Atypical cells are not always cancerous, and a range of things can lead to such findings on a pathology report. If a doctor identifies abnormal cells in a sample, the next step is usually further testing and follow-up to find out more about what is happening. Sometimes, the problem resolves on its own or can be treated, and in other cases, it may be a warning that the patient needs close monitoring to check for dangerous cellular changes.
Biopsy samples can include tissue scrapings from the skin and mucus membranes, as well as samples of deeper tissue. A pathologist will examine the cells under a microscope and take note of any unusual features. These could include abnormal shapes or structures inside the cell, as well as unusually sized cells. Cell changes can occur for a lot of reasons, and the pathologist will usually discuss possible causes if any atypical cells are present in a sample.
Aging can cause cells to change, and this is an important consideration when evaluating samples. Inflammation and infection both cause temporary cell changes. If the patient receives treatment, a follow-up test should show that cells have returned to normal and are not growing where they should not be. Sometimes, a sample is poorly prepared or handled and cells look odd, but are not actually abnormal; in cases like this, contamination may be the culprit. For example, a pathologist might find atypical cells in a urine sample because it wasn't collected appropriately.
Sometimes, atypical cells are a precursor to cancer. Doctors can look for specific cellular changes and may request that the patient return for another biopsy within a set period of time to see if the cells are still changing, as well as to take note of any other issues. Even having precancerous cells does not necessarily mean that a patient will develop cancer; it is possible that the cells may remain stable, without any further changes, or may not turn into a malignant growth if they do start to grow out of control.
Hearing that a pathology report contains a finding of atypical cells can be frightening. Patients should pay close attention to their doctors when discussing results, and doctors are usually happy to answer questions or refer the patient to more information. Patients should ask about the possible implications of the finding and how to move forward with further diagnosis or treatment. Doctors cannot predict the future, and may be reluctant to speculate on the nature of the cells without more testing and examination.