Crystalline bodies in cervical smears. Clinicocytologic correlation

Area of Science:

• Cytopathology
• Gynecologic Pathology
• Cervical Cancer Screening

Background:

• Distinguishing between hematoidin and crystalline bodies in cervical smears is crucial for accurate interpretation.
• Previous literature suggests hematoidin bodies are linked to pregnancy complications, while crystalline bodies are not well-characterized.

Purpose of the Study:

• To differentiate hematoidin bodies from crystalline bodies in cervical smears.
• To investigate the clinical associations of crystalline bodies, including their prevalence in specific patient groups and relation to pregnancy outcomes.
• To explore the association between crystalline bodies and cervical intraepithelial neoplasia.

Main Methods:

• Analysis of 6,132 cervical smears with strict criteria for differentiating crystalline bodies from hematoidin bodies.
• Literature review on crystalline structures in cervical cytology.
• Statistical analysis to assess associations with oral contraceptive use, pregnancy, and pregnancy complications.

Main Results:

• Crystalline bodies were identified in 37 cases, significantly more common than hematoidin bodies.
• Increased incidence of crystalline bodies observed in women using oral contraceptives and in pregnant women.
• No association found between crystalline bodies and increased pregnancy complications or abnormal births.
• Unexpectedly high association between crystalline bodies and low-grade squamous intraepithelial lesion (CIN1).

Conclusions:

• Cervical smears can contain two distinct crystalline structures: hematoidin bodies (linked to hemorrhage and potential pregnancy complications) and crystalline bodies (not linked to complications).
• Crystalline bodies are more prevalent than hematoidin bodies.
• Crystalline bodies are frequently found in women on oral contraceptives and during pregnancy, and notably associated with CIN1, warranting further investigation.