Introduction<\/p>\n
Reminder: You may click on any slide image<\/strong><\/p>\n for an enlarged view.<\/strong><\/p>\n Criteria<\/p>\n Tissue Presentation<\/strong><\/p>\n Cytoplasm<\/strong><\/p>\n N\/C Ratio<\/strong><\/p>\n Nucleus<\/strong><\/p>\n Nuclear Membrane <\/strong><\/p>\n Chromatin<\/strong><\/p>\n Nucleoli<\/strong><\/p>\n Look Alikes for Atypical Endocervical Cells (NOS)<\/p>\n Endocervical Repair:<\/p>\n Cell Type:<\/strong> Endocervical Unique Features<\/strong><\/p>\n Tubal Metaplasia:<\/p>\n Cell Type: <\/strong>Small cuboidal fallopian tube-type glandular cells Unique Features <\/strong><\/p>\n Lower Uterine Segment:<\/p>\n Cell Type:<\/strong> Endometrial Unique Features<\/strong><\/p>\n Atypical Endocervical cells favor Neoplasia or AIS:<\/p>\n Cell Type:<\/strong> Endocervical Unique Features<\/strong><\/p>\n\n
\n![\"Image](\"\/gallery\/images_large\/slide1355.jpg\" "\\"Click")
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\nA well organized, flat sheet of glandular cells in a “school of fish” arrangement. Biopsy – Decidual changes-20x<\/div>\n<\/div>\n\n
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\nPictured is a sheet of endocervical cells with slightly disordered architecture, slight depth of focus to group, abundant cytoplasm, uniform, bland chromatin pattern and prominent nucleoli in each nucleus. The diagnosis of atypia may arise due to depth of focus to the group and slightly disordered architecture. Biopsy – Inflammatory Atypia – 60X<\/div>\n<\/div>\n\n
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\nAtypical cells with abundant cytoplasm maintaining a low N\/C ratio. Biopsy – Endocervical polyp – 60x<\/div>\n<\/div>\n\n
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\nThe specimen contains a rounded up (3-dimensional) group of endocervical cells with slight disruption to architecture. Nuclei are all similar in size and nuclear membranes are smooth to slightly irregular.
\nBiopsy – Chronic Inflammation – 60x<\/div>\n<\/div>\n\n
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\nThe nuclei in this group exhibit nuclear membranes with slight irregularities and thickening.
\nBiopsy – Decidual changes – 40x<\/div>\n<\/div>\n\n
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\nA loose grouping of endocervical cells exhibits an apparent loss of polarity. Nuclei are round to oval with slight nuclear membrane irregularities and slight crowding. The chromatin is granular but evenly distributed and prominent nucleoli are present. Biopsy – Chronic Inflammation – 60x<\/div>\n<\/div>\n\n
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\nNuclei contain single to multiple nucleoli that are small to moderate in size.
\nBiopsy – Decidual changes – 60x<\/div>\n<\/div>\n
\nTissue Presentation<\/strong><\/p>\n\n
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\nRepair – Note the flatness of this sheet of reparative cells. All of the nuclei are in the same plane and lack the nuclear crowding characteristic of AIS. Nuclei are uniformly spaced and round to oval, rather than elongate. 40x<\/div>\n<\/div>\n
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\nEndocervical repair – 40x<\/div>\n<\/div>\n\n
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\nRepair often shows “school of fish” architecture. Polarity is maintained and the N\/C ratio of the cells is in the normal range. 40X<\/div>\n<\/div>\n
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\nRepair shows smooth nuclear contours and polarity is maintained within group. 60x<\/div>\n<\/div>\n
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\nRepair can present with prominent nucleoli, some multiple. 40x<\/div>\n<\/div>\n
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\nRepair may contain mitosis and macronucleoli. 60x<\/div>\n<\/div>\n
\nTissue Presentation <\/strong><\/p>\n\n
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\nTubal metaplasia can closely mimic AIS. However, on close inspection the abnormalities, ie: crowding, nuclear elongation, irregular nuclear membranes and abnormal tissue fragments are less severe. Locating cilia and\/or terminal bars confirms benignancy. 60X<\/div>\n<\/div>\n
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\nCrowded glandular cells have enlarged nuclei but a closer inspection reveals evenly distributed chromatin. 40x<\/div>\n<\/div>\n\n
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\nA strip of columnar cells with hyperchromatic, crowded nuclei. Close observation reveals distinct cytoplasmic vacuoles and cilia possibly representing tubal metaplasia. 60X<\/div>\n<\/div>\n
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\nIn this higher power view of the first photograph (20x) a distinct row of cilia is evident. 60x<\/div>\n<\/div>\n
\nTissue Presentation<\/strong><\/p>\n\n
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\nA fragment of cells from the lower uterine segment, which has folded over itself causing a three dimensional appearance. 20X<\/div>\n<\/div>\n
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\nLower uterine segment – 40X<\/div>\n<\/div>\n
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\nLower uterine segment may have prominent nucleoli. 40X<\/div>\n<\/div>\n\n
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\nThis tissue fragment of lower uterine segment is composed of small, cuboidal cells with uniform nuclei and bland chromatin. At low power the cells appear crowded; however on closer inspection they are simply tightly packed. The cohesiveness and uniformity of such fragments at low power are the keys to diagnosis. A stromal component is usually present as well and is an aid in diagnosis. 20x<\/div>\n<\/div>\n
\nTissue Presentation<\/strong><\/p>\n\n
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\nEndocervical cells presenting in a strip with pronounced nuclear crowding. Biopsy – AIS – 60x<\/div>\n<\/div>\n
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\nA strip of endocervical cells exhibiting pseudostratification and finely vacuolated cytoplasm with indistinct cytoplasmic borders. Architecture is disrupted although cells are still attempting to maintain a glandular configuration. Note increased N\/C ratio and the variable presence of nucleoli. Biopsy – AIS – 60x<\/div>\n<\/div>\n
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\nEndocervical cells presenting in a pseudo-rosette formation and exhibiting “feathering” and nuclear elongation due to crowding. Biopsy – AIS – 60x<\/div>\n<\/div>\n\n