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Negative for intraepithelial lesion or malignancy
o no signs of cancer, pre-cancer, or other significant abnormalities were found
o There may be findings that are unrelated to cervical cancer, such as signs of infection with yeast,
herpes, or Trichomonas vaginalis
o “Reactive cellular changes”, which is the way cervical cells appear when infection or other
inflammation is around
Epithelial cell abnormalities
o The cervix or vagina show changes that might be cancer or a pre-cancer
o Divided into several groups for squamous cells and glandular cells
Squamous cell abnormalities
o ASCs (atypical squamous cells):
 ASC-US
 Atypical squamous cells of uncertain significance  cells that look abnormal, but
it isn’t possible to tell if this is 2/2 infection, irritation, or a pre-cancer
 Most of the time these cells are not pre-cancer, but more testing (eg, HPV test) is
needed to confirm
 ASCH-H
 Atypical squamous cells where high-grade squamous intraepithelial lesion (HSIL)
can’t be excluded  when cells look abnormal but are more concerning for a
possible pre-cancer that needs more testing and may need Tx
o SILs (squamous intraepithelial lesions):
 LSIL
 Low-grade SIL  cells look mildly abnormal
 Otherwise known as mild dysplasia or cervical intraepithelial neoplasia grade 1
(CIN1)
 HSIL
 High-grade SIL  cells look severely abnormal and are less likely than the cells in
LSIL to go away w/out Tx
 More likely to eventually develop into cancer if not treated
 Otherwise known as mod-severe dysplasia or cervical intraepithelial neoplasia
grade 2 or 3 CIN2 and/or CIN3)
 FYI: if SIL is seen on a Pap test, further tests are needed; if Tx is needed, it can cure most
SILs and prevent invasive cancer from forming
o Squamous cell carcinoma:
 This result means the woman is likely to have an invasive cancer
 Further testing will be done to confirm the Dx before Tx can be planned
Glandular cell abnormalities
o Atypical glandular cells (AGCs):
 Then the glandular cells don’t look normal, but they have concerning features that could
be cancerous
 More testing should be done
o Adenocarcinoma:
 Cancer of the glandular cells
Other malignant neoplasms
o This category is characterized by other forms of cancer that rarely affect the cervix such as
malignant melanoma, sarcomas, and lymphoma
Microinvasive CA
o Refers to invasive cancer at its earlies stsage
o It has broken through the basement membrane, but doesn’t extend beyond a depth of 3 mm
(stage IA1) or 5 mm (stage IA2) or a width of 7 mm
o Often asymptomatic but may present with abnormal vaginal bleeding
o The referral smear usually shows features of an HSIL but may occasionally describe specific
cytological markers for invasion