PART TWO
Diagnostic Cytology
Fig. 8.77 Severe dysplasia. Cells in a syncytial aggregate and singly lying
with relatively large irregular nuclei and a dense, coarsely granular, irregularly
distributed hyperchromatic nuclear chromatin (Papanicolaou x HP).
principal goal of cervical cytology is to detect precancerous
lesions and asymptomatic, preclinical cancer. The purpose
of cytologic screening is to signal these abnormalities and to
induce further evaluation of lesions that have proved to be per-
sistent or that may progress. Colposcopy could have an impor-
tant place in the evaluation of these patients. Colposcopically
guided biopsies may clarify inconclusive cytologic findings and
give an assessment of the location, size, and extent of a lesion.
There is a good correlation between the presence of abnormali-
ties detected by colposcopy and histologically but little correla-
tion between colposcopic categories and histologic grades of
intraepithelial lesions.69
Cellular Reactions Simulating Dysplasia
Certain stimuli may cause reactions in the cervical mucosa that
may stimulate dysplasia. Chronic inflammatory processes and
instrumental treatment for erosion or other surface abnormali-
ties of the cervix (electrocautery, cryotherapy, laser treatment)
may induce changes that may be confused with dysplastic
changes when relevant clinical information is lacking. Certain
Fig. 8.78 Dysplasia of metaplastic type. Irregular arrangement of
sometimes bizarre-shaped abnormal cells, bordered by regular endocervical
columnar epithelium (H&E x HP).
Fig. 8.79 Large abnormal squamous cell. with multiple irregular,
hyperchromatic nuclei. Compare the size of this cell with the other abnormal
squamous cells (Papanicolaou x OI).
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