Document Detail

Histology correlation with atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) cytology diagnoses: An argument to ensure ASCUS follow-up that is as aggressive as that for LSIL.
MedLine Citation:
PMID:  10495326     Owner:  NLM     Status:  MEDLINE    
The purpose of the present study was to compare histology outcomes of cytological atypical squamous cells of undetermined significance (ASCUS) to the histology outcomes of cytological low-grade squamous intraepithelial lesion (LSIL). Cases with a cytology diagnosis of ASCUS and LSIL that had correlative histology obtained within 3 mo of the cervico-vaginal smear were accrued from the files of the Cytology and Histology Departments of Mercy Hospital Medical Center (Des Moines, IA). All of the cytology cases were examined by a cytotechnologist, a cytopathologist, and the histopathologist who signed out the biopsy material. The laboratory's benign: ASCUS: LSIL: HSIL + ratio was 94.0%: 3.8%: 1.5%: 0.7% for the time period of this analysis; its ASCUS:SIL proportion was 1.76. Histology correlations to 249 ASCUS cases showed 45 (18%) CIN2s (cervical intraepithelial neoplasm 2) or CIN3s, 134 (54%) CIN1s, and 70 (28%) nonneoplastic biopsies. Ten of 24 (42%) ASCUS cases that showed histological CIN3 and seven of 21 (33%) ASCUS cases that showed histological CIN2 contained atypical immature squamous metaplastic cells, while the remainder showed squamous cells with mature, superficial/intermediate-type cytoplasm. Histology correlations to 576 LSIL cases showed 96 (17%) CIN2s or CIN3s, 397 (69%) CIN1s, and 83 (14%) nonneoplastic biopsies. One hundred forty-six (59%) ASCUS and 424 (74%) LSILs had histological koilocytosis with nuclear atypia (KA); the sole histological finding of KA was seen among 76 (30.5%) ASCUS and 146 (25.3%) LSIL cases. The majority of cytological ASCUS and LSIL cases selected by clinicians for biopsy have histological CIN and a substantial minority show CIN2 and CIN3, which, in the case of ASCUS, is frequently associated with atypical immature squamous metaplastic cells. There is a high prevalence of histological KA among ASCUS and LSIL cases. Diagn. Cytopathol. 21:292-295, 1999.
K A Dvorak; M Finnemore; J A Maksem
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Diagnostic cytopathology     Volume:  21     ISSN:  8755-1039     ISO Abbreviation:  Diagn. Cytopathol.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-10-26     Completed Date:  1999-10-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8506895     Medline TA:  Diagn Cytopathol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  292-5     Citation Subset:  IM    
Copyright Information:
Copyright 1999 Wiley-Liss, Inc.
School of Cytotechnology, Mercy Hospital Medical Center, Des Moines, Iowa 50314, USA.
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MeSH Terms
Cervical Intraepithelial Neoplasia / diagnosis*,  pathology*
Cervix Uteri / pathology*
Diagnosis, Differential
Neoplasms, Squamous Cell / diagnosis*,  pathology*
Retrospective Studies
Uterine Cervical Neoplasms / diagnosis*,  pathology*
Vaginal Smears*

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