Type of Preparation: Conventional Magnification: Medium Interpretation: NILM: Reactive cellular changes associated with IUD Cytomorphologic Criteria: Note small cluster of glandular cells with cytoplasmic vacuoles displacing nuclei. The cytoplasmic vacuoles may displace the nucleus, creating a signet-ring appearance. Explanatory Notes: The cells may be shed as clusters or singly. Clusters such as these may mimic cells from adenocarcinoma. One should diagnose adenocarcinoma with caution in the presence of an IUD. If in doubt, consider repeat sampling after removal of the IUD.