clinical management of patients with
TRANSCRIPT
Clinical Management of Patients with Abnormal Pathology Report of Uterine Cervix
Fatemeh Nili Assistant Professor of Pathology
Imam Khomeini Hospital Complex
Tehran University of Medical Sciences
Azam-Sadat MousaviProfessor of Gynecology Oncology
Imam Khomeini Hospital Complex
Tehran University of Medical Sciences
1) Unsatisfactory for Evaluation
• A 34 year old woman with this cytology smear
Clinical approach…
Refer for colposcopy
After 2 consecutives unsatisfactory test
1) Unsatisfactory for Evaluation/partially obscured by…..
2) Absence of Endocervical / T-zone component
Clinical approach?
3) ASCUS versus Reactive cellular change in association with inflammation
ASCUS: Triage
HPV Test : Neg ;surveillant 1 year
4) ASCUS versus LSIL
Contin…..
Recommendation of Surveillance
ASCUS HPV Negative
LSIL HPV Negative
NILM HPV Positive
•Of 1473 interpretations as ASCUS, only 43% were concordant with QC results
• 38% were negative
•Histologic interpretative reproducibility on biopsies was not better
• 41% of originally diagnosed CIN1 were negative on QC results
5) Positive HPV test and negative biopsy• A 34 year old woman with ASCUS in cytology, positive HPV test (type 58)
and this biopsy
5) ASC-H versus HSIL
High grade test result: CIN3+ >25%
ASC-H
H-SIL
AGC
REFER FOR COLPOSCOPY
A
B
6) Atypical Endocervical/Endometrial/Glandular Cell, NOS
A
B
Management of AIS
Thanks