Sunday, March 8, 2015

Case of the Week 340

The following were seen on a Papanicolaou-stained cervical smear from a woman with complaints of dysuria and vaginal discharge (taken at 400 and 1000x magnification).  Identification?







8 comments:

Anonymous said...

Size and morphology compatible with Trichomonas vaginalis. At higher magnification, we may see what seems to be a flagella.

Florida Fan

aubreynoelle said...

clue cells

Javier Martinez said...

Trochomona Vaginalis

Anonymous said...

I think Trichomonas vaginalis, I think I can see faint flagella.

Lee

Arthur Morris said...

Well Trichomonas vaginalis would seem most likely due to the symptomatology and site of infection, although I see nothing I would consider flagella and the general morphology is not all that consistent with T.vaginalis. To me these resemble trophozoites of Chilomastix mesnili, with the nucleus at one end, eccentric karyosomes, oval shape with some nice pointed specimens on picture 4, and small size. However this would be a very unusual presentation since C.mesnili is enteric and generally considered non-pathogenic. All this in mind, T.vaginalis is more likely but C.mesnili would be fascinating!

Micro Michigan said...

Trichomonas vaginalis would be the obvious answer considering the source. Without being able to focus in and out to see the flagellum or the undulating membrane makes this difficult (but I think I can see both if I turn my imagination up ). The only thing that makes me nervous are the nuclei. They don’t look quite right to me, I think of T.vag as having more solidly colored nuclei, and these you can almost see a central karyosome and smooth peripheral chromatin more like an Entamoeba. But my vote is T.vag.

Luciana Becker Delving said...

Trichomonas vaginalis, in my opinion...

Anonymous said...

The site of infection is more consistent with T. vaginalis, the very elongated to oblong nucleus also agrees with such identification. We also need to keep in mind that we are looking at a three dimensional organism, and the appearance does change with the rotational axis i.e a football is elliptical on a horizontal view, but it will be round when seen from the ends.
C. mesnili would be half the size of T. vaginalis and its nucleus would be circular.
I have not seen T. vaginalis in a PAP smear, but on a Giemsa smear, the organism would show more morphology details.

Florida Fan