Moderately expressed leukocyte infiltration of the cervix. Leukocyte cervical infiltration

Content

To maintain health, a woman is advised to timely conduct preventive diagnostics and treatment of gynecological diseases with regular visits to a gynecologist. In the absence of complaints and chronic pathologies, a preventive visit to the doctor is recommended annually.

Gynecological examination is the basis for determining the norm of the microflora of the vagina and the cellular composition of the cervix.

One of the standard gynecological procedures is the study of the contents of the vagina and urethra on the flora and oncocytology. Smears are taken from every woman.

Smear for oncocytology and flora  It is carried out annually in the absence of pathology, and in addition to the flora in women with complaints from the genital organs.

  White blood cells and cervix

White blood cells are considered one of the main components of the human body related to the white blood sprout. The main function of leukocytes is to protect against harmful pathogens entering the body from the outside.

The protective function of white blood cells is:

• specific - from certain pathogens;
• non-specific  or general.

With the penetration of inflammatory reagents into the body, an inflammatory response develops, which is normally characterized by an increase in the concentration of leukocytes.

White blood cells digest foreign agents. Normally, with a high concentration of pathogens, leukocytes begin to break down, which is accompanied by an inflammatory reaction with the development of characteristic changes in the form of:

• hyperemia, or redness;
• swelling;
• local fever.

A smear on the flora is a microscopic examination of scrapings from the urethra, cervix and vagina by bacterioscopy. For analysis, a disposable spatula is used that has a rounded end.

A glass slide has 3 smear designations:

• U - from the urethra;
• V - from the vagina;
• C - from the cervix or cervix.

In the laboratory, the dried smear is examined under a microscope, after which a conclusion is given on the composition of the microflora. The conclusion has designations of visibility:

• L is the number of white blood cells;
• Ep - amount of squamous epithelium;
• Gn - the presence or absence in the smear of gonococci, pathogens of gonorrhea;
• Trich - the presence or absence of Trichomonas in the smear, which are the causative agents of trichomoniasis.

Indications for passing a smear

In the absence of complaints from a woman, among the indications for analysis are:

• annual routine inspection;
• registration for pregnancy;
• 18, 30, 36, 40 weeks of gestational age;
• cervical erosion;
• ectopia of the cervix;
• ectropion of the cervix;
• cervical dysplasia;
• stump of the cervix after surgery.

If there are complaints, a smear for the study is taken with:

• discoloration or consistency of vaginal discharge;
• the appearance of an unpleasant smell of discharge;
• violation of the act of urination in the form of discomfort, pain;
• genital itching;
• burning sensation;
• pain in the lower abdomen;
• discomfort or pain during intercourse;
• changes in the nature of discharge or discomfort while taking medications.

A smear on the flora is normal, if a woman has complaints, it is taken at the first appearance in a antenatal clinic. During pregnancy, vaginal examination and swab are performed more frequently if indicated.

  Preparation and conduct

To obtain a reliable smear test result, it is necessary to properly prepare for a visit to the gynecologist. Special training is not required. However, simple rules should be followed.

1. Avoid sexual intercourse within 48 hours before the smear.
2. Do not use gel lubricants, vaginal suppositories or creams 24 hours before the study.
3. It is forbidden to douche 24 hours before a doctor's appointment.
4. On the day of the smear when washing the genitals, do not use any means for intimate hygiene.
5. After the last day of taking antibacterial drugs, 10 to 14 days should pass.
6. It is not recommended to do a study during menstruation. Particular attention is paid to copious spotting.
7. The last act of urination before visiting the gynecologist should be carried out 2 hours before admission.

Sexual life, funds for local use, douching can distort the reliability of the result due to changes in microbiocenosis.

In the presence of spotting in the field of view of the microscope will be red blood cells. With abundant secretions, other elements and pathogenic microorganisms may not be detected.

During the act of urination, cell elements and microorganisms can be washed away with urine.

The study is carried out as follows.

1. The woman is on the gynecological chair.
2. The doctor inserts gynecological mirrors into the vagina and exposes the cervix.
3. A smear is taken from the cervix, urethra, vagina on the flora.
4. A thin layer of material is applied to a glass slide under the designations: C, V, U.
5. The material is transferred to the laboratory, where it is stained with special dyes and examined under a microscope.

  White blood cell counts are normal

White blood cell counts normally depend on the location of the material and are determined in the field of view of the microscope.

1. Vagina or V. White blood cells - 0 - 15, epithelial cells - 5 - 10, mucus - moderately. Gram-positive flora in the form of bifidobacteria and lactobacilli can be determined.
2. Cervix or C.  White blood cells - 0 - 30, epithelial cells - 5 - 10, mucus in moderation.
3. Urethra or U. White blood cells - 0 - 5.

