Search the slide for more obvious HSIL or CGIN before reporting the slide
Discuss difficult cases with colleagues before sending out ASC-H or AGL reports
Colposcopy and multidisciplinary review of histology and cytology slides can avoid unnecessary treatment in atypical cases
Remember that judicious use of ASC-H and AGL categories can avoid false positives and false negatives
Learning points from Chapter 10
Dyskaryosis should be present in all false negative and absent in all false positive cellular abnormalities (at least on review)
ASC and AGL (borderline) reports should only be used for genuine doubt between negative/reactive and SIL/neoplasia
False negatives can be avoided by familiarity with their main causes: sparse, pale and small cell dyskaryosis, hyperchromatic crowded cell groups, and dyskaryosis masked by inflammation
Hyperchromatic crowded cell groups and sparse dyskaryotic cells are potential false negatives in LBC as well as conventional smears
False positives may be avoided by familiarity with the full spectrum of reactive changes in metaplastic and inflammatory conditions
Endocervicitis, atrophic vaginitis, immature squamous metaplasia, tubal metaplasia and tuboendometrioid metaplasia are important potential false positives
False positives are important because unnecessary excision biopsy may increase risk of premature rupture of membranes in pregnancy
Atypical/borderline reports when used in cases of genuine doubt may avoid false negatives and false positives