Severe leukocyte infiltration. Deciphering a smear for cytology using the Betsed method. How many days does a smear cytology test take?

A smear is taken during a gynecological examination using a cytobrush, and then the material is placed on glass (for liquid oncocytology, a removable cytobrush is used, which, together with the material, is immersed in a bottle with a special medium).

Oncocytology of the cervix, as a rule, is not limited to one smear (vaginal portion of the cervix), since there is a need to study the epithelium of the cervical (cervical) canal. This happens because the most problematic area in relation to the oncological process is the junction zone (transformation zone) - the place of transition of the multilayer squamous epithelium the vaginal part of the cervix (ectocervix) into a single-layer prismatic (cylindrical) epithelium cervical canal(endocervix).

Of course, it is unacceptable to “slap” both smears on one glass during diagnosis (this is only possible during a medical examination), because they can get mixed up and the smear will turn out to be inadequate.

Young in cervical smear healthy woman you can see the cells of the surface and intermediate layer (in various proportions) of non-keratinizing four-layer squamous epithelium growing from the basal cell, which is normally located deep and does not enter the smear, as well as cells prismatic epithelium cervical canal.

Pap test - fast, inexpensive, informative method diagnosis of diseases of the vagina and cervix.

The main task of cervical smear cytology: - identification atypical cells;- diagnosis of precancerous changes (dysplasia) and cervical cancer (CC).

Cervical screening (mass examination of cervical smears) - method secondary prevention RSM.

Primary prevention of cervical cancer is vaccination against the human papillomavirus HPV.

More about the symptoms of papilloma viral infection in women and HPV treatment read here: Condylomas acuminata.

The main task of cytological analysis of cervical smears is to identify atypical cells.

Atypical cells are morphologically altered cells: precancerous, cancerous.

• In malignant atypical cells, oncogenic mutations affect both the nucleus and the cytoplasm.

Cytological signs of malignant atypia:
- increase in core size;
- change in the shape and color of the kernel;
- abnormalities in the cytoplasm of cells.

The severity of atypia can suggest the level of precancerous changes (degree of dysplasia) of the cervix.
But! Cytology does not determine the depth of tissue damage and does not distinguish dysplasia from non-invasive cancer(carcinoma in situ) or invasive microcarcinoma. Histology solves these problems.

Cytology smear: interpretation

Oncocytology implies microscopic analysis(studying cellular composition and the state of cell organelles) material suspicious of an oncological process and taken from any accessible place.

In this regard, patients should not be surprised by smears for oncocytology, prepared not only from scrapings of the female genital organs, but also fine-needle aspiration biopsy(TAB):

• Enlarged regional lymph nodes (cancer of the larynx, nasal cavities and paranasal sinuses, salivary glands, penile cancer, eye tumors, etc.);
• Tumors of the pancreas, liver, gallbladder and extrahepatic bile ducts;
• Seals and nodes of the mammary and thyroid glands.

Squamous metaplasia is a protective mechanism that occurs due to the proliferation of stem cells that differentiate towards squamous epithelium. Large amounts of metaplastic epithelium may be associated with human papillomavirus (HPV). Hyperkeratosis is keratinization of the cells of the surface layer. Clinical diagnosis simple leukoplakia in cytological smears appears as clusters (single or more) of squamous epithelial scales. In leukoplakia with atypia, cells with various cytopathic changes are identified, which can be associated with both HPV and cervical neoplasia. In case of hyperkeratosis, oncological vigilance is necessary and it is recommended additional examination to exclude a malignant process. Parakeratosis is a nonspecific protective reaction of the epithelium. Pathological keratinization of squamous epithelial cells may be an indirect sign of HPV. Parakeratosis is also determined after trauma, childbirth, and with cervical leukoplakia. Pseudoparakeratosis is noted in postmenopause, as it is associated with degenerative changes. In endocervical smears in women of fertile age, it is observed in the second phase of the cycle. Dyskeratosis is a pathological keratinization of squamous epithelial cells, which is an indirect sign of HPV. Multinucleated cells – bi- and multinucleated cells, which are indirect morphological feature viral infection: HPV, HSV (herpes simplex virus). In conclusion, other cytopathic signs are reflected and their probable genesis is indicated: “ indirect signs HPV? Multinucleated cells may be associated with inflammatory and reactive processes. Koilocytes – squamous epithelial cells with certain cytopathic changes in the nucleus and cytoplasm – are a specific cytological sign of HPV. Dystrophic and dysregenerative changes in cells are associated with nutritional and metabolic disorders. Degenerative changes in the cells of both squamous and cylindrical epithelium are most often associated with the process of inflammation, but can be a manifestation of the effects of hormones. Reparative changes. During the repair process, an increase in cell nuclei, the appearance of cells with hyperchromic nuclei, increased eosinophilia of the cytoplasm, and a decrease in mucin content are determined. These changes in the epithelium of the endocervix, as well as in stratified squamous epithelium, have focal character and are located in areas with inflammatory phenomena. The process is accompanied by the development of granulation tissue, the appearance on a surface devoid of epithelium of a layer of cylindrical or immature metaplastic cells, which, as they proliferate and differentiate, form multilayered squamous epithelium. Reparative changes can be caused by inflammation, cryo-, laser treatment, radiation therapy. Reactive changes. Reason reactive changes may become inflamed, chronic infections, surgical intervention etc. Reserve cells are not normally visible. Identified in reserve cell hyperplasia, squamous metaplasia, as well as during pregnancy, use oral contraceptives and in menopause.

