title: Atypical parakeratosis: a marker of dysplasia?
abstract: The Bethesda System categorizes atypical parakeratosis (APK) as "ASCUS or SIL depending on the degree of cellular abnormalities." APK, however, is not well-defined. We retrospectively reviewed 68 cervicovaginal specimens with follow-up material to identify specific criteria and clinical significance of APK. APK cells were small cells, 2-3 times the diameter of neutrophil, with dense, orangeophilic cytoplasm, high nuclear cytoplasmic ratio, dense, often uneven chromatin, and irregular nuclear contour. Of 62 cases with APK, 37 had accompanying dysplastic cells. Of 25 cases with APK alone, follow-up revealed 12 with squamous intraepithelial lesion (5 HSIL and 7 LSIL) and 13 with benign changes. A major diagnostic pitfall of APK was inflammation with degeneration. Abundant APK cells, minimal inflammation and degeneration, and previous history of dysplasia frequently were associated with follow-up SIL. The findings of this study identify APK as an important marker for dysplasia that warrants careful evaluation and follow-up.
authors.affiliation: Department of Cytopathology, Lankenau Hospital, Wynnewood, PA 19096, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Voytek
authors.forename: V
authors.initials: V
authors.lastname: Kannan
authors.forename: T S
authors.initials: TS
authors.lastname: Kline
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D006801:Humans; D010241:Parakeratosis / Q000473:pathology*; D011230:Precancerous Conditions / Q000473:pathology*; D012189:Retrospective Studies; D014626:Vaginal Smears / Q000379:methods
chemical_list: D014408:Biomarkers, Tumor