Cytological findings and clinical implications of the Diagnosis “atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion”

DOI 19 References
  • KASE Hiroaki
    Department of Obstetrics and Gynecology, Nagaoka Chuo General Hospital
  • INOUE Sayaka
    Department of Obstetrics and Gynecology, Nagaoka Chuo General Hospital
  • SUZUKI Kumiko
    Department of Obstetrics and Gynecology, Nagaoka Chuo General Hospital
  • IKARASHI Toshihiko
    Department of Pathology, Nagaoka Chuo General Hospital

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  • 子宮頸部細胞診 ASC-H 判定症例の検討
  • Cytological findings and clinical implications of the Diagnosis ^|^ldquo;atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion^|^rdquo;

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Objective : To examine the cytological findings and biopsy results in patients with “atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) ” .<br>Study Design : We examined ASC-H cases encountered at our hospital over a period of 2.5 years.<br>Results : (1) Of 8,874 uterine cervix specimens, atypical squamous cells were found in 255 cases ; of these, ASC-H accounted for 57 cases (22.7%). (2) Lesions showing moderate dysplasia or greater (CIN2+) were confirmed in 32 (52.3%) of the 54 specimens for which biopsy results were obtained. (3) Atypical metaplasia-like aggregates were observed in 36 specimens, of which lesions showing CIN2+ were confirmed in 21 specimens (58.3%). Atrophic sheet-like aggregates making the cytological findings difficult to confirm were observed in 17 (65.4%) of 26 specimens, solitary atypical cells in 10 (66.7%) of 15 specimens, cervical gland hyperplasia-like aggregates in 6 (60.0%) of 10 specimens, and multilayered aggregates in 17 (70.8%) of 24 specimens. (4) The atrophic aggregates showed CIN2+ in 44.4% of postmenopausal patients, but 76.5% of premenopausal patients. (5) CIN2+ was observed in all of the specimens obtained from 5 pregnant patients.<br>Conclusion : The presence of multilayered aggregates and appearance of atrophic sheet-like aggregates making the cytological findings difficult to confirm in premenopausal patients might be important for the differential diagnosis of ASC-H lesions.

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