Clinical Management of Patients with
Transcript of Clinical Management of Patients with
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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
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1) Unsatisfactory for Evaluation
• A 34 year old woman with this cytology smear
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Clinical approach…
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Refer for colposcopy
After 2 consecutives unsatisfactory test
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1) Unsatisfactory for Evaluation/partially obscured by…..
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2) Absence of Endocervical / T-zone component
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Clinical approach?
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3) ASCUS versus Reactive cellular change in association with inflammation
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ASCUS: Triage
HPV Test : Neg ;surveillant 1 year
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4) ASCUS versus LSIL
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Contin…..
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Recommendation of Surveillance
ASCUS HPV Negative
LSIL HPV Negative
NILM HPV Positive
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•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
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5) Positive HPV test and negative biopsy• A 34 year old woman with ASCUS in cytology, positive HPV test (type 58)
and this biopsy
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5) ASC-H versus HSIL
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High grade test result: CIN3+ >25%
ASC-H
H-SIL
AGC
REFER FOR COLPOSCOPY
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A
B
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6) Atypical Endocervical/Endometrial/Glandular Cell, NOS
A
B
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Management of AIS
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Thanks