Cytopathology Challenge! Weekly Cases

October 22th 2007

Pap Smear Special Edition!

24 year old female. ThinPrep papA. TrichomonasB. LactobacillusC. GonorrheaD. Bacterial VaginosisE. Artifact

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

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34 year old female. ThinPrep papA. Endocervical cellsB. HSILC. Endometrial cellsD. Squamous metaplasiaE. Lymphocytes

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

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24 year old female. ThinPrep papA. TrichomonasB. LactobacillusC. GonorrheaD. Bacterial VaginosisE. Artifact

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

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

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29 year old female. ThinPrep papA. ReactiveB. Endocervical cellsC. ASC-USD. LSILE. HSIL

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

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34 year old female. ThinPrep papA. Contaminant from a BALB. HSILC. Endometrial cellsD. AdenocarcinomaE. Tubal metaplasia

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.