What is an Epithelial Cell Abnormality?

Jennifer Long

An epithelial cell abnormality is the term for unusually sized or shaped cells found on the cervix in the vagina. This test result, most often received following a pap smear, does not necessarily indicate a malignant or cancerous growth; rather, it just indicates that there might be pre-cancerous cells or cancerous cells. There are several categories of abnormal cells that can be found by a pap smear. When atypical cells are discovered, repeated testing may be necessary, sometimes at two to three month intervals depending on the findings. In many cases, an epithelial cell abnormality consists of cells that function and grow normally.

Epithelial cell abnormalities are unusually sized or shaped cells found on the cervix in the vagina.
Epithelial cell abnormalities are unusually sized or shaped cells found on the cervix in the vagina.

Types of Abnormalities

Atypical epithelial cells are broken down into two broad categories: squamous cells and glandular cells. Squamous cells are simply smooth, surface layer cells, while glandular cells excrete bodily materials, like hormones or sweat. The most common reasons for a finding of unusual squamous cells are Atypical Squamous Cells (ASC), Squamous Intraepithelial Lesions (SIL), or squamous cell carcinoma. Glandular cell problems are typically categorized as Atypical Glandular Cells (AGCs) or adenocarcinoma. Of both squamous and glandular cell abnormalities, only findings of squamous cell carcinoma and adenocarcinoma almost definitely indicates cancer.

The test to check for epithelial cell abnormalities usually happens right after a pap smear.
The test to check for epithelial cell abnormalities usually happens right after a pap smear.


ASCs are clearly not normal, but it's not entirely clear why. Cells in this category can be either Atypical Squamous Cells of Undetermined Significance (ASCUS) or Atypical Squamous Cells with possible High-Grade Changes (ASC-H). The first type is generally not a cause for concern, although health care providers often recommend a follow-up pap smear just to be sure. The second type indicates that there may be a SIL or other pre-cancerous cells on the surface of the cervix, but it's not entirely certain. In this case, a health care provider will generally call for a colposcopy, which is a diagnostic test in which a gynecologist visually examines the inside of the vagina for other abnormalities or lesions.

A gynecologist can evaluate epithelial cell abnormalities.
A gynecologist can evaluate epithelial cell abnormalities.


SILs are growths on the surface of the cervix that can lead to cancer. They are categorized as low or high risk depending on how likely they are to cause cancer. After a finding of SIL, a health care provider will usually recommend a colposcopy or biopsy to confirm the level of risk associated with the cell.

An epithelial cell abnormalities require assessment via lab testing to determine the nature of the cells.
An epithelial cell abnormalities require assessment via lab testing to determine the nature of the cells.

Squamous cell carcinoma

Squamous cell carcinoma is the most common type of cervical cancer, and can be fatal if left untreated. If it is indicated by a pap smear, health care providers will usually perform a colposcopy or biopsy to determine what stage the cancer is in, ranging from "in situ," which means that cancerous cells exist, but have not yet spread into the tissue surrounding them; to stage 4, in which the carcinoma has spread beyond the cervix. Once this has been determined, a woman can start a treatment regimen.


This finding can indicate that the glandular cells in either the cervix or the lining of the uterus, also called the endometrium, may have a problem. About half of the time AGCs are not a cause for concern, similarly to ASCUS. They can, however, be pre-cancerous, so health care providers usually do a biopsy just to be sure.


This is a fairly rare type of cancer that is similar to squamous cell cancer, but affects glandular cells instead. As with a finding of squamous cell cancer, health care providers generally order further testing to determine the stage of the cancer, and then begin treatment.


One cause of abnormal epithelial cells is cervical dysplasia. In this case, cervical cells grow abnormally, and they are either shaped oddly or they grow in larger quantities. This cell growth is not malignant, but can develop into cancer over the course of 10 years or longer. Cervical dysplasia occurs more often in women from 25 to 35 years old and typically has no symptoms.

Unusual cells are sometimes reported because of infections such as herpes and human papillomavirus (HPV), one of the primary risk factors for cervical cancer. The presence of parasites or yeast infections can also yield a positive result. A cellular sample can turn up abnormal because of an injury. If an infection or injury is suspected, then there is usually no concern for cancer as a result of finding an epithelial cell abnormality.


Treatment for an epithelial cell abnormality depends on the individual problem. If the cells are non-cancerous, there is not usually any immediate treatment, except for future tests. Treatment for cancerous lesions can vary from case to case. If these are found in an early stage, the condition is often treatable with minor procedures; while more advanced cases may require surgery, medication, and radiotherapy. The exact course of treatment often depends on the condition and the advice of multiple health care professionals.

