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Pap smear terminology common causes of abnormal Paps

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Updated March 29, 2010

More terms you may see on your Pap smear report:

  • Within normal limits This is good!

  • Benign cellular changes; see descriptive diagnosis

  • Epithelial cell abnormality; see descriptive diagnosis

Descriptive Diagnosis:

  • Benign cellular changes These are the most common reason for abnormal Pap smears.
    • Infection:
      • Trichomonas vaginalis

      • Fungal organisms morphologically consistent with Candida

      • Predominance of coccobacilli consistent with shift in vaginal flora-suggestive of but not a definitive diagnosis of bacterial vaginosis.

      • Bacteria morphologically consistent with Actinomyces- actinomyces is a rod-shaped bacteria. This result is associated with an infection.

      • Cellular changes associated with herpes simplex virus

      • Other

      Reactive cellular changes associated with:

      • Inflammation (includes typical repair)

      • Atrophy with inflammation ("atrophic vaginitis")

      • Radiation

      • Intrauterine contraceptive device (IUD)

      • Other

      Epithelial Cell Abnormalities

      • Squamous cell:
        • Atypical squamous cells of undetermined significance (ASCUS): qualify*

        • Low-grade squamous intraepithelial lesion (LSIL) encompassing HPV** mild dysplasia/CIN 1

        • High-grade squamous intraepithelial lesion (HSIL) encompassing moderate and severe dysplasia, CIS/CIN 2, and CIN

        • Squamous cell carcinoma

        Glandular cell:

        • Endometrial cells, cytologically benign, in a postmenopausal woman

        • Atypical glandular cells of undetermined significance: should be qualified as to whether a reactive or a premalignant/malignant process is favored

        • Endometrial adenocarcinoma

        • Extrauterine adenocarcinoma

        • Adenocarcinoma, not otherwise specified

        • Other malignant neoplasms: specify

        Hormonal evaluation

        This is for women who have vaginal smears only:
        • Hormonal pattern compatible with age and history

        • Hormonal pattern incompatible with age and history; specify

        • Hormonal evaluation not possible due to...(specify)

        It's important to remember that in the majority of cases abnormal Pap smear results do not mean you have cancer. The number of deaths due to cervical cancer decreased dramatically in the last half of the 20th century due to yearly cervical cancer screening. In fact, the Pap smear is the only screening tool for cancer that has caused such a significant decrease in the number of deaths from any type of cancer.

        Annual Pap smear screening and follow up as recommended by your physician are your best tool against future cervical cancer, and survival if cervical cancer is detected. All women who are age 18 or older must have yearly pelvic exams that include a Pap smear. Women who are younger than 18 and are sexually active should schedule an appointment for a pelvic exam and Pap smear whenever they become sexually active.

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