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Candida-related changes and ASCUS: a potential trap!

N L Miguel1, C M Lachowicz, T S Kline

  • 1Lankenau Hospital, Philadelphia, PA 19096, USA.

Diagnostic Cytopathology
|January 1, 1997
PubMed
Summary
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Pathologists should recognize Candida-associated changes that mimic atypical squamous cells of undetermined significance (ASCUS). Awareness prevents misdiagnosis and ensures appropriate patient management, avoiding unnecessary follow-ups for benign conditions.

Area of Science:

  • Cytopathology
  • Gynecologic Pathology
  • Infectious Disease Pathology

Background:

  • Accurate interpretation of cervical smears is crucial for patient management.
  • Atypical squamous cells of undetermined significance (ASCUS) can be challenging to diagnose.
  • Candida species can cause cytologic changes that mimic ASCUS.

Purpose of the Study:

  • To identify potential pitfalls in ASCUS interpretation.
  • To evaluate the impact of Candida-associated changes on ASCUS diagnosis.
  • To improve diagnostic accuracy and patient management.

Main Methods:

  • Retrospective review of 50 cervicovaginal specimens with Candida spp.
  • Cases initially reviewed for possible ASCUS diagnosis.
  • Re-evaluation using strict Bethesda System criteria and awareness of Candida-associated changes.

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Main Results:

  • Initially, 16 cases were interpreted as ASCUS and 34 as benign.
  • Upon review, 10 of the 16 ASCUS cases were reclassified as benign.
  • Candida-associated changes included nuclear enlargement, hyperchromasia, orangeophilia, vacuoles, and perinuclear rings.

Conclusions:

  • Knowledge of Candida-associated changes can prevent misinterpretation of ASCUS.
  • Accurate diagnosis avoids overuse of the ASCUS term.
  • This leads to optimal, cost-effective patient management.