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Cytopathologic detection of chlamydia trachomatis in vaginopancervical (fast) smears
Author(s) -
Gupta Prabodh K.,
Shurbaji Muhammad S.,
Mintor Lori Jo,
Ermatinger Susan V.,
Myers Joseph,
Quinn Thomas C.
Publication year - 1988
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.2840040309
Subject(s) - chlamydia trachomatis , medicine , chlamydia , gynecology , chlamydia trachomatis infection , chlamydiales , chlamydiaceae , immunology
Abstract The value of the Papanicolaou‐stained vaginopancervical (Fast) smear in the detection of chlamydial infection has been disputed. We examined 116 satisfactory Fast smears from 203 women enrolled in the Johns Hopkins Fertility Control Clinic and compared tissue‐culture results with cytopathologic detection using various published morphologic criteria. All Chlamydia culture‐positive cases were reviewed, and certain cytologic features considered helpful in the detection of chlamydial infection in cervical smears obtained from this selected high‐risk population were identified. The changes that had the highest correlation with tissue culture included fine vacuolation ofmetaplastic endocervical cells, giving their cytoplasm a rarefied “moth‐eaten” appearance. Using these criteria, cytopathologic changes of chlamydial infection were observed in 24 of 28 cases of tissue‐culture‐positive cases and in 8 of 88 tissue‐culture‐negative cases. The sensitivity and specificity of the Fast‐smear cytodiagnosis of Chlamydia infection utilizing these morphologic changes and compared with tissue culture were 86% and 91%, respectively. Other cytologic features, including inflammatory background and intracytoplasmic structures consistent with initial and intermediate chlamydial bodies within the metaplastic cells, were found to be useful although less specific and less sensitive. The implications of these diagnostic features, the conditions to be considered in their differential diagnosis, and the pitfalls of chlamydial cytodiagnosis and the chlamydia culture studies have been critically reviewed. Study design and the high unsatisfactory cervical smear rate are discussed. Diagn Cytopathol 1988;4:224–229.