, Lee S, Kim H. Morphologic Analysis of Cytomegalovirus Infected Cells in Bronchial Washing Cytology: Comparison of Liquid-Based Preparation and Conventional Smear. J Pathol Transl Med 2016; 50:147-54. [PMID: 26875760 PMCID: PMC4804150 DOI: 10.4132/jptm.2015.12.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 12/15/2015] [Accepted: 12/24/2015] [Indexed: 11/30/2022] Open
Abstract
Background: The cytopathic effects of cytomegalovirus (CMV) infection have been well described since the virus was first reported; however, the morphology of CMV infection has not been clearly studied. We examined the difference in detailed cytologic findings in bronchial washing cytology between liquid-based and conventionally prepared smears. Methods: Bronchial washing cytology was processed using either the conventional preparation (CP) or liquid-based preparation (LBP). Sixty-nine cells with typical cytopathic effects of CMV infection were detected on CP slides and 18 cells on LBP slides. Using the image analyzer, area, circumference, major axis, and minor axis of the cytoplasm, nucleus, and intranuclear inclusion were measured in singly scattered CMV-infected cells, and histiocytes were used as a control. Results: The mean cytoplasmic area of CMV-infected cells was 1.47 times larger than that of histiocytes in CP and 2.92 times larger in LBP (p<.05). The mean nuclear area of CMV-infected cells was 2.61 times larger than that of histiocytes in CP and 4.25 times larger in LBP (p<.05). The nucleus to cytoplasm ratio and intranuclear inclusion to cytoplasm ratio of the mean area, circumference, major axis, and minor axis in CP were larger than those in LBP (p<.05). Conclusions: The sizes of cytoplasm, nucleus, and intranuclear inclusion were larger in LBP than in CP, indicating that CMV-infected cells are easily detectable in LBP. However, the nucleus-to-cytoplasm ratio was larger in CP, suggesting that differentiation from malignancy or regenerative atypia requires caution in CP.
Collapse
Affiliation(s)
- Jae Yeon Seok
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| | - Jungsuk An
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| | - Seung Yeon Ha
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| | - Dong Hae Chung
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| | - Sangho Lee
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| | - Hyunchul Kim
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| |
Collapse
|
5
|
Costa MOLP, Heráclio SA, Coelho AVC, Acioly VL, Souza PRE, Correia MTS. Comparison of conventional Papanicolaou cytology samples with liquid-based cervical cytology samples from women in Pernambuco, Brazil. ACTA ACUST UNITED AC 2015; 48:831-8. [PMID: 26247400 PMCID: PMC4568811 DOI: 10.1590/1414-431x20154252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 03/09/2015] [Indexed: 11/22/2022]
Abstract
In the present study, we compared the performance of a ThinPrep cytological method
with the conventional Papanicolaou test for diagnosis of cytopathological changes,
with regard to unsatisfactory results achieved at the Central Public Health
Laboratory of the State of Pernambuco. A population-based, cross-sectional study was
performed with women aged 18 to 65 years, who spontaneously sought gynecological
services in Public Health Units in the State of Pernambuco, Northeast Brazil, between
April and November 2011. All patients in the study were given a standardized
questionnaire on sociodemographics, sexual characteristics, reproductive practices,
and habits. A total of 525 patients were assessed by the two methods (11.05% were
under the age of 25 years, 30.86% were single, 4.4% had had more than 5 sexual
partners, 44% were not using contraception, 38.85% were users of alcohol, 24.38% were
smokers, 3.24% had consumed drugs previously, 42.01% had gynecological complaints,
and 12.19% had an early history of sexually transmitted diseases). The two methods
showed poor correlation (k=0.19; 95%CI=0.11–0.26; P<0.001). The
ThinPrep method reduced the rate of unsatisfactory results from 4.38% to 1.71%
(χ2=5.28; P=0.02), and the number of cytopathological changes diagnosed
increased from 2.47% to 3.04%. This study confirmed that adopting the ThinPrep method
for diagnosis of cervical cytological samples was an improvement over the
conventional method. Furthermore, this method may reduce possible losses from
cytological resampling and reduce obstacles to patient follow-up, improving the
quality of the public health system in the State of Pernambuco, Northeast Brazil.
