The significance of a negative Papanicolaou smear with hyperkeratosis or parakeratosis.

The significance of a cytologic diagnosis of hyperkeratosis or parakeratosis on a Papanicolaou smear reported as negative is unknown. We conducted a review of 170 women without uterine descensus who presented to Tripler Army Medical Center cervical clinic with a negative Papanicolaou smear but with hyperkeratosis or parakeratosis noted on the slide. All patients underwent colposcopy, and 64% had either cervical punch biopsy or endocervical curettage. Six women (3.5%) had cervical intraepithelial neoplasia documented histopathologically. We conclude that the cellular findings of hyperkeratosis or parakeratosis on a Papanicolaou smear are not associated with an increased histologic or colposcopic detection of cervical intraepithelial neoplasia.