Progression From “Precancer” Stage to Early Carcinoma of Cervix Within One Year: Combined Cytologic and Histologic Study with Report of a Case

Abstract

Growth changes in the cervical epithelium of a woman, age 32, para 3, were studied over a period of 1 yr. by combined cytologic and histologic technics. A modification of Papanicolau''s exfoliative cytologic tech-nic, the "surface-biopsy" method of Ayre,was used in obtaining smears for cell study on repeated occasions during this time. Two specimens were obtained for biopsy. Studies were begun in July, 1948. Initially, clusters of abnormal cells of a "precancer" type were present in the smear. Their presence was confirmed in July and again in Sept. and Oct. The 1st biopsy in Oct. showed only squamous metaplasia. Histochemical studies on smear prepns. revealed that the abnormal cells were consistently low in glycogen. In an effort to influence their glycogen content progesterone and estrogen were admd. In addition, large doses of Vitamin B complex were given orally and intramuse. During this period of 5 months, 60 cytologic cervical scrapings were taken at frequent intervals. The glyr cogen content of the cells was not influenced by therapy. Morphologic cell studies indicated progression to actual carcinoma. Clinically the cervix remained normal in appearance throughout the period of observation.