1. Cytopathology Challenge! Weekly Cases October 22th 2007 Pap Smear Special Edition!

2. 24 year old female. ThinPrep pap A.Trichomonas B.Lactobacillus C.Gonorrhea D.Bacterial Vaginosis E.Artifact 1

3. 2 34 year old female. ThinPrep pap A.Reactive endocervical cells B.Squamous metaplasia C.ASCUS D.LSIL E.HSIL

4. 3 34 year old female. ThinPrep pap A.Endocervical cells B.HSIL C.Endometrial cells D.Squamous metaplasia E.Lymphocytes

5. 4 29 year old female. ThinPrep pap A.Squamous metaplasia B.Reactive endocervical cells C.ASC-US D.LSIL E.HSIL

6. 5 24 year old female. ThinPrep pap A.Trichomonas B.Lactobacillus C.Gonorrhea D.Bacterial Vaginosis E.Artifact

7. 6 29 year old female. ThinPrep pap A.Squamous metaplasia B.Reactive endocervical cells C.ASC-US D.LSIL E.HSIL

8. 7 29 year old female. ThinPrep pap A.Squamous metaplasia B.Reactive endocervical cells C.ASC-US D.LSIL E.HSIL

9. 8 29 year old female. ThinPrep pap A.Reactive B.Endocervical cells C.ASC-US D.LSIL E.HSIL

10. 9 34 year old female. ThinPrep pap A. Squamous metaplasia B. Reactive endocervical cells C. ASC-US D. LSIL E. HSIL

11. 10 34 year old female. ThinPrep pap A.Contaminant from a BAL B.HSIL C.Endometrial cells D.Adenocarcinoma E.Tubal metaplasia

12. Answers 1.D Bacterial Vaginosis Clue cells with cocci on them 2.D LSIL Koilocytes! 3.C Endocervical cells Honeycomb, regular, not dysplastic 4.E HSIL High NC ratio, irregular nuclei 5.B Lactobacillus Rods on the cells 6.D LSIL Koilocytes again! 7.A Squamous Metaplasia Can look like HSIL, but nuclei not so big and still regular in contour. 8.A Reactive See the trichomonas hiding in there…… 9.E. HSIL High NC ratio, irregular nuclei 10.E Tubal metaplasia Ciliated cells in a pap smear can be metaplastic ciliated metaplasia.