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1 - Introduction of Cytopathology
1 - Introduction of Cytopathology
cervix.
Glandular epithelial secretion: Breast (Nipple secretion).
Sputum
Urine
Exudates and transudate:
Pleural
fluid
Pericardial
fluid
Peritoneal fluid
Joint fluid
CSF
fluids
Cysts:
Solid
Role of cytopathology
Early detection of unsuspected diseases (malignant
or pre-malignant lesions).
Confirmation of suspected diseases without surgical
trauma.
Diagnosis of hormonal imbalance.
Useful in flow up the course of disease or
monitoring therapy.
Advantage of Cytopathology
Rapid diagnosis
- Inexpensive
- Simple
Disadvantage of Cytopathology
Interpretation of the morphological cellular changes is
of samples.
Type of fixative, stain, and processing of the technique
used.
cycles
Pathological conditions (1928)
Normal Cervix
mortality
Deaths from cervical cancer decreased from 26,000 to
follow-up.
Requires access to care
50% of women with cervical cancer were never
Who to screen
Any woman with a cervix who has ever had sexual
activity.
When to screen
Start within 3 years of onset of sexual activity or by age
Screening frequency
Yearly until three consecutive normal pap smears, then
recommend.
Columnar Epithelium
Upper and middle endo-cervical canal
Single layer of columnar cells arranged in
folds
Mucin producing (not true glands)
Squamous Metaplasia
Central ectocervix and proximal endocervical canal
Replacement of columnar cells by squamous epithelium
Progressive and stimulated by
Acidic environment with onset of puberty
Estrogen causing eversion of endocervix
Transformation Zone
Zone between original squamo-columnar junction and
zone if present
epithelium
epithelium
Found on ecto-cervix or in endo-cervical canal
Majority of cervical cancers and precursor lesions
Squamous Epithelium
Parabasal Cells
Intermediate Cells
Superficial
Cells
Endocervix
Endocervical Cells
Endometrial Cells
Non-Epithelial Cells
Lymphocytes
Polymorphs
sperms
Normal smear
Ectropion / Erosion
At puberty & pregnancy the endocervical cells are
Normal
Ectropion
Wide Ectropion
Metaplasia
The endocervical cells are transformed into squamous
Metaplastic Cells