{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:51:09Z","timestamp":1787032269772,"version":"build-2736575974"},"reference-count":18,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,7]]},"abstract":"\n Context<\/jats:italic>\n .\u2014Follicular cervicitis is usually easily identifiable on Papanicolaou (Pap) tests; however, historically, follicular cervicitis is reported to lead to false-positive diagnoses of epithelial cell abnormalities.\n <\/jats:p>\n \n Objectives<\/jats:italic>\n .\u2014To assess participant responses in the College of American Pathologists (CAP) Pap educational program (CAP-PAP) to determine the accuracy and false-positive rate of follicular cervicitis cases.\n <\/jats:p>\n \n Design<\/jats:italic>\n .\u2014We performed a retrospective review of 4914 participant responses for gynecologic cytology challenges with the reference diagnosis of follicular cervicitis during 11 years (2000\u20132010) from CAP-PAP. Reference diagnosis category, false-positive rates by participant type (laboratory, cytotechnologist, pathologist), and preparation type (conventional smears, ThinPrep) were analyzed.\n <\/jats:p>\n \n Results<\/jats:italic>\n .\u2014Of the total 4914 general category responses, 4368 (88.9%) were benign while 546 (11.1%) responses were epithelial cell abnormalities (false positives). Of benign responses, only 2026 (46.4%) were an exact match to follicular cervicitis. Adenocarcinoma and high-grade squamous intraepithelial lesion were the most common diagnoses chosen as a false-positive interpretation (42.3% and 20.1%, respectively). Participant type was significantly associated with false-positive interpretations (laboratory: 19.2%; cytotechnologist: 11.1%; pathologist: 7.9%;\n P<\/jats:italic>\n < .001). ThinPrep was also significantly associated with false-positive results as compared to conventional smears (12.2% versus 3.6%;\n P<\/jats:italic>\n < .001).\n <\/jats:p>\n \n Conclusions<\/jats:italic>\n .\u2014In an interlaboratory comparison educational program, follicular cervicitis is difficult to interpret accurately and represents an important cause of false-positive responses. Follicular cervicitis may mimic adenocarcinoma or high-grade squamous intraepithelial lesion, particularly in liquid-based preparations. The diagnostic difficulty most likely arises from the lymphocytes being less conspicuous in the background as well as their tendency to aggregate in ThinPrep as compared to conventional smears.\n <\/jats:p>","DOI":"10.5858\/arpa.2012-0184-cp","type":"journal-article","created":{"date-parts":[[2013,6,28]],"date-time":"2013-06-28T15:22:43Z","timestamp":1372432963000},"page":"907-911","source":"Crossref","is-referenced-by-count":11,"title":["Accuracy and False-Positive Rate of the Cytologic Diagnosis of Follicular Cervicitis: Observations From the College of American Pathologists Pap Educational Program"],"prefix":"10.5858","volume":"137","author":[{"given":"Manon","family":"Auger","sequence":"first","affiliation":[{"name":"From the Department of Pathology, McGill University and McGill University Health Center, Montreal, Quebec, Canada (Dr Auger); the Department of Pathology, University of Pittsburgh Medical Center and Shady Side Hospital, Pittsburgh, Pennsylvania (Dr Khalbuss); the Department of Pathology, Northwestern University and Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); the Department of Pathology, University of Pittsburgh Medical Center and Magee Women's Hospital, Pittsburgh..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"Khalbuss","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, McGill University and McGill University Health Center, Montreal, Quebec, Canada (Dr Auger); the Department of Pathology, University of Pittsburgh Medical Center and Shady Side Hospital, Pittsburgh, Pennsylvania (Dr Khalbuss); the Department of Pathology, Northwestern University and Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); the Department of Pathology, University of Pittsburgh Medical Center and Magee Women's Hospital, Pittsburgh..