Normally, the number of leukocytes does not exceed 15 in the field of view. With an increase in their number, one can judge the nature of inflammation: the higher the concentration of leukocytes is determined, the more pronounced the inflammatory reaction.

The squamous epithelium is the surface layer of cells that is located at the entrance to the cervix and lines the vagina. Normally, it is always determined at childbearing age. With a decrease in estrogen levels, their amount decreases.

Mucus is determined in the material from the vagina. If it is found in material from the urethra, diseases of the genitourinary system should be differentiated.

Doderlein sticks are lactic acid bacteria that create a normal acidic flora in the vagina. With enough of them, microflora is the norm.

Normally, there is no pathogenic microflora in the smear in the form of gonococci, trichomonads, chlamydia, gardnerella, yeast, cocci.

  During pregnancy and depending on the phase of the cycle

The number of leukocytes in the smear varies depending on the phase of the menstrual cycle and during gestation, which is due to fluctuations in the hormonal background.

Normally, the number of leukocytes in the cervical canal is greater than in the vagina.

The concentration of leukocytes increases in the middle of the menstrual cycle and rises before the onset of menstruation. For a correct interpretation of the result, it is necessary to compare the ratio of leukocytes to squamous epithelium. Normally, 10 polymorphonuclear leukocytes per 1 cell of squamous epithelium.

During gestation  the norm of the number of definitions of leukocytes in the field of view rises. This is due to the fact that leukocytes and mucus protect the fetus and uterus from infection in the form of a cervical plug, which is located in the cervix.

In the case of high values \u200b\u200bof white blood cells during gestation, this may indicate a risk of complications of gestation in the form of:

• IUI or intrauterine infection of the fetus;
• premature birth;
• spontaneous miscarriage;
• weakness of labor.

  Reasons for the increase

Among the main reasons that lead to an increase in white blood cells in a smear are:

• colpitis or inflammatory lesion of the vagina;
• cervicitis or inflammatory disease in the cervix;
• endometritis or damage to the uterine endometrium;
• salpingoophoritis or inflammation of the uterus;
• urethritis or inflammation of the urethra;
• malignant processes of reproductive organs;
• STI
• bacterial vaginosis;
• hormonal imbalance;
• immune disorders;
• severe stressful situations;
• frequent douching;
• anatomical features of the vulva;
• intestinal dysbiosis.

It should be noted that the increase in leukocytes and the inflammatory process in the vagina, neck, can be asymptomatic. A regular gynecological examination allows you to eliminate the infectious and inflammatory process in time.

anonymous, Female, 28 years old

Hello! I am 27 years old. There were no pregnancies. We have been planning with my husband for 3 years. A history of HPV since 2011, incl. high oncogenic risk. In 2014 - CIN 1 step. In January 2017, she was with a gynecological oncologist. According to the results of a smear for cytology, inflammation and signs of HPV infection were detected. The doctor said that I was not shown to perform operations on the cervix. Prescribed candles with methyluracil and metrogil vaginal gel. My question is how to treat my husband, because it was he who initially "awarded" me with HPV (although now he does not have HPV smear) they answered that if he has healthy kidneys, then he should drink Groprinosin. I repeatedly underwent treatment with candles (eg Genferon) and tablets (Isoprinosin and Groprinosin), immediately after I passed a smear for cytology, and it was good, “clean”. But then time passed again (from 3 to 6 months), I took the cytology again, and the smear again showed inflammation against the background of HPV infection. Tell me, please, how can I still treat my husband? I think that he constantly infects me, as a result of which then inflammation is again found in the smear. Or then, if it is not his fault (since he does not have HPV right now), is it effective for me to undergo treatment again and again for a temporary result. I really want a baby, I'm afraid that this particular infection in some way (or even not it, but its consequences in the form of constant inflammation) can interfere with conception, because we passed all other infertility examinations (including invasive ones) on infertility, and did not reveal any reasons. Here are the results of the Cytological study 1. Quality of the drug: Exocervix - the quality of the drug is adequate. Endocervix - the quality of the drug is adequate. 2. Cytogram (description). Exocervix - cells of the squamous epithelium of the surface layers, with a predominance of cells of the intermediate layer, were found in the obtained material. A small amount of metaplasized epithelium. Weak, sometimes moderately expressed leukocyte infiltration. Endocervix - cells of squamous epithelium of the surface, intermediate layers and cells of the cylindrical epithelium were found in the obtained material. Squamous cell metaplasia. Moderate, sometimes expressed leukocyte infiltration. Cells of squamous and metaplasized epithelium with slightly enlarged nuclei were noted. 3. Additional clarifications. Cells with signs of malignancy were not found in the obtained material. Mixed flora, including coccobacillary. Is it possible to determine the exact diagnosis by this result. Is there a CIN? I really hope for an answer !!!

