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Cytology – Epithelial Cell Abnormalities

Epithelial Cell Abnormalities and Squamous

Atypical Squamous Cells of Uncertain Significance (ASC-US)

A new terminology” atypical squamous cells of undetermined significance (ASC-US)” was introduced in 1988. Bethesda classification to encompass equivocal cytological abnormalities which show more than inflammatory atypia but fall short of definitive criteria to be labeled as SIL. Outcome of ASC-US in different clinical settings varied from mostly benign lesions to potentially ominous lesions in some cases because of their differing management protocols. Thus in 1991, Bethesda Committee recommended to qualify ASC-US lesions into 3 categories: ASC-US-favor reactive,

Cytology of SIL


Cytologist relies on individual cell’ changes only for recognizing and grading the abnormality unlike histopathologist who examines the whole tissue. However changes in cells from the uppermost layers of epithelium examined in smears do reflect the overall tissue pattern and degree of SILlCIN in majority of the cases.

Cytological features of SIL include maturation of squamous cells, size and shape of the cells, nature of cytoplasm, nuclear: cytoplasmic ratio and nuclear abnormality which are most significant features. Nuclear abnormality includes enlargement, hyperchromasia, variation in size and shape,abnormal appearance and distribution of chromatin, irregular nuclear outline, irregular thickening of nuclear membrane, nuclear indentations or protrusions and multinucleation. Of these, 

colposcopy of precancerous lesions


Colposcopy is taken into account extra delicate than Pap smear in detecting cervical epithelial abnormalities. Due to limitation of time and expense, colposcopy can’t be used as screening process for precancerous lesions. It is strongly recommended to hold out colposcopy in sufferers having irregular Pap smear or unhealthy or suspicious trying cervix or presenting

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