Case 10-2009 -- A 23-Year-Old Woman with an Abnormal Papanicolaou Smear

doi:10.1056/NEJMcpc0810837

Volume 360:1337-1344		March 26, 2009		Number 13

Case 10-2009 — A 23-Year-Old Woman with an Abnormal Papanicolaou Smear

Mark A. Goldstein, M.D., Annekathryn Goodman, M.D., Marcela G. del Carmen, M.D., M.P.H., and David C. Wilbur, M.D.

Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

Dr. Naana Afua Jumah (Student, Harvard Medical School): A 23-year-oldwoman was seen in the gynecology clinic of this hospital becauseof a high-grade squamous intraepithelial lesion seen on pathologicalexamination of a Papanicolaou (Pap) smear.

Four weeks earlier, the patient had come to the adolescent andyoung adult medicine clinic of this hospital to establish careand to receive counseling regarding oral contraception, screeningfor sexually transmitted infections, and vaccination for thehuman papillomavirus (HPV).

Menarche had occurred at the age of 13 years, and menses hadbeen monthly and regular. She had been sexually active sincethe age . . . [Full Text of this Article]

Differential Diagnosis

Risk Factors for HPV Infection

Pathological Discussion

Discussion of Management

Anatomical Diagnoses

Source Information

From the Divisions of Adolescent and Young Adult Medicine (M.A.G.) and Gynecologic Oncology (A.G., M.G.C.) and the Departments of Obstetrics, Gynecology, and Reproductive Biology (A.G., M.G.C.) and Pathology (D.C.W.), Massachusetts General Hospital; and the Departments of Pediatrics (M.A.G.), Obstetrics, Gynecology, and Reproductive Biology (A.G., M.G.C.), and Pathology (D.C.W.), Harvard Medical School.