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80184<br />

Useful For: Investigation of patients with possible Wilson disease<br />

Interpretation: Values or =18 years: 15.0-30.0 mg/dL<br />

Females<br />

0-17 years: 14.0-41.0 mg/dL<br />

> or =18 years: 16.0-45.0 mg/dL<br />

Clinical References: Cox DW, Tiimer Z, Roberts EA: Copper transport disorders: Wilsonâ€s<br />

disease and Menkes disease. In Inborn Metabolic Disease. Edited by J Fernandes, JM Sandubray, F<br />

VandenBerghe. Berlin, Heidelberg, New York, Springer-Verlag, 2000, pp 385-391<br />

Cervical Papanicolaou Smear, Diagnostic without Physician<br />

Interpretation<br />

Clinical Information: Squamous cell carcinoma of the cervix is believed to develop in progressive<br />

stages from normal through precancerous (dysplastic) stages, to carcinoma in situ, and eventually invasive<br />

carcinoma. This sequence is felt to develop over a matter of years in most patients. The etiology of<br />

cervical carcinoma is unknown, but the disease is believed to be related to sexual activity and possibly<br />

sexually transmitted viral infections such as human papilloma virus (HPV). Most cervical carcinomas and<br />

precancerous conditions occur in the transformation zone (squamo-columnar junction), therefore, this area<br />

needs to be sampled if optimum results are to be obtained.<br />

Useful For: Screening for cervical carcinoma and a number of infections of the female genital tract<br />

including HPV, herpes, Candida, and trichomonas<br />

Interpretation: The report is an estimate of the nature of the abnormality using the Bethesda<br />

nomenclature. Specimen adequacy is characterized as: -Satisfactory for evaluation (with quality indicators<br />

if applicable) or -Unsatisfactory for evaluation, further subdivided as follows: -Specimen processed and<br />

examined but unsatisfactory for evaluation of epithelial abnormality because of inadequate cellularity,<br />

obscuring blood or inflammation, etc. -Specimen rejected because of a broken slide, unlabeled specimen,<br />

etc. The diagnostic interpretation may include: -Negative for intraepithelial lesion or malignancy (NIL)<br />

-Atypical squamous cells of undetermined significance (ASCUS) characterized further as either: -Atypical<br />

squamous cells of undetermined significance or -Atypical squamous cells, cannot exclude high grade<br />

intraepithelial lesion -Low grade squamous intraepithelial lesion (LSIL), which includes mild squamous<br />

dysplasia (cervical intraepithelial neoplasia I [CINI]) and koilocytotic changes consistent with HPV<br />

effect. -High grade squamous intraepithelial lesion (HSIL), which includes moderate squamous dysplasia<br />

(CINII), severe squamous dysplasia (CINIII), and squamous carcinoma in situ (CINIII) -Atypical<br />

Glandular Cells Patients with this diagnosis are at increased risk for a clinically significant lesion<br />

including adenocarcinoma in situ, high-grade squamous intraepithelial lesion, invasive cervical<br />

carcinoma, or endometrial carcinoma and should have appropriate clinical follow up that may include<br />

gynecologic examination, colposcopy, or biopsy. The correlation from cytology to subsequent histologic<br />

examination is imprecise.<br />

Reference Values:<br />

Satisfactory for evaluation. Negative for intraepithelial lesion.<br />

Note: Abnormal results will be reviewed by a physician at an additional charge.<br />

Clinical References: 1. Wright TC Jr, Cox JT, Massad LS, et al: ASCCP-Sponsored Consensus<br />

Conference. 2001 Consensus Guidelines for the management of women with cervical cytological<br />

abnormalities. JAMA 2002 April;287(16):2120-9 2. Solomon D, Davey D, Kurman R, et al: The 2001<br />

Bethesda System: terminology for reporting results of cervical cytology-Consensus Statement JAMA.<br />

Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or <strong>Mayo</strong><strong>Medical</strong><strong>Laboratories</strong>.com Page 425

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