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Atlas Interpretation:
Interpreted image
Type of Preparation:
Conventional

Magnification:
Medium

Clinical History:
A 45 year old female for a routine visit

Interpretation:
NILM

Cytomorphologic Criteria:
Lower uterine segment (LUS). Large tissue fragments with a biphasic pattern of glands and spindle cells. Densely packed spindle cells are seen with glands embedded within. Glands are simple, nonbranching, with indistinct cytoplasm and round uniform nuclei.

Explanatory Notes:
The lower uterine segment (LUS) can easily be sampled if the endocervical sampling device is pushed into the endocervical canal far enough to reach the LUS. In isolation, the epithelial fragments may be mistaken for endocervical adenocarcinoma, endocervical adenocarcinoma in situ, tubal metaplasia or reactive endocervical cells. The spindle cells alone may also appear as "hyperchromatic groups" and cause concern. Abraded LUS does not carry the same significance as exfoliated endometrial cells and should not be reported.

Follow-up:
Normal follow up for 5 years

Bethesda Interobserver Reproducibility Data:
NILM: Negative for Intraepithelial Lesion or Malignancy # people picked NILM: Negative for Intraepithelial Lesion or Malignancy 237 51%
Endometrial cells in a woman >= 40 # people picked Endometrial cells in a woman >= 40 144 31%
ASC-US # people picked ASC-US 5 1%
ASC-H # people picked ASC-H 4 1%
LSIL # people picked LSIL 0 0%
HSIL # people picked HSIL 6 1%
Invasive Squamous Cell Carcinoma # people picked Invasive Squamous Cell Carcinoma 1 0%
Atypical Endocervical Cells # people picked Atypical Endocervical Cells 27 6%
Atypical Endometrial Cells # people picked Atypical Endometrial Cells 18 4%
Adenocarcinoma in situ (AIS), Endocervical # people picked Adenocarcinoma in situ (AIS), Endocervical 20 4%
Adenocarcinoma # people picked Adenocarcinoma 5 1%
 
467 interpretations were submitted.

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