Clinical Management of Patients with Abnormal Pathology Report of Uterine Cervix

Fatemeh Nili Assistant Professor of Pathology

Imam Khomeini Hospital Complex

Tehran University of Medical Sciences

Azam-Sadat MousaviProfessor of Gynecology Oncology

Imam Khomeini Hospital Complex

Tehran University of Medical Sciences

1) Unsatisfactory for Evaluation

• A 34 year old woman with this cytology smear

Clinical approach…

Refer for colposcopy

After 2 consecutives unsatisfactory test

1) Unsatisfactory for Evaluation/partially obscured by…..

2) Absence of Endocervical / T-zone component

Clinical approach?

3) ASCUS versus Reactive cellular change in association with inflammation

ASCUS: Triage

HPV Test : Neg ;surveillant 1 year

4) ASCUS versus LSIL

Contin…..

Recommendation of Surveillance

ASCUS HPV Negative

LSIL HPV Negative

NILM HPV Positive

•Of 1473 interpretations as ASCUS, only 43% were concordant with QC results

• 38% were negative

•Histologic interpretative reproducibility on biopsies was not better

• 41% of originally diagnosed CIN1 were negative on QC results

5) Positive HPV test and negative biopsy• A 34 year old woman with ASCUS in cytology, positive HPV test (type 58)

and this biopsy

5) ASC-H versus HSIL

High grade test result: CIN3+ >25%

ASC-H

H-SIL

AGC

REFER FOR COLPOSCOPY

A

B

6) Atypical Endocervical/Endometrial/Glandular Cell, NOS

A

B

Management of AIS

Thanks