Cytomorphologic study on the atypical cells following cryosurgery for the treatment of chronic cervicitis.

One hundred and twenty-nine patients of chronic cervicitis were treated by cryosurgery and periodically followed up by Pap smears and biopsies. Cytomorphologic studies were carried out on atypical cells following cryosurgery. Atypical cells were detected within four weeks. These were divided into two categories. The first group consisted of cells with abundant cytoplasm and occurred in sheets, aggregates and/or as isolated forms. Irregular nuclear borders were observed in 5.1 per cent and fine granular chromation pattern was found in 99.4 per cent. Irregular nucleolar borders were observed in 7.5 per cent and macronucleoli, over 2.5 microns in diameter, were disclosed in 11.3 per cent. Nuclei within 10 microns in diameter were observed in 56.6 per cent, and the maximum length was 20 microns. It was suggested that these cells were exfoliated from either basal cell hyperactivity or atypical reserve cell hyperplasia. The second group consisted of cells with scanty cytoplasm of bare nuclei and occurred in aggregates. Irregular nuclear borders were observed in 1.7 per cent and fine granular chromatin patterns were found in 99.7 per cent. Irregular nucleolar borders could not be encountered. Macronucleoli were observed in only 0.4 per cent. Nuclel within 10 microns in diameter were observed in 95.3 per cent and the maximum measured length was 15 microns. It was suggested that these cells could be derived from reserve cell hyperplasia or from immature squamous metaplasia. In conclusion, atypical cells following cryosurgery exfoliate from the regenerating tissue in which atypia is frequently observed. The cells of the first group have identical features with those observed in the cases of tissue repair; on the other hand, the cells of the second group were derived from reserve cell hyperplasia or from immature squamous metaplasia.