George N. Papanicolaou was a Greek physician and anatomist in the United States
(1883 - 1962).
SAMPLING TECHNIQUES
Natural exfoliation – urine, sputum
Cervical PAP smear
1. Ayres spatula
2. Aylesbury device
3. Cytobrush + extended tip device. One-day
training workshop required.
Vaginal smear
Endometrial aspiration cytology
Smear of vulva lesions
Fine needle aspiration cytology +/- imaging
Peritoneal washings
Buccal smear
USES OF THE PAP SMEAR
Detection of occult pathologic
abnormalities of the uterine cervix in
asymptomatic women
Detection of recurrence of known
pathologic abnormalities of the uterine
cervix
Evaluation of a suspected hormonal
abnormality
Monitoring of hormonal therapy
PATHOLOGIC ABNORMALITIES
OF THE CERVIX ON PAP SMEAR
Pre-malignant and pre-invasive malignant conditions
of the cervix
Menopausal Syndrome
Great individual variation. Early in the climacteric, the smear may show high
proliferation, but no cycling. In some cases, atrophic changes may occur
abruptly, whereas in others, varying degrees of proliferation may be evident for
years, with a gradual shift in the maturation index to the left.
FINE NEEDLE ASPIRATION
CYTOLOGY
This is frequently used to provide a rapid diagnosis with or without the
use of imaging from ascitic fluid, ovarian tumours, lymph nodes, vulva
cysts etc.
Advantages of FNA over open surgical biopsy
Diagnosis with a simple, cheaper, outpatient procedure