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Normal cells / non-neoplastic findings
Hyperkeratosis / keratinization
Reviewer: Marilin Rosa, M.D., University of Florida (see Reviewers page)
Revised: 12 October 2010, last major update August 2010
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● Patches of anucleated squamous cells with irregular, angulated edges
● In one study, criteria for extensive hyperkeratosis was 5+ low power fields on a conventional smear and 3+ low power fields in liquid based preparation
● An abnormal finding; may be associated with malignancy (0-2%) or HPV/dysplasia (17-22%) (Acta Cytol 2003;47:749,
Am J Obstet Gynecol 2002;187:997)
● In cases of extensive keratinization, SIL is difficult to grade (Am J Clin Path 2001;115:80)
● Pathology reports of prominent atypical keratosis should state: SIL, grade cannot be determined due to extensive keratosis
Liquid based smear
● SIL: irregular chromatin clumping, irregular nuclear membranes, disorganized growth pattern, vno marked hyperkeratosis (Diagn Cytopathol 1997;17:447)
Cervix-cytology > Normal cells / non-neoplastic findings > Hyperkeratosis / keratinization
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