Cyto and histological study of so-called “atrophic pattern” of the vaginal smear

Abstract

We investigated the cytological characteristics of the socalled atrophic pattern of normal vaginal smears in 711 elderly women, ranging from 60 to 98 years of age, and the histopathologic background of the cytology of these atrophic vaginal smears, using autopsy materials from another 54 elderly women, ranging from 65 to 100 years of age.
The results were as follows:
The atrophic pattern of vaginal smears was found in 375 cases and the non-atrophic pattern in 336.
Therefore, the ratio of the former to the latter was almost one to one. This ratio was not influenced by aging.
The atrophic pattern of these vaginal smears was divided into four main types and their subtypes: syncytial cell type (S type), naked cell type (N type), round cell type (R type) and polygonal cell type (P type), with degenerated and distorted cell subtypes in all four categories.
The syncytial cell type was found in 46.1%, making it the most numerous. This type was assumed to be the basic pattern for atrophic smears.
When the epithelium of the vaginal wall of the 54 autopsy cases was divided into evolutional and involutional types, the former was found in 21 cases (38.9%) and the latter in 33 (61.1%). Both types were found in every decade from the 60s to the 90s.
The evolutional type was found in a specimen from a 100-year-old woman.
In the involutional type the epithelium was composed of four to eight layers of parabasal cells and these cells were morphologically, compatible with atrophic cells of the S, N, R and P types.