title: Cytologic correlates of benign versus dysplastic abnormal keratinization.
abstract: The purpose of this study was to determine the cytologic and histologic features that differentiate benign from squamous intraepithelial lesion (SIL)-associated cervical abnormal keratinization, defined as hyperkeratosis, parakeratosis, or individual cell dyskeratosis. Fifty-four cervical Papanicoloau (Pap) smears that contained abnormally keratinized cells were reviewed without knowledge of the concurrent biopsy. Twenty-three Pap smears were diagnosed as SIL and the corresponding biopsy showed SIL in 21 (91%) of these cases. Of the 23 Pap smears diagnosed as negative for SIL, the corresponding biopsy in 20 cases (87%) showed benign (SIL negative) abnormal keratinization. Eight Pap smears showed squamous atypia, of these 5 showed SIL on biopsy, and the other 3 revealed benign keratinization. The Pap smear correlates of the 25 biopsies that were negative for SIL included marked hyperkeratosis (18/25-72 vs. 5/29-17% for biopsies with SIL) and regular nuclear membranes (16/18-89% cases with nucleated dyskeratotic cells vs. 5/29-17% for biopsies with SIL). The cytologic correlates of the 29 biopsies that showed SIL included irregular chromatin clumping (27/29-93% vs. 3/18-17% for biopsies without SIL), and a disorganized growth pattern (24/29-83 vs. 5/25-20% for biopsies without SIL). It is concluded that the cytologic distinction between benign and SIL-related Pap smears with abnormal keratinization can be reliably made by the degree of hyperkeratosis, nuclear chromaticity pattern and contour, and the growth pattern of the dyskeratotic cells.
authors.affiliation: Department of Pathology, SUNY at Stony Brook, USA.
authors.forename: M
authors.initials: M
authors.lastname: Navarro
authors.forename: B
authors.initials: B
authors.lastname: Furlani
authors.forename: L
authors.initials: L
authors.lastname: Songco
authors.forename: M L
authors.initials: ML
authors.lastname: Alfieri
authors.forename: G J
authors.initials: GJ
authors.lastname: Nuovo
mesh_terms: D001706:Biopsy; D002584:Cervix Uteri / Q000166:cytology / Q000473:pathology*; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D017403:In Situ Hybridization; D007642:Keratosis / Q000175:diagnosis*; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics; D030361:Papillomavirus Infections / Q000175:diagnosis; D014412:Tumor Virus Infections / Q000175:diagnosis; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*; D014626:Vaginal Smears