In spite of numerous controversies and challenges throughout the decades, the pap test remains one. Although recommendations have been issued to prioritise patients at high oncological risk, postponing those with unsuspicious presentations, real world data have not been reported yet. The original significance of each class was so modified by pathologist that the meaning of any class has become hopelessly confusing to the clinician. Cytology specimen collection and processing gynecological cytology specimens pap smear thinprep pap test principle a gynecological cytology specimen pap smear is an evaluation for the presence of abnormal cells, which may be indicative of malignancy or other conditions requiring treatment. The images are tagged with the keyword entity name and are also searchable by chapter index and preparation type directsmear versus liquidbased. Gynecological cytology specimens pap smear thinprep pap test. Cytology is a valuable method to screen for and prevent cervical cancer. Anal cytology was first included in the 2001 bethesda system atlas and has been thoroughly updated in the third edition of the atlas the bethesda system for reporting cervical cytology, 2015 to incorporate the most recent epidemiologic literature and photomicrographs of findings unique to anal cytology.
Colposcopy and biopsy was carried out in 45 cases with abnormal cytology either on pap spin or conventional pap smear. Papanicolaou society of cytopathology dedicated to. The cytopathology department of the johns hopkins university school of medicine and the office of medical informatics have created this site to enhance the teaching program at the school of medicine in regards to the cytopathology course. Pdf second edition of the bethesda system for reporting cervical. Screening may be discontinued at the age of 70 if there is an adequate negative cytology screening history in the previous 10 years.
Atlas of exfoliative cytology by georg ne papanicolaou. Clinical professo o anatomf r emeritusy cornel, universitl medicay collegl e published fo thr commonwealte fun bdhy harvard universit pressy cambridge, mass. A pap smear may also help find other conditions, such as infections or inflammation. The pap test richard mac demay, md professor of pathology director of cytopathology university of chicago ascp press american society for clinical pathology. Edited by frappart l, fontaniere b, lucas e, sankaranarayanan r. The second edition of this colour atlas provides a comprehensive guide to the variety of gynaecological and nongynaecological cytology appearances as seen in daily clinical practice.
Histology and cytology specimen labeling and requisitions requirements specimens will not be processed unless. This study identified factors that influence inter. This atlas is an invaluable aid for pathologists and trainees who have worked with conventional smear cytology but need to familiarize themselves with the appearance seen in liquidbased cytology, which has largely replaced conventional smears for cervical screening. Pap smears, cytology and cchc lab work and follow up. Manual for cytology pdf 44p this book covers the following topics. The history of the bethesda system for reporting cervical cytology goes back almost 3 decades. A total of 5,457 pap smear records were identified during the study period. Gynecologic cytology laboratory practice and methodology. Every chapter has been updated to provide the latest necessary information on scientific advances. It includes state of the art information on normal pap smears. For further information on the bethesda web atlas, please visit the educational resources page on the american society of cytopathology website. Gynecologic cytopathology is a subset of cytopathology. Pdf atlas of exfoliative cytopathology download full.
A pap smear also known as the pap test is a medical procedure in which a sample of cells from a womans cervix the end of the uterus that extends into the vagina is collected, processed and stained. The iac is pleased to offer its members access to an interactive virtual slide set consisting of whole slide images. Preparation and staining of vaginal, endocervical and endometrial aspiration and of cervical swab smears. It is very successful for detecting squamous lesions and. Conventional pap smear and liquid based cytology for cervical.
Ppt gynecologic cytopathology powerpoint presentation. Smear samplingslide preparation for conventional cytology. This concise atlas evaluates the use of digital imaging technology, with emphasis on telepapology, for the pathological examination of gynaecological problems, specifically the pap smear. Atlas of gynecologic cytology download ebook pdf, epub. Gynecologic usually refers to pap test specimens, i. The scope of morphology ranges from basic cell patterns. The current reporting system is the bethesda system, which was introduced in 19886 and later updated again in 1999 table 1. The pap test and bethesda 2014 wiley online library. If diagnostic please indicate patient s signs, symptoms or history.
Essentials of gynecologic cytology is written for practicing pathologists in private. In normal cells the cytoplasm appears much larger than the nucleus. Main purpose of the test is to detect precancerous lesions called squamous intraepithelial lesion sil, which are often caused by sexually transmitted human papillomaviruses. Pdf atlas of exfoliative cytopathology download full pdf.
