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
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