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abstract American Journal of Clinical Pathology
Objectives:
Abnormal signs or symptoms recorded on Papanicolaou (Pap) test
requisitions may reflect disease not detected with Pap testing. Since
2009, these cases have been reviewed in our laboratory by a second
cytotechnologist and a cytopathologist. The objective of this study was
to document follow-up findings on these patients.
Methods:
A search for Pap test results of “Negative for intraepithelial lesion
or malignancy, abnormal clinical signs or symptoms” was performed for
cases from January 1, 2009, to October 10, 2013. Clinical information
and follow-up findings were documented.
Results:
1,104 cases were identified. Signs and symptoms were abnormal bleeding
897 (81%), polyps 83 (8%), pelvic mass 54 (5%), visible cervical lesions
48 (4%), vaginal lesions 17 (2%) and endometrial masses 6 (0.5%). Six
hundred sixty-seven (60%) had follow-up results, including 517 with
histopathologic diagnoses. Two-hundred thirty-three (45%) had
nonspecific benign diagnoses, 216 (42%) had benign tumor-like
conditions, 28 (4%) had insufficient specimens, 16 (3%) had precancerous
diagnoses and 23 (4%) had malignancies. Endometrial malignancy was
identified in 14 (61%), ovarian in 6 (26%), and miscellaneous in 3
(13%). No cervical cancers were identified.
Conclusions:
We report follow-up findings from patients with abnormal clinical signs
or symptoms, negative Pap test results, and follow-up recommendations
highlighting reported abnormal signs or symptoms. Abnormal clinical
signs and symptoms should routinely be considered in assessment and
management of patients with negative cervical screening test results.
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