Gynecologic cytology. Practical considerations and limitations

Diagnostic problems arise as a result of overlap of cytologic criteria of some squamous and glandular lesions of the female genital tract, lack of experience, or an overzealous attempt to interpret some features. This article emphasizes the role and limitations of cytology in the diagnosis of neoplasia and preneoplasia of squamous and glandular elements of the uterus. Sampling techniques greatly influence the pathologist's ability to interpret the material. The classifications and cytologic features of preneoplastic and neoplastic squamous and glandular epithelia, including the new Bethesda System for reporting, are reviewed. Problems in interpretation, particularly of nondysplastic conditions that mimic true neoplasia, and reasons for false-negative and false-positive results are discussed.