The present study aimed to determine the histopathological correspondence of the diagnosis of atypical squamous cells of uncertain significance (ASCUS) in the absence of squamous intraepithelial neoplasia (SIL) in loop electrical excision procedure (LEEP) products. Retrospective histopathological analysis of 70 LEEP products preceded by ASCUS was consistently detected by two consecutive Pap smears. The presence or absence of several histopathological findings in cases with (23/70) and without (47/70) histological diagnosis of SIL were compared. Immature squamous metaplasia, severe cervicitis, and tube-endometrial metaplasia were found with similar frequency on positive and negative neoplastic disease specimens. Reactive squamous atypia, keratosis, atrophy, glandular reactive/inflammatory atypia, tunnel clusters, and microglandular hyperplasia were less frequently found in LEEP specimens presenting with SIL. Reactive squamous atypia and keratosis were consistently associated with SIL absence and appear to be responsible for the cytological diagnosis of ASCUS (P < 0.05).
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