Prevalence, identification and significance of fiber contaminants in cervical smears.

OBJECTIVE

To determine the prevalence of fiber contaminants, to provide morphologic descriptions of various fiber types and to try to understand the significance of their presence in cervical smears.

STUDY DESIGN

Fibers from cotton swab tips, hair, cardboard slide transporters, Cytobrush bristles and three commercial brands of tampons were smeared onto glass slides, Papanicolaou stained and examined. Then a prospective study of consecutively screened cervicovaginal smears from 1,368 women was undertaken to identify fiber contaminants.

RESULTS

Fibers were identified in 178 cases (13%). In 120, the fibers were considered extrinsic, commonly having the microscopic features of cardboard. In 58, the fibers were considered to be intrinsic to the smear because of their presence in the same plane and alignment as the cells, an associated inflammatory cell reaction, and adherent or absorbed cellular products, occasionally hemosiderin. The most common intrinsic fibers were cotton and rayon. No statistically significant relationship was identified for the presence of intrinsic fibers and patients' ages, stated menstrual dates or pathologic lesions.

CONCLUSION

Fiber contaminants are commonly present in cervicovaginal smears, usually do not originate in the patient (are "extrinsic") and have no pathologic significance. Knowledge of the microscopic features of fiber contaminants enables them to be identified confidently and distinguished from fungal hyphae and other filamentous pathogens.