Cytologystuff. com – gyn atlas section 4a

No diagnostic classification causes more debate than Atypical Squamous Cells (ASC). Bleeding after endometrial biopsy New terms have arisen from the revised classification of The Bethesda System (TBS) in 2001. What is endometrial biopsy TBS indicates that the ASC category should be the diagnostic consideration when squamous abnormalities are present that are more marked than those attributable to reactive changes, but fall qualitatively or quantitatively short of the diagnostic criteria for a low grade or high grade squamous intraepithelial lesion.


Endometrial biopsy results how long Furthermore, TBS stresses the importance of qualifying this diagnosis as “undetermined significance” (ASC-US) or “cannot exclude HSIL.” (ASC-H)

The proper classification of ASC challenges the cytotechnologist and pathologist and, writing any chapter describing the morphologic criteria of ASC is challenging, given the subjectivity of this interpretation. What is an endometrial biopsy Since the adoption of TBS, laboratory professionals interpreting the conventional Pap smear may have used this category as a “catch all” for smears that are difficult to classify.

The epithelial cells that are generally incorporated in the ASC category are the mature squamous and squamous metaplastic cells exhibiting changes that are minimal and fall short of a diagnosis of LSIL or HSIL. Biopsy endometrial The nuclei are slightly enlarged and this enlargement is compared to the normal entity of the same cell type. Skin biopsy results time The nuclei may show slight nuclear membrane irregularities but are more often smooth. Pipelle endometrial biopsy When dealing with the metaplastic component, one needs to make sure that the irregularities aren’t due to a vacuole(s) pushing the nucleus into the aberrant shape. Endometrial biopsy procedure The chromatin pattern is finely granular and evenly distributed. Endometrial biopsy side effects Chromocenters or nucleoli are generally inconspicuous or absent unless a reactive process is occurring in conjunction with the atypia at which point the differential diagnosis of reactive needs to be considered depending upon the presence or lack of the other criteria.

With either conventional or ThinPrep ® slides, an ASC interpretation may arise from any of several different cellular changes, including but not limited to, squamous atypia, atypical squamous metaplasia, and atypical parakeratosis. Liver biopsy recovery time The criteria for ASC on the ThinPrep Pap Test are as follows:

As previously mentioned, ASC will not be eliminated by the adoption of the ThinPrep ® Pap Test. Abnormal endometrial biopsy results In fact, the better cellular preservation that is afforded by liquid fixation can lead to over interpretation of nuclear size and chromatin as ASC if one is not familiar with the consequences of liquid fixation as discussed in the introductory material regarding “microscopic evaluation of ThinPrep slides”. There are circumstances where laboratory staff may transiently experience an increase in their use of ASC classification immediately after adoption of the ThinPrep Pap Test, then, after gaining experience, see that rate drop below that which was experienced with the conventional Pap.

ASC, as long as it remains a category in TBS, will be used by pathologists because of inherent subjectivity of human diagnosis, and variable interpretation of criteria. Endometrial biopsy recovery Also important is the biologic nature of Human Papilloma Virus (HPV) that causes morphologic perturbations in cells that are less than LSIL. Endometrial biopsy video The morphologic changes caused by HPV are discussed in greater detail in the section covering Low Grade Squamous Intraepithelial Lesions. The role of this virus in the causation of ASC has created the opportunity to determine the relative risk of ASC changes by the determination of high- vs. Pain after endometrial biopsy low-risk types of virus through ancillary testing of the material in the ThinPrep Pap Test vial.

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