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Answer:
4. Reactive endocervical cells
- An inflammatory background
- Actinomyces present
- Cells occur in sheets and strips with some cell crowding
- Nuclei
are overlapping, slightly enlarged, variation in size and shape
Slide B
5. ASC-H
- Single oval cell with high N/C ratio
 Figures 1: Reactive endocervical cells with vacuoles in slide A |
 Figure 2: Reactive endocervical cells with vacuoles in slide B |
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Conclusion
- Slide A was signed out as ASCUS
- It was reviewed by retrospective screening
- Reactive and atypical metaplastic and endocervical cells are noted
- The reactive changes can be explained by the effect of IUCD
- Slides B was signed as ASCUS
- On review, the retrospective screening result was ASCUS not ASC-H
- Reactive / atypical metaplastic and vacuolated glandular cells are noted
- The cellular change is compatible with the effect of IUCD
Summary of IUCD effect
- Atypical / reactive cells are seen: hypervacuolated endocervical cells, vacuolated metaplastic cells and endometrial cells
- Actinomyces present
- Inflammatory background without tumour diathesis
- Single cells with high N/C ratio
Remarks
- Abnormalities may coexist with IUCD effect
- Recommend to remove the device for further assessment