Help for interpreting (hungarian) cytological findings:
1. "KENET MINŐSÉGE" (SMEAR QUALITY)
"MEGFELELŐ" (APPROPRIATE) Epithelial cells are clearly visible in the smear, and a correct diagnosis can be given about them
"ÉRTÉKELHETŐ, DE:" (ACCEPTABLE, BUT) Epithelial cells are visible in the smear, but some technical problem makes the diagnosis difficult. - "zavaró mértékű vér" (a disturbing amount of blood): the smear was bloody, and the many red blood cells cover the cells you want to see. It is recommended to repeat the application after anti-inflammatory treatment! - "zavaró gyulladás" (disturbing inflammation): in the inflammatory processes of the cervix, many white blood cells are present, which also cover the cells you want to see. It is recommended to repeat the application after anti-inflammatory treatment! - "endocervicalis átmenetri zóna hiányzik" (endocervical transition zone is missing): for some reason, only one of the two epithelium types is smeared. In this case, it is recommended to repeat the smear, usually 2-3 mm deeper than usual (it is also painless!!) - "sejtszegény kenet" (cell-poor smear): this type of finding can primarily occur if there is more mucus on the cervix than average, and because of this, the cytological sampling device can sweep off fewer cells from the surface of the cervix. In this case, it is recommended to repeat the smear in the second phase of the menstrual cycle. - "elégtelenül fixált" (insufficiently fixed): the fixing chemical could not preserve the cells, so they partially disintegrated. It is recommended to repeat the smear.
"ÉRTÉKELHETETLEN" (UNAPPROPRIATE) Due to some technical or administrative problem, a diagnosis cannot be given from the smear. Repetition is definitely recommended
2. "KENET ÉRTÉKELÉSE" (SMEAR EVALUATION)
"NEGATÍV" (NEGATIVE) The cell smear shows a completely normal, healthy picture.
"EGYÉB" (OTHER) There are only minor, benign differences in the smear, which are detailed in the next point.
"KÓROS HÁMELVÁLTOZÁSOK" (ABNORMAL EPITHELIAL CHANGES) Unfortunately, the smear contains abnormal epithelial cells. The specific type and severity of the lesion is detailed in the next point.
3. "RÉSZLETES DIAGNÓZIS - FERTŐZÉSEK"
(DETAILED DIAGNOSIS - INFECTIONS)
"Candida" (Candida) Characteristic germinating fungi were also found in the smear, which indicates the presence of candida (fungus). It is important that presence is not the same as infection, so its treatment requires a unique assessment
"Trichomonas vaginalis" (Trichomonas vaginalis) Typical protozoan pathogens were also found in the smear, indicating a trichomonas infection. Suspicion of infection can be confirmed or ruled out with a targeted pathogen detection test.
"Actimomyces" (Actinomyces) This type of infection usually occurs with older types of IUDs. If you have an IUD, we definitely need to consult about what to do! (device removal or antibiotic course)
"Kóros flóra" (Pathological flora) This does not mean a specific pathogen, but indicates that the normal lactic acid-producing vaginal flora has weakened and primarily anaerobic bacteria have overgrown. A probiotic suppository is recommended, in rarer cases stronger suppositories are required.
"Herpes fertőzés gyanúja" (Suspicion of herpes infection) Genital herpes infection is accompanied by unpleasant, painful, vesicular rashes. The first infection can be caught sexually, but later e.g. under stress, it can recur even without an external source.
3. "RÉSZLETES DIAGNÓZIS - REPARATÍV JELEK" (DETAILED DIAGNOSIS - REPARATIVE SIGNS)
"Gyulladás, reaktív hámelváltozással" (Inflammation with reactive epithelial changes) There is inflammation in the area of the cervix, it can be mild or significant.
"Atrophia / gyulladás" (Atrophy / inflammation) The atrophy of the epithelium is caused mainly by estrogen-deficient states, such as menopause. A topical estrogen-containing vaginal cream can help with this.
"Sugárhatás" (Radiation effect) Irradiation of the pelvic organs (oncological treatment) can cause typical cell changes.
