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Guidelines for reporting negative cytology

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Negative for intraepithelial lesion or malignancy

The Bethesda system links previous categories ‘normal and benign alterations’ as a single ‘negative’ category.  The EU guidelines support this opinion (Arbyn et al. 2008; Herbert et al. 2007). 


Benign changes that need not be reported in a negative report

  • Hormonal patterns (post-partum or atrophic)
  • Repair changes
  • Microglandular hyperplasia
  • Tubal metaplasia
  • Sampling of the lower uterine segment
  • Irradiation changes
  • Alterations due to inflammation or the presence of an intrauterine device
  • Benign changes occasionally seen after hysterectomy
  • Endometrial cells in women under 40 years of age

“As long as these changes are recognised as such they need not be reported” (Arbyn et al. 2008; Herbert et al. 2007).  It should be noted that some of these features are ‘at risk’ for false positive reports.


Organisms that may be mentioned in a negative report

  • Trichomomas vaginalis
  • Candida
  • Actinomyces-like organisms
  • Herpesvirus multinucleated cells.

These organisms may be mentioned because they may have clinical relevance but are not related to intraepithelial lesions.