What does an abnormal Pap smear with atypical squamous cell changes mean?
When the cytologist or pathologist is looking at a Pap smear, they basically look for cells that have increased nuclear activity. If you remember your biology, the nucleus is larger in proportion to the cytoplasm in the cell than it normally is. This increased nuclear activity can be due to infection or cellular repair processes, irritation associated with atrophic changes of the low estrogen menopausal state, or external agents causing cell damage such as radiation therapy. Sometimes, however, the increased nuclear activity can indicate the cell is more rapidly dividing and thus replacing normal cells. This is called dysplasia and is considered premalignant change. If cellular changes associated with human papilloma virus are present, that may explain much of the increased nuclear activity. If your Pap smear has atypical squamous changes, it should be read out as either ASCUS favor benign or ASCUS favor dysplasia. Most physicians do not currently recommend colposcopy and cervical biop
