Cytologic detection of cervical granuloma inguinale
Diagnostic Cytopathology (Impact Factor: 1.12). 04/1986; 2(2):138-43. DOI: 10.1002/dc.2840020208
Two cases of granuloma inguinale detected cytologically on routine Papanicolaou-stained cervical smears are presented; the cytologic and histologic features are described in detail, and the electron microscopic appearances are shown. The suitability of the Papanicolaou stain in the detection of granuloma inguinale is discussed, with emphasis on possible differential diagnoses to be considered. It is concluded that a definitive diagnosis of granuloma inguinale can be made on routine Papanicolaou-stained smears showing the following spectrum of changes: intact capillaries indicative of epithelial and stromal ulceration; a marked inflammatory cell infiltrate consisting predominantly of neutrophils; epithelioid histiocytes representing granuloma formation; and Donovan bodies located in characteristic single or multiple intracytoplasmic vacuoles within large histiocytes. Recognition of this cytologic picture may enable early diagnosis, even in nonendemic areas, of a potentially disfiguring venereal disease.
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- "Infection usually starts as submucosal nodules that may ulcerate producing painless, granulomatous lesions associated with tissue deformity. Infection of the cervix is very rare, and has been described with and without external genitalia involvement. The organism is seen within thin-walled intracytoplasmic vacuoles inside histiocytes. "
ABSTRACT: Rare entities in the Pap test, including neoplastic and non-neoplastic conditions, pose challenges due to their infrequent occurrence in the daily practice of cytology. Furthermore, these conditions give rise to important diagnostic pitfalls. Infections such as tuberculosis cervicitis may be erroneously diagnosed as carcinoma, whereas others, such as schistosomiasis, are associated with squamous cell carcinoma. These cases include granuloma inguinale (donovanosis), tuberculosis, coccidioidomycosis, schistosomiasis, taeniasis, and molluscum contagiosum diagnosed in Pap tests. Granuloma inguinale shows histiocytes that contain intracytoplasmic bacteria (Donovan bodies). Tuberculosis is characterized by necrotizing granulomatous inflammation with Langhans-multinucleated giant cells. Coccidioidomycosis may show large intact or ruptured fungal spherules associated with endospores. Schistosoma haematobium is diagnosed by finding characteristic ova with a terminal spine. Molluscum contagiosum is characterized by the appearance of squamous cells with molluscum bodies. This article reviews the cytomorphology of selected rare infections and focuses on their cytomorphology, differential diagnosis, and role of ancillary diagnostic studies.
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ABSTRACT: Granuloma inguinale (donovanosis) is commonly thought to be a superficial disease, which spreads by continuity and does not affect the regional lymph nodes. Two patients with the disease affecting lymph nodes in the neck are reported from a series of 108 seen in a continuing study of granuloma inguinale. An immunofluorescent antibody test is described that showed antigenic relatedness between the intracellular organisms in these patients and in patients with typical genital granuloma inguinale. Lymphadenitis associated with granuloma inguinale appears to be a stage in the pathogenesis of the pseudobubo, an uncommon feature of this disease.
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ABSTRACT: Donovanosis is a predominantly tropical cause of genital ulcer occurring chiefly in small endemic foci in all continents except Europe. Diagnosis requires the careful collection, staining and examination of smears or biopsies of characteristic genital and, occasionally, extragenital lesions for demonstration of the pathognomonic Donovan bodies (Calymmatobacterium granulomatis) within histiocytes. Successful isolation of C. granulomatis has rarely proved feasible, the last report being in 1962. Donovanosis has a characteristic histopathological picture which occasionally simulates epithelioma. The antibiotics reported as showing good activity in donovanosis are those with good activity against gram negative bacilli and whose lipid solubility ensures good intracellular penetration. They include streptomycin, chloramphenicol, erythromycin, lincomycin, cotrimoxazole and the tetracyclines. More recently, good results have been reported with norfloxacin and thiamphenicol. The treatment of donovanosis in pregnant women and patients with AIDS poses special problems. Complications of donovanosis such as elephantiasis, stricture and pelvic abscess may require surgery. Contacts should be traced for examination but only treated if lesions are found.
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