CLINICOPATHOLOGICAL CORRELATION OF COLPOSCOPIC AND HISTOPATHOLOGICAL FINDINGS IN WOMEN WITH INFLAMMATORY CERVICAL CYTOLOGY: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background: Inflammatory changes are among the most frequently reported findings on conventional Papanicolaou (Pap) smear, yet their correlation with underlying cervical pathology remains incompletely characterized, often prompting unnecessary anxiety and over-referral for colposcopic evaluation. Objective: To describe the spectrum of colposcopic and histopathological findings in women with inflammatory cervical cytology and to examine the correlation between cytological severity, colposcopic appearance, and histopathological diagnosis. Methods: This prospective observational study enrolled 100 consecutive women aged 21–65 years with inflammatory Pap smear reports attending the gynecology outpatient department of a saveetha medical college and hospital. All participants underwent colposcopic examination using the 2011 International Federation for Cervical Pathology and Colposcopy (IFCPC) nomenclature, followed by cervical biopsy from the most abnormal or, in its absence, a representative inflammatory area. Histopathological diagnoses were classified per World Health Organization (WHO) criteria. The relationship between cytological, colposcopic, and histopathological findings was examined descriptively. Results: Mild inflammatory changes were the most common cytological finding (47.0%), followed by moderate (38.0%) and severe (15.0%) inflammation. Cervical ectopy (28.0%) and congestion/hyperemia (22.0%) were the predominant colposcopic findings. Chronic cervicitis (41.0%) was the most frequent histopathological diagnosis, followed by squamous metaplasia (24.0%) and endocervicitis (15.0%). No case of cervical intraepithelial neoplasia (CIN) or invasive carcinoma was identified. Cross-tabulation of colposcopic findings against histopathological diagnosis showed a benign, concordant predominant diagnosis for every colposcopic category, with row-wise concordance ranging from 40.0% to 100.0%. Conclusion: Inflammatory cervical cytology was overwhelmingly associated with benign colposcopic and histopathological findings in this cohort, with no premalignant or malignant lesions detected, supporting a conservative, reassurance-oriented approach to women presenting with isolated inflammatory Pap smear reports.