citologia clinica

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 Prof.Fernando Luis Bacelar Lobato 
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Células normais escamosas 
 
 
 
 
Tipos diferentes das pilhas squamous - A: pilhas superficial (setas); B: pilhas do ntermediate i; C: pilhas 
parabasal; D: pilhas metaplastic. (obj. 20x). 
 
Normal squamous cells 
 
 
 
A: Superficial squamous cells, flat basophilic or eosinophilic cytoplasm. B: Atrophic pattern. (obj. 20X) 
 
 
 
 
 
 
 
 
 
 
 
3 
Normal squamous cells 
 
 
 
 
Normal ectocervix: intermediate and superficial squamous cells, basophilic or eosinophilic. Some 
polymorphs are present. (obj. 10x) 
 
Normal squamous cells 
 
 
 
 
Normal ectocervix: intermediate and superficial squamous cells with basophilic or eosinophilic cytoplasm. 
(obj. 10x) 
 
 
 
 
 
 
 
 
 
4 
Normal squamous cells 
 
 
 
 
 
Normal ectocervix: intermediate and superficial squamous cells predominantly basophilic, with a few 
eosinophilic. (obj. 10x) 
 
Normal squamous cells 
 
 
 
 
Normal ectocervix: basophilic intermediate squamous cells and superficial cells with basophilic or 
eosinophilic cytoplasm. (obj. 10x) 
 
 
 
 
 
 
 
 
5 
Normal squamous cells 
 
 
 
 
Normal ectocervix: normal superficial eosinophilic cells. Some debris in the background. (obj. 20x) 
 
Normal squamous cells 
 
 
 
 
Normal ectocervix: intermediate basophilic squamous cells and basophilic and eosinophilic superficial cells 
(arrows). Note normal nuclear size variations. (obj. 20x). 
 
 
 
 
 
 
 
 
 
 
6 
Normal squamous cells 
 
 
 
 
Normal ectocervix: rare basophilic intermediate squamous cells and many superficial basophilic and 
eosinophilic cells. Note the nuclear sizes are different. Two keratinized cells with brownish 
cytoplasm(arrows). (obj. 20x). 
 
Normal squamous cells 
 
 
 
 
Normal ectocervix: basophilic intermediate squamous cells. Some polymorphs. (obj. 20x) 
 
 
 
 
 
 
 
 
 
7 
 Normal squamous cells 
 
 
 
 
Normal ectocervix: basophilic squamous cells with histiocytes or macrophages and polymorphs. (obj. 20x) 
 
Normal squamous cells 
 
 
 
 
Normal ectocervix: superficial squamous cells with basophilic or eosinophilic cytoplasm. One polymorph 
(arrow). (obj. 20x) 
 
 
 
 
 
 
 
 
 
 
8 
 
Normal squamous cells 
 
 
 
 
Normal ectocervix: intermediate basophilic squamous cells and basophilic and eosinophilic superficial cells. 
Note the presence of mature squamous metaplasia (arrows). (obj. 20x) 
 
Normal squamous cells 
 
 
 
 
Normal ectocervix: basophilic intermediate squamous cells and superficial basophilic and eosinophilic cells. 
(obj. 20x) 
 
 
 
 
 
 
 
 
9 
 Normal squamous cells 
 
 
 
 
Normal ectocervix: basophilic intermediate cells, basophilic and eosinophilic superficial squamous cells. 
(obj. 40x) 
 
 Normal squamous cells 
 
 
 
 
Normal ectocervix: basophilic intermediate squamous cells. Note some cytoplasms are very pale. (obj. 40x) 
 
 
 
 
 
 
 
 
 
 
10 
Normal squamous cells 
 
 
 
 
Liquid based preparation: normal smear, intermediate and superficial squamous cells. (obj. 40x) 
 
 Normal squamous cells 
 
 
 
 
Mid-cycle smear (ovulatory phase): eosinophilic superficial squamous cells, clean background. (obj. 10x) 
 
 
 
 
 
 
 
 
 
 
 
11 
Normal squamous cells 
 
 
 
 
Mid-cycle (ovulatory) smear: cervical mucus forming fern-like crystalline structures and eosinophilic 
superficial squamous cells. (obj. 2.5x) 
 
Normal squamous cells 
 
 
 
 
Luteal phase with basophilic squamous cells with folded cytoplasm. (obj. 10x) 
 
 
 
 
 
 
 
 
 
 
12 
 Normal squamous cells 
 
 
 
 
Luteal phase with abundant Lactobacilli and cytolysis (naked nuclei and cytoplasmic debris in the 
background) and basophilic squamous cells with cytoplasmic folding. (obj. 10x) 
Cytopathology of the uterine cervix - digital atlas 
Frappart L., Fontanière B., Lucas E., Sankaranarayanan R. 
 
 
Normal squamous cells 
 
 
 
 
Basophilic squamous cells from intermediate layers. Polymorphs are present. (obj. 10x) 
Cytopathology of the uterine cervix - digital atlas 
Frappart L., Fontanière B., Lucas E., Sankaranarayanan R. 
 
