Isolated or phagocytosed miniature dyskeratotic cells in papilloma virus infection associated with cervical neoplasia.

Dyskeratotic cells that occur in squamous cervical epithelium under certain abnormal conditions appear in cervical smears in sheets or aggregates, or as miniature cells, either isolated or phagocytosed. In order to determine the tissue correlates of such cells, 116 cervical biopsies with a histopathologic diagnosis of papillomavirus (HPV) infection were reviewed and compared to previous findings in cytological smears; the patients were 18-65 yr of age. Eighty of the 116 cases had, in addition, cervical intraepithelial neoplasia (CIN). A much higher number of miniature dyskeratotic cells was recorded in the biopsies from patients with both HPV and CIN types of lesions (76.3% of the biopsies had isolated miniature cells and 41.3% showed phagocytosed miniature cells), compared to those with only HPV infection (19.4% with isolated and 5.5% with phagocytosed miniature cells). In addition, in the HPV plus CIN patients, the more advanced the neoplastic lesion, the higher the percentage of cases in which both types of dyskeratocytes are observed. These highly keratinized isolated miniature cells are found in, and are considered to arise from, the deeper layers of the epithelium; when phagocytosed they appear in the center of a concentric arrangement of cells. These cells constitute a pathological entity that can be distinguished from the sheets and aggregates of dyskeratotic cells that come from the superficial layers of parakeratotic epithelia.

Squamous papilloma of the esophagus diagnosed by cytology. Report of a case with concurrent occult epidermoid carcinoma.

Esophageal material for cytologic smears was obtained by the gel-foam technique from an 84-year-old man with dysphagia and symptoms of obstruction in whom initial attempts at endoscopic biopsy were nondiagnostic. The smears contained cells with koilocytotic atypia, similar to those described in smears from uterine cervix lesions produced by human papilloma virus. The cytologic diagnosis of an esophageal papilloma of viral origin was confirmed by the second biopsy. A third biopsy, from a lower level of the esophagus following dilatation procedures, revealed an epidermoid carcinoma in situ contiguous with the papilloma.

Cytologic and ultrastructural findings of a peculiar alteration in cervical cells from patients with human papillomavirus infections.

Inclusion bodies were previously found in Papanicolaou smears of patients infected by the human papillomavirus (HPV). To ascertain their origin, 12 biopsies from patients with colposcopic evidence of papillomatous lesions were studied by cytology and electron microscopy. In several instances, koilocytotic atypias and electron-dense masses included within epithelial cells were observed. Some of these epithelial cells appeared to be surrounded by other cells in a sort of concentric arrangement. The electron-dense masses were composed of intermediate filaments, vacuoles and electron-dense material. They seemed to be dyskeratotic cells. They can be compared with apoptotic bodies and may be related to a disturbance of the involucrin expression caused by the HPV infection.

Chlamydial infection in Papanicolaou-stained cervical smears.

Infection by Chlamydia trachomatis was frequently observed in routine cytologic smears studied for cancer detection. Seventy-three smears from 187 Chlamydia-positive cases seen in a two-and-one-half-year period were reviewed to establish the relationship between C. trachomatis infection and the incidence of metaplastic and dysplastic cells. An inflammatory process with metaplastic cells was found in 72.6% of the smears and dysplastic cells in 16.4%. The Papanicolaou stain gave enough detail not only for the identification of the inclusions but also for the relation of different types of inclusions to the different stages of the life cycle of the microorganism.