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Related Experiment Videos

Reactive cell change in cervicovaginal smears

L M Marshall1, Z Cason, D E Cabaniss

  • 1Department of Cytotechnology, University of Mississippi Medical Center, USA.

Biomedical Sciences Instrumentation
|January 1, 1997
PubMed
Summary

Reactive cell changes in Pap smears are clarified. Key criteria include metaplastic cells with nucleoli and fine chromatin, often associated with inflammation or infections. Some cases may normalize with follow-up.

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Area of Science:

  • Cytopathology
  • Gynecologic Pathology

Background:

  • Reactive cell change in cervicovaginal smears is often controversial.
  • Commonly cited criteria include nuclear enlargement, nucleoli, binucleation, vacuolization, and polychromasia.

Purpose of the Study:

  • To specifically define the criteria for reactive cell change in cervicovaginal smears.
  • To improve diagnostic accuracy and reduce ambiguity in cytopathology reports.

Main Methods:

  • Retrospective review of 61 cervicovaginal smears initially diagnosed as reactive.
  • Re-evaluation of smears for specific cellular features, inflammatory cells, and organisms.
  • Correlation with biopsy findings when available.

Main Results:

  • Of 61 cases, 53 were confirmed as reactive and 8 reclassified as negative.

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  • Inflammatory cells were present in 79%; organisms (Herpes, Trichomonas, Chlamydia, Gardnerella, Candida) in 23%.
  • Key criteria identified: aggregates of metaplastic cells with central nuclei, nucleoli, and fine chromatin; presence of organisms.

    • Conclusions:

    • Aggregates of metaplastic cells with specific nuclear features are the most important criteria for reactive cell change.
    • A significant proportion of cases with reactive changes on Pap smear may have underlying squamous intraepithelial lesions.
    • Follow-up Pap smears may show normalization over two years in some cases.