 
 
 
 
13 
Normal squamous cells 
 
 
 
 
Luteal phase with basophilic squamous cells and folded cytoplasm, forming aggregates. (obj. 10x) 
 
Normal squamous cells 
 
 
 
 
Luteal phase with marked cytolysis and abundant Doderlein bacilli. Naked nuclei from intermediate cells and 
cytoplasmic debris. (obj. 40x) 
 
 
 
 
 
 
 
 
 
 
14 
Squamous metaplasia 
 
 
 
 
A and B: mature squamous metaplasia. C: immature squamous metaplasia. D: immature squamous 
metaplasia with pattern of transitional metaplasia. (obj. 20x) 
 
 
Mature squamous metaplasia 
 
 
 
 
Intermediate type squamous cells of metaplastic origin. These cells are generally round. (obj. 10x) 
 
 
 
 
 
 
 
 
 
15 
Histiocytes and inflammatory cells 
 
 
 
 
Normal endocervix: histiocytes and rare endocervical glandular cells (arrow). (obj. 10x) 
 
Histiocytes and inflammatory cells 
 
 
 
 
Mild inflammation in a normal endocervix: secretory glandular cells (ellipse) with histiocytes (arrow) and 
polymorphs. (obj. 20x) 
 
 
 
 
 
 
 
 
 
 
16 
Histiocytes and inflammatory cells 
 
 
 
 
Normal endocervix: mixture of endocervical glandular cells (ellipse) and histiocytes (arrows) or 
macrophages. It may be difficult to distinguish glandular cells from histiocytes. (obj. 10x) 
 
Histiocytes and inflammatory cells 
 
 
 
 
Normal endocervix with mild inflammation: mixture of polymorphs and histiocytes or macrophages. (obj. 
20x) 
 
 
 
 
 
 
 
 
 
17 
Histiocytes and inflammatory cells 
 
 
 
 
Normal endocervix: endocervical mucus with naked nuclei from normal cylindrical cells. Some histiocytes 
(ellipse) and polymorphs are present. (obj. 10x) Cytopathology of the uterine cervix - digital atlas 
Frappart L., Fontanière B., Lucas E., Sankaranarayanan R. 
 
Histiocytes and inflammatory cells 
 
 
 
 
 
 
 
 
 
 
 
 
 
18 
 
Histiocytes and inflammatory cells 
 
 
 
 
Normal endocervix: histiocytes with micro-vacuolated cytoplasm. (obj. 40x) Cytopathology of the uterine 
cervix - digital atlas 
Frappart L., Fontanière B., Lucas E., Sankaranarayanan R. 
 
Histiocytes and inflammatory cells 
 
 
 
 
Atrophic normal endocervix (menopause): columnar cells (ellipse) and histiocytes may be difficult to 
distinguish. (obj. 40x) Cytopathology of the uterine cervix - digital atlas 
Frappart L., Fontanière B., Lucas E., Sankaranarayanan R. 
 
 
 
 
 
19 
 
 
Histiocytes and inflammatory cells 
 
 
 
 
Atrophic menopausal cervix: many histiocytes are visible in the endocervicalsample. (obj. 40x) 
 
Histiocytes and inflammatory cells 
 
 
 
 
Normal endocervix: histiocytes and polymorphs, high magnification. (obj. 40x) 
Cytopathology of the uterine cervix - digital atlas 
Frappart L., Fontanière B., Lucas E., Sankaranarayanan R. 
 
 
 
 
 
 
20 
 
 
 
Histiocytes and inflammatory cells 
 
 
 
Normal cervix: a superficial squamous cell with eosinophilic cytoplasm with polymorphs, histiocytes (black 
arrow) and macrophages (purple arrows). (obj. 40x) 
 
Histiocytes and inflammatory cells 
 
 
 
Endocervical smear: high magnification of histiocytes. (obj. 40x) 
 
 
 
 
 
 
 
 
 
21 
 
 
 
Histiocytes and inflammatory cells 
 
 
 
Normal but inflammatory endocervical smear: a multinucleated histiocyte among many polymorphs. (obj. 
10x) 
 
 
 Histiocytes and inflammatory cells 
 
 
 
Normal but inflammatory endocervical smear: a multinucleated histiocyte among many polymorphs. (obj. 
20x) 
 
 
 
 
 
 
 
22 
 
 
 
 Immature squamous/transitional metaplasia 
 
 
 
Immature squamous metaplasia: a sheet of metaplastic cells, moderately cohesive with their cytoplasmic 
processes. Some isolated squamous and columnar endocervical cells are present. (obj. 10x) 
 
 Immature squamous/transitional metaplasia 
 
 
 
 
Immature squamous metaplasia : a sheet of metaplastic cells, moderately cohesive with their cytoplasmic 
processes. Some isolated squamous and columnar endocervical cells are present. (obj. 20x) Cytopathology of 
the uterine cervix - digital atlas 
Frappart L., Fontanière B., Lucas E., Sankaranarayanan R. 
 
