Papanicolaou smear discrepancy: resolution by review.
BACKGROUND
Discrepancy between Papanicolaou smears and colposcopically directed biopsies often creates a treatment dilemma, especially when the cytologic specimen suggests a higher grade lesion than the histologic specimen. A method of side-by-side review using the Bethesda System was evaluated as a means of resolving this discrepancy between cytologic and histologic specimens.


METHODS
By means of a retrospective chart review, we selected 150 patients undergoing colposcopic evaluation for abnormal cytologic findings. Thirty-eight patients had higher grade lesions on cytologic examination than on histologic examination. Twenty-four of these patients had both cytologic and histologic slides available, and these specimens were evaluated in a blinded review by a single pathologist using the Bethesda System of classification.


RESULTS
Reevaluation yielded resolution of discrepancy in 19 of 24 cases, a 79.2 percent resolution.


CONCLUSIONS
Review of cytologic and histologic specimens by an experienced pathologist using the Bethesda System can resolve many of the cases in which the cervical lesion is considered to be of a higher grade by cytologic examination than by histologic examination.
Cline
M K
MK
Anderson Area Medical Center Family Practice Center, SC.
Baxley
E G
EG
Montgomery
R P
RP
D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy; D005260:Female; D006801:Humans; D008485:Medical Audit; D015588:Observer Variation; D065006:Papanicolaou Test; D015203:Reproducibility of Results; D012189:Retrospective Studies; D002577:Uterine Cervical Diseases / Q000453:epidemiology / Q000473:pathology*; D014626:Vaginal Smears