The following were an unexpected finding on anal Papanicolaou-stained pap smear from a male with papular anal lesions. Identification? (CLICK ON IMAGES TO ENLARGE).
Giardia intestinalis cysts! Also, that squamous epithelial cell looks a little suspicious - maybe a koilocyte? Does this patient have condyloma acuminata? It also has an interesting inclusion...hmmm.
Squame is koilocytic with binucleate and perinuclear halo but would probably leave as ASCUS rather than LSIL unless more and better although is really a distinction without meaning but seems to stir less anxiety.
These anal Paps were a great idea 10 yrs ago but incidence of anal sq cancer in the MSM/HIV crowd seems to have gone way done so not sure is worthwhile now.
Very cool - some cytotech had his/her mind open to see this. Squame is koilocytic and if a few more probably would call LSIL; if just this leave as ASCUS not that there is much/any management difference. Anal Paps in the HIV population were a great idea 10-15 years ago but I'm not sure they're worthwhile now that the incidence of ca seems way down with HAART.
Giardia intestinalis cysts! Also, that squamous epithelial cell looks a little suspicious - maybe a koilocyte? Does this patient have condyloma acuminata? It also has an interesting inclusion...hmmm.
ReplyDeleteI agree with the Giardia.
ReplyDeleteGiardia Lamblia cysts.
ReplyDeleteMMLNE
I see the small blue cysts of Giardia lamblia.
ReplyDeleteCan the big pink thing be a liver fluke ?
Cute bugs.
ReplyDeleteSquame is koilocytic with binucleate and perinuclear halo but would probably leave as ASCUS rather than LSIL unless more and better although is really a distinction without meaning but seems to stir less anxiety.
These anal Paps were a great idea 10 yrs ago but incidence of anal sq cancer in the MSM/HIV crowd seems to have gone way done so not sure is worthwhile now.
Very cool - some cytotech had his/her mind open to see this. Squame is koilocytic and if a few more probably would call LSIL; if just this leave as ASCUS not that there is much/any management difference. Anal Paps in the HIV population were a great idea 10-15 years ago but I'm not sure they're worthwhile now that the incidence of ca seems way down with HAART.
ReplyDelete