请查问，病人有无子宫脱垂。 Whenever you see this type of parakeratosis in cervical cytology, you have at least three DDx: 1) HPV related change; 2) Fungal infection; 3) uterine prolapse change. This woman is 61 year old. You should first to rule out prolapse changes for her before jumping on "cervical dysplasia".

Cytomorphologically, this smear show atrophy in photo 4. Rest of the photos do not have very low N/C cells with unremarkable nuclei. A diagnosis of ASCUS is enough in my humble opinion to make sure she has no LSIL lesion. There is no HSIL in this case based my reading. Only differential diagnosis for me to think about on the malignant side is invasive SCC, which usually has tumor diathesis and worse nuclear changes than this case. Also if she has invasive SCC, it often has clinical bleeding or other manifestation. She is a relative "normal" one came for routine physical examination. Therefore, My bet will be: she will have a normal biopsy.

 HSIL

细胞有退变，5图倾向于ASCUS, 1-2图没感觉有多大的问题。

 ding

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