Pap Smear (cont.)
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What information is included on a Pap smear report?
The first items on a Pap smear report are for purposes of identification. The
report is expected to have the name of the woman, the name of the pathologist
and/or the cytotechnologist who read the smear, the source of the specimen (in
this case, the cervix), and the date of the last menstrual period of the woman.
The Pap smear report should also include the following:
- A description of the woman's menstrual status (for example,
"menopausal" (no longer menstruating) or "regular menstrual periods")
- The woman's relevant medical history (example, "history
of genital warts")
- The number of slides (either one or two, depending on
the health care practitioner's routine practice)
- A description of the specimen adequacy (whether the
sample is satisfactory for interpretation)
- The final diagnosis (for example, "within normal limits")
- The recommendation for follow-up (for example, "recommend routine follow-up" or
"recommend repeat smear")
Why is a woman's menstrual status important for the Pap smear?
A woman who is menstruating sheds cells from the lining
of her uterus called endometrial cells. If these cells are seen on the Pap smear
of a menstruating woman, the report may note "endometrial cells, cytologically
benign, in a menstruating woman. The comment that cells are "cytologically
benign" means that they do appear not to be malignant (cancerous) cells. A
comment of this nature is absolutely not worrisome since a menstruating woman may be expected to
shed such cells.
However, if a woman is menopausal (no longer menstruating) she would not be
expected to be shedding cells from the uterine lining. Therefore, endometrial
cells on a Pap report might be indicative of an abnormal thickening of the
endometrium, the lining of the uterus. The Pap smear is not specifically
designed to detect such an abnormality. Nonetheless, if these cells are noted in
a non-menstruating woman, her physician should attempt to determine the cause of
the shedding of the endometrial cells.
Sometimes, the cause is endometrial hyperplasia, a precancerous condition of the uterine lining, which can be
detected by a relatively simple office procedure called an endometrial biopsy.
Sometimes, menopausal hormone therapy can cause shedding of endometrial cells
that appear on a Pap smear. The pattern of bleeding, the exact type of hormone
therapy, and the
individual woman's health history are the three components that guide the physician
to know whether and what type of further evaluation is necessary.
Next: Why is a woman's past Pap smear history pertinent? »
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