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritu","family":"Nayar","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, McGill University and McGill University Health Center, Montreal, Quebec, Canada (Dr Auger); the Department of Pathology, University of Pittsburgh Medical Center and Shady Side Hospital, Pittsburgh, Pennsylvania (Dr Khalbuss); the Department of Pathology, Northwestern University and Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); the Department of Pathology, University of Pittsburgh Medical Center and Magee Women's Hospital, Pittsburgh..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengquan","family":"Zhao","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, McGill University and McGill University Health Center, Montreal, Quebec, Canada (Dr Auger); the Department of Pathology, University of Pittsburgh Medical Center and Shady Side Hospital, Pittsburgh, Pennsylvania (Dr Khalbuss); the Department of Pathology, Northwestern University and Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); the Department of Pathology, University of Pittsburgh Medical Center and Magee Women's Hospital, Pittsburgh..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Wasserman","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, McGill University and McGill University Health Center, Montreal, Quebec, Canada (Dr Auger); the Department of Pathology, University of Pittsburgh Medical Center and Shady Side Hospital, Pittsburgh, Pennsylvania (Dr Khalbuss); the Department of Pathology, Northwestern University and Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); the Department of Pathology, University of Pittsburgh Medical Center and Magee Women's Hospital, Pittsburgh..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhona","family":"Souers","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, McGill University and McGill University Health Center, Montreal, Quebec, Canada (Dr Auger); the Department of Pathology, University of Pittsburgh Medical Center and Shady Side Hospital, Pittsburgh, Pennsylvania (Dr Khalbuss); the Department of Pathology, Northwestern University and Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); the Department of Pathology, University of Pittsburgh Medical Center and Magee Women's Hospital, Pittsburgh..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Thomas","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, McGill University and McGill University Health Center, Montreal, Quebec, Canada (Dr Auger); the Department of Pathology, University of Pittsburgh Medical Center and Shady Side Hospital, Pittsburgh, Pennsylvania (Dr Khalbuss); the Department of Pathology, Northwestern University and Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); the Department of Pathology, University of Pittsburgh Medical Center and Magee Women's Hospital, Pittsburgh..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann T","family":"Moriarty","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, McGill University and McGill University Health Center, Montreal, Quebec, Canada (Dr Auger); the Department of Pathology, University of Pittsburgh Medical Center and Shady Side Hospital, Pittsburgh, Pennsylvania (Dr Khalbuss); the Department of Pathology, Northwestern University and Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); the Department of Pathology, University of Pittsburgh Medical Center and Magee Women's Hospital, Pittsburgh..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"key":"i1543-2165-137-7-907-b01","series-title":"The Bethesda System for Reporting Cervical Cytology: Definitions, Criteria, and Explanatory Notes. 2nd ed","author":"Solomon\n D,","year":"2004","unstructured":"Solomon\n D, \n \n Nayar\n R, \n \n eds. The Bethesda System for Reporting Cervical Cytology: Definitions, Criteria, and Explanatory Notes. 2nd ed. New York, NY: Springer-Verlag;2004."},{"key":"i1543-2165-137-7-907-b02","series-title":"The Art and Science of Cytopathology: Exfoliative Cytology. 2nd ed., Chapter 1: The Pap Test","first-page":"31","author":"DeMay\n RM.","year":"2012","unstructured":"DeMay\n RM. \n \n The Art and Science of Cytopathology: Exfoliative Cytology. 