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Pap Smear Interpretation and Management of Abnormals

Interpretation of Pap smear reports can be challenging at times. Unfortunately, the terminology or language of Pap smears is complex, changing, and not uniformly applied.

The following are links to explanations of different results you might see on a Pap smear. While not all-encompassing, it includes all of the common descriptive terms. I also included some of the older terminology in the event you may encounter it.

Organizational Listing (Bethesda 2001 System)

SPECIMEN ADEQUACY

GENERAL CATEGORIZATION

Negative for intraepithelial lesion or malignancy
Epithelial cell abnormality

Other

Negative for Intraepithelial Lesion or Malignancy

Atrophy

Trichomonas vaginalis

Fungal oganisms morphologically consistent with Candida species

Shift in flora suggestive of bacterial vaginosis

Bacteria morphologically consistent with Actinomyces species

Cellular changes consistent with herpes simplex virus

Reactive cellular changes associated with:

Inflammation (includes typical repair)
Radiation
Intrauterine contraceptive device

Glandular cells status posthysterectomy

Atrophy

Epithelial Cell Abnormalities

Squamous cell

Atypical squamous cells (ASC) of undetermined significance (ASC-US)
cannot exclude HSIL (ASC-H)
Low-grade squamous intraepithelial lesion (LSIL) encompassing: human papillomavirus/mild dysplasia/cervical intraepithelial neoplasia (CIN) 1
High-grade squamous intraepithelial lesion (HSIL) encompassing: moderate and severe dysplasia, carcinoma in situ; CIN 2 and CIN 3
Squamous cell carcinoma

Glandular cell

Atypical glandular cells (AGC) (specify endocervical, endometrial, or not otherwise specified)

Atypical glandular cells, favor neoplastic (specify endocervical or not otherwise specified)

Endocervical adenocarcinoma in situ (AIS)

Adenocarcinoma

Other (Includes some older terminology)

Endometrial cells in a woman 40 years of age
Dysplasia
Carcinoma-in-Situ
Chlamydia
CIN
CIS
Coccoid Bacteria
Condyloma
Drying Artifact
Endocervical Cells
Estrogen Effect
Inadequate Smear
Inconclusive Smear
Koilocytosis
Leptothrix
Nuclear Atypia
SIL
Squamous Metaplasia

Alphabetical Listing

Actinomyces
Adenocarcinoma

AGC

AIS

ASC

ASC-H

ASC-US

Atrophy

Atypical glandular cells

Atypical glandular cells, favor neoplastic

Atypical squamous cells

Atypical squamous cells of undetermined significance

Bacterial vaginosis

Candida

Cannot exclude ASC-H

Carcinoma-in-situ

Cervical intraepithelial neoplasia

Chlamydia

CIN

CIN 1

CIN 2

CIN 3

CIS

Coccoid bacteria

Colposcopy

Condyloma

Drying artifact

Dysplasia

Endocervical cells

Endocervical adenocarcinoma in situ

Endometrial cells

Epithelial cell abnormality

Estrogen effect

Fungal oganisms

Gardnerella

Glandular cell

Herpes

High grade squamous intraepithelial lesion

HPV

HSIL

Human Papilloma Virus

Inadequate Smear

Inconclusive Smear

Inflammation

Invasive cancer of the cervix

IUD

Koilocytosis

Leptothrix

LSIL

Low grade squamous intraepithelial lesion

Mild dysplasia

Moderate dysplasia

Monilia

Negative for intraepithelial lesion or malignancy

Nuclear atypia

Radiation

Reactive changes

Repair

SIL

Satisfactory

Severe dysplasia

Specimen rejected/not processed

Squamous cell

Squamous cell carcinoma

Squamous intraepithelial neoplasia

Squamous metaplasia

Trichomonas

Unsatisfactory

Yeast

This information is provided by The Brookside Associates. The Brookside Associates, LLC. is a private organization, not affiliated with any governmental agency. The opinions presented here are those of the author and do not necessarily represent the opinions of the Brookside Associates or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. All material presented here is unclassified.