Candida-related changes and ASCUS: a potential trap!

Abstract

Detection of potential pitfalls for the ASCUS interpretation is essential for appropriate patient management. Between 1991-1994, 50 cervicovaginal specimens with Candida spp. were submitted for pathologists' review because of a possible ASCUS diagnosis. None had been preceded by abnormal smears, and all were followed by one or more benign smears and/or biopsy. Candida-associated changes included nuclear enlargement with focal hyperchromasia and cytoplasmic changes of orangeophilia, vacuoles, and perinuclear rings. Initially, 16 cases had been interpreted as ASCUS and 34 as benign. Upon review, utilizing strict Bethesda System criteria for ASCUS and awareness of Candida-associated changes, 10 of the 16 ASCUS cases were reclassified as benign. Knowledge of Candida-associated changes which may mimic ASCUS can prevent overuse of the ASCUS term, providing optimal, cost-effective management.