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以下是引用cqzhao在2008-12-12 11:29:00的发言:
To wy1992: You mentioned "The smear strongly suggest carcinoma in situ but the appearance of cervix is OK!The genecologist don't think there is something wrong with this woman!" Could you tell us why the smear stroungly suggests carcinoma in situ? |
朱正龙
以下是引用cqzhao在2008-12-12 11:29:00的发言:
To wy1992: You mentioned "The smear strongly suggest carcinoma in situ but the appearance of cervix is OK!The genecologist don't think there is something wrong with this woman!" Could you tell us why the smear stroungly suggests carcinoma in situ? |
朱正龙
以下是引用cqzhao在2008-12-12 0:34:00的发言:
Very busy day and have about 600 breast slides to read. Come here for some fun. Smears show some large cells with dark nuclei, few cell with binucleation. I also notice tha atypical cells with abundant cytoplasm and relately regular nuclear membrane. Also nucleioli may be present in some cells. I feel unconfortable to call HSIL for this case. The stain is not very good and make the dx more difficult. If it was my case here I may call ASC-US. Then reflex high risk HPV testing will be ordered. If I call LSIL, no HPV testing will be ordered. When I get HPV testing result, I will think over how to sign out the case. If HPV positive, I will strongly suggest the women have colposcopy. high risk HPV rate is low in this age population. Suggestion to wy1992: 1.Try to know patient's history such as, previous Pap, HPV testing ... 2. You may consider to call LSIL. The patient should have colposcopy even though you call lsil. In this way you have not delayed the treatment or dx even if the patient has CIN2/3. Suggestion to all: you should be sure when you want to call HSIL. Otherwise you can consider to call ASC-H ....or LSIL plus ASC-H for some cases. Just for your reference. Thanks so much!The smear strongly suggest carcinoma in situ but the appearance of cervix is OK!The genecologist don't think there is something wrong with this woman! |
朱正龙