1. GYN SPECIAL EDITION NUMBER 2
Cytopathology Challenge!
Weekly Cases
Feb 1st, 2008
GYN SPECIAL EDITION NUMBER 2

2. 1 24 year old female. ThinPrep pap LSIL HSIL ASCUS Squamous Metaplasia
Endocervical Cells 1

3. 2 34 year old female. ThinPrep pap Reactive endocervical cells
Squamous metaplasia
ASCUS
LSIL
HSIL 2

4. 3 34 year old female. ThinPrep pap ASCUS LSIL HSIL Squamous Metaplasia
Reactive/Inflammatory 3

5. 4 29 year old female. ThinPrep pap Squamous metaplasia
Reactive endocervical cells
ASC-US
LSIL
HSIL 4

6. 5 32 year old female. ThinPrep pap Squamous metaplasia
Reactive endocervical cells
ASC-US
LSIL
HSIL 5

7. 6 23 year old female. ThinPrep pap Squamous metaplasia Parakeratosis
LSIL
HSIL
SCCA 6

8. 18 year old female.
ThinPrep pap
CMV
HIV
HPV
HSV
EBV 7

9. 8 52 year old female. ThinPrep pap Reactive endocervical cells
Normal endometrial cells
AIS
Adenocarcinoma
HSIL 8

10. 9 44 year old female. ThinPrep pap A. Squamous metaplasia
B. Reactive endocervical cells
C. Atrophy
D. LSIL
E. HSIL 9

11. 10 34 year old female. ThinPrep pap Reactive ASCUS LSIL HSIL
Squamous Metaplasia 10

12. Answers D Squamous Metaplasia A Endocervical cells E Reactive D LSIL
Nuclei not enlarged, smooth contours, NC ratio OK. Not HSIL.
A Endocervical cells
Small round and regular nuclei. Compare to Ques #1.
E Reactive
See the trichomonas organism!
D LSIL
Koilocytes!
B Parakeratosis
Sometimes associated with dysplasia
D HSV
Herpes Simplex Viral changes in Nucleus
D Adenocarcinoma
Crowded overlapping nuclei with prominent nucleoli. No “feathering” so not Adeno in situ (AIS)
E HSIL
High NC ratio, irregular nuclei. This actually turned out to be a SCCA on biopsy.
A Reactive
No dysplasia, just some squamous cells with neutrophils.