{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T19:13:24Z","timestamp":1783538004108,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,2,28]],"date-time":"2018-02-28T00:00:00Z","timestamp":1519776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cytopathology"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The characteristic features of Papanicolaou (Pap) tests collected from female\u2010to\u2010male (<jats:styled-content style=\"fixed-case\">FTM<\/jats:styled-content>) transgender patients on androgen therapy have not been well defined in the literature. <jats:styled-content style=\"fixed-case\">FTM<\/jats:styled-content> transgender patients require cervical cancer screening with the same recommended frequency as cis\u2010gender females. Dysplasia remains challenging to differentiate from atrophy. Without pertinent history, the atrophic findings in younger transgender patients can be misinterpreted as high\u2010grade dysplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A review of all cervical Pap tests of transgender patients receiving androgen therapy (2010\u20102017) was performed. Bethesda diagnosis, cytomorphological features, <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content> testing and cervical biopsy results were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven transgender patients receiving androgen therapy were identified with 23 cervical Pap tests, 11 <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content> tests and five cervical biopsies performed. A review of the Pap tests demonstrated: 57% negative for intraepithelial lesion; 13% unsatisfactory; 13% atypical squamous cells of undetermined significance; 13% atypical squamous cells \u2013 cannot exclude high\u2010grade squamous intraepithelial lesion; and 4% high\u2010grade squamous intraepithelial lesion. The rates of abnormal tests were higher than our age\u2010matched cis\u2010gender atrophic cohort rates of unsatisfactory (0.5%), atypical squamous cells of undetermined significance (7%), atypical squamous cells\u2014cannot exclude high\u2010grade squamous intraepithelial lesion (0%) and high\u2010grade squamous intraepithelial lesion (0.5%). The cytological findings from liquid\u2010based preparations included dispersed and clustered parabasal\u2010type cells, scattered degenerated cells, smooth evenly dispersed chromatin, and occasional mild nuclear enlargement and irregularity. Dysplastic cells had larger nuclei, hyperchromatic clumped chromatin, and more irregular nuclear contours.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The evaluation of dysplasia can be challenging on Pap tests from transgender patients on androgen therapy. The cohort evaluated had higher rates of unsatisfactory and abnormal Pap tests. Pathologists should be familiar with the distinctive cytomorphological changes in the Pap tests from patients on androgen therapy to evaluate them appropriately.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cyt.12525","type":"journal-article","created":{"date-parts":[[2018,2,28]],"date-time":"2018-02-28T08:44:41Z","timestamp":1519807481000},"page":"281-287","source":"Crossref","is-referenced-by-count":34,"title":["Characteristic findings of cervical Papanicolaou tests from transgender patients on androgen therapy: Challenges in detecting dysplasia"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9480-2762","authenticated-orcid":false,"given":"B. D.","family":"Adkins","sequence":"first","affiliation":[{"name":"Pathology, Microbiology and Immunology Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. B.","family":"Barlow","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Jack","sequence":"additional","affiliation":[{"name":"Pathology, Microbiology and Immunology Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. J.","family":"Schultenover","sequence":"additional","affiliation":[{"name":"Pathology, Microbiology and Immunology Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. M.","family":"Desouki","sequence":"additional","affiliation":[{"name":"Pathology, Microbiology and Immunology Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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