Pap Smear Interpretation and Management of Abnormals

Interpretation of Pap smear reports can be challenging at times. Unfortunately, the terminology or language of Pap smears is complex, changing, and not uniformly applied.

The following are links to explanations of different results you might see on a Pap smear. While not all-encompassing, it includes all of the common descriptive terms. I also included some of the older terminology in the event you may encounter it.

• Negative for intraepithelial lesion or malignancy

• Epithelial cell abnormality

• Other

Negative for Intraepithelial Lesion or Malignancy

• Atrophy

• Trichomonas vaginalis

• Fungal oganisms morphologically consistent with Candida species

• Shift in flora suggestive of bacterial vaginosis

• Bacteria morphologically consistent with Actinomyces species

• Cellular changes consistent with herpes simplex virus

Reactive cellular changes associated with:

• Inflammation (includes typical repair)

• Radiation

• Intrauterine contraceptive device

• Glandular cells status posthysterectomy

• Atrophy

• Atypical squamous cells (ASC) of undetermined significance (ASC-US)

• cannot exclude HSIL (ASC-H)

• Low-grade squamous intraepithelial lesion (LSIL) encompassing: human papillomavirus/mild dysplasia/cervical intraepithelial neoplasia (CIN) 1

• High-grade squamous intraepithelial lesion (HSIL) encompassing: moderate and severe dysplasia, carcinoma in situ; CIN 2 and CIN 3

• Squamous cell carcinoma

Glandular cell

• Atypical glandular cells (AGC) (specify endocervical, endometrial, or not otherwise specified)

• Atypical glandular cells, favor neoplastic (specify endocervical or not otherwise specified)

• Endocervical adenocarcinoma in situ (AIS)

• Adenocarcinoma

• Endometrial cells in a woman 40 years of age

• Dysplasia

• Carcinoma-in-Situ

• Chlamydia

• CIN

• CIS

• Coccoid Bacteria

• Condyloma

• Drying Artifact

• Endocervical Cells

• Estrogen Effect

• Inadequate Smear

• Inconclusive Smear

• Koilocytosis

• Leptothrix

• Nuclear Atypia

• SIL

• Squamous Metaplasia

• Actinomyces

• Adenocarcinoma

• AGC

• AIS

• ASC

• ASC-H

• ASC-US

• Atrophy

• Atypical glandular cells

• Atypical glandular cells, favor neoplastic

• Atypical squamous cells

• Atypical squamous cells of undetermined significance

• Bacterial vaginosis

• Candida

• Cannot exclude ASC-H

• Carcinoma-in-situ

• Cervical intraepithelial neoplasia

• Chlamydia

• CIN

• CIN 1

• CIN 2

• CIN 3

• CIS

• Coccoid bacteria

• Colposcopy

• Condyloma

• Drying artifact

• Dysplasia

• Endocervical cells

• Endocervical adenocarcinoma in situ

• Endometrial cells

• Epithelial cell abnormality

• Estrogen effect

• Fungal oganisms

• Gardnerella

• Glandular cell

• Herpes

• High grade squamous intraepithelial lesion

• HPV

• HSIL

• Human Papilloma Virus

• Inadequate Smear

• Inconclusive Smear

• Inflammation

• Invasive cancer of the cervix

• IUD

• Koilocytosis

• Leptothrix

• LSIL

• Low grade squamous intraepithelial lesion

• Mild dysplasia

• Moderate dysplasia

• Monilia

• Negative for intraepithelial lesion or malignancy

• Nuclear atypia

• Radiation

• Reactive changes

• Repair

• SIL

• Satisfactory

• Severe dysplasia

• Specimen rejected/not processed

• Squamous cell

• Squamous cell carcinoma

• Squamous intraepithelial neoplasia

• Squamous metaplasia

• Trichomonas

• Unsatisfactory

• Yeast