title: Does a diagnosis of atrophic vaginitis on Papanicolaou test signify the presence of inflammation?
abstract: OBJECTIVE
  Vaginal atrophy in menopause shows increased parabasal cells on cytology. This may be accompanied by abundant neutrophils. A shift in maturation index in the absence of significant inflammation is more accurately termed "atrophic pattern." This study aims to determine whether a diagnosis of "atrophic vaginitis" or atrophic pattern on Papanicolaou test is a reliable indicator of what is present on the slide.
  
  
  METHODS
  A retrospective review of Papanicolaou test slides from University Hospital Newark was performed. Cases that had been diagnosed as either atrophic vaginitis (n = 100) or atrophic pattern (n = 100) were selected. Exclusion criteria included any additional diagnosis of neoplasia. Slides were re-reviewed and scored based on abundance of neutrophils: 0 to 5, 6 to 10, or more than 10 neutrophils per high-power field (×40), with 10 fields per slide reviewed. Data were analyzed by χ analysis.
  
  
  RESULTS
  Among 200 cases with atrophic vaginitis or atrophic pattern, the proportion of those diagnosed with atrophic vaginitis to those diagnosed with atrophic pattern increased across three neutrophil categories (P < 0.0001).
  
  
  CONCLUSIONS
  A diagnosis of atrophic vaginitis on Papanicolaou test is reliably associated with increased numbers of neutrophils. A diagnosis of atrophic pattern is indicative of low numbers of neutrophils. As the Papanicolaou test diagnosis of atrophic vaginitis does not correlate with clinical symptoms, a single diagnostic term that does not suggest a disease process would more reliably communicate cytology findings to clinicians.
authors.affiliation: From the 1Departments of Obstetrics, Gynecology, and Women's Health, Rutgers New Jersey Medical School, Newark, NJ; and 2Departments of Pathology and Laboratory Medicine, Rutgers New Jersey Medical School, Newark, NJ.
authors.forename: Debra S
authors.initials: DS
authors.lastname: Heller
authors.forename: Gerson
authors.initials: G
authors.lastname: Weiss
authors.forename: Sara
authors.initials: S
authors.lastname: Bittman
authors.forename: Laura
authors.initials: L
authors.lastname: Goldsmith
mesh_terms: D059268:Atrophic Vaginitis / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology*; D007958:Leukocyte Count; D008875:Middle Aged; D009504:Neutrophils; D065006:Papanicolaou Test; D017698:Postmenopause; D012189:Retrospective Studies