Hello. According to this cytological conclusion, there are currently no signs of "inflammation in the background". I would like to understand how the cervix looks like, is there an ectopic site? Have you had a colposcopy? Recent PCR analysis for HPV high oncogenic risk. Has your partner received treatment with gronprinosin or? According to what scheme did you take the drug? Many questions arise here to give you a quality answer. I recommend making a colposcopy, preferably with a photo for you in conclusion, so you can see and evaluate. It is possible to perform targeted biopsy of the cervix under the control of a colposcope. According to the result of which (histological examination) it will be possible to accurately say about the presence of CIN, because very often against the background of an unchanged cervix visually, good cytology, but persistent HPV infection, there are changes in the deep layers of exo-endocervix.

anonymously

Thank you very much for your reply. I answer in order. Colposcopy was done to me more than once. True, in our city they don’t give out photos. According to its results revealed some area with a mosaic. Then they did an aim biopsy, which "showed nothing wrong," as the doctor told me, though it was necessary to send this section to our city morgue for a deeper examination, which I unfortunately did not do (about which I reproach myself). An HPV test has been tested repeatedly; neither my husband nor my virus is detected. We underwent treatment both (though long ago 3 years ago) according to scheme 2 tab. 3 times a day for 10 days with Groprinosin. And before that, in 2011 (when the virus was first discovered, there were condylomas that later disappeared) I took Isoprinosin in the same way. Now in our city there are no Izoprinosin or Groprinosin drugs in any city pharmacy. Maybe you will advise some other drug to activate immunity against this virus. Why do I periodically cure my inflammation, and the smear is clean, and then again and again they tell me about inflammation according to the results of cytology. In January of this year, I went to the Oncology Center of Kazan. I gave a smear there for cytology, which showed inflammation, signs of HPV infection, ASC-US. I was prescribed treatment with suppositories with methyluracil and metrogyl vaginal gel, and then come back and take a smear. The doctor said that the operation is not indicated, if not grade 3 dyspalmia. I mean, just wait? Can such a condition of the cervix affect a long absence of a planned pregnancy (other factors ruled out)? A gynecologist in our clinic (Perinatal Center of Yoshkar-Ola) recommends that I perform a neck operation by removing a dubious area with a laser, and a gynecologist in Kazan claims that the operation was not shown to me. I’m very tired of the uncertainty, that no one can prescribe an effective treatment for me. Can there be a transition from 1 CIN to 3 during pregnancy?

Squamous cell metaplasia is a protective mechanism that occurs in connection with the proliferation of stem cells that differentiate in the direction of squamous epithelium. A large number of metaplasized epithelium can be associated with human papillomavirus (HPV). Hyperkeratosis - keratinization of cells of the surface layer. The clinical diagnosis of simple leukoplakia in cytological smears is manifested as clusters (single or more) of squamous epithelium. In leukoplakia with atypia, cells with various cytopathic changes that can be associated with both HPV and cervical neoplasia are determined. With hyperkeratosis, oncological alertness is necessary and an additional examination is recommended to exclude the malignant process. Parakeratosis is a nonspecific protective reaction of the epithelium. Pathological keratinization of squamous cells may be an indirect sign of HPV. Parakeratosis is also determined after injuries, childbirth, with cervical leukoplakia. Pseudoparakeratosis is noted in postmenopausal women, as it is associated with degenerative changes. In endocervical smears in women of childbearing age is observed in the second phase of the cycle. Diskeratosis is a pathological keratinization of squamous cells, which is an indirect sign of HPV. Multinucleated cells are two- and multinucleated cells, which are an indirect morphological sign of a viral infection: HPV, HSV (herpes simplex virus). In conclusion, they reflect other cytopathic symptoms and indicate their probable genesis: "indirect signs of HPV?" Multinucleated cells may be associated with inflammatory and reactive processes. Coilocytes - squamous cells with certain cytopathic changes in the nucleus and cytoplasm - a specific cytological sign of HPV. Dystrophic and dysregenerative changes in cells are associated with malnutrition and metabolism. Degenerative changes in the cells of both squamous and cylindrical epithelium are most often associated with the process of inflammation, but can be a manifestation of the effects of hormones. Reparative changes. In the process of repair, an increase in the nuclei of cells, the appearance of cells with hyperchromic nuclei, an increase in eosinophilia of the cytoplasm, a decrease in the content of mucin are determined. These changes in the epithelium of the endocervix, as well as in the stratified squamous epithelium, are focal in nature and are located in areas with inflammatory phenomena. The process is accompanied by the development of granulation tissue, the appearance on the surface deprived of the epithelium, a layer of cylindrical or immature metaplastic cells, which, as they proliferate and differentiate, form a stratified squamous epithelium. Reparative changes can be caused by inflammation, cryo-, laser treatment, radiation therapy. Reactive changes. The cause of reactive changes can be inflammation, chronic infections, surgery, etc. Reserve cells are normally not visible. They are detected with reserve cell hyperplasia, squamous metaplasia, as well as during pregnancy, the use of oral contraceptives and menopause.

