mgh:cyto-week1-5

Week 1

• Content Expert: David C. Wilbur, MD
• Cytotechnologist: Peter Brown
• Objective: To describe the common morphologic features in glandular cell lesions found in pap smears.

Related PDFs of Lectures

• Glandular Lesions of the Cervix - Dr. Wilbur
• Gyn Cyto - Dr. Brachtel

Normal endocervicals – MG07-41719

• Column cells with basally located nuclei
• Basophilic vacuolated cytoplasm
• Picket fence arrangement when seen on side, honeycomb when seen from above
• Nuclei round, oval, slightly larger than em nuclei, similar to sq. met.

Normal endometrial cells – MG07-37747

• Nuclei small, round, dark, indistinct nucleoli
• Cytoplasm is scant, may have vacuoles
• Deep stromal cells, dark, degenerate with scant cytoplasm
• Superficial stromal cells look like histocytes
• 3-D ball like clusters

Reactive endocervicals – C02-X21800

• Slightly to moderately enlarged nuclear size
• Prominent nucleoli
• Can see multinucleation
• Chromatin normal
• Nuclear contours regular
• In groups cells maintain polarity

Endocervical atypia 10D –C92-1561 and MG09-21470

• Changes are seen in endometrial cells or endocervical cells, em’s shed at mid cycle
• Single cells or small clusters of reaction endocervicals
• Normal or slightly irregular ems with vacuoles
• Actinomyces

Tubal metaplasia – G11-37675

• Single ec’s cells, strips of ec’s with pseudostratification or in clusters with either terminal bars or cilia
• Nuclei can be round or oval
• Slightly coarse chromatin (without the presence of cilia or terminal bars can be mistaken for AIS)

AIS endocervical – MG06-00971 and C01-D39098

• Columnar cells in crowded groups, strips on rosettes
• Strips may have pseudostratification, groups with irregular polarity
• Peripheral nuclear palisading (feathering)
• Irregular dark chromatin, nuclear enlargement

Endocervial Adenoca – MG09-31908

• Ec’s with enlarged hyperchromatic nuclei in strips
• Rosettes, pseudostratification, feathering
• Loss of polarity
• Difficult to differentiate from AIS

Endocervical Adenoca – C98-17153

• Strips, rosettes, feathering
• Disorderly arrangement
• High N/C ratio
• Coarse chromatin
• Architectural features similar to AIS but with greater loss of polarity
• Prominent nucleoli
• Mitosis
• Diasisis

Endometrial CA Grade III – C02-R1948

• Ball like and papillary groups of irregular glandular cells
• Nuclear contour irregularities
• Prominent nucleoli
• Watery tumor diathesis

Metastatic ovarian adenocarcinoma – C02-N42569

• Papillary architecture
• Nuclear enlargement
• Crowding
• Loss of polarity
• Psammoma bodies may be present