Medium power: Pap stain
Hyperchromatic parabasal cells consistent with ASC-H
Note that these cells are singly dispersed, and have small size, so they may be missed. Look for ASC-H cells in the gaps between superficial and intermediate cells
Pap stain: High power
Single atypical metaplastic cell. Note hyperchromatic nucleus with irregular nuclear membrane
Pap stain: High power
Note single metaplastic cell with irregular nuclear, increased N:C ratio and abnormal chromatin distribution
Pap stain: Medium power
Numerous normal squamous cells with single atypical cell, consistent with ASC-H. Note the nuclear hyperchromasia and irregularity with slightly increased N:C ratio
Pap stain: Medium power
Scattered small cells, consistent with ASC-H with background normal squamous cells
Features
• Liquid based
• Cells involved: Metaplastic and parabasal cells
• Single cells
• Dense cytoplasm
• Nuclear enlargement
• Increased nucleus cytoplasmic ratio (between 1:3 to 1:2)
• Nuclear membrane irregularity
• Hyperchromatic nucleus
• Irregular chromatin distribution
• Nucleoli • absent to inconspicuous
• Quantum of atypical cells is less in ASC-H and sheets of atypical cells are absent as compared to HSIL