Normal endocervical glandular cells, cubic or cylindrical, without secretion. Cytopathology detached cells fluid, brushings fine needle invasive procedure 5 min. This article deals only with cervical cytopathology. Atrophic pap smears, differential diagnosis and pitfalls. Role of diagnostic cytology, collection and preparation of material for cytodiagnosis, cytopreparatory techniques of serous effusions, fixation of cytology specimens, staining methods in cytology. In spite of numerous controversies and challenges throughout the decades, the pap test remains one of the most utilized and successful cancer. Ontario cervical screening cytology guidelines summary. The following outline is a brief reference to the information thatwill be contained in the cytology report. Screening test for cervical carcinoma and precursor lesions exfoliative cytology pioneered by george papanicolaou in 1920s more than 60 million tests in u. Essentials of gynecologic cytology pathology university of british. Most information and illustrations in this book are extracted from the authors.
From a diagnostic perspective, atrophic smears may be misinterpreted as positive smears in postmenopausal and occasionally in perimenopausal women. Cytology in the time of coronavirus disease covid19. It identifies premalignant changes and allows selection of women with atrisk findings for more intense clinical examination, treatment and followup. Combining the cytology and serological result, the diagnosis of cat scratch disease was made. This monograph essentials of pap smear and breast cytology is prepared at the request of a large number of students in cytology who wish to have a small and concise book with numerous illustrations for easy reference during their laboratory training. This is accomplished by gathering cells from the cervix and searching for dysplasia, or precancerous changes. Th e pap test has had a remarkable history, essentially in establishing the. Residents ppap smearap smear bioline international. The subject has been presented in a way which will help students reproduce in exams. Click download or read online button to get atlas of gynecologic cytopathology book now. For a sputum specimen collected in 70% ethanol, the classic pick and smear technique is used, and 2 to 4 smears are prepared, immediately fixed in 95% ethanol and stained by the pap technique. Gynecological cytology specimens pap smear thinprep pap. Gynaecological cytology pap smears the cervical pap smear is a long established screening test for cervical carcinoma. Reaspiration of cystic lesions while keeping the needle of the first pass inside the mass is a very helpful trick that helps sample the wall of the lesion and believed to increase sensitivity reprinted with permission from alabbadi, editor, salivary gland cytology.
The educator of the year award is presented to a pathologist in recognition of hisher meritorious service, and contributions to the field of cytopathology education. Evolution of the pap smear to cervical cancer screening today. Introduction the coronavirus disease 2019 covid19 is changing the way we practice pathology, including fine needle aspiration fna diagnostics. The pap test and bethesda 2014 fulltext acta cytologica 2015. Liquid based or conventional slide pap smear to include the number of slides submitted 4.
It is sometimes done at the same time as a pelvic exam and may also be done at the same time as a test for certain types of human papillomavirus hpv. The text of this second edition has been completely revised, planned and written with two goals in mind. Papanicolaou society of cytopathology dedicated to clinical. Pattern of cervical smear cytology in rural medical college shrivastava m, shrivastava o p, jaiswal s s abstract the present study was undertaken with the aim to evaluate the abnormal cytological entities detected by cervical pap smears among patients reporting to outdoor department of. The papanicolaou test abbreviated as pap test, also known as pap smear, cervical smear, cervical screening or smear test is a method of cervical screening used to detect potentially precancerous and cancerous processes in the cervix opening of the uterus or womb or colon in both women and men. Pattern of cervical smear cytology in rural medical college. Out of these 36 smears were reported as atypical glandular cells using the bethesda system of reporting 2001. If cytology is normal, screening should be done every 3 years.
On the other hand, low sensitivity and specificity of pap smear particularly in conventional type impose serious consequences including false negative and false positive results 5. Digital slides scanned from selected interesting cases listed below give users access to the entire slide. The pap smears from the former were alcoholfixed with commercial fixatives and those from the latter were air dried, rehydrated and then. Gynecologic cytopathology conventional pap smear historical overview cervical cytology practice. The test may also detect infections and abnormalities in the endocervix and endometrium. The absence of t zone is not a reason to repeat a pap test earlier than the recommended interval. Atlas on bethesda system for reporting cervical cytology. Educational curricula for cytomorphology criteria, laboratory methodologies, and quality assurancequality control processes learned over the years from the pap test form a foundation on which the rest of cytopathology expands.
Bethesda system for reporting cervical cytology 2001 dr 3 based on. Preferably, several direct smears should be prepared for all fineneedle aspiration specimens submitted to cytopathology. The discipline was founded by george nicolas papanicolaou in 1928. At the end of the test or after every question if you want you will have the possibilty to view the correct answers, and in some but not all the cases you will find the corresponding. Cervical dysplasia and cancer herpes virus infection other infections. The original papanicolaou system of reporting pap smears based on five classes was judged to be ill suited to the practice of preventive oncology. Pap smear and breast cytology pathology university of british. Cytopathology of the uterine cervix digital atlas screening iarc. Second edition of the bethesda system for reporting cervical cytology atlas, website, and. Given all the recent press about new methods of cervical cancer screening and the lack of sensitivity of the pap test, some may question the significance of a new edition of the. Pamlpshmc cytology uses the bethesda 2001 reporting system for all gyn samples. In our study the age of patients with abnormal cervical cytology in pap smear cin were ranged from 31 to 40 years with the mean of 36. Mar 28, 2019 the papanicolaou test abbreviated as pap test, known earlier as pap smear, cervical smear, or smear test is a method of cervical screening used to detect.
