Clinical and Morphological Diagnosis and Treatment of Sexually Transmitted Infections - Yakymova T. P. 2007

Introduction

Methods of Biomaterial Collection for Cytological Examination

Methods for Obtaining Biomaterial for Cytological Examination

Methods for Staining Cytological Preparations

Peculiarities of Treatment of Sexually Transmitted Diseases

Gonorrhea. Clinical and Morphological Characteristics of Modern Gonorrhea. Treatment of Gonorrhea

Gonorrhea. Clinical and morphological characteristics of modern gonorrhea. Treatment of gonorrhea.

Specifics of sample collection for the diagnosis of gonorrhea depending on sex and the nature of the pathological process

Bacterial Vaginosis: Modern Diagnostic Methods, Morphological Characteristics, and Treatment

Leptotrichosis: Clinical Presentation, Morphological Types, Significance for the Patient, and Treatment

Candidiasis: Clinical and Morphological Diagnosis, Course Features, and Treatment

Trichomoniasis. Clinical features and morphological diagnosis of trichomonal infection. Treatment of trichomoniasis

Chlamydia. Clinical and morphological criteria and features of the cellular structure of chlamydial infection. Treatment of chlamydia

Mycoplasma infection: features of morphological diagnosis and clinical course. Treatment of mycoplasma infection

Genital herpes. Clinical features, morphological characteristics, and diagnostic criteria for genital herpes. Treatment of genital herpes

Human Papillomavirus: Clinical and Morphological Diagnostics. Treatment of Human Papillomavirus Infection

Morphological Diagnostics, Clinical Course, and Treatment of Syphilis

References

Appendix

Acute gonorrhea. Cervical smear. Against a background of pus, numerous neutrophilic granulocytes intracellularly contain a significant amount of diplococci, with only a few specimens located extracellularly. Methylene blue stain (x56).

Acute gonorrhea. A purulent smear shows numerous neutrophilic granulocytes containing abundant diplococci. Large groups of diplococci are located extracellularly. Romanowsky stain (x56)

Acute gonorrhea. Multiple Neisseria diplococci located intra- and extracellularly in a purulent smear. Brilliant green staining (×630)

Transition of acute gonorrhea to a chronic form. Intracellular localization of diplococci. Size polymorphism and heterochromia of diplococci, some of which stain Gram-positive. Gram stain (x630)

Exacerbation of chronic gonorrhea. The pus smear shows a small number of large diplococci located extracellularly. Pappenheim stain (x630)

Vaginal discharge. Acute gonorrhea. In the purulent smear, a few neutrophilic granulocytes contain a significant number of Neisseria diplococci, which are abundant extracellularly. Methylene blue staining (x70)

Supplement

First degree of vaginal cleanliness. Single cells of the superficial layer of the vaginal epithelium and a significant number of Döderlein bacilli. Pappenheim stain (x630)

Appendix

Second grade of vaginal cleanliness. Single superficial cells, a large number of Döderlein bacilli, and few leukocytes. A parabasal epithelial cell is visible in the lower right. Pappenheim stain (×630)

Chronic purulent colpitis. Among a moderate number of neutrophilic granulocytes, clusters of macrophages, small lymphocytes, plasma cells, and histiocytes are visible. Pappenheim staining (×630)

Purulent vaginitis; grade IV vaginal cleanliness. Histiocytes and intracellular diplococci are present in the purulent discharge. Pappenheim stain (x630)

Chronic purulent colpitis. Among a large number of neutrophilic granulocytes, there are large and medium-sized histiocytes and isolated small lymphocytes. Pappenheim stain (x630)

Chronic purulent colpitis. Multiple disintegrating and destroyed neutrophilic granulocytes and solitary destroyed epitheliocytes. Large histiocyte. Pappenheim stain (x630)

"Clue cell" — a superficial squamous epithelial cell densely covered with small bacilli, known as "bacterial dust". Romanowsky-Giemsa stain (x630)

Gardnerellosis. Superficial surface epithelium with Gardnerella cells densely adhering to the cell surfaces, forming thick borders around the cells. Methylene blue staining (x630)

Cervical smear. Mixed infection involving chlamydiosis and leptotrichosis

Cervical smear. Long and short thin filamentous Leptotrichia against the background of squamous epithelium. Pappenheim staining (×630)

Pharyngeal smear. Thick septate leptotrichia against a background of cellular detritus and bacterial microflora. Pappenheim stain (x630)

Cervical smear. Thick septate *Leptothrix*. Methylene blue staining (×630)

Cervical smear. Thick septate Leptotrichia. Methylene blue staining (x700)

