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Pap Smear Interpretation and Management of Abnormals

Interpretation of Pap smear reports can be challenging at times. Unfortunately, the terminology or language of Pap smears is complex, changing, and not uniformly applied.

The following are links to explanations of different results you might see on a Pap smear. While not all-encompassing, it includes all of the common descriptive terms. I also included some of the older terminology in the event you may encounter it.

Organizational Listing (Bethesda 2001 System) SPECIMEN ADEQUACY Satisfactory for evaluation Unsatisfactory for evaluation Specimen rejected/not processed GENERAL CATEGORIZATION Negative for intraepithelial lesion or malignancy Epithelial cell abnormality Other Negative for Intraepithelial Lesion or Malignancy Atrophy Trichomonas vaginalis Fungal oganisms morphologically consistent with Candida species Shift in flora suggestive of bacterial vaginosis Bacteria morphologically consistent with Actinomyces species Cellular changes consistent with herpes simplex virus Reactive cellular changes associated with: Inflammation (includes typical repair) Radiation Intrauterine contraceptive device Glandular cells status posthysterectomy Atrophy Epithelial Cell Abnormalities Squamous cell Atypical squamous cells (ASC) of undetermined significance (ASC-US) cannot exclude HSIL (ASC-H) Low-grade squamous intraepithelial lesion (LSIL) encompassing: human papillomavirus/mild dysplasia/cervical intraepithelial neoplasia (CIN) 1 High-grade squamous intraepithelial lesion (HSIL) encompassing: moderate and severe dysplasia, carcinoma in situ; CIN 2 and CIN 3 Squamous cell carcinoma Glandular cell Atypical glandular cells (AGC) (specify endocervical, endometrial, or not otherwise specified) Atypical glandular cells, favor neoplastic (specify endocervical or not otherwise specified) Endocervical adenocarcinoma in situ (AIS) Adenocarcinoma Other (Includes some older terminology) Endometrial cells in a woman 40 years of age Dysplasia Carcinoma-in-Situ Chlamydia CIN CIS Coccoid Bacteria Condyloma Drying Artifact Endocervical Cells Estrogen Effect Inadequate Smear Inconclusive Smear Koilocytosis Leptothrix Nuclear Atypia SIL Squamous Metaplasia

Alphabetical Listing Actinomyces Adenocarcinoma AGC AIS ASC ASC-H ASC-US Atrophy Atypical glandular cells Atypical glandular cells, favor neoplastic Atypical squamous cells Atypical squamous cells of undetermined significance Bacterial vaginosis Candida Cannot exclude ASC-H Carcinoma-in-situ Cervical intraepithelial neoplasia Chlamydia CIN CIN 1 CIN 2 CIN 3 CIS Coccoid bacteria Colposcopy Condyloma Drying artifact Dysplasia Endocervical cells Endocervical adenocarcinoma in situ Endometrial cells Epithelial cell abnormality Estrogen effect Fungal oganisms Gardnerella Glandular cell Herpes High grade squamous intraepithelial lesion HPV HSIL Human Papilloma Virus Inadequate Smear Inconclusive Smear Inflammation Invasive cancer of the cervix IUD Koilocytosis Leptothrix LSIL Low grade squamous intraepithelial lesion Mild dysplasia Moderate dysplasia Monilia Negative for intraepithelial lesion or malignancy Nuclear atypia Radiation Reactive changes Repair SIL Satisfactory Severe dysplasia Specimen rejected/not processed Squamous cell Squamous cell carcinoma Squamous intraepithelial neoplasia Squamous metaplasia Trichomonas Unsatisfactory Yeast

OB-GYN 101: Introductory Obstetrics & Gynecology
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