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Monday, May 12, 2014

CELLULAR CHANGES ASSOCIATED WITH TRICHOMONAS VAGINALIS




Trichomonas Vaginalis (TV) is a pear shaped organism. It can contain a faintly visible intracellular structure known as polar bodies. Cervical samples containing TV can show inflammatory epithelial changes such as altered cytoplasmic staining, perinuclear halos and mild nuclear enlargement. TV can congregate in clusters around intermediate squamous cells.


Organism : 
§  Size ranging from 15 – 30 µm 
§ Cyanophilic small, round to oval “pear shaped” organism with an indistinct eccentric  pale basophilic nucleus and eosinophilic cytoplasmic granules.  
§Flagella are not usually seen (CP). 
§Leptothrix is associated with T.vaginalis in about 80% cases. 
§On LBP, eosinophilic granules better visualized and flagella are preserved.

Cellular changes : 
§ Dirty, fuzzy background with round aggregates of neutrophils (“cannonballs” or “pus ball”) 
§Reactive nuclear changes, inflammatory perinuclear halos, and pseudoeosinophilia of the cytoplasm and nucleus of squamous epithelial cells.





Figure 1: The figure shows T. vaginalis  are stained bluish, are often attached to the glycogen-rich and orange-colored superficial squamous cells. Cannon ball appearance (clustering of neutrophils) is also noted. (CP)


Figure 2 : The Figure shows a dirty fuzzy background of slide with increased cellular maturation or eosinophilia and aggreagtes of inflammatory cells. Smears containing trichomonads often contain highly eosinophilic mature squamous cells and the nuclei of the squamous are sometimes surrounded by a small perinuclear halo.


Figure 3 : The figure shows long filamentous organism ( Leptothrix) are seen overlying on the cells and smear background. These organism are long and look like a child scribbles on conventional smear.



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