Cytologic Manifestations of Cervical and Vaginal Infections

Abstract

We used multiple logistic regression to analyze microbiological and clinical correlates of inflammatory and epithelial cell changes on Papanicolaou-stained cervical smears in patients from a sexually transmitted disease clinic. Among randomly selected patients, increased numbers of histiocytes and polymorphonuclear leukocytes and the presence of transformed lymphocytes were associated with Chlamydia trachomatis infection, while increased lymphocytes were associated with Trichomonas vaginalis infection; minimal squamous atypia was associated with yeast infection; and moderate squamous atypia and koilocytosis were associated with cervical condylomata visualized by colposcopy. Among patients referred for cervicitis, C trachomatis infection was also associated with reactive or atypical metaplastic cells. Distinct inclusions were seen by Papanicolaou smear in only 22% of C trachomatis infections. In randomly selected patients, however, the presence of transformed lymphocytes or increased histiocytes had a sensitivity of 95%, a specificity of 75%, and a positive predictive value of 50% in relation to isolation of C trachomatis, and could therefore be used for selection of patients for confirmatory testing for C trachomatis infection.

Cervical Cytopathological Findings in Korean Women withChlamydia trachomatis,Mycoplasma hominis, andUreaplasma urealyticumInfections

“…Chlamydia infection has been reported to be associated with RCC [7, 24], with more than 80% of Chlamydia positive cases showing RCC in one study [24]. This is similar to our finding that 63% of the subjects positive for Chlamydia showed RCC, compared to 25% of Chlamydia negative women.…”

The Role of Bacterial Vaginosis and Trichomonas in HIV Transmission Across The Female Genital Tract

“…TV infection results in recruitment of immune cells to the vaginal mucosa and in inflammation. Lymphocytes, including those that express CD4, are increased in swabs taken from mucosa of TV infected women [81, 96, 97]. Neutrophil numbers are also increased in women with TV although this is not know to affect HIV susceptibility [44, 79].…”

Colposcopic evaluation of cervix with persistent inflammatory Pap smear: A prospective analytical study

“…Persistent inflammation leads to increased cellular turnover, especially in the epithelium, and provides a selection pressure that results in the emergence of cells that are at a high risk for malignant transformation[1] Inflammatory Pap smear is the most common report the gynecologist receives even when the cervix appears normal. The original Papanicolau classification of class 2 smears denotes inflammation and the recommendation is to repeat the smear after treating the infection[2] However, this does not specify the type of infection, and the present reporting of Pap smear by the Bethesda system reports on specific infections and classifies it under benign cellular changes. [3] The cervical screening algorithm for benign cellular changes recommends treatment of infection if indicated and performing a repeat Pap smear in 4 to 6 months time and, if the inflammatory changes persist, to subject the patient to colposcopy.…”