ASCUS, mature metaplastic type. Cytologic diagnosis and follow-up

Area of Science:

• Cytopathology
• Cervical Cancer Screening

Background:

• Atypical squamous cells of undetermined significance (ASCUS) is a common finding in cervical cytology.
• Mature metaplastic cells within the ASCUS category require clear cytologic criteria for appropriate management.

Purpose of the Study:

• To establish cytologic criteria for the follow-up of mature metaplastic cells classified as ASCUS.
• To correlate cytologic findings with patient follow-up data.

Main Methods:

• Review of 2,632 squamous epithelial abnormalities, focusing on 134 metaplastic cases within the ASCUS category.
• Selection of 89 cases with follow-up via biopsy or at least two Pap smears and no prior epithelial abnormality.
• Tabulation of cytologic parameters including cell morphology, nuclear features, and review for inflammation and hormonal status.

Main Results:

• Mature metaplastic cells (ASCUS-M) were characterized by specific cytologic features (e.g., polygonal shape, thickened cytoplasm, stippled chromatin).
• Of the 69 confirmed ASCUS-M cases, follow-up revealed 42 benign findings, 9 persistent ASCUS-M, and 18 low-grade squamous intraepithelial lesions.

Conclusions:

• Mature metaplastic cells with minimal atypia, in the absence of prior or concurrent dysplasia, exhibit follow-up patterns similar to ASCUS-superficial/immediate squamous cells.
• Conservative follow-up management is appropriate for these patients.