Collapse
Affiliation(s)
- M O L P Costa
- Laboratório Central de Saúde Pública do Estado de Pernambuco, Recife, PE, BR
| | - S A Heráclio
- Laboratório Central de Saúde Pública do Estado de Pernambuco, Recife, PE, BR
| | - A V C Coelho
- Departamento de Genética, Universidade Federal de Pernambuco, Recife, PE, BR
| | - V L Acioly
- Laboratório Central de Saúde Pública do Estado de Pernambuco, Recife, PE, BR
| | - P R E Souza
- Departamento de Biologia, Universidade Federal Rural de Pernambuco, Recife, PE, BR
| | - M T S Correia
- Departamento de Bioquímica, Universidade Federal de Pernambuco, Recife, PE, BR
| |
Collapse
|
6
|
Daloglu FT, Karakaya YA, Balta H, Altun E, Duman A. Cervical cytological screening results of 8,495 cases in Turkey--common inflammation but infrequent epithelial cell abnormalities? Asian Pac J Cancer Prev 2015; 15:5127-31. [PMID: 25040962 DOI: 10.7314/apjcp.2014.15.13.5127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cervical cancer is the ninth most common cancer among females in Turkey. Cervical smear is a routine screening test used for the detection of cervical abnormalities and also it detects certain infections of the cervix. OBJECTIVE To analyze cervical smear results of our clinic in order to determine most frequent pathology of the women in North Eastern Anatolia Region of Turkey. MATERIALS AND METHODS In a retrospective study design, 8,495 cervical cytology cases diagnosed at the Pathology Department of the Regional Education and Research Hospital in Erzurum over the last one and half years extending from August 2012 to December 2013 were investigated. RESULTS The most common diagnosis was found to be inflammation, 65.5 % (5,566 out of 8,495), and the least was squamous epithelial abnormalities 0.2% (13 out of 8,495). There was some variation among the three pathologists regarding diagnosis but findings for the latter. CONCLUSIONS Regular cervical smear tests are one of the most important strategies in early diagnosis of cervical cancer but there are conflicting data regarding the prevalence of epithelial cell abnormalities in Turkey, and the reasons of this should be investigated.
Collapse
Affiliation(s)
- Ferah Tuncel Daloglu
- Department of Pathology, Education and Research Hospital, Erzurum, Turkey E-mail :
| | | | | | | | | |
Collapse
|
7
|
Qiu T, Zhu H, Cai M, Han Q, Shi J, Wang K. Liquid-Based Cytology Preparation Can Improve Cytological Assessment of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration. Acta Cytol 2015; 59:139-43. [PMID: 25823893 DOI: 10.1159/000376545] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 01/27/2015] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study investigated whether liquid-based cytology (LBC) can improve diagnostic values of cytological assessment of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). STUDY DESIGN A cohort of 600 cases in West China Hospital was prospectively studied from June 2012 to September 2013. EBUS-TBNA was carried out in outpatients under local anesthesia and moderate sedation. The procedure was performed with an echobronchoscope (BF-UC160F-OL8, Olympus, Tokyo, Japan). Histological cores were stained with hematoxylin and eosin for further study. Additional immunohistological analysis was performed for establishing a reliable diagnosis when necessary. Aspirates were smeared on glass slides and separate aspirates were processed by the monolayer SurePath method. RESULTS In total, 480 malignant tumors and 120 benign lesions were confirmed by histological examination. The sensitivity of SurePath liquid-based preparations and conventional smears was 82.1 and 56%, and the specificity was 87.5 and 82.5%, respectively. The combined specificity was 100%. Positive predictive values of the two groups were 96.3 and 92.8%, whereas negative predictive values were 54.9 and 31.9%, respectively. The difference between the two groups was significant (p < 0.001). CONCLUSIONS LBC preparation can improve cytological assessment of EBUS-TBNA. Histological study is necessary in cases in which the cytological diagnosis is obscure.
