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Atlas Interpretation:
Interpreted image
Type of Preparation:
ThinPrep/ LBP


Clinical History:
32 year old with prior abnormal Pap test


Cytomorphologic Criteria:
Clusters of abnormal squamous cells may be seen in ?spike-like? aggregates. These clusters should be classified as NILM, ASC, or SIL based on the degree of nuclear abnormalities. This patient had an LSIL interpretation on a conventional smear, two months prior to this LBP, that was interpreted as ASC-US (atypical PK).

Explanatory Notes:
Limited personal experiences suggest that this pattern is more frequent in liquid based preparations. It has been hypothesized that it may represent the Pap Test equivalent of a histologic "condylomatous spike". Limited correlation with HPV testing suggests that cases showing this pattern (and without obvious SIL elsewhere in the Pap test) can be positive for high-risk HPV.

Bethesda Interobserver Reproducibility Data:
NILM: Negative for Intraepithelial Lesion or Malignancy # people picked NILM: Negative for Intraepithelial Lesion or Malignancy 43 9%
Endometrial cells in a woman >= 40 # people picked Endometrial cells in a woman >= 40 0 0%
ASC-US # people picked ASC-US 289 58%
ASC-H # people picked ASC-H 55 11%
LSIL # people picked LSIL 82 16%
HSIL # people picked HSIL 22 4%
Invasive Squamous Cell Carcinoma # people picked Invasive Squamous Cell Carcinoma 7 1%
Atypical Endocervical Cells # people picked Atypical Endocervical Cells 0 0%
Atypical Endometrial Cells # people picked Atypical Endometrial Cells 0 0%
Adenocarcinoma in situ (AIS), Endocervical # people picked Adenocarcinoma in situ (AIS), Endocervical 0 0%
Adenocarcinoma # people picked Adenocarcinoma 0 0%
498 interpretations were submitted.

See Also: thumbnail for figure LSILSP-4.jpg
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