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. 2013 Aug;7(8):1715-6.
doi: 10.7860/JCDR/2013/5799.3265. Epub 2013 Aug 1.

"Cannon balls or pus balls" in pap smears: a case report

Vijay Kumar Bodal  1 , Sarbhjit Kaur, Ranjiv Bhagat, Rupinder Kaur, Manjit Singh Bal
Affiliations

"Cannon balls or pus balls" in pap smears: a case report

Vijay Kumar Bodal et al. J Clin Diagn Res. 2013 Aug.

Abstract

A 50-year old female presented with the chief complaint of a discharge per vaginum, which was there for the past 15 days. A routine PAP smear was received in the Department of Pathology, Government Medical College, Patiala, India. After its fixation and staining, it was examined under the microscope. It showed the Trichomonas vaginalis infection, with the neutrophils forming cannon balls at places. Neutrophils in the PAP smear are a nonspecific finding, particularly if they are low in numbers or if they are seen in the premenstrual and the menstrual phases. The neutrophils which are adherent to the squamous cells are called "cannon balls" or "pus balls", which are common in the Chlamydia infection. This case is being presented because of the presence of these rare morphological structures i.e. "cannon balls" or "pus balls".

Keywords: Cannon ball; PAP; Trichomonas vaginalis.

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Figures

[Table/Fig-1]:
[Table/Fig-1]:
Red Arrow showing Trichomonas vaginalis (Pap 1800 X 1600)
[Table/Fig-2]:
[Table/Fig-2]:
Yellow arrow showing “cannon ball” appearance- neutrophils adherent to squamous cells (Pap 1800 x 1600)
See this image and copyright information in PMC

References

    1. Vanacova S, Liston DR, Trachezy J, Johnson PJ. Molecular biology of the amitochondriate Parasites Giardia intestinalis, Entamoeba histilytica and Trichomonas vaginalis. Int J Parasitol. 2003;33:235–55. - PubMed
    1. Demirezen S, Safi Z, Beksac S. The interaction of trichomonas vaginalis with epithelial cells, polymorphonuclear leucocytes and erythrocytes on vaginal smears: light microscopic observation. Cytopathology. 2000;11(5):326. - PubMed
    1. Sellors J, Howard M, Pickard L, Jang D, Mahony J, Chernesky M. Chlamydial cervicitis: testing the practice guidelines for presumptive diagnosis. CMAJ. 1998;158(1):41. - PMC - PubMed
    1. Bertolino JG, Rangel JE, Blake RL Jr, Silverman D, Ingram E. Inflammation on the cervical Papanicolaou smear: the predictive value for infection in asymptomatic women. Family Medicine. 1992;24(6):447. - PubMed
    1. Malik SN, Wilkinson EJ, Drew PA, Hardt NS. Benign cellular changes in Pap smears, Causes and significance. Acta Cytol. 2001;45(1):5. - PubMed

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