Vaginal wall smear. Small clusters of yeast-like cells and pseudohyphae. Pappenheim stain (x630)

Vaginal wall smear. Colony of yeast-like fungi of the genus Candida – chlamydospores. Pappenheim stain (×630)

Chronic purulent colpitis characterized by numerous large trichomonads with polymorphic nuclei and nuclear and cytoplasmic vacuolization. Leukocytes undergoing degeneration. Neutrophilic granulocytes exhibit cytoplasmic vacuolization, karyolysis, and cytolysis; lymphocytes show fatty degeneration of the nucleus. Pappenheim stain (x630)

Acute trichomonal purulent colpitis. A single protozoan specimen with a rounded nucleus and a wide rim of cytoplasm. Brilliant green staining (x630)

A large accumulation of trichomonads, partially undergoing degradation with polymorphism and heterochromia. The nuclei of the protozoa are small, resembling a "plum stone." Pappenheim stain (x630)

Chronic trichomonal colpitis. Polymorphism of protozoan sizes and their nuclei, cytolysis, karyolysis of neutrophilic granulocytes. At the bottom is a stratified squamous epithelial cell with grade I dysplasia. Pappenheim stain (x630)

Single columnar epithelial cells in a smear from the cervical canal. One of the cells contains mucous secretion in the form of a vacuole, while the cell with high cytoplasm also exhibits a reticular body on the nucleus resembling a 'cardinal's cap' and elementary bodies appearing as red punctate inclusions. Pappenheim stain (x630)

Cervical smear: a sheet of tall columnar epithelial cells without visible inclusions, featuring purple cytoplasm. Pappenheim stain (x630)

Secretory columnar epithelium with large clear vacuoles containing cervical mucus. Pappenheim stain (×630)

Cervical smear. High columnar epithelial cells with multiple elementary bodies appearing as punctate red inclusions in the supranuclear cytoplasm. Pappenheim stain (x630)

High columnar epithelium of the cervical canal in sheets with numerous elementary bodies both intracytoplasmically and extracellularly. Pappenheim stain (x630)

Uterine cavity scraping. Chronic endometritis combined with chlamydial infection. Chlamydial inclusions in the form of punctate elementary pink bodies within the columnar epithelium. The background of the preparation consists of erythrocytes, neutrophilic granulocytes, and macrophages. Pappenheim stain (x630).

Chlamydial infection in squamous epithelium. Smear from the buccal surface of the oral cavity. Large reticular Prowazek-Halberstaedter bodies visible as rounded inclusions of various sizes in the cytoplasm and on the nuclei of superficial epitheliocytes in the form of a "cardinal's cap". Pappenheim staining (x630)

Cervical smear. Multiple round inclusions of variable size and staining intensity in the cytoplasm and on the nucleus, forming a "cardinal's cap" appearance. Pappenheim staining (x630)

Cervical smear. Mixed infection showing chlamydial inclusions in the form of reticular bodies on the nuclei, and leptotrichosis characterized by filamentous septate bacteria. A large macrophage with multiple phagocytized inclusions is visible on the left. Pappenheim stain (x630)

Cervical smear. Chlamydial infection in the columnar epithelium. Pappenheim stain (x630)

Cervical smear. Mixed infection. Superficial epithelial cells with chlamydial inclusions are visible on the left and top.

Subsequent transformation of a cell infected with HSV. Enlarged nucleus, marked cytoplasmic basophilia. Pappenheim stain (x56)

Multinucleated giant cell in genital herpes virus infection. A clear, uniform perinuclear zone separates and surrounds the contours of the congruently arranged nuclei with granular chromatin. Pappenheim stain (x56)

Cervical smear in herpesvirus infection showing variants of transformation into giant multinucleated squamous epithelial cells. A giant multinucleated cell with a barely distinguishable cytoplasmic rim. Pappenheim stain (x630)

Different types of "viral" cells in a cervical smear. Pappenheim stain (x630)

Complex of “viral” cells at various stages of transformation in a cervical smear during herpesvirus infection. Pappenheim stain (x630)

Giant multinucleated cell in a cervical smear, featuring a perinuclear colorless halo of uniform width and pink inclusions in the cytoplasm. Pappenheim stain (x630)

Giant multinucleated “viral” cell. A distinct halo of a colorless zone surrounds some of the nuclei. Pink inclusions are present in the cytoplasm. Pappenheim stain (x630)

Giant multinucleated "viral" cell in genital herpes. Cytoplasm with pale basophilic pink inclusions and a dark blue border. Pappenheim stain (x630)

Giant multinucleated "viral" cell with pale basophilic cytoplasm and pink inclusions. Pink inclusions are also present in the nuclei. Pappenheim stain (x630)

