clinicalmanagementnaturalhistoryofcervicaldysplasia.pptVIP

Clinical Management / Natural History of Cervical Dysplasia (CIN) and Related Findings NORMAL AND NEOPLASTIC CELLULAR CHANGES WITHIN THE TRANSFORMATION ZONE CERVICAL INTRAEPITHELIAL NEOPLASIA (CIN): The Bethesda 2001 System Bethesda 2001 Cervical Cytology Classification Bethesda 2001 Cervical Cytology Classification COMPARISON OF THE WHO AND BETHESDA SYSTEM TERMINOLOGY CAUSES OF NON-CORRELATION BETWEEN CYTOLOGY AND COLPOSCOPY Specimen Adequacy Satisfactory for Evaluation (describe presence or absence of endocervical/ transformation zone component and any other quality indicators, e.g., partially obscuring blood, inflammation, etc) Unsatisfactory for Evaluation Specimen rejected (not processed) because … Specimen processed and examined, but unsatisfactory for evaluation because of … Other Non-Neoplastic Findings Optional to report; list not inclusive Reactive cellular changes associated with inflammation (includes typical repair) radiation intrauterine contraceptive device (IUD) Glandular cells status post hysterectomy Atrophy Other Endometrial cells (in a woman 40 years of age) exfoliated (not abraded) endometrial cells not stromal cells or macrophages Optional Comment: Endometrial cells after age 40, particularly out of phase or after menopause, may be associated with benign endometrium, hormonal alterations, and, less commonly, endometrial abnormality. Clinical correlation recommended. Atypical Squamous Cells (ASC) Atypical squamous cells of undetermined significance (ASC-US) cannot exclude HSIL (ASC-H) ASC frequency and association with CIN Sensitivity of a single repeat Pap test for detection of CIN 2 or CIN 3 ALTS: ASCUS Cytology Review Ancillary Testing Provide a brief description of the test methods and report the result so that it is easily understood by the clinician Encourage use of simultaneous/integrated reporting of cytology and HPV testing Report test method (type specific vs cocktail) Report result as positive or negative HPV Testing vs. Ce