ATYPICAL CELLS OF UNDETERMINED SIGNIFICANCE

This is a pap smear that the pathologist, who is the physician who looks at the cells from the cervix, cannot say is normal; but he also cannot say for sure that it is abnormal, either.

These inconclusive results can be caused by several things, such as if:

1) There is not enough cellular material to read. The mid-cycle, at the time of ovulation, produces a watery cervical mucus that can dilute the cells. It is best to get a pap smear in the last half of the cycle when the mucus is thicker.

2) There is an infection. If you go to get your yearly exam because you have a yeast infection, your pap may need to be repeated after the infection has been treated.

3) The cervical cells are masked by blood cells. If you go to see your doctor because you are having a bleeding problem or when you are menstruating, the red blood cells can mask the cervical cells that need to be seen.

4) The cells do not look "normal" to the pathologist, but he cannot say just why. Like all doctors, one of the pathologist's most important diagnosis is "this is not quite normal;" but like all physicians he may not always know what is wrong without some additional information. He does not want to miss a pre-cancerous cervical problem, and this is why he requests another pap to look at or possibly a biopsy of the cervix to examine. This result is now frequently followed up with a DNA test for high risk HPV (Human Papilloma Virus). High risk (HR) HPV leads to cervical cancer and in itself with an atypical pap demands a closer look.

The reason you must wait two months to repeat the test is that doing the pap test the first time scrapes the cervix and creates inflammation and healing that can appear "abnormal" if the test is repeated too soon. We do not want to confuse pre-cancerous cells with a healing process. If you have two inconclusive Pap smears in a row without a definitive diagnosis or a positive HR-HPV, most doctors will want to do further investigation. This investigation involves looking closely at the cervix under magnification and is called colposcopy.

FRED CREUTZMANN, M.D. CARROLLTON

972-394-7277 or www.DrCmd.com