WOMENS-HEALTH Messages for April, 1997: Re: Abnormal Pap Smears

Re: Abnormal Pap Smears - Missing Cells

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Wed, 16 Apr 1997 15:42:31 -0500 (CDT)

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In reply to: Lisa: "Abnormal Pap Smears - Missing Cells"

At Wed, 16 Apr 1997, Lisa wrote: >
>During the past two months I have had three pap smears, all of which
>have come back "fine", but are missing what my doctor calls
>"endocervical" cells. After the first test, she said that it was
>important to take another test, because the location of these cells is
>where cancer is most likely to occur.

Maybe not most likely, but may occur and should be checked out if possible. the American College of Obstetrics and Gynecology does not classify a pap as inadequate or insufficient for diagnosis if endocervical cells are missing. This is an important distinction.

>I read Dr. Chudacoff's response
>to another posting, dated 3/19/97, in which he describes the two types
>of cells. I assume my doctor is referring to "squamous" cells.

Nope. It's the endocervical cells inside the linig of the cervix. The squamous cells are on the outside (portio) of the cervix.

>After
>the third test, she stated she would not test again because she feared
>damaging my uterus if she went any further to try to get the cell
>sample. Do you know why I would be "missing" these cells? Is there a
>disease or situation that would cause this?

The cells aren't missing. Pap smears are the reading of cells being shed or ready to be shed by the cervix. Sometimes people have (as I call them in the office) obnoxious endocervical cells. They just won't come out and play. This is rarely a problem. There are different instruments used to get endocervical cells. The better the sample, occasionally, the more the bleeding or staining after the pap. Your doctor may be trying to spare you the possible bleeding afterwards. If none of these methods work and a sample of the endocervix is mandatory, an endocervical curettage (a few seconds of cramping as the lining of the cervix is scraped).

-- Harvey S. Marchbein, M.D. FACOG, FACS OBGYN.net U.S. Representative, New York Great Neck, New York

*Note: Opinions expressed here are for educational purpose only. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options.

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