Bethesda: Non-neoplastic Findings Flashcards
If there is no cellular evidence of neoplasia within the Pap, what section is that reported in?
- General categorization and/or
- Interpretation/Results
Are organisms or other non-neoplastic findings required to be reported?
No, they are not.
What are some of the normal cellular elements found within Pap tests that must be reported?
- Squamous cells
- Endocervical cells
- Endometrial cells
- Lower uterine segment cells
What are some of the non-neoplastic findings that are cellular variations? (optional to report)
- Squamous metaplasia
- Keratotic changes
- Tubal metaplasia
- Atrophy
- Pregnancy-associated changes
- Glandular cells status post hysterectomy
What types of conditions/situations can you observe reactive cellular changes?
- Inflammation (including typical repair)
- Lymphocytic (follicular) cervicitis
- Radiation
- Intrauterine contraceptive device (IUD)
What organisms can be typically identified on Pap tests?
- Trichomonas vaginalis
- Fungal organisms, morphologically consistent with Candida sp.
- Shift in flora suggestive of bacterial vaginosis
- Bacteria morphologically consistent with Actinomyces sp.
- Cellular changes consistent with herpes simplex virus
- Cellular changes consistent with CMV
NILM: Negative for intraepithelial malignancy category encompasses what types of things?
- spectrum of non-neoplastic changes including:
- protective and reactive responses
- inflammation
- hormonal effects
- colonizing or infectious organisms
When are superficial squamous cells seen?
- proliferative phase of the menstrual cycle
- in the presence of irritation
What is the morphology of the superficial squamous cell?
- highly condensed (pyknotic) nucleus
- abundant, eosinophilic cytoplasm
- keratohyaline granules can be seen in the cytoplasm
- they are red-pink to purple
- they are HMWK protein
When are intermediate squamous cells seen most?
- secretory phase of the menstrual cycle
- they can compose both the superficial and
intermediate cell layers
- they can compose both the superficial and
- very prominent in pregnancy
- seen during the use of progestational agents
What is the morphology of the intermediate cell?
- larger nucleus than that of the superficial cell
- nucleus has finely granular chromatin pattern
- nucleus is often elongated, longitudinal nuclear groove
Why is the intermediate cell so important?
- it is used as the basic size reference for other cells in cervical cytology specimens
When do you seen “naked” intermediate cell nuclei?
- often seen in the second half of the cycle secondary to bacterial cytolysis
When are parabasal cells seen?
- generally NOT present in specimens from a hormonally mature epithelium
- derived from deep cell layers
- can see them in post-menopausal women as well as post-partum
What is the morphology of parabasal cells?
- nuclei are larger than intermediate cells
- cytoplasmic area is smaller
- N:C ratio is higher
- cytoplasmic texture is more granular and dense
