Epithelial Cell Abnormalities: Squamous

Henry, Michael R.; Russell, Donna; Luff, Ronald D.; Prey, Marianne U.; Nayar, Ritu

doi:10.1007/978-3-319-11074-5_5

Cited by 11 publications

(18 citation statements)

References 39 publications

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“…Pap tests were reviewed by cytopathologists blinded to these proportions. Reviewers were asked to provide a cytologic interpretation according to The Bethesda System (TBS) for reporting cervical cytology [10,11]. For SMILE-dominant (≥50%) cases, a separate review for a defined set of architectural, cellular and background features was performed (W.R.G., Z.G., V.D., H.M.K.…”

Section: Methodsmentioning

confidence: 99%

Stratified Mucin-Producing Intraepithelial Lesion of the Cervix: Subtle Features Not to Be Missed

Schwock

Ko²,

Dubé³

et al. 2016

Acta Cytologica

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Objectives: Stratified mucin-producing intraepithelial lesion (SMILE) is an uncommon premalignant lesion of the uterine cervix. A detailed examination of preinvasive SMILE cases including a comparison of the cytologic features with usual-type adenocarcinoma in situ (AIS) and human papillomavirus (HPV) genotyping was performed. Study Design: Excisions and preceding Papanicolaou (Pap) tests were retrieved from the files of 2 tertiary care centers. Histologic review estimated the lesional SMILE proportion. Pap tests were reviewed and assessed for architectural, cellular and background features. Cobas® HPV test was performed. Results: 13 cases were identified. Mean/median patient age was 35/33 years (range 23-51 years). Concurrent high-grade squamous intraepithelial lesion was found in 10/13 (77%) and AIS in 8/13 (62%) cases. In 6 cases, SMILE was dominant (≥50%) and represented in 5/6 corresponding Pap tests. Cytology interpretations differed more often in the SMILE-dominant group (p < 0.05). SMILE and AIS had overlapping features. Feathering and prominent nucleoli were absent in SMILE. HPV DNA was detected in all 12 cases tested. HPV 18 was most common (7/12). Excisions with positive/suspicious margins were reported in 5/6 SMILE-dominant versus 3/7 nondominant cases. Conclusion: SMILE is best considered as an AIS variant for cytologic, etiologic and management purposes. Cytologic features overlap with AIS, but are more subtle and easily missed. HPV testing may play a role in facilitating SMILE detection.

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Section: Methodsmentioning

confidence: 99%

Stratified Mucin-Producing Intraepithelial Lesion of the Cervix: Subtle Features Not to Be Missed

Schwock

Ko²,

Dubé³

et al. 2016

Acta Cytologica

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“…While the diagnostic cytological and histological features of endocervical adenocarcinoma (EAC) and endocervical adenocarcinoma in situ (AIS) are defined by The Bethesda System for Reporting Cervical Cytology (5) and the WHO Classification of the Tumours of Female Reproductive Organs (6), respectively, there are currently no accepted lower grade precursor lesions for adenocarcinoma like there are the intraepithelial neoplasias for cervical squamous cell carcinoma (5)(6)(7)(8). In cytological cervical samples, a large amount of the lesions behind glandular diagnoses (atypical endocervical cells, NOS, atypical endocervical cells, favour neoplastic, endocervical adenocarcinoma in situ and endocervical adenocarcinoma) are non-neoplastic or of squamous or endometrial origin or other carcinomas leading to a low screening specificity for EAC and AIS (9)(10)(11)(12)(13)(14)(15)(16)(17).…”

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confidence: 99%

The role of Pap smear in the diagnostics of endocervical adenocarcinoma

Pulkkinen

Huhtala

Kholová

2021

APMIS

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In the high‐income countries, the amount of cervical adenocarcinomas is on the rise. The pap smear sampling has a low sensitivity and a low specificity for endocervical malignancies, and there are only a few cytomorphological features, that are specifically associated with glandular atypia. In this study, 298 pap smears of 60 patients with endocervical adenocarcinoma or adenocarcinoma in situ (AIS) and 30 patients with high‐grade intraepithelial lesion (HSIL) in histology were reviewed. The pap smear type (screening/clinical), the HPV status and the time from sampling to the histological confirmation of diagnosis were recorded for each case. Despite that no cytomorphological features could be associated with adenocarcinoma statistically, 70% of the pap smears were initially correctly diagnosed as an endocervical glandular lesion. Palisading cell borders, nuclear pleomorphism and the lack of single atypical cells present simultaneously were found to be associated with adenocarcinoma and AIS with the corresponding ORs of 5.89 (95% CI 1.96–17.70), 3.71 (95% CI 1.14–12.02) and 10.76 (95% CI 1.20–59.50). This combination of features was seen in smears taken up to 5 years before the histological diagnosis. Of all our screening samples, 10.9% were HPV‐positive. There were no HPV‐negative samples among patients with adenocarcinoma.

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“…They sometimes present finely granular chromatin but rarely hypochromasia and no or inconspicuous nucleolus. Such cells fall into the LSIL category as defined by the 2014 Bethesda classification . We are fully aware of the fact that bizarre cells of the ectocervix, as described above, may defy straightforward cytological classification in terms of the 2014 Bethesda classification.…”

Section: Discussionmentioning

confidence: 99%

“…This specific morphological cell type is not fully discussed in the third edition of the Bethesda classification. Nonetheless, a single picture resembling this type of cells is included (Figure 5.3 on page 139) and properly described but ultimately designated LSIL. In routine LBC practice, the dominant feature of LSIL is easily and accurately identified, and then a search for individual parabasal cells with possible atypia follows.…”

Section: Discussionmentioning

confidence: 99%

“…However, identifying such cases as LSIL would lead to some delay, as LSIL management consists of repeated pap smears according to most of the European and Northern American guidelines . The current third edition of the Bethesda system places bizarre cells, as we described them above, implicitly into the LSIL category . There are some authors who are in favour of use of the LSIL‐H category; however, such suggestions have not reached a consensus yet .…”

Section: Discussionmentioning

confidence: 99%

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Significance of bizarre cells in cervical screening liquid‐based cytology: A prospective study of 15 cases

Ondič

Ferko

Kičinová³

et al. 2017

Cytopathology

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Objective: The aim of this study was to assess the significance of bizarre cells (cells of squamous origin with a superficial squamous cell-type cytoplasm and characterised by multinucleation that produces bizarre nuclear shapes) in liquid-based cytology (LBC) Papanicoaou (pap) smears with clinical and histological follow-up correlation.Methods: Fifteen patients, all with LBC samples containing bizarre cells, were identified in routine ThinPrep â LBC workload. HPV testing was performed in each case using residual LBC material. Cytological-histological correlations were reviewed. In this study, we have taken a step further to prospectively identify LBC pap smear cases containing bizarre cells as described earlier

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Epithelial Cell Abnormalities: Squamous

Cited by 11 publications

References 39 publications

Stratified Mucin-Producing Intraepithelial Lesion of the Cervix: Subtle Features Not to Be Missed

Stratified Mucin-Producing Intraepithelial Lesion of the Cervix: Subtle Features Not to Be Missed

The role of Pap smear in the diagnostics of endocervical adenocarcinoma

Significance of bizarre cells in cervical screening liquid‐based cytology: A prospective study of 15 cases

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