Specimen collection procedure fineneedle aspiration adequate cellular material for cytologic evaluation obtained from an appropriately performed fineneedle aspiration is required. The bethesda system for reporting cervical cytology. All requisitions adequately completed with pertinent information regarding clinical history 3. The award is presented during the papanicolaou society of cytopathology companion meeting held during the annual meeting of the united states and canadian academy of pathology. Preparations are fixed in 95% alcohol and stained using papanicolaou staining method. The cytotechnologist screens the pap test for benign lesion and reports the suspected malignant ones to the pathologist for. Pap smear the pap smear is used to screen for cervical cancer. Definition of pap smear nci dictionary of cancer terms. Histopathology and cytopathology of the uterine cervix digital atlas. The images are formatted to conform to the print atlas the bethesda system for reporting thyroid cytopathology ali sz, cibas es, eds, springer, 2010. Methods the percentages of the cytological sample types. The overall sensitivity of pap smears in detecting glandular abnormality was 70%.
Atlas of gynecologic cytopathology download ebook pdf, epub. Dec 22, 20 this is an atlas with more nearly 100 images, authentic taken from nci web atlas. It is important to sample the cervix or vagina well. An introduction to cytopathology is in the cytopathology article cervical cytology redirects to this article. This is an atlas with more nearly 100 images, authentic taken from nci web atlas. At the end of the test or after every question if you want you will have the possibilty to view the correct answers, and in some but not. The rest of the specimen is fixed in formalin and embedded in paraffin for cb sections. Atlas of gynecologic cytopathology download ebook pdf. This is a multimedia atlas and tutorial for cytotechnologist learning. Papanicolaou in 1948, the pap smear has remained the foundation for cervical cancer screening worldwide. Atlas on bethesda system for reporting cervical cytology slideshare. Today, however, lowresource countries continue to lack the infrastructure to sustain a cytology based screening program, i.
Ppap smear reportingap smear reporting the pap smear reporting classification has evolved and been refined over time. It is important to sample the cervix or vagina well with minimal artifact and obscuring materials. The bethesda system and guidelines for the management of. Introduction and an overview of the evolution of the pap smear to cervical cancer screening as it is today. The endocervexbrush provides 600 separate collection bristles for the simultaneous collection of cellular material. This monograph essentials of pap smear and breast cytology is prepared at the. The pap test pap smear, papanicolaou test is a screening test used in gynecology. Smear tbs 2001 separates unsatisfactory for technical reasons from those processed but unsatisfactory typical rates of unsatisfactory smears are reported as 0. This article is jointly published in journal of the american society of cytopathology, cancer cytopathology, journal of lower genital tract disease, and acta cytologica by the american society of cytopathology, the american cancer society, the american society for colposcopy and cervical pathol. Rovers endocervexbrush is a one piece cytology brush designed to optimize cellular yield in pap smear, chlamydia, and gonorrhea testing. The bethesda system bethesda atlaspap testcervical cytologyreporting.
The fda has approved thinprep as an alternative for the cp smear and approved claims that it is more. The smear showed fungal hyphae characteristic of mucor species hematoxylin and eosin. Free cytology books download ebooks online textbooks tutorials. An introduction to cytopathology is in the cytopathology article. A gynecological cytology specimen pap smear is an evaluation for the presence of abnormal cells, which may be indicative of malignancy or other conditions requiring treatment. See more ideas about pap smear, anatomy and physiology and love my job. Cytopathology and more pap proficiency testingfor whom. Telepapology is a webbased diagnostic process allowing virtual slides to be analysed and interpreted remotely. Papanicolaou test also called pap smear, pap test, cervical smear, or smear test is a screening test used to detect potentially precancerous and cancerous processes in the the endocervical canal transformation zone of the female reproductive system. Pdf a joint task force of the american society of cytopathology asc and. Removal after consecutive negative pap smears consecutive negative pap smears and negative hrhpv results 3 years from the last identified criterion for high risk status. Cytopathology is generally used on samples of free cells or tissue fragments, in contrast to histopathology, which studies whole. Pap smears predating histopathology diagnosis were available in 27 cases. Pdf detection of abnormal cervical cytology in papanicolaou.