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By Edmund S. Cibas, MD, and Barbara S. Ducatman, MD (Auth.)

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With their enlarged nucleus they mimic an LSIL (see Fig. 27B). They are recognized by the company they keep (arranged alongside smaller, more recognizable endocervical cells) and by their granular rather than smooth cytoplasm. Mild but noticeable nuclear changes and larger cytoplasmic cavities raise the possibility of LSIL but sometimes fall short qualitatively or quantitatively. Squamous cells that are suspicious but not conclusive for LSIL are reported as ASC-US. The management of a woman with an LSIL Pap depends on her particular circumstances.

As HSIL. Their true nature is often clarified only after histologic correlation (Fig. 42). The neoplastic cells of AIS share many of the nuclear features of HSIL. Clusters of neoplastic cells are more likely to represent HSIL rather than AIS, unless there is clear columnar differentiation in the form of feathering or rosette formation. SQC should be considered whenever the cytologic criteria for HSIL are fulfilled, but in addition one finds prominent nucleoli or necrotic debris. In some cases, uncertainty remains regarding the true nature of the cells examined.

With their enlarged nucleus they mimic an LSIL (see Fig. 27B). They are recognized by the company they keep (arranged alongside smaller, more recognizable endocervical cells) and by their granular rather than smooth cytoplasm. Mild but noticeable nuclear changes and larger cytoplasmic cavities raise the possibility of LSIL but sometimes fall short qualitatively or quantitatively. Squamous cells that are suspicious but not conclusive for LSIL are reported as ASC-US. The management of a woman with an LSIL Pap depends on her particular circumstances.

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