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Prevalence, identification and significance of fiber contaminants in cervical smears
K H van Hoeven1, P K Bertolini
1Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.
Objective:
To determine the prevalence of fiber contaminants, to provide morphologic descriptions of various fiber types and to try to understand the significance of their presence in cervical smears.
Study Design:
Fibers from cotton swab tips, hair, cardboard slide transporters, Cytobrush bristles and three commercial brands of tampons were smeared onto glass slides, Papanicolaou stained and examined. Then a prospective study of consecutively screened cervicovaginal smears from 1,368 women was undertaken to identify fiber contaminants.
Results:
Fibers were identified in 178 cases (13%). In 120, the fibers were considered extrinsic, commonly having the microscopic features of cardboard. In 58, the fibers were considered to be intrinsic to the smear because of their presence in the same plane and alignment as the cells, an associated inflammatory cell reaction, and adherent or absorbed cellular products, occasionally hemosiderin. The most common intrinsic fibers were cotton and rayon. No statistically significant relationship was identified for the presence of intrinsic fibers and patients' ages, stated menstrual dates or pathologic lesions.
Conclusion:
Fiber contaminants are commonly present in cervicovaginal smears, usually do not originate in the patient (are "extrinsic") and have no pathologic significance. Knowledge of the microscopic features of fiber contaminants enables them to be identified confidently and distinguished from fungal hyphae and other filamentous pathogens.
Insights
Fiber contaminants are common in cervical smears, with most originating externally and lacking pathological significance. Identifying these fibers helps distinguish them from fungal infections.
Area of Science:
- Cytopathology
- Gynecologic Pathology
- Microscopy
Background:
- Cervical smears are routinely screened for various cytologic abnormalities.
- The presence of foreign materials, such as fibers, can sometimes complicate interpretation.
- Understanding the origin and significance of these fibers is crucial for accurate diagnosis.
Purpose of the Study:
- To determine the prevalence of fiber contaminants in cervicovaginal smears.
- To describe the morphologic characteristics of different fiber types.
- To assess the clinical significance of fiber presence in cervical cytology.
Main Methods:
- Fibers from various sources (e.g., cotton swabs, tampons, slide transporters) were artificially smeared and stained.
- A prospective study analyzed 1,368 consecutive cervicovaginal smears for fiber identification.
- Papanicolaou staining and microscopic examination were employed.
Main Results:
- Fibers were detected in 13% (178/1,368) of smears.
- The majority of fibers (120 cases) were extrinsic, often resembling cardboard.
- Intrinsic fibers (58 cases), primarily cotton and rayon, showed no significant association with patient age, menstrual dates, or lesions.
Conclusions:
- Fiber contaminants are frequently found in cervicovaginal smears.
- Most identified fibers are extrinsic and do not represent a pathological condition.
- Microscopic identification of fiber contaminants aids in differentiating them from pathogens like fungal hyphae.