Squamous cells in cytology

Morphology of healing endocervicosis

The healing process of endocervicosis is accompanied by complex mucosal remodeling. During this process, simple columnar epithelium is gradually replaced by non-keratinizing stratified squamous epithelium. This phenomenon is called epidermization.

As the glandular structures become covered by squamous epithelium, specific retention lesions—Nabothian cysts—may form. The presence of two types of epithelium (columnar and squamous) determines the features of clinical and laboratory diagnostics of this condition, requiring a comprehensive approach to rule out more dangerous pathologies.

Role of cytological examination

In practice, cytological examination performed by taking smears or scrapes is considered a low-informativity method if the sole purpose is to confirm epidermization or endometriosis.

Nevertheless, collecting material for cytology is a strict and mandatory standard. The main and only task of this stage is to search for altered cells. The cytopathologist must carefully examine the stratified squamous epithelium to reliably rule out any cellular atypia that may indicate precancerous changes. Thus, squamous cell analysis serves as a method of oncological alertness rather than a tool for assessing endocervicosis itself.

Instrumental and visual diagnostics

Optical methods are used for clinical assessment of the mucosa to evaluate the degree and completeness of endocervicosis healing:

1. Speculum examination. Allows visual differentiation of epithelial types. Ectopic areas covered by simple columnar epithelium have a distinct red color. This occurs because the vascular subepithelial layer shines through the thin epithelial layer. In turn, areas of completed epidermization acquire the usual gray hue characteristic of mature stratified squamous epithelium.
2. Colposcopy. This is the primary method of differential diagnosis. It helps the physician distinguish Nabothian cysts from a range of other pathologies, including ectopia, erythroplakia, cervical polyps, ectropion, and cervical endometriosis.

When is histological verification necessary?

When the capabilities of colposcopy and cytological examination are insufficient, invasive diagnostics are used. Histological verification via biopsy is prescribed in strictly defined situations:

• When concomitant cervical dysplasia is suspected.
• When signs of cellular atypia are detected during the cytological stage.
• In cases where the colposcopic picture remains unclear and does not allow a definitive differentiation between a benign process and a potentially dangerous lesion.

Class and exam questions

What else to study on this topic

• Cervical ectopia
• Nabothian cysts: morphogenesis
• Erythroplakia
• Cervical polyps
• Ectropion and cervical endometriosis

Other topics in the "Additional Topics" section

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