"Cannon balls or pus balls" in pap smears: a case report

A 50-year old female presented with the chief complaint of a discharge per vaginum, which was there for the past 15 days. A routine PAP smear was received in the Department of Pathology, Government Medical College, Patiala, India. After its fixation and staining, it was examined under the microscope. It showed the Trichomonas vaginalis infection, with the neutrophils forming cannon balls at places. Neutrophils in the PAP smear are a nonspecific finding, particularly if they are low in numbers or if they are seen in the premenstrual and the menstrual phases. The neutrophils which are adherent to the squamous cells are called "cannon balls" or "pus balls", which are common in the Chlamydia infection. This case is being presented because of the presence of these rare morphological structures i.e. "cannon balls" or "pus balls".