THE ART OF CYTOLOGY
by Suzanne L. Adams, CT (ASCP)
cytotechnologist and artist

Dedicated to Education & Research in Nutrition & Disease Prevention
Helping to Build Strong Genes and Healthy Cells


Play Your Part in the Prevention of Birth Defects and Disease Processes-
Take a Quality Assured Multivitamin/Mineral with Folic Acid Every Day

Cerebral Folate Deficiency
What You Should Know
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Autism and Cerebral Folate Deficiency
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Folate Deficiency and HPV Infection
 


.FOLIC ACID/B12 DEFICIENCY
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.Cytopathology Illustration
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Folic Acid Deficiency Changes in Cervical Cells
cervical cell sample-folic acid deficiency, copyright, Suzanne L. adams
(illustration by Suzanne L. Adams, CT(ASCP), copyright)
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GENERAL INFORMATION
  Although macrocytic formation of hematopoetic cells has commonly been the first recognized disorder of a folic acid/B12 deficiency, changes in the hormone sensitive, rapidly proliferating cells of the cervix often develop several weeks sooner (DeMay RM, 1996,Koss LG 1979Klaus H, 1971).  Cell changes of overall cytomegaly (enlargement of both cytoplasm and nucleus while maintaining a normal N/C ratio) as well as nuclear folding and creasing are characteristic (Van Niekerk WA, 1966, Klaus H, 1971).  Changes can be deceptively similar to dysplasia, and new studies show a deficiency in cervical cells may be the precursor stage of HPV (human papilloma virus) (Kwasniewska A, 1997, Koss LG, 1979). High levels of folic acid appear to provide a protective effect against the initiation of HPV-related dysplasias (Piyathilake CJ,2004, Liu T, 1995, Harper JM, 1994, Grio R, 1993, Butterworth CE, 1993).  Improving folate acid levels in women at risk of getting infected or who are already infected with high-risk HPV may have a positive impact in the prevention of cervical cancer (Piyathilake CJ, 2004). Alterations in other types of epithelial cells such as gastric, bronchial, and endothelial, are known to occur as well (Heimburger DC, 1992) Radiation and chemotherapy effect cells similarly as these interventions arrest cell division by inhibiting DNA thymine synthesis of which folic acid takes part (Ames BN, 1999, DeMay RM, 1996). Antioxidant deficiencies (vitamins A, E, C, zinc, and selenium) have been shown to exhibit the same morphological cell changes as folic acid/B12 deficiency (Ames BN, 1999,  Blount BC, 1997). 

CHARACTERISTIC CERVICAL CELL CHANGES

SQUAMOUS CELLS
 *General cytomegaly most often occurring in intermediate cells
*Cells may enlarge to 70 microns in diameter or more
*Superficial cells may be effected similarly but not as often
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NUCLEAR CHARACTERISTICS
 *Nuclei >14 microns in diameter, about twice their normal size
*Nuclear membrane folding and creasing may be more frequent than cytomegaly
*Look for longitudinal lines of chromatin within the nucleus
*Enlarged nuclei usually appear bland with prominent chromocenters
*Nuclear clearing (wide pale clear space around the nucleus) may be seen,
especially in association with radiation and chemotherapy
*Occasional "masquerading" dysplastic nucleus may be found
*Sometimes overall changes may mimic mild dysplasia
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CYTOPLASMIC FEATURES
*Enlarged, pale, and often polychromatic
*Vacuolization may be quite pronounced, especially around the nucleus
*Conspicuous fibrils (thin lines that ring the nucleus) may be observed
*Bizarre shapes may be found, some with psuedopod-like projections
(they are more frequently associated with radiation and chemotherapy)
*PMN’s may be ingested in vacuoles


METAPLASTIC CELLS
*May appear enlarged with bland nuclei
*Some groups may look reactive but remain intact


ENDOCERVICAL GLAND CELLS
*May be enlarged with hypochromatic nuclei
 *Some groups may acquire a reparative expression
*Vacuolization and enlargement of cytoplasm can be seen
*Some crowding and hyperchromasia may be worrisome


ASSOCIATED CELLS/CHANGES
*Occasional bizarre enlarged bi or multinucleated macrocytes
(bizarre cells are more often associated with radiation and chemotherapy)
*Hypersegmented PMN’s are possible (5-6 or more lobes)
*Inflammation may or may not be present


Excerpt from the Art of Cytology

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Learn More About Nutrition and Cellular Health in This New Book

The Art of Cytology:
An Illustrative Study Guide With Micronutrient Discussions

read what health care professionals say about this book
read what patients and lay persons say
 



..New Reports
Stroke Rates Take Major Dive After Folate Fortification of Grain
Folic Acid Enzymes Inhibit UV Sun Damage
Age-Associated Changes in the Metabolism of Vitamin B(12) and Folic Acid
Effect of Folic Acid on Endothelial Function Following Acute Myocardial Infarction
Efficacy of Folic Acid Supplementation in Stroke Prevention
.Niacin (Vitamin B3) Improves HDL Levels
Plasma Folate, Vitamin B6, vitamin B12, Homocysteine, and Risk of Breast Cancer

Birth Defects
Cerebral Folate Deficiency
Report of the Effects on Children with Brain Deficiency
Endothelial Function in Newborn Infants is Related to Folate Levels and Birth Weight
Folic Acid Deficiency and Birth Defects- It's Not Just about NTD's
Folic Acid Blood Levels Falling In Young Women, Even After Fortification
See CDC's MMWR-2007-Full Report

Can You Pass the Folic Acid Quiz?
"Point 4 the Future" Campaign
A Folic Acid Awareness Program Aimed at Increasing Folic Acid
Intake Among College WomenTo Protect Future Generations
Drugs that Deplete Folic Acid

.Brain Function
Alzheimer's Disease and Folic Acid
.Folic Acid, DNA, and Alzheimer's Disease
Homocysteine and B Vitamins Relate to Brain Volume and White-Matter
Changes in Geriatric Patients with Psychiatric Disorders
Folate and Cognitive Function
B Vitamin Deficiency in Neurological and Psychiatric Disorders
..Treatment of Depression: Time to Consider Folic Acid and B12

Cervical Cancer
Diet and Premalignant Lesions of the Cervix:
Protective Role of Folate, Riboflavin, Thiamin, and Vitamin B12
Folate Deficiency and HPV Infection
 



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Copyright, Suzanne Adams, 2007
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