cytopathology challenge! weekly cases

Feb 1st, 2008

GYN SPECIAL EDITION NUMBER 2

24 year old female. ThinPrep papA. LSILB. HSILC. ASCUSD. Squamous MetaplasiaE. Endocervical Cells

1

2

34 year old female. ThinPrep papA. Reactive endocervical cellsB. Squamous metaplasiaC. ASCUSD. LSILE. HSIL

3

34 year old female. ThinPrep papA. ASCUSB. LSILC. HSILD. Squamous MetaplasiaE. Reactive/Inflammatory

4

29 year old female. ThinPrep papA. Squamous metaplasiaB. Reactive endocervical cellsC. ASC-USD. LSILE. HSIL

5

32 year old female. ThinPrep papA. Squamous metaplasiaB. Reactive endocervical cellsC. ASC-USD. LSILE. HSIL

6

23 year old female. ThinPrep papA. Squamous metaplasiaB. ParakeratosisC. LSILD. HSILE. SCCA

7

18 year old female. ThinPrep papA. CMVB. HIVC. HPVD. HSVE. EBV

8

52 year old female. ThinPrep papA. Reactive endocervical cellsB. Normal endometrial cellsC. AISD. AdenocarcinomaE. HSIL

9

44 year old female. ThinPrep papA. Squamous metaplasiaB. Reactive endocervical cellsC. AtrophyD. LSILE. HSIL

10

34 year old female. ThinPrep papA. ReactiveB. ASCUSC. LSILD. HSILE. Squamous Metaplasia

Answers1. D Squamous Metaplasia

• Nuclei not enlarged, smooth contours, NC ratio OK. Not HSIL.

2. A Endocervical cells• Small round and regular nuclei. Compare to Ques #1.

3. E Reactive• See the trichomonas organism!

4. D LSIL• Koilocytes!

5. D LSIL• Koilocytes!

6. B Parakeratosis• Sometimes associated with dysplasia

7. D HSV• Herpes Simplex Viral changes in Nucleus

8. D Adenocarcinoma• Crowded overlapping nuclei with prominent nucleoli. No “feathering” so not Adeno in situ (AIS)

9. E HSIL• High NC ratio, irregular nuclei. This actually turned out to be a SCCA on biopsy.

10. A Reactive• No dysplasia, just some squamous cells with neutrophils.