Pap smear: Medium power
Tadpole like cell with Herxheimer spiral
Note that the nucleus of the cell is round and nucleus to cytoplasmic ratio is low. The chromatin is open.
These features distinguish it from dysplastic tadpole like cells of squamous cell carcinoma
Pap smear: High power
Cluster of cells with nuclear atypia characterized by multinucleation and slight nuclear irregularity and nucleoli
Note although nuclei are enlarged N:C ratio is not high
Note the lack of nuclear size variation
Note also the dense nature of cytoplasm
Pap Smear: High power
School of fish like flowing cluster of squamous cells with irregular nuclei and multinucleation.
Note low N:C ratio and open, fine granular chromatin of cells
Pap stain: Medium power
Tadpole like cell of radiation atypia. It may appear similar to squamous cell carcinoma; however in radiation atypia the cell lacks keratinization, has regular nucleus, fine chromatin and low N:C ratio
Pap stain: Medium power
Typical intermediate cell of radiation atypia. Note cytoplasmic processes, low N:C ratio and fine chromatin with small nucleoli
Pap stain: high power
Group of parabasal cells with slightly irregular nuclei and small nucleoli.
Note the finely vacuolated cytoplasm and focal multinucleation
Pap stain: High power
Typical example of radiation changes in intermediate and parabasal cells
Note the multinucleation and background inflammation
Also note the fine chromatin and low NC ratio
Pap stain: Low power
Two groups of cells with radiation atypia joined by long cytoplasmic processes of a cell in the middle.
Note background has low cellularity and shows inflammation
Features
• Liquid based
• Variable cellularity but usually low
• Usually cell groups
• Cells with changes: Intermediate and parabasal
• Vacuolated and frothy blue green cytoplasm
• Cytoplasmic processes
• Tadpole like forms†
• Herxheimer spirals†
† note: these may be seen in Squamous cell carcinoma too
• Single to multiple nuclei
• Enlarged nuclei (2.5-3x background normal intermediate cells) but N:C ratio is NOT high
• Slight nuclear irregularity
• Smudgy or finely granular chromatin
• Small to prominent nucleoli
• Acute inflammatory cells
• Pigment laden histiocytes and macrophages