Gyn Cytology

There will be times where an accurate diagnosis cannot be given due several limiting factors:

• Insufficient tissue sampled;
• A full representation of the cervix is not present;
• Poor fixation.

The presence of several physiological and non-physiological contaminants can lead to an inaccurate diagnosis.

The physiological contaminants are blood, mucus and inflammatory cells, as they can completely obscure the tissue needed for diagnosis.

The non-physiological factors, are not limited to, but mainly consist of lubricant, talc & sperm.

Contaminants such as these can lead to a false negative or false positive report.

Squam­ous le­sions form the bulk of the ab­nor­mal­it­ies de­tec­ted in the cer­vic­al screen­ing pro­gram. There are 2 defin­it­ive cat­egor­ies and 2 am­bigu­ous cat­egor­ies due to the vari­a­tion in in­ter­pret­a­tion of the subtle nuc­lear changes that are ob­served.

The defin­it­ive cat­egor­ies are LSIL and HSIL. LSIL (low grade squam­ous in­trae­pitheli­al le­sions) are re­served for ab­nor­mal nuc­lear changes in ma­ture squam­ous cells. HSIL (high grade squam­ous in­trae­pitheli­al le­sions) are re­served for ab­nor­mal nuc­lear changes in im­ma­ture squam­ous cells.

The am­bigu­ous le­sions can be broken down in­to 2 cat­egor­ies: ASC-US (Atyp­ic­al Squam­ous Cells of&nb­sp; Un­deter­mined Sig­ni­fic­ance) and ASC-H (Atyp­ic­al Squam­ous Cells High grade).

ASC-US is re­served for cells that are show­ing changes that could eith­er be linked to a low-grade disease, an in­fect­ive or­gan­ism or simply re­act­ive changes. ASC-H is nor­mally re­served for cells that are show­ing changes that could equate to HSIL.

Squam­ous cell car­cinoma of the cer­vix is the in­vas­ive le­sion of the ec­to­cer­vix.

As cer­vic­al cyto­logy is a screen­ing test, a very high per­centage of cases fall in­to this cat­egory. A cer­vic­al smear should con­sist of squam­ous cells and a samp­ling of the trans­form­a­tion zone (TZ).

The TZ con­sists of meta­plast­ic cells where it is be­lieved most ab­nor­mal­it­ies be­gin. For a com­plete pic­ture of the cer­vix, en­do­cer­vic­al cells should also be present.

The im­ages are a rep­res­ent­a­tion of how neg­at­ive samples can be seen us­ing the NOVAprep tech­no­logy.

Gyneco­lo­gic­al cyto­logy is not dia­gnost­ic for mi­cro-or­gan­isms, but it is pos­s­ible to identi­fy sev­eral mi­cro­bi­al in­fec­tions in gyneco­lo­gic­al LBC samples:

• Trichomonas vaginalis;
• Candida species;
• Herpes simplex virus;
• Actinomyces species;
• Lactobacilli and coccobacilli;
• Leptothrix.

The ab­sence of a mi­crobe from a gyneco­lo­gic­al LBC sample does not con­clus­ively prove that the pa­tient does not have an in­fec­tion.