Abstract
Objective: Vaginal atrophy of menopause shows increased parabasal cells on cytology. This may be accompanied by abundant neutrophils. A shift in the maturation index in the absence of significant inflammation is more accurately termed atrophic pattern. The purpose of this study was to determine whether the diagnoses “atrophic vaginitis” or “atrophic pattern” rendered on a pap were reliable indicators of what was present on the slide. Methods: A retrospective review of pap smear slides from University Hospital, Newark was performed. Cases that had been diagnosed with either “atrophic vaginitis” (n=100) or “atrophic pattern” (n=100) were selected. Exclusion criteria included any additional diagnosis of neoplasia. Slides were re-reviewed and scored based on abundance of neutrophils (0-5, 5-10, or >10 neutrophils/high power (40x) field, with 10 fields per slide reviewed. Data were analyzed by Chi squared analysis. Results: Among the 200 cases with “atrophic vaginitis” or "atrophic pattern", the proportion of those diagnosed with "atrophic vaginitis" versus "atrophic pattern" increased across three increasing neutrophil categories (p<0.0001). Conclusion: A diagnosis of “atrophic vaginitis” on a pap smear was reliably associated with increased numbers of neutrophils. A diagnosis of “atrophic pattern” was indicative of low numbers of neutrophils. As the pap diagnosis of atrophic vaginitis does not correlate with clinical symptomatology, a single diagnostic term that does not suggest a disease process would more reliably communicate the cytology findings to clinicians.