Atrophic menopausal smear (atrophic pattern)
Smear showing an atrophic pattern taken in a menopausal woman (naturally or after treatment).
The cytopathologic features of the atrophic cervico-vaginal smear are: a variable cellularity, with miniature polygonal to round squamous cells with orangeophilic cytoplasm and dot like pyknotic nuclei (red atrophy or pseudoparakeratosis).
Parabasal cells, either isolated or in tissue fragments, may show nuclear enlargement and pale, smudgy chromatin. Intermediate cells with binucleation or multinucleation may be present. Pleomorphic forms with nuclear enlargement, smudgy, pale to hyperchromatic nuclei are frequent, as well as bare nuclei (blue blobs). Cellular, amorphous, or inflammatory debris are associated.
These modifications are reversed by oestrogen treatment. (see also: atrophic cervix, atrophy)