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Original Articles
- Histologic and Cytologic Follow-up in Atypical Squamous Cells of Undetermined Significance(ASCUS) on Cervical Smears.
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Mi Kyung Shin
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Korean J Cytopathol. 1998;9(1):29-36.
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Abstract
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- In 1988, The Bethesda System for reporting cervical and vaginal cytologic diagnoses was introduced and this was revised in 1991. The new diagnostic category "atypical squamous cells of undetermined significance(ASCUS)" introduced by The Bethesda System is an area of controversy about the diagnostic category, clinical significance and appropriate treatment. A retrospective 2 years and 9 months study(April,1994-December,1996) was performed to evaluate the significance of reporting ASCUS on cervical smears.
Sixtyseven(1.17%) of 5,730 smears were diagnosed as ASCUS and 21 cases were followed by cervical biopsies and/or endocervical curettages in 4 cases(19%), and repeat cervical smears in 17 cases (81%). Tissue diagnoses were benign in 2 cases and squamous cell carcinoma in situ in 2 cases.
Cytologic diagnosis of follow up smear were negative in 14 cases (82.4%) and persistent ASCUS in 3 cases(17.6%).
- Qualification of Atypical Squamous Cells of Undetermined Significance - "ASCUS, R/O HSIL": Cytologic Features and Histologic Correlation.
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Hye Sun Kim, Bock Man Kim, Yee Jung Kim, Hy Sook Kim
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Korean J Cytopathol. 2002;13(1):14-20.
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Abstract
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- Cytologic and histopathologic features and human papillomavirus (HPV) DNA detection associated with 101 cervicovaginal smears which are classified as 'atypical squamous cells of undetermined significance, rule out high grade squamous intraepithelial lesion(ASCUS, R/O HSIL)' were reviewed and compared to 89 smears of 'ASCUS, not otherwise specified(NOS)' . Cytologic fieatures of ASCUS, R/O HSIL included atypical single small cells(36.6%), hyperchromatic tissue fragments(35.6%), atypical metaplastic cells(18.8%), endometrial cell-like clusters(5.9%), and atypical parakeratotic cells(3.0%). A final diagnosis of HSIL on biopsy was assigned to 47(54.0%) of 87 women with ASCUS, R/O HSIL and to 13(14.6%) of 89 women with ASCUS, NOS ( p=0.000). There was no difference in HPV DNA detection rate between ASCUS, R/O HSIL and ASCUS, NOS smears. These data suggest that subclassification of ASCUS is helpful to manage patients because ASCUS, R/O HSIL is more often associated with an underlying HSIL on biopsy. Therefore, women with ASCUS, rule out HSIL should be actively managed with colposcopic examination.
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