In order to diagnose gynecological pathologies in time, it is necessary to regularly take tests, including smears for cytology. What can leukocyte infiltration indicate and for what diseases is it the main symptom?

Quite often, women have to deal with such a pathological condition as leukocyte infiltration of the cervix. What is it and how dangerous is it?

Leukocyte infiltration - the presence in the tissues of a huge number of white blood cells. In this case, white blood cells are not found in the usual smear taken from the mucous membranes, but in the cytological material.

Why is cytological analysis needed and in what cases is it prescribed? Doctors advise scraping from the cervix and directing it to cytology once every 1-2 years in the absence of any complaints, in order to prevent it. If a woman is at risk, consult a gynecologist more often. Cytological studies allow timely diagnosis of erosion, cervical cancer, the appearance of atypical cells and pathological tissues.

In order to be able to accurately diagnose leukocyte infiltration, it is necessary to prepare for the analysis. Doctors recommend certain days of the cycle for this procedure. It is best to take biological material from 5 to 10 days of the cycle. Observe this rule is necessary so that by the time the next menstruation occurs, the wound has healed. During sampling, the cervical mucosa is often injured.

A day before going to the gynecologist, it is recommended to abandon sexual intimacy. On the day of the test, do not carry out the hygiene procedures too hard. A few days before the test, you should stop using vaginal suppositories. If this is not possible, you need to tell your doctor about all the medications you use.

Taking a smear is carried out on a gynecological chair. After taking the biological material, specialists analyze it and give the result. If a large number of leukocytes is found in the tissues of the cervix, this condition is called leukocyte infiltration. It always indicates the course of the inflammatory process in the genital tract, but to clarify the diagnosis, an anamnesis is needed. You should also take into account from which part of the neck the smear was taken.

Leukocyte infiltration may indicate:

Exocervicitis (inflammation of the outer surface of the cervix);

Endocervicitis (inflammation of the inner channel of the cervix);

Vaginitis (inflammation of the vagina).

With exocervicitis and endocervicitis, a woman is bothered by pains in the lower abdomen, discomfort appears, discharge from the genital tract can acquire a yellowish or greenish tint, become plentiful and thick. But the symptoms of the disease are often expressed in completely different ways and to different degrees. A lot depends on the causative agent of this pathological condition.

Cervicitis can occur against the background of infection with sexually transmitted infections, infection with a fungus, hypothermia, decreased immunity, and trauma to the cervix. Diagnose cervicitis by the results of the analysis. But leukocyte infiltration only indirectly indicates the development of such a disease. To make a more accurate diagnosis, a gynecological examination is necessary to identify the localization of the inflamed area.

Leukocyte infiltration may also indicate the development of vaginitis. In this case, the inflammatory process affects the inner surface of the vagina, and not just the cervix. Symptoms of the disease are similar to cervicitis and it occurs against the background of the same reasons. Leukocyte infiltration also serves as a sign of erosion on the cervix. Unlike cervicitis, this pathology is most often asymptomatic and chronic.

After clarifying the diagnosis, the doctor decides on the tactics of treatment. If the disease is in acute form, it is necessary to identify the pathogen and select antimicrobial, antifungal drugs with targeted action. With non-specific vaginitis, broad-spectrum antibiotics can be used. The greatest results can be achieved through complex therapy.

The use of antibiotics can be combined with physiotherapy, douching, the introduction of tampons soaked in drugs into the vagina. Alternative medicine methods can only be used in combination with medications and only after consultation with a doctor. Sedentary baths with the addition of a decoction of herbs help to achieve very good results.

Surgical treatment is indicated only with the development of serious complications, in the presence of erosion on the cervix. It should be remembered that many experts consider erosion to be a precancerous condition and with the diagnosed leukocyte infiltration, the appearance of atypical cells on the inner surface of the epithelium cannot be ruled out. After the treatment, it is necessary to pass a control smear and subsequently visit the gynecologist no more than 1 time per year.

Leukocyte infiltration is a pathological condition in which a large number of white blood cells are found in a cytological smear taken from the cervix. It may indicate the development of cervitis, vaginitis or the presence of erosion on the neck.