A cytohistologic study of atypical glandular cells detected in cervical smears during cervical screening tests in Iran

Abstract

Atypical glandular cells (AGC) often cause diagnostic uncertainty in cervicovaginal smears. To determine the incidence of significant pathologies associated with AGC on Papanicolaou test, AGC smears were correlated with subsequent biopsy diagnoses. A retrospective review of archives of our cytology files for cervicovaginal smears diagnosed as AGC from April 1998 to March 2001 was performed. In 9390 cervicovaginal smears, AGC were reported in 76 (0.81%) cases, with histologic follow-up in 42 patients (55.3%). Twenty-two patients (52.4%) had preneoplastic or neoplastic, squamous, or glandular lesions on histologic examination. Among them were cervical intraepithelial neoplasia, basal cell abnormality of undetermined significance, cervical adenocarcinoma, endometrial hyperplasia or adenocarcinoma, vaginal adenocarcinoma, endocervical glandular dysplasia, metastatic breast carcinoma, and simple nonvillous trophoblastic tissue. Therefore, presence of AGC in cervical smears may exhibit a spectrum of findings, ranging from benign/reactive changes to squamous or glandular premalignancy or malignancy. A majority of these lesions are squamous dysplasia, and a significant number of patients had glandular malignancy. The results of the current study underline the importance of follow-up for patients with the diagnosis of AGC. To our knowledge, this is the first report in Iran showing the significance of AGC diagnosis.

The Evaluation of Cervical Cytology Results in a Tertiary Health Centre Between 2006-2015

“…15 When the rate according to age group is examined, LSIL was observed most often in the adolescent period (between 13-22 years) in one study and between the ages of 15-30 in another study. 20 The result of our study is consistent with studies showing an increased proportion among younger age groups. It is an expected result due to HPV transmission in these patients that engage in sexual intercourse at an early age and do not have enough information about sexual health and contraception.…”

Clinical implications and histological correlation of atypical glandular cells found in cervicovaginal smears

“…In Brazil, according to the Ministry of Health data for 2009, it was diagnosed 0.13% AGC among all satisfactory examinations performed, and 4.6% considering only the abnormal results (10) . We also know that AGC diagnosis tends to be more frequent in patients older than 40 years of age, representing up to 71.4% of cases (11) .…”

“…Among benign or reactive changes are included endocervical and endometrial polyps, tubal metaplasia, cervical endometriosis, microglandular hyperplasia, genital tract inflammatory changes, and direct sampling of the lower uterine segment cells. On the other hand, it may also represent/correspond to squamous and glandular cervical lesions (malignant and pre-malignant), endometrial hyperplasia, invasive endometrial adenocarcinoma, and extra-uterine tumor (tubal, ovarian, and bowel), among others (2,3,11,12) . ACG are divided in two groups, according to their estimated significance: "possibly non-neoplastic" or "cannot exclude highgrade intraepithelial lesion", as the Nomenclatura Brasileira para Laudos de Colpocitologia (Brazilian Nomenclature for Cervical Cytology Reporting).…”

“…In 2001, the term AGUS was abandoned, and was replaced by "atypical glandular cells" (AGC) to avoid similarity with the acronym ASCUS ("atypical squamous cells of undetermined significance") (7,14) . These glandular atypia are defined as cells with insufficient nuclear changes for diagnosis of adenocarcinoma, but that exceeds the criteria for classification as reactive glandular cells or reparative process (2,11) .…”

Cervical Glandular Intraepithelial Neoplasia (CGIN)

“…However, subclassification of AGC has yet to be proved clinically effective, and although The Bethesda Committee and many others have studied cytologic criteria important in subclassification, these criteria have not been tested vigorously. The rates of AGC (reported as AGUS before 2001) quoted in the literature vary from 0.095% to 1.83% (Nasu et al, 1993;Mood et al , 2006;Marques et al,2011;Tam et al,2003;Scheiden et al,2004;Pecorelli et al, 2009). Occasional mitosis may be seen.…”