 
 
 
 
23 
 
 
 
Immature squamous/transitional metaplasia 
 
 
 
 
Transition zone: a sheet of immature metaplastic cells (repair cells), nuclei with clear chromatin and visible 
nucleoli. Inflammatory background. (obj. 20x) 
 
Immature squamous/transitional metaplasia 
 
 
 
 
 
Transition zone (TZ) smear: sheet of metaplastic or repair cells (clear chromatin and visible nucleoli) in a 
bloody and inflammatory background. (obj. 10x) 
 
 
 
 
 
24 
 
 
 
 Immature squamous/transitional metaplasia 
 
 
 
 
Transition zone: typical squamous metaplastic cells, loosely cohesive (field A) or forming a sheet (field B), 
surrounded by normal squamous cells, in a bloody and inflammatory background. (obj. 20x) 
 
Immature squamous/transitional metaplasia 
 
 
 
 
Transition zone (TZ): sheet of metaplastic or repair cells (clear chromatin and visible nucleoli). Some 
maturing isolated cells (field B-ellipse). (obj. 40x) 
 
 
 
 
 
 
25 
 
 
 
Immature squamous/transitional metaplasia 
 
 
 
 
Transition zone (TZ): sheet of metaplastic or repair cells (clear chromatin and visible nucleoli). Some 
maturing isolated cells (field A). (obj. 40x) 
 
 
 Immature squamous/transitional metaplasia 
 
 
 
 
 
Transition zone: typical squamous metaplastic cells forming a sheet, in a bloody and inflammatory 
background. High magnification. (obj. 40x) 
 
 
 
 
26 
 
 
 
Immature squamous/transitional metaplasia 
 
 
 
 
Transition zone: immature metaplastic cells. (obj. 40x) 
 
 
 Immature squamous/transitional metaplasia 
 
 
 
 
Transition zone (TZ): sheet of immature metaplastic cells. (obj. 40x). 
 
 
 
 
 
 
 
27 
 
 
 
 
Immature squamous/transitional metaplasia 
 
 
 
 
Transition zone (TZ): sheet of immature metaplastic cells. (obj. 40x) 
 
 
Immature squamous/transitional metaplasia 
 
 
 
Transition zone (TZ): sheet of immature metaplastic cells. (obj. 40x) 
 
 
 
 
 
 
 
28 
 
 
 
Immature squamous/transitional metaplasia 
 
 
 
 
Liquid-based cytology: group of immature squamous metaplastic cells. (obj. 20x) 
 
 
 
 Immature squamous/transitional metaplasia 
 
 
 
Liquid-based cytology: group of immature metaplastic cells. (obj. 40x) 
 
 
 
 
 
 
 
29 
 
 
 
Immature squamous/transitional metaplasia 
 
 
 
Transitional metaplasia: immature cells with clear and oval nuclei, with visible nucleoli. Longitudinal 
nuclear grooves (arrows). (obj. 20x, 2 different fields A and B) 
 
 
 
Immature squamous/transitional metaplasia 
 
 
 
Transitional metaplasia: immature cells with clear and oval nuclei, with visible nucleoli. Some longitudinal 
nuclear grooves (arrows) (field B). (field A: obj. 20x, field B: obj. 40x) 
 
 
 
 
 
 
30 
 
 
 
Immature squamous/transitional metaplasia 
 
 
Transitional metaplasia: immature cells with clear and oval nuclei, with visible nucleoli. Longitudinal 
nuclear grooves (arrows). (obj. 20x) 
 
 
Immature squamous/transitional metaplasia 
 
 
 
Transitional metaplasia: immature cells with clear and oval nuclei, with visible nucleoli. Some longitudinal 
nuclear grooves (arrow). (obj. 20x) 
 
 
 
 
 
 
 
31 
 
 
 
 
Immature squamous/transitional metaplasia 
 
 
 
 
Transitional metaplasia: immature cells with clear and oval nuclei, with visible nucleoli. Some longitudinal 
typical nuclear grooves (arrows). Non specific cytoplasmic inclusion. (obj. 40x) 
 
Immature squamous/transitional metaplasia 
 
 
 
Transitional metaplasia: immature cells with clear and oval nuclei, with visible nucleoli. Some longitudinal 
typical nuclear grooves (arrows). (obj. 40x) 
 
 
 
 
 
 
32 
 
 
 
 
Immature squamous/transitional metaplasia 
 
 
 
Transitional metaplasia: immature cells with clear and oval nuclei, with visible nucleoli. Longitudinal 
nuclear grooves. (obj. 20x) 
 
Immature squamous/transitional metaplasia 
 
 
 
Transitional metaplasia: immature cells with clear and oval nuclei, with visible nucleoli. Longitudinal 
nuclear grooves. (field A: obj. 10x, field B: obj. 20x) Cytopathology of the uterine cervix - digital atlas 
Frappart L., Fontanière B., Lucas E., Sankaranarayanan R. 
 
 
 
 
 
33 
 
 
 
 
 
Immature squamous/transitional metaplasia 
 
 
 
Transitional metaplasia: immature cells with clear and oval nuclei, with visible nucleoli. Some longitudinal 
typical nuclear grooves. (obj. 40x) 
 
 
 
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