BCH shows a regular cell population without atypia. Squamous metaplasia, the process by which mature, non-squamous epithelium is replaced by stratified squamous epithelium, is a well-described phenomenon in the endocervical canal of both women and laboratory animals. Hyperchromasia in nuclei of dysplastic cells reflects an abnormality in DNA synthesis, for example, an abnormal number of chromosomes in that particular nucleus. The presence of endocervical and metaplastic cells was associated with higher detection rates of HSIL.

Endocervical cells were present in 93.1% of the smears and absent in 6.9%. Satisfactory for evaluation. There are pitfalls even in this situation. Bos AB. At your next yearly exam, you could discuss with your ob-gyn your concern about prior Pap smears lacking an endocervical component.

8.30). 18.7A and E) and, when detached, should not be confused with histiocytic aggregates. Cancer 2001;93:237Y40 3 Elumir-Tanner L, Doraty M. Management of Papanicolaou test results that lack endocervical cells. Nuclei are relatively small, centrally located, and uniform in size and shape, and show finely granular, evenly distributed chromatin with occasional micronucleoli.

This approach is a reasonable compromise in light of the conflicting data regarding the significance of an EC/TZ component cited above and the paucity of data on other obscuring indicators. BCH, which is all but full-thickness, may be confused with severe SD or SCCIS by the unwary. Cases with EIN should be managed as for any EIN. In the second edition of their published conclusions, the experts downplayed the significance of endocervical cells in the Pap smear, with their new recommendations no longer deeming Pap collections lacking endocervical cells as “unsatisfactory.”. Nuclei display finely granular uniform chromatin with inconspicuous nucleoli; occasional prominent nucleoli are observed. No significant differences were seen in proportions of pre-invasive lesions found in women after having negative Pap smears without endocervical cells when compared to negative Pap smears which did have endocervical cells. As discussed in Chapter 19, the terms adenoacanthoma and adenosquamous carcinoma have been abandoned in lieu of the term adenocarcinoma with squamous differentiation.18 In some cases, the carcinomatous glandular component may be very subtle. The presenting clinical features reflect the associated underlying process associated with it. A repeat Pap test in 12 months is now the recommended management for women with a satisfactory Pap either (1) lacking EC/TZ component or (2) exhibiting partially obscuring factors: excess blood, etc. It will probably be reassuring to you to know that all the Pap smears that you have had did indeed look at the surface cells of the cervix, so the test has still been useful.

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