anonymous, Female, 28 years old

Hello! I am 27 years old. There were no pregnancies. My husband and I have been planning for 3 years now. History of HPV since 2011, incl. high oncogenic risk. In 2014 - CIN stage 1. In January 2017, I visited a gynecological oncologist. Cytology smear results revealed inflammation and signs HPV infection. The doctor said that I was not advised to undergo cervical surgery. She prescribed suppositories with methyluracil and metrogyl vaginal gel. In response to my question about how to treat my husband, because initially it was he who “awarded” me with HPV (although now HPV was not detected in his smear), they answered me that if he has healthy kidneys then let him drink Groprinosin. I was treated more than once with suppositories (for example, Genferon) and tablets (Isoprinosin and Groprinosin), immediately after taking a smear for cytology, and it was good, “clean”. But then time passed again (from 3 to 6 months), I took cytology again, and the smear again revealed inflammation due to HPV infection. Tell me, please, how can I still treat my husband? I think that it is he who constantly infects me, as a result of which inflammation is then detected in the smear again. Or then, if it is not his fault (since his HPV is not detected now), then is it effective for me alone to undergo treatment again and again for a temporary result. I really want a baby, I’m afraid that this infection in some way (or even not it, but its consequences in the form of constant inflammation) may interfere with conception, because We went through all other examinations (including invasive ones) for infertility, and no reasons were identified. Here are the results of Cytological examination 1. Quality of the drug: Exocervix - the quality of the drug is adequate. Endocervix - the quality of the drug is adequate. 2. Cytogram (description). Exocervix - squamous epithelial cells were found in the resulting material surface layers, with a predominance of cells of the intermediate layer. Not a large number of metaplastic epithelium. Weak, sometimes moderately pronounced leukocyte infiltration. Endocervix - the resulting material contained squamous epithelial cells of the superficial, intermediate layers and columnar epithelial cells. Squamous metaplasia. Moderate, sometimes pronounced leukocyte infiltration. Cells of squamous and metaplastic epithelium with slightly enlarged nuclei are noted. 3. Additional clarifications. No cells with signs of malignancy were found in the obtained material. The flora is mixed, including coccobacillary. Is it possible to determine from this result accurate diagnosis. Is there a CIN? I really hope for an answer!!!

Hello. According to this cytological conclusion, there are signs of “inflammation against the background” on this moment No. I would like to understand what the cervix looks like, is there an area of ​​ectopia? Have you had a colposcopy? Latest data on PCR analysis for HPV of high oncogenic risk. Has your partner been treated with Gronprinosin or? How did you take the drug? There are many questions here to give you a quality answer. I recommend having a colposcopy, preferably with a photo for you in conclusion, so that you can look and evaluate. It is possible to perform a targeted biopsy of the cervix under the control of a colposcope. Based on the result of which (histological examination), it will be possible to accurately say about the presence of CIN, because very often, against the background of a visually unchanged cervix, good cytology, but persistent HPV infection, there are changes in the deep layers of the exo-endocervix.

anonymously

Thank you very much for your answer. I answer in order. I have had colposcopy done more than once. It’s true that in our city they don’t give out photos. Based on its results, some area with a mosaic was identified. Then they did a targeted biopsy, which “didn’t show anything wrong,” as the doctor told me, although it was necessary to then send this section to our city morgue for a more in-depth examination, which I unfortunately didn’t do (for which I blame myself). I have been tested for HPV several times, and neither my husband nor I have the virus. We both underwent treatment (though 3 years ago) according to the 2-tablet regimen. 3 times a day for 10 days with the drug Groprinosin. And before that, in 2011 (when the virus was first discovered, there were condylomas, which later disappeared) I took the drug Isoprinosin according to the same regimen. Now in our city there are no drugs Isoprinosin or Groprinosin in any pharmacy in the city. Maybe you can recommend some other drug to activate immunity against this virus. Why do I periodically cure my inflammation, and the smear is clean, and then again and again I am told about inflammation according to the results of cytology. In January of this year I went to Oncology Center Kazan. I had a cytology smear there, which showed inflammation, signs of HPV infection, ASC-US. I was prescribed treatment with methyluracil suppositories and Metrogyl vaginal gel, and then to come again and take a smear. The doctor said that the operation is not indicated if it is not grade 3 dyspalsia. Should I just wait? Can this condition of the cervix affect long absence planned pregnancy (other factors excluded)? Gynecologist in our clinic ( Perinatal center Yoshkar-Ola) recommends that I undergo surgery on the cervix, removing the questionable area with a laser, and an oncologist-gynecologist in Kazan claims that the operation is not indicated for me. I'm very tired of the uncertainty, of the fact that no one can assign me effective treatment. Can there be a transition from CIN 1 to CIN 3 during pregnancy?