2nd ed., Chapter 1: The Pap Test. Chicago, IL: ASCP Press;2012:31\u201332."},{"issue":"6","key":"i1543-2165-137-7-907-b03","series-title":"Cytopathology","first-page":"364","article-title":"Cytologic features of chronic follicular cervicitis in liquid-based specimens: a potential diagnostic pitfall","volume":"13","author":"Halford\n JA.","year":"2002","unstructured":"Halford\n JA. \n \n Cytologic features of chronic follicular cervicitis in liquid-based specimens: a potential diagnostic pitfall. Cytopathology. 2002;13(6):364\u2013370."},{"issue":"2","key":"i1543-2165-137-7-907-b04","series-title":"Br J Obstet Gynaecol","first-page":"174","article-title":"Follicular cervicitis-colposcopic appearances and association with Chlamydia trachomatis","volume":"88","author":"Hare\n MJ,","year":"1981","unstructured":"Hare\n MJ, \n \n Toone\n E, \n \n Taylor-Robinson\n D, \n et al\n . Follicular cervicitis-colposcopic appearances and association with Chlamydia trachomatis. Br J Obstet Gynaecol. 1981;88(2):174\u2013180."},{"issue":"5","key":"i1543-2165-137-7-907-b05","series-title":"Acta Cytol","first-page":"344","article-title":"Lymph follicles in cervical smears","volume":"9","author":"Eisenstein\n R,","year":"1965","unstructured":"Eisenstein\n R, \n \n Battifora\n H. \n \n Lymph follicles in cervical smears. Acta Cytol. 1965;9(5):344\u2013346."},{"issue":"3","key":"i1543-2165-137-7-907-b06","series-title":"Acta Cytol","first-page":"235","article-title":"Chronic lymphocytic cervicitis: cytologic and histopathologic manifestations","volume":"19","author":"Roberts\n TH,","year":"1975","unstructured":"Roberts\n TH, \n \n Ng\n ABP. \n \n Chronic lymphocytic cervicitis: cytologic and histopathologic manifestations. Acta Cytol. 1975;19(3):235\u2013243."},{"issue":"4","key":"i1543-2165-137-7-907-b07","series-title":"Int J Gynecol Pathol","first-page":"289","article-title":"Lymphoma-like lesions of the lower female genital tract: a report of 16 cases","volume":"4","author":"Young\n RH,","year":"1985","unstructured":"Young\n RH, \n \n Harris\n NL, \n \n Scully\n RE. \n \n Lymphoma-like lesions of the lower female genital tract: a report of 16 cases. Int J Gynecol Pathol. 1985;4(4):289\u2013299."},{"key":"i1543-2165-137-7-907-b08","series-title":"Diagnostic Cytopathology","first-page":"656","article-title":"Normal vulva, vagina and cervix: hormonal and inflammatory conditions","author":"Boon\n M,","year":"1995","unstructured":"Boon\n M, \n \n Gray\n W. \n \n Normal vulva, vagina and cervix: hormonal and inflammatory conditions. In: GrayW, ed. Diagnostic Cytopathology. Edinburgh, Scotland: Churchill Livingstone;1995:656\u2013657."},{"issue":"1","key":"i1543-2165-137-7-907-b09","series-title":"Cancer","first-page":"26","article-title":"Routine endometrial sampling of asymptomatic premenopausal women shedding normal endometrial cells in Papanicolaou tests is not cost effective","volume":"111","author":"Kapali\n M,","year":"2007","unstructured":"Kapali\n M, \n \n Agaram\n NP, \n \n Dabbs\n D, \n \n Kanbour\n A, \n \n White\n S, \n \n Austin\n MR. \n \n Routine endometrial sampling of asymptomatic premenopausal women shedding normal endometrial cells in Papanicolaou tests is not cost effective. Cancer. 2007;111(1):26\u201333."},{"key":"i1543-2165-137-7-907-b01","series-title":"The Bethesda System for Reporting Cervical Cytology: Definitions, Criteria, and Explanatory Notes. 2nd ed","author":"Solomon\n D,","year":"2004","unstructured":"Solomon\n D, \n \n Nayar\n R, \n \n eds. The Bethesda System for Reporting Cervical Cytology: Definitions, Criteria, and Explanatory Notes. 2nd ed. New York, NY: Springer-Verlag;2004."},{"key":"i1543-2165-137-7-907-b02","series-title":"The Art and Science of Cytopathology: Exfoliative Cytology. 2nd ed., Chapter 1: The Pap Test","first-page":"31","author":"DeMay\n RM.","year":"2012","unstructured":"DeMay\n RM. \n \n The Art and Science of Cytopathology: Exfoliative Cytology. 2nd ed., Chapter 1: The Pap Test. Chicago, IL: ASCP Press;2012:31\u201332."