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Re: Inflammatory PapFrom: Marco A. Pelosi, III, MD (marcop@tao.agoron.com)Fri Oct 31 14:49:11 1997
At Fri, 31 Oct 1997, Robert J Woolley wrote: > >Case for your collective wisdom: > >28 year-old medical student, completely asymptomatic throughout the events >below, married and monogamous now (though I didn't ask about previous # of >partners). Assume her to be reliable for whatever follow-up you recommend. > >5/95: Routine Pap, normal. > >4/96: Pap with reading "atypical benign (020); Bethesda system--benign >pathology", with comment "Inflammation." No treatment instituted. Advised >follow-up >in 6 months to repeat. > >12/96: Pap with precisely the same reading as before. > >QUESTION #1: Would you recommend, at this point: > >A) Colposcopy >B) Empiric treatment of some sort >C) Repeat Pap in 1 year >D) Repeat Pap sooner (e.g., 4-6 months) > >? Truly benign cellular changes are not cervical cancer precursors. Inflammatory changes warrant assessment for infection. After 4/96, I would have obtained cervical assays for GC & chlamydia, vag pH and wet mount. In the absence of significant findings, no tx, follow-up PAP 4 months. After 12/96, 2nd opinion on PAP slides. If confirmed benign, no tx. If not, colposcopy.
-- M.A. Pelosi, III, MD
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