To diagnose in time gynecological pathologies, it is necessary to undergo regular tests, including smears for cytology. What can leukocyte infiltration indicate and for what diseases is it the main symptom?

Quite often, women have to deal with such a pathological condition as leukocyte infiltration of the cervix. What is it and how dangerous is it?

Leukocyte infiltration - presence in tissues huge amount leukocytes. IN in this case leukocytes are not detected in a regular smear taken from the mucous membranes, but in cytological material.

Why is cytological analysis needed and in what cases is it prescribed? Doctors advise scraping the cervix and sending it for cytology once every 1-2 years in the absence of any complaints, for preventive purposes. If a woman is at risk, she should consult a gynecologist more often. Cytological studies allow timely diagnosis of erosion, cervical cancer, the appearance of atypical cells and pathological tissues.

To be able to diagnose leukocyte infiltration as accurately as possible, it is necessary to prepare for the test. Doctors recommend certain days of the cycle for this procedure. It is best to donate biological material from days 5 to 10 of the cycle. Observe this rule necessary so that by the time the next menstruation occurs, the wound has time to heal. During sample collection, the mucous membrane of the cervix is ​​often injured.

A day before going to the gynecologist, it is recommended to abstain from sexual intercourse. On the day of the test, you shouldn’t do too much hygiene procedures. A few days before the test, you should stop using vaginal suppositories. If this is not possible, you should tell your doctor about all the medications you are taking.

A smear is taken on a gynecological chair. After the pick up biological material specialists analyze it and give the result. If a large number of leukocytes are found in the tissues of the cervix, this state called leukocyte infiltration. It always indicates the occurrence of an inflammatory process in the genital tract, but to clarify the diagnosis, a medical history is required. You should also take into account from which part of the cervix the smear was taken.

Leukocyte infiltration may indicate:

Exocervicitis (inflammation of the outer surface of the cervix);

Endocervicitis (inflammation of the internal canal of the cervix);

Vaginitis (inflammation of the vagina).

With exocervicitis and endocervicitis, a woman is bothered by pain in the lower abdomen, discomfort, discharge from the genital tract may acquire a yellowish or greenish tint and become abundant and thick. But the symptoms of the disease are often expressed in completely different ways and in varying degrees. A lot depends on the causative agent of this pathological condition.

Cervicitis can occur due to sexually transmitted infections, fungal infection, hypothermia, decreased immunity, or injury to the cervix. Cervicitis can be diagnosed based on the results of the analysis. But leukocyte infiltration only indirectly indicates the development similar disease. To make a more accurate diagnosis, it is necessary gynecological examination to identify the location of the inflamed area.

Leukocyte infiltration may also indicate the development of vaginitis. In this case inflammatory process affects the inner surface of the vagina, and not just the cervix. The symptoms of the disease are similar to cervicitis and it occurs against the background of the same reasons. Leukocyte infiltration is also a sign of the development of erosion on the cervix. Unlike cervicitis, this pathology Most often it is asymptomatic and chronic.

After clarifying the diagnosis, the doctor decides on treatment tactics. If the disease is in acute form, you need to identify the pathogen and select antimicrobials, antifungal drugs directed action. For non-specific vaginitis, antibiotics can be used wide range actions. The greatest results can be achieved through complex therapy.

Taking antibiotics can be combined with physiotherapy, douching, and insertion of tampons soaked into the vagina. medicines. Methods traditional medicine can only be used in combination with medications and only after agreement with the doctor. Very good results Sitz baths with the addition of a decoction of medicinal herbs help achieve this.

Surgical treatment is indicated only when serious complications, in the presence of erosion on the cervix. It should also be remembered that many experts consider erosion to be a precancerous condition, and with diagnosed leukocyte infiltration, the appearance of atypical cells on the inner surface of the epithelium cannot be ruled out. After treatment, you should definitely take a control smear and subsequently visit a gynecologist no more than once a year.

Leukocyte infiltration is pathological condition, in which a large number of leukocytes are detected in a cytological smear taken from the cervix. It may indicate the development of cervitis, vaginitis, or the presence of erosion on the cervix.