Collapse
Affiliation(s)
- Ting Qiu
- Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, PR China
| | | | | | | | | | | |
Collapse
|
8
|
Hoda RS, Loukeris K, Abdul-Karim FW. Gynecologic cytology on conventional and liquid-based preparations: a comprehensive review of similarities and differences. Diagn Cytopathol 2012; 41:257-78. [PMID: 22508662 DOI: 10.1002/dc.22842] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 01/10/2012] [Indexed: 02/06/2023]
Abstract
Liquid-based preparations (LBPs) have largely replaced conventional Papanicolaou smears (CPS) for cervical samples in the United States and in many other industrialized countries. The two FDA-approved LBP currently in use include ThinPrep (TP), (Hologic Inc., Bedford, MA) and SurePath (SP), (BD Diagnostic, Burlington, NC). Split-sample and direct-to-vial studies have shown that LBPs show an overall improvement in sample collection and processing, reduce artifacts that interfere in diagnosis, are more sensitive, can be utilized for ancillary tests and are a cost-effective replacement for CPS. Comparative analyses of diagnostic accuracy indicate that LBPs perform at least as well as CPS. However, the added advantages of standardized, automated preparations and screening, reduced unsatisfactory rate, improved specimen adequacy and ability to perform human papillomavirus (HPV) test, are enough to continue use of LBP. The cytologic features in LBP are similar to CPS with subtle differences, particularly in background information. There are also subtle differences between the two LBPs, SP and TP, which are reflective of different sampling devices, collection media, and processing techniques. Architecturally, LBP shows smaller cell clusters and sheets and more dyscohesion. Cytologically, enhanced nuclear features and smaller cell size are more prominent. Advances in liquid-based Papanicolaou's (Pap) test have lead to well-defined patient management guidelines by the American Society for Colposcopy and Cervical Pathology. Herein, we review these aspects of Pap test including, morphology, automation, ancillary tests (HPV and immunochemistry), pertinent QA/QC monitors, patient management guidelines, and review of pertinent literature.
Collapse
Affiliation(s)
- Rana S Hoda
- Department of Pathology & Laboratory Medicine, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York 10065, USA.
| | | | | |
Collapse
|
9
|
Donders GGG, Berger J, Heuninckx H, Bellen G, Cornelis A. Vaginal flora changes on Pap smears after insertion of levonorgestrel-releasing intrauterine device. Contraception 2010; 83:352-6. [PMID: 21397094 DOI: 10.1016/j.contraception.2010.08.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 08/06/2010] [Accepted: 08/16/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND The levonorgestrel intrauterine system (LNG-IUS) combines a uterine foreign body and the continuous release of low-dose levonorgestrel for contraception. Its influence on the rate of vulvovaginal infections and flora disturbance is insufficiently known, but important for contraceptive advice in women, especially those who develop recurrent vaginosis or Candida vulvovaginitis. STUDY DESIGN Slides of 286 women who had a Pap smear taken before and 1 to 2 years after placement of a LNG-IUS were blindly reviewed for the presence of abnormal vaginal flora (AVF), bacterial vaginosis (BV), aerobic vaginitis (AV) and Candida vaginitis (CV). RESULTS Prior to insertion, there were no differences in vaginal flora abnormalities between women using different kinds of contraception. LNG-IUS users did not have different rates of AVF, BV, AV or CV, but the general risk to develop any infection was increased. Uterine bleeding after insertion did not seem to predict a different flora type. CONCLUSION We found that Pap smears suggested more vaginal infections after 1 year of LNG-IUS use than prior to insertion of the device.
Collapse
|
10
|
Aslan DL, Pambuccian SE, Prekker FL, Schacker TW, Southern P, Savik K, McKeon D, Gulbahce HE. Accuracy of herpes simplex virus detection in liquid-based (SurePath) Papanicolaou tests: a comparison with polymerase chain reaction. Diagn Cytopathol 2008; 36:94-103. [PMID: 18181191 DOI: 10.1002/dc.20732] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
A review of our institution's Papanicolaou test records over an 11-yr period showed that liquid-based Papanicolaou tests (LBPTs) had a significantly higher frequency of diagnoses of Herpes simplex virus (HSV)-related cellular changes compared to conventional Papanicolaou smears (77/302,841, 0.026% vs. 56/376,173, 0.015%, P = 0.002). To investigate the accuracy of the diagnosis of HSV by LBPT, we performed conventional polymerase chain reaction (PCR) on the residual samples from 258 prospectively collected LBPT and real-time PCR using a different primer set on a subset of 40 LBPT. Conventional PCR was positive in 22 of 22 cases diagnosed of HSV, 1 of 2 cases diagnosed as suspicious for HSV, and none of 234 LBPT without a cytologic HSV diagnosis. Real-time PCR was positive in 8 of 8 cases diagnosed as HSV and none of the 32 controls. We conclude that LBPT allows an increased detection of HSV that is highly accurate.
Collapse
Affiliation(s)
- Deniz L Aslan
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Fairview University Medical Center, 420 Delaware Street SE, Minneapolis, MN 55455, USA
| | | | | | | | | | | | | | | |
Collapse
|
11
|
|