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Oncology (General Cancer)/pap smear results, atypical glandular cells


QUESTION: Hi Dr. Higby,
      This is a follow-up regarding my original post on 07/31/2013.  I just received part of my test results.  I am still waiting on the colposcopy and ECC.  I forgot to mention in my previous correspondence that my ob/gyn took a urine sample, at my insistence.   I had complained about mild off and on pain in lower left side and some mild intermittent burning in my vagina.  Also, the way I explained one of my symptoms to her is that it sometimes feels as though my vagina is slightly dilated.  Of coarse I am not pregnant, but that is the best way I can explain some of what I have been feeling. I also have been feeling slightly dizzy at times, my voice has been very slightly hoarse at times, not to mention I am often VERY tired.
     Anyway, I got back my urine test results: chlamydia/trachomatis, rRNA, urin Not Detected, and Neisseria gonorrhoeae, rRNA, urin Not detected.  It also reads 50,000 CFU/ml Klebsiella pneumoniae ssp pneumoniae.  Well this is a first for me.  Could this finding have anything to do with my  pap smear of atypical glandular cells of endocervical origin?  Could this urine test result be the cause of my abnormal pap?  What the heck does this result mean?
     A side note: Wouldn't it have been prudent for her to have performed a D & C, along with the colposcopy and ECC?  Aren't glandular cells in the uterus as well as the cervix?
     Thank you. I will keep you posted as soon as I get additional results.        Connie

ANSWER: You don't have chlamydia and you don't have gonnorhea.  You might have an infection of the urinary tract with the organism called Klebsiella which is a bacterium.  I don't think this is the reason for your pap smear abnormalities.  A d and c is generally indicated when the lining of the uterus is likely to be abnormal -- prolonged menstrual bleeding being the main indication.  Otherwise endocervical biopsies are sufficient.  There are glandular cels in the uterus as well as the cervix, but remember, glandular cells in and of themselves are not abnormal.  Cancers that arise from the uterine lining almost always come from the normal lining cells, not the glandular cells.  
Your systemic symptoms (dizziness, hoarseness, and being very tired -- I don't think these have anything to do with your gyn complaints, and I'd approach your family internist about these symptoms which may point to anemia or hypothyroidism or something along those lines.  

---------- FOLLOW-UP ----------

QUESTION: Hi Dr. Higby,
     Thank you for all your help.  I got my ECC and Colposcopy test results.  They read as follows:
     Endocervix, Curettage:  Benign endocervical glandular epithelium.  Scant benign squamous epithelium.

     Cervix At 2 O'clock, Brush Biopsy:  Benign squamous epithelium.

     Cervix At 7 O'clock, Brush Biopsy:  Benign Squamous epithelium.

What does this all mean?  My Ob/Gyn recommended that I get another PAP smear in three months?          Connie

She scraped the surface of the inside of your cervix, and only normal tissue came back.  The two brush biopsies also showed normal tissue.  If this was all there was, I would probably do another pap in a year, but your gyn is being cautious, probably because of the slightly atypical findings with the other pap smear.  But right now there is no evidence of malignancy or even pre-malignant condition.  Sleep well, get your next pap smear on schedule, see your internist about your other symptoms.  

Oncology (General Cancer)

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Donald Higby, M.D.


I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.


I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

American Society of Clinical Oncology

New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

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