A gynecologist may perform a test called a colposcopy to investigate epithelia cell abnormalities.
A gynecologist may perform a test called a colposcopy to investigate epithelia cell abnormalities.

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Discussion Comments


My UR shows Epithelial cell Rare Squamous abnormal. The doctor has ordered a pelvic sonogram. Should I be worried?


I just got the result of my Pap and it said I had epithelial cell abnormalities, atypical glandular. What does that mean? My uncle just had cancer of the esophagus, so does that mean I also can get cancer? I already had the second Pap today and in a week I will get the result, but now I am very nervous and scared. They said in November, I will have a colposcopy. Does that mean I have cancer?


I was diagnosed with cervical adenocarcinoma in February. I was given a total hysterectomy, including my ovaries.

I also had a lymphadenectomy that showed cancer in five of my pelvic lymph nodes. I was treated with six chemo sessions using Cisplatin, and 25 targeted radiation treatments. Six weeks after completing treatment, I had another pap smear. The cytology showed epithelial cell abnormalities and intraepithelial lesions. Does this mean that I still have cancer, or that I will develop cancer again?


I've had abnormal cells on my pap so I went to a specialist to have a biopsy, then I went through a process in which they froze my cells. When I got the test done again, it showed it was normal.

I went back to the doctor a month ago and a few days ago, I got my results which show abnormal cells again. I need to go to a specialist once again.


I got my Pap results back and they said, "Epithelial Cell Abnormality. Atypical Squamous cells, Cannot Exclude high-grade squamous epithelial lesion."

I went to the gynecologist and the doctor did a biopsy. I am so damn scared. I am literally in fear to death thinking that I might have cancer. I am 30 and I am so desperate for a kid now. I have to wait for one more week to get the results. Can't wait.


Since my very first pap, 20 plus years ago, I have always had abnormal readings with epithelial cell abnormality and low grade squamous interephithelial lesions. I can't possibly get too excited as additional tests show nothing. I just want other women to know it could be normal to their body and you shouldn't get too excited as this stage, as it's quite possible it means nothing!


I had a pap almost two weeks ago and last week my doctor told me I had epithelial cell abnormalities. My doctor (not my ob/gyn, he just did my pap as part of my routine physical) told me not to put it off and to see my gyno within a month or two, but would not elaborate on what exactly it means.

So of course, I went to the internet and if you ever want to create a small hysteria in yourself, look up some medical test results. I have a colonoscopy scheduled in four days. My family has histories of hysterectomies so I am a little worried, since I am only 29. And we also have a history of other types of cancer in young women in my family, mostly in their 40's. I'm trying not to be worried and just go with the flow until I know something for sure but its hard considering I have no idea how long it will be before the results of the colonoscopy are in and I will have some answers.


I just got my results: Epithelial cell abnormality. Vaginal intraepithelial neoplasia, grade II (VAIN I). I have had a total Hysterectomy. Should I be concerned? Please advise.


I just got the results of my pap and my doctor says its abnormal, possibly pre-cancerous. On my results sheet, it says the general categorization is epithelial cell abnormality and the interpretation/result says atypical Squamous Cells of Undetermined Significance (ASC-US).

She's recommending a repeat pap in one to two months with HPV testing as well. I'm really trying not to freak out but it's hard not to. I don't want to take it lightly, nor do I want to overreact.


Burcidi: You are very right. It is important to be monitored for abnormalities as often as recommended by a doctor. Yes, it is possible for nothing bad to come from having an abnormality, but it should also not be ignored.


My brother is a doctor. He tells me that there are different categories of epithelial cell abnormality. It depends on the number of abnormal cells found in that tissue and there are varying levels too.

So just because someone has cell abnormality, they should not jump to conclusions about what might happen. It might be the case that there are only a few abnormal cells which will not develop into anything. The only way to know is by regular monitoring.


My best friend found out that she has abnormal epithelial cells in her cervix. They took a sample, and thankfully it is not cancer. Now she is going for regular check ups and smear testing.

I'm really happy that she caught it early on so that she can monitor it case it develops into a tumor. But I've heard that quite a few of these abnormalities develop into cancer in the following years.

I just wish that there was a treatment option at this stage to prevent cancer from developing in the first place. It's sort of like she is waiting to see what happens.

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