"Metaplázia" (Metaplasia) Metaplasia means the transformation of the normal glandular cells into normal epithelial cells, and is considered as a healthy phenomenon. It is more common during adolescence and pregnancy.
"Endometrium sejtek >45 éves kor" (Endometrial cells above the age of 45) Over the age of 45, if endometrial cells are seen in the cervical smear, the possibility of endometrial proliferation or tumor may arise, and for this reason additional examinations (ultrasound, endometrial biopsy) may be necessary.
3. "RÉSZLETES DIAGNÓZIS - LAPHÁM ELVÁLTOZÁSOK"
(DETAILED DIAGNOSIS - EPITHELIAL CHANGES)
ASC-US Atypical squamous cells of unknown significance. It usually indicates a mild, initial precancerous stage and often heals on its own. A detailed examination is definitely required!!
LSIL (or "HPV" or "CIN I.") "Low-grade squamous intraepithelial lesion", i.e. mild squamous cell abnormality. It is usually caused by the HPV virus and refers to an initial precancerous stage, can be cured often completely. A detailed investigation is definitely required!!
HSIL (or "CIN II." or "CIN III.") "High-grade squamous intraepithelial lesion", i.e. severe squamous cell abnormality. This finding indicates the presence of a direct precancerous condition and, with very few exceptions, requires histological excision as soon as possible (conization).
ASC-H "Atypical squamous cells, cannot exclude HSIL". Clinically, it should be treated in the same way as an HSIL finding.
"Laphámcarcinoma, invázió gyanúja" (Squamous cell carcinoma, suspicion of invasion) Unfortunately, the possibility of cervical cancer arises realistically. Immeadiate further examination needed!
3. RÉSZLETES DIAGNÓZIS - MIRIGYHÁM ELVÁLTOZÁSOK
(DETAILED DIAGNOSIS - GLANDULAR CHANGES)
AGC-NOS "Atypical glandular cells - not otherwise specified" Here, the atypical cells come from the cervical canal or the uterine lining. Further investigation is definitely required!
AIS Adenocarcinoma in situ, i.e. the precancerous state of the glandular epithelium, from which an (invasive) tumor spreading to the surrounding tissues can develop within a few years. It definitely requires further treatment, histological excision (conization + abrasion).
AGC-FN "Atypical glandular cells, favor neoplasia", i.e. atypical glandular epithelial cells, tumor is likely. It definitely requires further treatment (conization + abrasion)
Adenocarcinoma Unfortunately, cells of glandular cancer origin were found in the smear, which can originate from the cervix (cervical canal) or the uterine cavity. It definitely needs further treatment!!
4. JAVASLAT (RECOMMENDATION)
"Ismétlés szükség szerint" (Repeat as needed) That is, the smear is fine, it is recommended to continue with routine cancer screening.
"Ismétlés lobellenes kezelés után" (Repetition after anti-inflammation treatment ) That is, inflammation was visible in the smear. Repeated smearing is required after antibiotic suppository treatment.
"Ismétlés hormonkezelés után" (Repeat after hormone treatment) That is, epithelial atrophy due to estrogen deficiency is visible in the smear. Repeated smearing is required after an estrogen-containing vaginal suppository treatment.
"Szoros cytológiai kontroll X hónap múlva" (Close cytological control after X months) In order to monitor the process (is it improving? is it getting worse?), it is recommended to take a smear earlier than the time of the routine cancer screening.
"HPV tipizálás javasolt" (HPV typing is recommended) For any serious cell abnormality, it is important to know whether the background is the HPV virus or something else. The HPV test is a special smear from which the DNA of the HPV virus is detected.
"CINTec vizsgálat javasolt" (A CINTec test is recommended) The above test involves a special immunohistochemical staining of the cell smear and viewing it under a microscope. This may be necessary mostly in questionable, unclear cases.
"Hisztológiai (szövettani) vizsgálat javasolt" (A histological examination is recommended) The cell picture seen raises serious changes or suspicions of them. Surgical excision serves two purposes: on the one hand, the bad epithelial cells are removed from the cervix (conization), and on the other hand, a detailed histological examination is also possible.