Significance of bizarre cells in cervical screening liquid-based cytology: A prospective study of 15 cases
Abstract
Objective: The aim of this study was to assess the significance of bizarre cells (cellsof squamous origin with a superficial squamous cell-type cytoplasm and charac-terised by multinucleation that produces bizarre nuclear shapes) in liquid- basedcytology (LBC) Papanicoaou (pap) smears with clinical and histological follow-upcorrelation.Methods: Fifteen patients, all with LBC samples containing bizarre cells, were iden-tified in routine ThinPrepâLBC workload. HPV testing was performed in each caseusing residual LBC material.
Cytological-histological correlations were reviewed.Results: All 15 LBC samples contained bizarre cells and tested positive for high-riskHPV types. Ten of the 15 cases were identified as atypical squamous cells - cannotexclude an HSIL (ASC-H) with secondary diagnosis of low-grade squamous intraep-ithelial lesion (LSIL), while five cases were identified as high-grade squamous intra-epithelial lesion (HSIL), and a subsequent biopsy was recommended.
Additionally,13/15 cases underwent cone biopsy or hysterectomy within 1-11 months, of which10 showed histologically confirmed HSIL end-points. LSIL was present in threecases.
Bizarre cells were identified in the HSIL epithelium of five cone biopsies.Conclusions: Identification of bizarre cells in LBC is straightforward and mayfacilitate diagnosis. The cytology of bizarre cells is associated with HSIL in conebiopsies.
We recommend assigning LBC samples containing bizarre cells as ASC-Hwith secondary diagnosis of LSIL.