LAUSR

A 31-year-old female resident of Afghanistan underwent a routine health check-up at Medanta, The Medicity Hospital, Gurgaon. Her obstetric and menstrual history was nonsignificant. She was Para 2 with her last childbirth 1 year ago. Her conventional cervicovaginal smear showed no epithelial abnormality. However, many hematoidin crystals (HCs) were observed in a background of moderate neutrophilic inflammation (Figure 1). HCs, also known as crystalline bodies and hematoidin cockleburs, have a characteristic morphology. They are rosette-shaped with radially arranged fine needle-like crystals measuring 2 to 200 μm with a peripheral club-like thickening and show golden to reddish brown staining with Pap stain. On electron microscopy, HCs have a core of empty clefts, suggestive of cholesterol crystals surrounded by myelinoid membrane aggregates. HCs are derived from the breakdown of hemoglobin in tissues harboring old hemorrhage. They lack iron in comparison with a closely associated pigment bilirubin. Few authors have suggested a morphological, histochemical, and immunohistochemical resemblance of HCs to pseudoactinomycotic radiate granules found in uterine curettings from patients using intrauterine devices. HCs show positive staining with Periodic and Schiff stain and negative staining with Perls' stain. HCs are rarely seen in cervicovaginal smears and more frequently associated with pregnancy and postpartum states although may be observed in nonpregnant females also. However, they do not hold any clinical significance. The case is reported due to its paucity in the published literature. As mentioned by Kapila et al, HCs are a forgotten entity.