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Atlas Interpretation:
Interpreted image
Type of Preparation:


Clinical History:
43 year old, routine smear

NILM: Tubal metaplasia

Cytomorphologic Criteria:
Columnar endocervical cells may occur in small groups or pseudostratified, often crowded groups. Nuclei are round to oval and may be enlarged, pleomorphic and hyperchromatic Chromatin is evenly distributed and nucleoli are usually not seen. N/C ratio can be high. The cytoplasm can show discrete vacuoles or goblet cell change (seen here).

Explanatory Notes:
Tubal metaplasia is a normal phenomenon in endocervical canal and includes ciliated columnar cells, peg cells and goblet cells. It is important to recognize that enlarged and/or crowded nuclei and nuclear stratification may lead to an interpretation of atypical endocervical cells unless terminal bars and cilia are identified.

Bethesda Interobserver Reproducibility Data:
NILM: Negative for Intraepithelial Lesion or Malignancy # people picked NILM: Negative for Intraepithelial Lesion or Malignancy 437 92%
Endometrial cells in a woman >= 40 # people picked Endometrial cells in a woman >= 40 1 0%
ASC-US # people picked ASC-US 2 0%
ASC-H # people picked ASC-H 0 0%
LSIL # people picked LSIL 0 0%
HSIL # people picked HSIL 1 0%
Invasive Squamous Cell Carcinoma # people picked Invasive Squamous Cell Carcinoma 0 0%
Atypical Endocervical Cells # people picked Atypical Endocervical Cells 28 6%
Atypical Endometrial Cells # people picked Atypical Endometrial Cells 0 0%
Adenocarcinoma in situ (AIS), Endocervical # people picked Adenocarcinoma in situ (AIS), Endocervical 5 1%
Adenocarcinoma # people picked Adenocarcinoma 1 0%
475 interpretations were submitted.

See Also: thumbnail for figure DS-306.jpg
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