Benign Glandular Cells Gyn Pap Test

Benign Glandular cells Gyn Pap test - by Dr May YU prepared on 19/01/2007

1) Endocervical cells End-on honey comb sheet with regular uniform nuclei, mucinous cytoplasm Side on strips of columnar cells with basally located, well aligned nuclei.

2) Endometrial cells due to menses : - donuts, - small clumps of degenerated small cells, usually out of focus with clear, pale or occasional vacuolated cytoplasm. Nuclei may be dark due to degeneration. - Superficial stromal cells : histiocytes like, the so called “sticky histiocytes”

D ue to direct scraping of lower uterus - can be biphasic: glandular clumps surrounded by loose strips of spindle cells - uniform nuclei - can have mitotic figures.

3) tubal metaplastic cells - more common associated with high sampling - may be pseudostratified, with single layer of cells but the nuclei at slightly different levels, i.e. basal to mid-levels - mild overlapping of nuclei – may appear slightly hyperchromatic - terminal bar +/- cilia at superficial end of cells, - not all cells have cilia, because easily dislodged during preparation or due to degeneration.

4) High sampling endocervical cells - large overlapping clumps and increased glandular cellularity - relatively higher N/C ratio - chromatin fine and uniform

5) Reactive endocervical cells - slight nuclei enlargement but usually not hyperchromatic, except for degenerated cells - small to prominent nucleoli, may be associated with repair cells in the vicinity - vacuolation - multinucleation - Background may be inflamed

6. Reactive endometrial cells - small clumps, usually out of focus - +/- mild variation in nuclear or cell size - +/- degenerated features - +/- vacuolation of cytoplasm - Background may be inflamed - may be seen with IUCD use, chronic endometritis, etc. - sometimes the features may overlap with or difficult to distinguish from atypical endometrial cells.

7. Radiation changes - may occur in both squamous and endocervical glandular cells - cells may be markedly enlarged with large bizarre nuclei but preserved N/C ratio, - polychromasia of cytoplasm

8. Glandular cells- post-hysterectomy - benign looking endocervical type glandular cells found in vaginal vault smear for patients already with total hysterectomy - more common in patients with post-operation radiotherapy.

9. Pregnancy related changes e.g. Arias Stella reaction