},{"issue":"6","key":"i1543-2165-137-7-907-b03","series-title":"Cytopathology","first-page":"364","article-title":"Cytologic features of chronic follicular cervicitis in liquid-based specimens: a potential diagnostic pitfall","volume":"13","author":"Halford\n JA.","year":"2002","unstructured":"Halford\n JA. \n \n Cytologic features of chronic follicular cervicitis in liquid-based specimens: a potential diagnostic pitfall. Cytopathology. 2002;13(6):364\u2013370."},{"issue":"2","key":"i1543-2165-137-7-907-b04","series-title":"Br J Obstet Gynaecol","first-page":"174","article-title":"Follicular cervicitis-colposcopic appearances and association with Chlamydia trachomatis","volume":"88","author":"Hare\n MJ,","year":"1981","unstructured":"Hare\n MJ, \n \n Toone\n E, \n \n Taylor-Robinson\n D, \n et al\n . Follicular cervicitis-colposcopic appearances and association with Chlamydia trachomatis. Br J Obstet Gynaecol. 1981;88(2):174\u2013180."},{"issue":"5","key":"i1543-2165-137-7-907-b05","series-title":"Acta Cytol","first-page":"344","article-title":"Lymph follicles in cervical smears","volume":"9","author":"Eisenstein\n R,","year":"1965","unstructured":"Eisenstein\n R, \n \n Battifora\n H. \n \n Lymph follicles in cervical smears. Acta Cytol. 1965;9(5):344\u2013346."},{"issue":"3","key":"i1543-2165-137-7-907-b06","series-title":"Acta Cytol","first-page":"235","article-title":"Chronic lymphocytic cervicitis: cytologic and histopathologic manifestations","volume":"19","author":"Roberts\n TH,","year":"1975","unstructured":"Roberts\n TH, \n \n Ng\n ABP. \n \n Chronic lymphocytic cervicitis: cytologic and histopathologic manifestations. Acta Cytol. 1975;19(3):235\u2013243."},{"issue":"4","key":"i1543-2165-137-7-907-b07","series-title":"Int J Gynecol Pathol","first-page":"289","article-title":"Lymphoma-like lesions of the lower female genital tract: a report of 16 cases","volume":"4","author":"Young\n RH,","year":"1985","unstructured":"Young\n RH, \n \n Harris\n NL, \n \n Scully\n RE. \n \n Lymphoma-like lesions of the lower female genital tract: a report of 16 cases. Int J Gynecol Pathol. 1985;4(4):289\u2013299."},{"key":"i1543-2165-137-7-907-b08","series-title":"Diagnostic Cytopathology","first-page":"656","article-title":"Normal vulva, vagina and cervix: hormonal and inflammatory conditions","author":"Boon\n M,","year":"1995","unstructured":"Boon\n M, \n \n Gray\n W. \n \n Normal vulva, vagina and cervix: hormonal and inflammatory conditions. In: GrayW, ed. Diagnostic Cytopathology. Edinburgh, Scotland: Churchill Livingstone;1995:656\u2013657."},{"issue":"1","key":"i1543-2165-137-7-907-b09","series-title":"Cancer","first-page":"26","article-title":"Routine endometrial sampling of asymptomatic premenopausal women shedding normal endometrial cells in Papanicolaou tests is not cost effective","volume":"111","author":"Kapali\n M,","year":"2007","unstructured":"Kapali\n M, \n \n Agaram\n NP, \n \n Dabbs\n D, \n \n Kanbour\n A, \n \n White\n S, \n \n Austin\n MR. \n \n Routine endometrial sampling of asymptomatic premenopausal women shedding normal endometrial cells in Papanicolaou tests is not cost effective. Cancer. 2007;111(1):26\u201333."}],"container-title":["Archives of Pathology and Laboratory Medicine"],"original-title":[],"link":[{"URL":"https:\/\/aplm.kglmeridian.com\/view\/journals\/arpa\/137\/7\/article-p907.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aplm.kglmeridian.com\/downloadpdf\/journals\/arpa\/137\/7\/article-p907.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aplm.kglmeridian.com\/downloadpdf\/journals\/arpa\/137\/7\/article-p907.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:58:56Z","timestamp":1770771536000},"score":1,"resource":{"primary":{"URL":"https:\/\/aplm.kglmeridian.com\/view\/journals\/arpa\/137\/7\/article-p907.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,7]]},"references-count":18,"journal-issue":{"issue":"7"},"URL":"https:\/\/doi.org\/10.5858\/arpa.2012-0184-cp","relation":{},"ISSN":["1543-2165","0003-9985"],"issn-type":[{"value":"1543-2165","type":"electronic"},{"value":"0003-9985","type":"print"}],"subject":[],"published":{"date-parts":[[2013,7]]}}}