INTERPRETATION / RESULT

EPITHELIAL CELL ABNORMALITIES

GLANDULAR CEL
• Atypical
- Endocervical cells ( NOS or specify in comments)
- Endometrial cells (NOS or specify in comments)
- Glandular cells (NOS or specify in comments)
• Atypical
- Endocervical cells, favor neoplastic
- Glandular cells, favor neoplastic
• Endocervical adenocarcinoma in situ
• Adenocarcinoma
- Endocervical
- Endometrial
- Extrauterine
- Not otherwise specified (NOS)
 INTERPRETATION / RESULT

EPITHELIAL CELL ABNORMALITIES

 GLANDULAR CELL
- endocervical, endometrial or undetermined origin
- “of undetermined significance” (AGUS) qualifier –
eliminated
- “favor reactive” qualifier – eliminated
- “favor neoplastic” qualifier – retained
- “endocervical adenocarcinoma in situ”→ added as a
discrete interpretation/diagnosis
- “atypical endocervical cells, probably AIS”
- “atypical epithelial cells, NOS”
 Endocervical
adenocarcinoma
in situ
Atypical endocervical cells,
favor neoplastic
Atypical endocervical cells,
NOS
Atypical endometrial cells,
NOS
ATYPICAL GLANDULAR CELLS

Rates should be less than 1%

 Endocervical
adenocarcinoma
 Endometrial
adenocarcinoma
 Extrauterine
adenocarcinoma
Other Malignant Neoplasms
HORMONAL EVALUATION
crude measure of estrogen-like effect on
squamous cells
not reproducible
does not correlate with symptoms or
plasma estrogen levels
require a separate vaginal wall smear
often inappropriately requested on cervical
specimens
requests are rarely accompanied by
appropriate clinical information
HORMONAL EVALUATION
deleted
practitioners should be discouraged
from using this crude evaluation in
clinical practice
estrogen effect should not be used
within the context of the
cervical/vaginal cytology screening
report
 RECOMMENDATIONS,
EDUCATIONAL NOTES AND
DISCLAIMERS
optional
should be directed by the laboratory
to the provider who requested the
test
should be concise and consistent
with clinical follow-up guidelines
published by professional
organizations (references to relevant
publications may be included)
 RECOMMENDATIONS,
EDUCATIONAL NOTES
AND DISCLAIMERS
When appropriate:
when further procedures would be helpful to
clarify ambiguous morphologic findings
e.g. Atypical Glandular Cells
Recommendation: As a significant
percentage of patients with this
interpretation have underlying high-grade
squamous or glandular intraepithelial
abnormalities, further diagnostic patient
follow-up procedures are suggested as
clinically indicated.
 RECOMMENDATIONS,
EDUCATIONAL NOTES
AND DISCLAIMERS
When appropriate:
to improve the quality of a specimen following
one of limited adequacy
e.g. Unsatisfactory due to lack of cellular
material and air-drying artifact (in a post-
menopausal woman)
Recommendation: A short course of estrogen
cream is suggested before obtaining a repeat
specimen in order to induce maturation of the
squamous epithelium.
 RECOMMENDATIONS,
EDUCATIONAL NOTES
AND DISCLAIMERS
When appropriate:
to identify patients with certain interpretations
that require further triage and potential
subsequent management
e.g. Endometrial cells present.
Educational Note: Endometrial cells after age 40,
particularly out of phase or after menopause, may be
associated with benign endometrium, hormonal
alterations and less commonly, endometrial/uterine
abnormalities. Clinical correlation is recommended.
 AUTOMATED REVIEW
 Computer-assisted cervical cytology
interpretation
 Instrumentation used and result
should be specified in the report
 Name/s of cytotechnologist and/or
pathologist
 Raw data
 Data verification
 ANCILLARY TESTING
 HPV DNA Testing – PCR, ISH, Hybrid
Capture
 Specific or multiple HPV types
 Differing sensitivity and specificity
 Useful in the triage of women with ASCUS
 Brief description of the method
 Reported in a manner conducive to clinical
understanding
 Integrated report
 Thank you
very much
for listening !