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Gyn Cytology Reporting

Accuracy and Quality       textbook2.JPG

Interpretation of Pap tests at Physicians Laboratory is performed by Cytotechnologists (registered by the American Society of Clinical Pathologists) and by board-certified Pathologists.  In compliance with the CLIA '88 regulations, supervisory level cytotechnologists perform random rescreen of 10% of all Pap tests daily before the reports are released.  "Within Normal Limits" Pap tests are reported by a cytotechnologist.  Cases routed to the pathologist for review are separated from the routine normal cases.

 

Cases sent to the pathologist for review include:

  • Reactive/reparative
  • All tests containing cellular abnormalities
  • Tests where the cellular pattern and clinical history do not correlate
  • Any test where the screening cytotechnologist has any question regarding a totally benign state

 

Physicians Laboratory uses the Bethesda System 2001 for reporting of Pap test results.  Reports utilize the following catagories and diagnoses:

 

 Specimen Adequacy

  • Satisfactory for evaluation
  • Unsatisfactory for evaluation

     Specimen rejected

     Specimen processed and examined, but unsatisfactory for evaluation of epithelial abnormality

 

General Catagorization

  • Negative for Intraepithelial Lesion or Malignancy
  • Epithelial Cell Abnormality
  • Other: See interpretation/diagnosis

 

Descriptive Interpretations/Diagnoses

     Non-Neoplastic

  • Negative for interaepithelial lesion or malignancy

Organisms:

  • Trichomonas vaginalis
  • Fungal organisms morphologicall consistent with Candida
  • Shift in vaginal flora suggestive of bacterial vaginosis
  • Bacteria morphologically consistent with Actinomyces
  • Cellular changes associated with Herpes simplex virus

Other Non-Neoplastic Findings (not inclusive)

  • Reactive cellular changes
  • Benign-appearing glandualr cells status post hysterectomy
  • Atrophy

     Other:

  • Endometrial cells in a woman > 40 years of age

 

     Epithelial Cell Abnormalities

     Squamous Cell

  • Atypical Squamous Cells

     Of undetermined significance (ASC-US)

     cannot exclued HSIL (ASC-H)

  • Low grade squamous intraepithelial lesion (LSIL)
  • High grade squamous intraepithelial lesion (HSIL)
  • Squamous cell carcinoma

     Glandular Cell

  • Atypical (AGC-US)
  • Atypical glandular/endocervical cells, favor neoplastic
  • Endocervical adenocarcinoma in situ
  • Adenocarcinoma

   Other Malignant Neoplasms: (specify)