PART TWO
Diagnostic Cytology
Fig. 8.93 Carcinoma in situ (HGSIL) and adenocarcinoma in situ/adenocarcinoma in histology and cytology. (A) Carcinoma in situ in collision with
adenocarcinoma in situ/adenocarcinoma (H&E x MP). (B) Increased magnification of the boxed area in (A). Left: endocervical lining with severely atypical
glandular cells from adenocarcinoma in situ (left) in collision with severely atypical squamous cells from carcinoma in situ (top) (H&E x HP). (C) Cells derived
from carcinoma in situ (top left) and small strips composed of pseudostratified atypical glandular cells derived from adenocarcinoma in situ (top right and
bottom middle) (Papanicolaou x MP). (D) Severely atypical squamous cells exhibiting nuclear overlap, polymorphism, hyperchromasia, and a coarse granular
chromatin pattern (Papanicolaou x HP). (E) Strip-like arrangement composed of pseudostratified glandular cells that contain elongated nuclei and vary in size
(Papanicolaou x MP). (F) Acinic structure derived from adenocarcinoma in situ. The cytoplasm is directed toward the center of the structure: the elongated
peripherally located nuclei vary in size and shape. The chromatin is finely granular (Papanicolaou x HP).
Fig. 8.94 Intestinal adenocarcinoma in situ. (A) ‘Back-to-back" cellular arrangement and prominent cytoplasmic vacuolation are evident (H&E x HP).
(B) Cervical glandular cells with abundant cytoplasmic vacuolation can be seen (Papanicolaou x HP).
Fig. 8.95 Endocervical/endometrioid adenocarcinoma in situ. (A) Endometrioid type (right) and endocervical components can be seen (left) (H&E x MP).
(B) On the right-hand side, relatively small cells corresponding to the endometrioid component can be seen; on the left-hand side, a rosette-like structure
derived from the endocervical component of adenocarcinoma in situ can be seen (Papanicolaou x HP).
atrophy was found. After correction of the estrogen deficiency,
the epithelial abnormality reverted to normal in a statistically
significant percentage of patients. Findings were epithelial atro-
phy in 58% of patients and no epithelial abnormalities in 37%.
Two patients had CIN grade 1, and two patients CIN grade 2.
One patient showed evidence of HPV infection. In our own
experience, the lesion disappeared completely in 18% of cases,
and moderate-to-severe atypia was reduced to slight atypia in
55% of cases. The estrogenic stimulus induced a marked increase
in maturation in 68% of smears. The smears were easier to read
because of a reduction in the admixture of inflammatory cells
and the degree of cytolysis of the cytoplasm of atrophic cells,
182
previous page 183 ComprehensiveCytopathology 1104p 2008 read online next page 185 ComprehensiveCytopathology 1104p 2008 read online Home Toggle text on/off