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This website is talk about the cellular changes in Pap Smear that associated with infections

Sunday, May 25, 2014

CELLULAR CHANGES ASSOCIATED WITH HUMAN PAPILLOMAVIRUS

Cytomorphological Criteria:
Cellular changes is caused by oncogenic type of HPV that is commonly from group 16 and 11.
The changes can be divided into 2 groups. Which are:
a) Classical Changes  (CC) – Cellular changes that occur as a confirmatory criteria of HPV infection
b) Non-classical Changes (NCC) - Cellular changes that occur at the early stage of the HPV infection. May be vary or have little differences from other cellular changes that caused by other viral infection.
Classical changes:
vKoilocytes – 60 – 70% cases
vKoilocytes is the term used to classified the cell that has perinuclear halos.
vIn HPV infection, the infected squamous cells will be seen having cytoplasmic condensation at the periphery giving hallow central portion.
Non-Classical Changes:
vKoilocytes are hardly be seen. 30 – 20% cases
vSquamous epithelial cell will appear to have heterogenous cytoplasm , unevenly stained. Mimicking dried smear.
vNuclei is small and pyknotic- slightly eccentrically placed
vNuclei varies from single to bitinucleated due to cytopathic effect.

vHyperchromatic nucleus with enlargement and eccentrically placed with slight, almost insignificant halos.



In the figure above, both are from the CP Pap-smear that shows characteristics of the infection due to HPV. In diagram “a”, the cytoplasm has shown irregularity of the outline. Besides, the heterogenousity of the nucleus is seen in variety in shapes and colours. Meanwhile in diagram “b”, the hyperchromatic nucleus is significantly clear with coarse chromatin. There is also binucleation occur one of the infected cells marked with “#”.

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