Diagnostic Cytology
intermediate cell layer of stratified nonkeratinizing squamous epithelium
(immunoperoxidase method x MP).
Fig. 8.16 Parabasal-type cells and leukocytes
in a cervical smear taken
after menopause (Papanicolaou x OI).
the vagina and cervix represents an abnormal differentiation. At
clinical examination, this area may appear as a white patch, a
sign of leukoplakia. In the cytologic smear, leukoplakia can be
recognized by the presence of numerous anucleated squames
found singly or in sheets8 (Fig. 8.20). These are often folded and
are pale yellowish pink. Remnants of nuclei may be visible as
Fig. 8.17
Cervical smear taken after menopause with evidence of
inflammation, degenerative nuclear changes, and drying artifacts
(Papanicolaou x MP).
Fig. 8.18 Superficial and intermediate squamous cell
in a cervical
smear after a short course of estrogenic hormones because of epithelial
atrophy postmenopause (same case as that in Figs 8.16 and 8.17)
(Papanicolaou x HP).
a central clear zone, so-called nuclear ghosts. Cells from the gran-
ular cell layer may be encountered in the smear, resembling inter-
mediate or superficial squamous cells, containing eosinophilic
or cyanophilic keratohyalin cytoplasmic granules.
Parakeratosis is another protective reaction of the nonkeratiniz-
ing squamous epithelium of the genital tract, characterized by
the presence of various numbers of layers of small squamous
cells, sharply demarcated from the underlying superficial zone.
The nuclei are small, frequently pyknotic, and hyperchromatic.
In cytologic specimens, cells from parakeratosis appear as
relatively small, superficial squamous cells, either isolated or in
sheets (Fig. 8.21). Shapes vary from round or oval to polygonal
or spindle shaped. Cytoplasmic staining usually is dark or light
eosinophilic, rarely cyanophilic.
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