Type of Preparation: Conventional Magnification: High Clinical History: 54 year old woman 4 months s/p radiation therapy for Stage I cervical cancer Interpretation: Atypical endocervical cells Cytomorphologic Criteria: Sheet of abnormal cells with markedly pleomorphic nuclei (vary widely in size and shape) and prominent nucleoli. Chromatin is finely granular and cell borders are fairly distinct. Occasional cytoplasmic vacuoles are noted. Explanatory Notes: Ionizing radiation therapy may produce striking atypias in the endocervical epithelium that can mimic residual carcinoma. This degree of atypia usually resolves within 18 months after completion of therapy. Follow-up: Changes became less severe over time on follow-up Pap smears. Findings are compatible with post radiation atypia