Cervix - Cytology
Benign / nonneoplastic lesions
Arias-Stella reaction

Author: Farnaz Hasteh, M.D. (see Authors page)

Revised: 18 April 2017, last major update November 2010

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PubMed search: Arias Stella reaction

Cite this page: Arias-Stella reaction. PathologyOutlines.com website. http://pathologyoutlines.com/topic/cervixcytologyAriasStella.html. Accessed April 24th, 2017.
Definition / General
  • Pregnancy related changes that without a clinical history may appear worrisome, including cytomegaly, enlarged nuclei, smudgy chromatin, frequent nuclear inclusions, prominent nucleoli
Clinical Features
  • Often overdiagnosed as SIL, but pregnant women with atypical glandular lesions (AGUS) may have SIL on subsequent biopsy (Acta Cytol 2001; 45:294)
  • Arias-Stella changes disappear after pregnancy
  • Pathologists are often not told patient is pregnant or post-partum (Acta Cytol 1995; 39:905 )
Case Reports
Cytology Description
  • Cytomegaly with dense variable cytoplasm, nucleomegaly, high N/C ratio, round/oval nuclei with smudgy chromatin, frequent nuclear inclusions, prominent nucleoli
  • No crowding, no mitosis
Micro Images
Histology (not cytology) images of endometrium (not cervix)

Differential Diagnosis
  • Clear cell adenocarcinoma: clinical mass, desmoplasia, infiltrative, high N/C ratio, marked atypia, mitotic figures (Am J Surg Pathol 2004;28:608)
  • Radiation or chemotherapy induced changes
  • Glandular atypia