Introduction of Cytopathology
Introduction of Cytopathology
Introduction of Cytopathology
cervix.
Glandular epithelial secretion: Breast (Nipple secretion).
Sputum
Urine Exudates and transudate:
Cysts: neck, breast & ovary Solid tissue: body organs, tumors & other swell
Role of cytopathology
Early detection of unsuspected diseases (malignant
or pre-malignant lesions).
Confirmation of suspected diseases without surgical
trauma.
Diagnosis of hormonal imbalance.
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.
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
Tobacco
Oral contraceptives
Screening frequency
Yearly until three consecutive normal pap smears, then
recommend.
Cervical histology
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
Transformation Zone
Zone between original squamo-columnar junction and
zone if present
epithelium
Found on ecto-cervix or in endo-cervical canal Majority of cervical cancers and precursor lesions
arise in immature squamous metaplasia, i.e. the leading edge of the squamo-columnar junction
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