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Atlas Interpretation:
Interpreted image
Type of Preparation:


Clinical History:
42 year old woman, LMP 2 weeks


Cytomorphologic Criteria:
This large cluster of cells exhibits a loss of polarity, nuclear enlargement and coarsely granular chromatin. Together with a high nuclear to cytoplasmic ratio, a diagnosis of HSIL is warranted. Some nuclei display discrete nucleoli.

Explanatory Notes:
Although uncommon, nucleoli may be seen in HSIL, especially with extension into endocervical gland spaces. The chromatin may also appear less coarsely granular in these cases. Thus the presence of nucleoli in dysplastic squamous cells in itself is not a specific morphologic indicator of "invasion" in a squamous epithelial abnormality.

Bethesda Interobserver Reproducibility Data:
NILM: Negative for Intraepithelial Lesion or Malignancy # people picked NILM: Negative for Intraepithelial Lesion or Malignancy 26 5%
Endometrial cells in a woman >= 40 # people picked Endometrial cells in a woman >= 40 75 14%
ASC-US # people picked ASC-US 2 0%
ASC-H # people picked ASC-H 14 3%
LSIL # people picked LSIL 1 0%
HSIL # people picked HSIL 99 18%
Invasive Squamous Cell Carcinoma # people picked Invasive Squamous Cell Carcinoma 17 3%
Atypical Endocervical Cells # people picked Atypical Endocervical Cells 128 23%
Atypical Endometrial Cells # people picked Atypical Endometrial Cells 85 15%
Adenocarcinoma in situ (AIS), Endocervical # people picked Adenocarcinoma in situ (AIS), Endocervical 66 12%
Adenocarcinoma # people picked Adenocarcinoma 41 7%
554 interpretations were submitted.

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