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Introduction Although the utility of high-risk human papillomavirus (hrHPV) testing is established in the triage of ASC-US Papanicolaou tests from the general population, its role in women who have been treated for cervical cancer and other HPV-related cancers is less clear. Materials and methods Records of patients with ASC-US Papanicolaou tests and HPV testing results submitted by our gynecologic oncology service with a history of malignancy between 2006 and 2012 were reviewed. Results Thirty-nine women with a history of treatment for HPV-related cancer and ASC-US Papanicolaou tests who had undergone hrHPV testing were identified. hrHPV was detected in the in specimens from 12 of the 39 patients. Among the 12 patients with ASC-US/hrHPV+ Papanicolaou tests, 2 had a subsequent Papanicolaou test with high-grade squamous intraepithelial lesion (HSIL) and 1 had a cervical biopsy that showed invasive squamous cell carcinoma. Among the 27 patients with ASC-US/hrHPV– Papanicolaou tests with pathologic follow-up, none had HSIL or worse. In patients with treated non-HPV-related cancers, hrHPV was detected in cervical/vaginal cytology specimens from 11 of 47 patients. Of 11 patients with ASCUS/hrHPV+ Papanicolaou tests, 1 had an HSIL Papanicolaou test and a negative vaginal biopsy within 18 months. None of the 36 patients with ASC-US/hrHPV– Papanicolaou tests had HSIL or worse on follow-up. Conclusion The rates of hrHPV positivity in ASC-US Papanicolaou tests from women treated for both HPV-related (31%) and non-HPV-related (23%) gynecologic malignancies were similar to those reported in women older than 45 years. hrHPV testing identified all women with ASC-US Papanicolaou tests who subsequently developed HSIL or worse.

Given the lack of recent literature regarding the aspiration cytology of immunohistochemically confirmed malignant mesothelioma (MM), we were interested in reviewing the experience of our institution and establishing useful morphologic criteria.Seventeen aspiration and touch preparation specimens with a diagnosis of MM obtained between 2002-2013 were reviewed along with 20 cases of adenocarcinoma and 16 cases of squamous cell carcinoma. The utility of a number of morphologic features was evaluated.In most cases of MM, a consistent pattern emerged. Aspirates and touch preps were cellular with irregularly shaped 2 and 3 dimensional clusters. The individual cells were predominantly angulated and had dense cytoplasm with eccentric nuclei. In every case, a minority of tumor cells contained prominent microvacuoles. The chromatin pattern tended to be fine with small nucleoli. While most cases were cytologically monotonous, five cases displayed striking pleomorphism and three cases contained occasional large atypical cells. Two cases contained metachromatic background material. Features which were most useful in discriminating MM from adenocarcinoma were angulated cell shape(P = 0.0002), dense cytoplasm(P = 0.0001), and cytoplasmic microvacuoles(P = 0.0001). In our material, cases of squamous cell carcinoma were often difficult to distinguish from MM. Useful discriminatory features present in squamous cell carcinoma included ink dot nuclei(P = 0.0003), a "dirty" cystic, necrotic background (P = 0.0027) and tumor balls with peripheral spindling(P = 0.0041).Most cases of MM have a consistent appearance in core biopsy touch preps and FNAs. Distinguishing MM from adenocarcinoma and squamous cell carcinoma can be facilitated by evaluating a few key morphologic features.