Pathology correlates of a Papanicolaou diagnosis of low-grade squamous intraepithelial lesion, cannot exclude high-grade squamous intraepithelial lesion.

BACKGROUND: The objective of this study was to compare findings after a cytologic report of low-grade squamous intraepithelial lesion, cannot exclude high-grade squamous intraepithelial lesion (LSIL-H) with findings after a report of low-grade squamous intraepithelial lesion (LSIL). METHODS: A review of patient records revealed that 312 women had cytologic findings of LSIL-H, and 324 consecutive women in a comparison group had cytologic findings of LSIL during 2005. Findings over 6 months after diagnosis were retrieved and analyzed using chi-square tests, Fisher exact tests, and independent group t tests. RESULT: Histology was available for 194 of 312 women (64%) with LSIL-H and for 184 of 324 women (57%) with LSIL. Of these, 47 of 194 women (24%) with LSIL-H had grade 2 cervical intraepithelial neoplasia or greater (CIN2+) versus 13 of 184 women (7%) with LSIL (P < .0001). No cancers were identified. High-grade SIL cytology was reported in 2 of 105 women who had LSIL (2%) and in 4 of 93 women who had LSIL-H (4%). Women with LSIL-H who were positive for CIN2+ were younger than those without CIN2+ (25 years vs 30 years; P = .0067) CONCLUSIONS: Clinicians whose laboratories report LSIL-H should manage women who have LSIL-H with colposcopy, whereas only serial cytologic surveillance is required after a report of LSIL.

Endometrial cells identified in cervical cytology in women > or = 40 years of age: criteria for appropriate endometrial evaluation.

OBJECTIVE: No consensus exists regarding evaluation of asymptomatic premenopausal women with benign endometrial cells (BECs) identified on cervical cytology. We determined the frequency of uterine pathology in asymptomatic women, > or = 40 years of age, positive for BECs on cervical cytology. STUDY DESIGN: Cervical cytopathology records from a Midwestern US teaching hospital from April 2002 through December 2005 were reviewed and cases with BECs identified. Patient age, symptomatology, and endometrial sampling results were obtained. RESULTS: Of 194,717 records examined, 1784 (0.9%) of women > or = 40 years had BECs present and 440 had follow-up endometrial pathology. There were 4 cases of complex hyperplasia with atypia, 2 from patients < or = 50 years, 1 was asymptomatic; 4 cases of adenocarcinoma were identified, all from women > 50 years. CONCLUSION: To date, the present study is among the largest follow-up studies of women with BECs on cervical cytology. Follow-up endometrial sampling may not be indicated in asymptomatic patients < or = 50 years.