The category atypical squamous cells of undetermined significance (Ascus), it was introduced in 1988 by the Bethesda System. The clinical conduct in such cases is controversial. Another difficulty is the lack of uniformity as to cytological criteria of this abnormality and as a result we have different rates of the ocurrence. The total number of Ascus in the present series was of 2.4% in respect to 111 cases, detected in an universe of 4,634 cytologic exams in the period of one year. All patients have been submitted to a colposcopic evaluation at the same time as the cytologic samples has been collected. Among those patients whose smears have been presented Ascus, 80 (72%) showed abnormalities to the colposcopic study and 38 biopsies (34%) were performed. The histopatologic evaluation detected chronic cervicitis and/or simple hyperplasia of the malpighian epithelium in 39% of the cases, being 61% of the remaining specimens presented proliferative lesions which varied from a low grade in 20 cases (52%) to a high grade in 3 cases (9%). Those cases of infection by HPV have been predominant (39%). The frequency of Ascus in our study is in agreement with the rates reported in literature. Take into account the percentages described above is evident the cytological meaning of Ascus wich showed its close relationship with squamous intraepithelial lesions at the hystopathologic exam including high grade lesions as well. Thus, the biopsy colposcopic in patients having Ascus would be recommended and it is in fact the most trustworthy means of evaluating those cases.
Ascus; Cytology; Colposcopy
