3: Name that Pap Result

Question 1

Benign-appearing endometrial cells in in women !45 – require evaluation in postmenopausal women or premenopausal with abnormal bleeding or risk factors for endometrial cancer - risk of adenocarcinoma and endometrial hyperplasia

Answer 1

Negative for Intraepithelial Lesions or Malignancy

Question 2

HPV persistent infection
CIN 2 (moderate dysplasia): Lesion involves one-third to less than two-thirds of the epithelial layer
CIN 3 (severe dysplasia, carcinoma in situ): Lesion involves two-thirds of the epithelial layer to full thickness

Answer 2

High-grade squamous intraepithelial lesion (HSIL)

Question 3

Abnormalities that must be treated aggressively.

Answer 3

Glandular cell abnormalities

Question 4

No epithelial abnormality identified

Answer 4

Negative for Intraepithelial Lesions or Malignancy

Question 5

ASCCP recommendations: 1 of the 3
Follow up now and in 6mo
Reflex HPV-DNA
Colposcopy

Answer 5

Cervical squamous Intraepithelial lesions (CSIL)

Question 6

This term is used when the squamous cells do not appear completely normal but it is not possible to determine the cause of the abnormal cells. A small percentage could have CIN 2 or 3 or invasive cancer.
HPV reflex testing:
If negative, do repeat HPV test in 3 years
If positive, colposcopy

Answer 6

Atypical Squamous Cells of Undetermined Significance (ASC-US)

Question 7

Malignant cells penetrate the basement membrane of the cervical epithelium and infiltrate the stromal tissue (supporting tissue). In advanced cases, cancer may spread to adjacent organs such as the bladder or rectum, or to distant sites in the body via the bloodstream and lymphatic channels.

Answer 7

Squamous carcinoma

Question 8

This finding in a woman 45+ could indicate malignant neoplasm.

Answer 8

Endometrial cells

Question 9

HPV transient infection
CIN 1 (mild dysplasia): Lesion involves the initial one-third of the epithelial layer

Answer 9

Low-grade squamous intraepithelial lesion (LSIL)

Question 10

Cannot exclude HSIL. (5-10%)

Answer 10

ASC-H

Question 11

May find: Trich, BV, Candida, gonorrhea, chlamydia, mechanical/chemical irritation, viral infx

Answer 11

Negative for Intraepithelial Lesions or Malignancy