Eurocytology

Regeneration and repair

Healing of the ulcerated or eroded epithelium is effected by proliferation of the basal cell layer of adjacent epithelium and expansion of the reserve cells of the local gland crypts. Initially the denuded area is covered by immature metaplastic cells which eventually transforms into mature squamous or columnar epithelium.
The degenerative changes associated with inflammation and the regenerative changes associated with repair are often seen in the same smear.


Regenerative changes are characterised by sheets of columnar and immature metaplastic cells with large nuclei and several prominent nucleoli or chromocentre reflecting recent mitotic activity

Chronic cervicitis

When injury persists discrete lymphocytes and plasma cells migrate into the inflamed area and can be found in moderate numbers among the polymorphs in the smear. In long standing cervicitis such as that associated with the insertion of a vaginal pessary for vaginal prolapse in a post menopausal woman, the epithelium may show reactive changes such as parakeratosis and hyperkeratosis. These changes may also be seen in the smear.

Chronic lymphocytic cervicitis is characterised by a mixture of polymorphs and lymphocytes in the smear. Some of the epithelial cells show intense eosinophilic staining consistent with hyperkeratotic changes

Follicular cervicitis: this condition is characterised by exposure of the lymphoid follicles which are sometimes found in the cervix due to disruption of the overlying epithelium. It occurs at any age but is most common In post menopausal smear when the follicles are covered by thin fragile atrophic epithelium which is easily removed by the spatula. The smear contains swathes of lymphoid cells (mature and immature lymphocytes) in varying stages of differentiation .Tingible body macrophages are also present .