Title | Underrecognized Patterns of High-Grade Squamous Intraepithelial Lesion on ThinPrep Preparations. |
Publication Type | Journal Article |
Year of Publication | 2021 |
Authors | Goyal A, Heymann JJ, Alperstein SA, Siddiqui MT |
Journal | Am J Clin Pathol |
Volume | 156 |
Issue | 2 |
Pagination | 300-312 |
Date Published | 2021 07 06 |
ISSN | 1943-7722 |
Keywords | Adult, Female, Humans, Middle Aged, Squamous Intraepithelial Lesions, Squamous Intraepithelial Lesions of the Cervix, Vaginal Smears |
Abstract | OBJECTIVES: To identify less readily identifiable patterns of high-grade squamous intraepithelial lesions (HSIL) in negative human papillomavirus (HPV)-positive Papanicolaou (Pap) tests on ThinPrep preparations. METHODS: Of all HPV-positive Pap tests that were negative for intraepithelial lesion or malignancy (NILM) from July 2013 to June 2018, those with HSIL on subsequent histology within 6 months were identified. ThinPrep slides from the latter group (group 1) and from NILM HPV-negative Pap tests with negative follow-up (group 2) were reviewed independently by 4 participants. Group 1 cases were then reviewed together for consensus and with the ThinPrep Imaging System (TIS). Any discrepancies from the original interpretation were recorded. RESULTS: The study cohort included 57 cases each in groups 1 and 2. On final review of group 1 cases, 17 (29.8%) were classified as NILM or unsatisfactory. Of the remaining, 4 cases revealed rare abnormal cells not flagged by the TIS in the fields of view. In the 36 cases (63.1%) with screening or interpretative errors, the key cytologic findings accounting for major discrepancies included atypical metaplastic cells, atypical repair, rare syncytial groups, and atypical immature metaplastic cells. CONCLUSIONS: There are 3 main underrecognized patterns of HSIL in cervical cytology: atypical metaplastic cells, atypical repair, and rare syncytial groups. |
DOI | 10.1093/ajcp/aqaa237 |
Alternate Journal | Am J Clin Pathol |
PubMed ID | 33630033 |
Related Faculty:
Abha Goyal, M.D. Jonas Heymann, M.D. Momin Siddiqui, M.D.