diagnosis: reactive or reparative epithelial changes
As to this file/page, you have been directed to
& now @ Dr. Shaw's personal website
I am indebted to Dr.
Marshall Austin for this excellent explanation of the above, or similar, diagnostic term which
often is the Pap smear diagnosis when we can't actually give a clear diagnosis of "within normal
Reactive Pap tests, classified in the Bethesda System as "Negative
For Diagnostic Epithelial Cell Abnormalities", contain cellular changes intermediate between those
in "Negative-Within Normal Limits" cases and those in "Atypical [squamous or glandular] Cells of
Undetermined Significance" [ASCUS or AGCUS] (The Bethesda System, Springer-Verlag, 1994). A small
proportion of these "reactive/reparative" cases will be variably interpreted by multiple qualified
pathologists or cytotechnologists as showing at least some degree of atypical [not absolutely
normal] cell features (Am. Jour. Clin. Path. 110:653, 1998;....Diag. Cytopath. 11:319, 1994).
Careful follow-up studies of women with a Pap diagnosis of "reactive/reparative cells" have later
found precancerous change, usually low grade, in about 5% of patients (Cancer Cytopathology 81:144,
1997). Therefore, special attention to have the patient get annual repeat Pap smear testing seems
warranted in these "reactive/reparative" cases....possibly at sooner intervals if the patient is
otherwise high-risk for uterine cancer or is poorly compliant (won't follow directions).
In general, it is important to remember that the Pap test is not
perfect; and it is impossible to make it perfect (with or without computer
***give me your comments about this
check out the Highest
(posted 7/21/98; latest review 4 August