Herpes simplex virus. Giant multinucleated cell with indistinct nuclear boundaries and a narrow rim of cytoplasm on one side. Pappenheim stain (x630)

Supplement

Giant multinucleated cell with extensive multiple pink inclusions in the cytoplasm. Pappenheim stain (x630)

Appendix

Cervical smear. Koilocytes with a clear perinuclear halo and a purplish tint of the cytoplasm. Pappenheim stain (x630)

Mixed smear type: basal, parabasal, intermediate, and superficial epithelial cells, as well as intermediate layer cells showing mild vacuolization during the early phase of transformation into koilocytes. Pappenheim stain (x630)

Basal and intermediate layer cells in a cervical smear transformed into koilocytes. Pappenheim staining (x630)

Koilocytes in cervical discharge with varying degrees of mild to moderate dysplasia. Pappenheim stain (x630)

Cervical discharge. Against a background of a purulent smear, clusters of altered parabasal epithelium and a koilocyte in the center of the slide. Pappenheim stain (x630)

Cervical smear. A polygonal koilocytosis adjacent to a keratinized cell with nuclear karyorrhexis. Pappenheim stain (x630)

Cervical smear — a group of koilocytes with pronounced fatty degeneration of the cytoplasm and severe dysplasia (cellular atypia), featuring very large nuclei with nucleoli and a disrupted nuclear-cytoplasmic ratio, highly suspicious for progression to cancer. Pappenheim stain (x630)

Supplement

Cervical smear. A koilocyte is visible in the center, a cell corresponding to epidermoid carcinoma on the right, and a keratinized anucleate scale on the left. Pappenheim stain (x630)

Appendix

Cervical smear. Sharply dystrophied keratinized squamous epithelium altered under the influence of HPV. Koilocytes, epithelium with moderate dysplasia (D-11 - bottom right), atypical cells on the right margin of the image, and keratinized cells on the top left. Pappenheim stain (x630)

Cervical smear. Koilocytes with moderate and severe dysplasia (left) and squamous cell carcinoma of the cervix (center and right). Pappenheim stain (x630)

Cervical smear in leukoplakia with atypia. In the center, a keratinized superficial epitheliocyte; to its right, a "naked" nucleus of an atypical cell and two macrophages; above, a malignant koilocyt. Pappenheim stain (x630)

Cervical smear. Koilocytes and epithelial cells, one with an enlarged nucleus and another binucleated from the intermediate layer, corresponding to mild dysplasia (D1). Pappenheim stain (x630)

Cervical smear. Mild Grade I dysplasia — DI. Epithelial cells from four layers. Polymorphism, dyskaryosis, and degenerative changes are visible in the intermediate layer cells (right) and basal epithelial cells. At the bottom, a binucleated cell with large nuclei is present. Single chlamydial inclusions are observed in superficial epithelial cells. Pappenheim stain (x630)

Cervical smear. A sheet of large parabasal and basal layer cells, partially with enlarged nuclei, dyskariosis, and an altered nuclear-cytoplasmic ratio favoring the nucleus in certain cells, which corresponds to moderate dysplasia D-II. Pappenheim stain (x630)

Cervical smear showing a group of basal and parabasal epithelial cells with severe dysplasia CIN III (D-III). Pappenheim staining (×630)

Cervical smear: among the cells from the intermediate layer in the center is a cell characteristic of squamous cell keratinizing carcinoma of the cervix. At the bottom is a basal epithelial cell. Pappenheim stain (x630)

Cervical smear. A mucopurulent smear shows parabasal and deep intermediate cells, with a squamous cell keratinizing carcinoma cell in the center. Pappenheim stain (×630)

Cervical smear. Against a background of neutrophil granulocytes, a macrophage and a cluster of atypical polymorphic cells, partially undergoing keratinization and consistent with moderately differentiated squamous cell carcinoma, are observed. Pappenheim stain (x630)

Cervical smear: in the center of the smear, a sheet of stratified squamous surface epithelium with severe dysplasia (CIN III), accompanied by moderately differentiated isolated cancer cells located to the left of the epithelial sheet and in its upper section. Pappenheim stain (x630)

Cervical smear. A sheet of polymorphic, markedly atypical cells corresponding to poorly differentiated squamous cell carcinoma. Pappenheim stain (x630)

Pale spirochete, the causative agent of syphilis, viewed in dark-field microscopy as a delicate, thin, undulating filament with small, regular, uniform curves (x630)

Supplement

Pale spirochete - the causative agent of syphilis in smears stained by the Althausen method (x630)