Cytologic Features of Squamous Cell Carcinoma in ThinPrep Slides

Evaluation of Cases That Performed Poorly Versus Those That Performed Well in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology

Andrew A. Renshaw, Barbara Dubray-Benstein, Camilla J. Cobb, Richard L. Lozano, Margaret H. Neal, Marianne Prey, Michael A. Schulte

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

Context.-Although the cytologic features of squamous cell carcinoma in ThinPrep specimens are well known, whether these features are different in cases that are easily identified than in cases that are more difficult to identify is not known. Objective.-To determine the cytologic features of squamous cell carcinoma in ThinPrep specimens that are easy to identify versus those that are difficult. Design.-The cytologic features of 6 cases of squamous cell carcinoma that performed poorly in the College of American Pathologists Interlaboratory Comparison Program were compared with 14 cases that performed extremely well. Results.-After evaluation of multiple criteria, 7 different cytologic features were analyzed based on review by a consensus panel blinded to the performance of the cases. The feature that was most strongly associated with cases that performed poorly was the presence of Trichomonas vaginalis (5/6 [83%] vs 0/14; P < .001). The presence of marked nuclear pleomorphism was more common in cases that performed well (4/14 [28%] vs 0/6; P = .27), but was not significant. The number of tumor cells, the number of normal cells, and the presence of keratinization, pleomorphism, nucleoli, and diathesis were not significant. The most common misdiagnosis after Trichomonas vaginalis was reparative change. Conclusions.-The presence of Trichomonas is characteristic of cases of squamous cell carcinoma in ThinPrep slides that are often misdiagnosed in this program. While Trichomonas is identified by participants in some of these cases, a significant percentage of participants interpreted the findings as reparative, without identifying the organism . These results emphasize the importance of distracting factors, whether identified or not, in evaluating gynecologic cytology.

Original languageEnglish (US)
Pages (from-to)403-405
Number of pages3
JournalArchives of Pathology and Laboratory Medicine
Volume128
Issue number4
StatePublished - Apr 1 2004

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Cell Biology
Squamous Cell Carcinoma
Trichomonas
Trichomonas vaginalis
Diagnostic Errors
Disease Susceptibility
Cell Count
Pathologists
Neoplasms

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

Cytologic Features of Squamous Cell Carcinoma in ThinPrep Slides : Evaluation of Cases That Performed Poorly Versus Those That Performed Well in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology. / Renshaw, Andrew A.; Dubray-Benstein, Barbara; Cobb, Camilla J.; Lozano, Richard L.; Neal, Margaret H.; Prey, Marianne; Schulte, Michael A.

In: Archives of Pathology and Laboratory Medicine, Vol. 128, No. 4, 01.04.2004, p. 403-405.

Research output: Contribution to journalReview article

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title = "Cytologic Features of Squamous Cell Carcinoma in ThinPrep Slides: Evaluation of Cases That Performed Poorly Versus Those That Performed Well in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology",
abstract = "Context.-Although the cytologic features of squamous cell carcinoma in ThinPrep specimens are well known, whether these features are different in cases that are easily identified than in cases that are more difficult to identify is not known. Objective.-To determine the cytologic features of squamous cell carcinoma in ThinPrep specimens that are easy to identify versus those that are difficult. Design.-The cytologic features of 6 cases of squamous cell carcinoma that performed poorly in the College of American Pathologists Interlaboratory Comparison Program were compared with 14 cases that performed extremely well. Results.-After evaluation of multiple criteria, 7 different cytologic features were analyzed based on review by a consensus panel blinded to the performance of the cases. The feature that was most strongly associated with cases that performed poorly was the presence of Trichomonas vaginalis (5/6 [83{\%}] vs 0/14; P < .001). The presence of marked nuclear pleomorphism was more common in cases that performed well (4/14 [28{\%}] vs 0/6; P = .27), but was not significant. The number of tumor cells, the number of normal cells, and the presence of keratinization, pleomorphism, nucleoli, and diathesis were not significant. The most common misdiagnosis after Trichomonas vaginalis was reparative change. Conclusions.-The presence of Trichomonas is characteristic of cases of squamous cell carcinoma in ThinPrep slides that are often misdiagnosed in this program. While Trichomonas is identified by participants in some of these cases, a significant percentage of participants interpreted the findings as reparative, without identifying the organism . These results emphasize the importance of distracting factors, whether identified or not, in evaluating gynecologic cytology.",
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T2 - Evaluation of Cases That Performed Poorly Versus Those That Performed Well in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology

AU - Renshaw, Andrew A.

AU - Dubray-Benstein, Barbara

AU - Cobb, Camilla J.

AU - Lozano, Richard L.

AU - Neal, Margaret H.

AU - Prey, Marianne

AU - Schulte, Michael A.

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N2 - Context.-Although the cytologic features of squamous cell carcinoma in ThinPrep specimens are well known, whether these features are different in cases that are easily identified than in cases that are more difficult to identify is not known. Objective.-To determine the cytologic features of squamous cell carcinoma in ThinPrep specimens that are easy to identify versus those that are difficult. Design.-The cytologic features of 6 cases of squamous cell carcinoma that performed poorly in the College of American Pathologists Interlaboratory Comparison Program were compared with 14 cases that performed extremely well. Results.-After evaluation of multiple criteria, 7 different cytologic features were analyzed based on review by a consensus panel blinded to the performance of the cases. The feature that was most strongly associated with cases that performed poorly was the presence of Trichomonas vaginalis (5/6 [83%] vs 0/14; P < .001). The presence of marked nuclear pleomorphism was more common in cases that performed well (4/14 [28%] vs 0/6; P = .27), but was not significant. The number of tumor cells, the number of normal cells, and the presence of keratinization, pleomorphism, nucleoli, and diathesis were not significant. The most common misdiagnosis after Trichomonas vaginalis was reparative change. Conclusions.-The presence of Trichomonas is characteristic of cases of squamous cell carcinoma in ThinPrep slides that are often misdiagnosed in this program. While Trichomonas is identified by participants in some of these cases, a significant percentage of participants interpreted the findings as reparative, without identifying the organism . These results emphasize the importance of distracting factors, whether identified or not, in evaluating gynecologic cytology.

AB - Context.-Although the cytologic features of squamous cell carcinoma in ThinPrep specimens are well known, whether these features are different in cases that are easily identified than in cases that are more difficult to identify is not known. Objective.-To determine the cytologic features of squamous cell carcinoma in ThinPrep specimens that are easy to identify versus those that are difficult. Design.-The cytologic features of 6 cases of squamous cell carcinoma that performed poorly in the College of American Pathologists Interlaboratory Comparison Program were compared with 14 cases that performed extremely well. Results.-After evaluation of multiple criteria, 7 different cytologic features were analyzed based on review by a consensus panel blinded to the performance of the cases. The feature that was most strongly associated with cases that performed poorly was the presence of Trichomonas vaginalis (5/6 [83%] vs 0/14; P < .001). The presence of marked nuclear pleomorphism was more common in cases that performed well (4/14 [28%] vs 0/6; P = .27), but was not significant. The number of tumor cells, the number of normal cells, and the presence of keratinization, pleomorphism, nucleoli, and diathesis were not significant. The most common misdiagnosis after Trichomonas vaginalis was reparative change. Conclusions.-The presence of Trichomonas is characteristic of cases of squamous cell carcinoma in ThinPrep slides that are often misdiagnosed in this program. While Trichomonas is identified by participants in some of these cases, a significant percentage of participants interpreted the findings as reparative, without identifying the organism . These results emphasize the importance of distracting factors, whether identified or not, in evaluating gynecologic cytology.

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