INTERPRETATION / RESULT

EPITHELIAL CELL ABNORMALITIES
GLANDULAR CEL • Atypical - Endocervical cells ( NOS or specify in comments) - Endometrial cells (NOS or specify in comments) - Glandular cells (NOS or specify in comments) • Atypical - Endocervical cells, favor neoplastic - Glandular cells, favor neoplastic • Endocervical adenocarcinoma in situ • Adenocarcinoma - Endocervical - Endometrial - Extrauterine - Not otherwise specified (NOS)

INTERPRETATION / RESULT
EPITHELIAL CELL ABNORMALITIES
 GLANDULAR CELL - endocervical, endometrial or undetermined origin - “of undetermined significance” (AGUS) qualifier – eliminated - “favor reactive” qualifier – eliminated - “favor neoplastic” qualifier – retained - “endocervical adenocarcinoma in situ”→ added as a discrete interpretation/diagnosis - “atypical endocervical cells, probably AIS” - “atypical epithelial cells, NOS”

Endocervical adenocarcinoma in situ

Atypical endocervical cells, favor neoplastic

Atypical endocervical cells, NOS

Atypical endometrial cells, NOS

ATYPICAL GLANDULAR CELLS

Rates should be less than 1%

Endocervical adenocarcinoma

Endometrial adenocarcinoma

Extrauterine adenocarcinoma

Other Malignant Neoplasms

HORMONAL EVALUATION
crude measure of estrogen-like effect on squamous cells not reproducible does not correlate with symptoms or plasma estrogen levels require a separate vaginal wall smear often inappropriately requested on cervical specimens requests are rarely accompanied by appropriate clinical information

HORMONAL EVALUATION
deleted practitioners should be discouraged from using this crude evaluation in clinical practice estrogen effect should not be used within the context of the cervical/vaginal cytology screening report

optional should be directed by the laboratory to the provider who requested the test should be concise and consistent with clinical follow-up guidelines published by professional organizations (references to relevant publications may be included)

RECOMMENDATIONS, EDUCATIONAL NOTES AND DISCLAIMERS

RECOMMENDATIONS, EDUCATIONAL NOTES AND DISCLAIMERS
When appropriate: when further procedures would be helpful to clarify ambiguous morphologic findings e.g. Atypical Glandular Cells Recommendation: As a significant percentage of patients with this interpretation have underlying high-grade squamous or glandular intraepithelial abnormalities, further diagnostic patient follow-up procedures are suggested as clinically indicated.

RECOMMENDATIONS, EDUCATIONAL NOTES AND DISCLAIMERS
When appropriate: to improve the quality of a specimen following one of limited adequacy e.g. Unsatisfactory due to lack of cellular material and air-drying artifact (in a postmenopausal woman) Recommendation: A short course of estrogen cream is suggested before obtaining a repeat specimen in order to induce maturation of the squamous epithelium.

RECOMMENDATIONS, EDUCATIONAL NOTES AND DISCLAIMERS
When appropriate: to identify patients with certain interpretations that require further triage and potential subsequent management
e.g. Endometrial cells present. Educational Note: Endometrial cells after age 40, particularly out of phase or after menopause, may be associated with benign endometrium, hormonal alterations and less commonly, endometrial/uterine abnormalities. Clinical correlation is recommended.

AUTOMATED REVIEW

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Computer-assisted cervical cytology interpretation Instrumentation used and result should be specified in the report Name/s of cytotechnologist and/or pathologist Raw data Data verification

ANCILLARY TESTING
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HPV DNA Testing – PCR, ISH, Hybrid Capture Specific or multiple HPV types Differing sensitivity and specificity Useful in the triage of women with ASCUS Brief description of the method Reported in a manner conducive to clinical understanding Integrated report

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