title: Benign cellular changes in Pap smears. Causes and significance.
abstract: OBJECTIVE
  We reviewed consecutive cases classified as benign cellular changes (BCC) over a four-month period.
  
  
  METHODS
  Cases classified as BCC were retrieved from the cytology files. A search was carried out to identify the previous Pap smears and concomitant cervical biopsies.
  
  
  RESULTS
  One thousand one hundred three cases (23% of our gynecologic smears) were classified as BCC. Ninety-two patients (8.3%) underwent concurrent cervical biopsies. Specific infections accounted for 8% of BCC cases; reactive changes accounted for 92%. Of the biopsy specimens, 8.3% had no significant pathologic change. The most common biopsy diagnoses were cervicitis (31.5%), immature squamous metaplasia (16.3%) and reserve cell hyperplasia (10.8%). Miscellaneous benign diagnoses accounted for 21.7%. Cervical intraepithelial neoplasia (CIN) 1/human papillomavirus (HPV) was present in 14% of cases. All patients with biopsy diagnoses of CIN 1 had at least two previous abnormal Pap smears. Previous biopsy reports were available for review in 127 (12%) of the 1,103 patients. Of these 127 cases, 53.5% had a previous diagnosis of CIN/HPV; 9.4% had invasive carcinoma. A benign diagnosis was reported in 36.5%.
  
  
  CONCLUSIONS
  The majority of BCC cases are due to reactive and inflammatory processes. In patients with a previous history of CIN, BCC may be of some significance. In patients with no significant prior cervical abnormalities, a Pap smear classified as BCC represents a reactive process.
authors.affiliation: Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, P.O. Box 100275, Gainesville, Florida 32610, USA.
authors.forename: S N
authors.initials: SN
authors.lastname: Malik
authors.forename: E J
authors.initials: EJ
authors.lastname: Wilkinson
authors.forename: P A
authors.initials: PA
authors.lastname: Drew
authors.forename: N S
authors.initials: NS
authors.lastname: Hardt
mesh_terms: D001706:Biopsy; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D008679:Metaplasia / Q000473:pathology; D065006:Papanicolaou Test; D012189:Retrospective Studies; D002578:Uterine Cervical Dysplasia / Q000145:classification* / Q000382:microbiology / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology; D002575:Uterine Cervicitis / Q000473:pathology; D014626:Vaginal Smears