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Indian Journal of Pathology and Oncology


Cytomorphology of vaginal pap smears- A spectrum of lesions in a tertiary hospital


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Author Details: R. Shubha Sangeetha, Rohini Dhanya, H.T. Jayaprakash

Volume : 3

Issue : 2

Online ISSN : 2394-6792

Print ISSN : 2394-6784

Article First Page : 320

Article End Page : 327


Abstract

Background: Pap test is an important and easy diagnostic tool to detect any abnormalities on vaginal cytology. It is routinely done in women of reproductive age group. In addition to detecting cellular and epithelial abnormalities; certain infections, rare entities including neoplastic and non-neoplastic conditions can also be identified.
Aims and Objectives: 1. To study the spectrum of abnormalities on vaginal pap cytology as per The Bethesda System (TBS) 2001.2. To study the utility of pap smears in early diagnosis of premalignant lesions.
Materials and Methods: This prospective study was conducted in Dr. B.R. Ambedkar Medical College, Bangalore where routine pap smears referred from the Obstetrics and Gynaecology Department were studied. Important clinical data like vaginal discharge, inter menstrual bleed, post–coital bleed and lower pain abdomen were collected. Pap smears were analysed, interpreted and categorised based on TBS2001. Importance of detecting premalignant lesions were highlighted in our study.
Results: 525 pap smears were interpreted in a 2 year prospective study out of which 400 cases were analysed after excluding 125 unsatisfactory case. The age range was 18-78 yrs (mean age of 48 yrs). 120 (30%) cases of nonspecific inflammation were identified. Specific infectious etiologies included 186 (46.5%) cases range including most common candida and Bacterial vaginosis to 2 rare infections, one case each of filariasis and granulomatous cervicitis. Significant number(82 cases) of premalignant conditions were diagnosed. 12 malignancies-10 SCC and 2Adenocarcinomas were reported.
Conclusions: Certain rare infectious entities were detected in our study which pose challenge due to infrequent occurance in our daily practice. Close follow- up and histological examination are necessary in premaligant lesions to avoid spread and untimely death of the patient. Thus emphasising effective utility of this simple and cost-effective tool.

Keywords
: Vaginal pap cytology, TBS 2001, NILM, Rare infections, Premalignant, Invasive cancers