Atypical glandular cells in conventional cervical smears: Incidence and follow-up

Scheiden, R; Wagener, C.; Knolle, U.; Dippel, Walter; Capesius, C.

doi:10.1186/1471-2407-4-37

Cited by 38 publications

(52 citation statements)

References 36 publications

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“…There has Address correspondence and reprint requests to Rita Demopoulos, 24 Sycamore Road, Scarsdale, New York 10583. E-mail: rita.demopoulos@ med.nyu.edu (4)(5)(6)(7)(8)(9)(10). However, we found no studies in the literature that focused on the truly negative Pap smears in patients with invasive endocervical adenocarcinoma, which correlated the Pap smears with the pathology findings for a possible explanation.…”

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confidence: 73%

Obstacles to the Early Detection of Endocervical Adenocarcinoma

Kalir

Simsir

et al. 2005

International Journal of Gynecological Pathology

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We observed that the ratio of in situ to invasive carcinomas of the cervix is significantly greater for squamous than for glandular lesions. We wondered whether Pap smears were less effective for the identification of in situ glandular lesions. The purpose of this study was to determine if the location, extent of disease, and growth patterns of endocervical adenocarcinomas influence the ability to detect malignant cells by Pap smears. Medical records, doctor's office records, and all pathology materials (reports and slides) including Pap smears, biopsies, LEEP/cone biopsies, and hysterectomy specimens from 53 consecutive patients diagnosed with endocervical adenocarcinomas were examined at New York University Medical Center (a total of 654 pathology slides and 51 Pap smears were reviewed). Findings were correlated for each patient using gross descriptions and histopathology and stratified by location/extent of disease and growth pattern (exophytic or endophytic or both). Ten patients had in situ disease, seven (70%) of which involved the transformation zone (TZ); all seven of these were identified by Pap smears. In contrast, of the other three cases that did not involve the TZ but were confined to the endocervix, only one was identified by Pap smear. Forty-three patients had invasive disease. Twenty involved the TZ, and 23 involved the endocervix but spared the TZ. Of the 20 tumors involving the TZ, 11 (55%) were identified by Pap smears, whereas of the 23 sparing the TZ, 11 (47.8%) were diagnosed by Pap smear. Among the 23 patients with invasive disease that spared the TZ, 6 (26%) had a documented history of negative Pap smears at New York University within 3 years of diagnosis. Conversely only 1 of the 20 patients with TZ involvement had a history of negative Pap smears, and 3 patients in this group denied having had Pap smears for several years. Including all 53 patients, a significantly higher proportion were not detectable by Pap smear if the TZ was spared (54% versus 25%, p = 0.036). Of the 23 invasive cancers that spared the TZ, 6 (14%) had verified negative Pap smears. These lesions did not shed malignant cells onto Pap smears. Noteworthy was the finding that two of these six lesions extended from the endocervix upward, through the stroma, and into the endomyometrium of the lower uterine segment. Four extended downward into the exocervix through the stroma, sparing the surface mucosa; one reached the upper vagina. All six displayed an endophytic growth pattern.

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confidence: 73%

Obstacles to the Early Detection of Endocervical Adenocarcinoma

Kalir

Simsir

et al. 2005

International Journal of Gynecological Pathology

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“…3 a, b). Similarly, another case was reported as invasive SCC on cytology, which showed [8] 21,854 83 0.4 Gutman et al [9] 11,800 45 0.38 Crasta et al [10] 10,787 19 0.17 Adhya et al [11] 18,376 65 0.35 Ajit et al [12] 22,618 74 0.32 Jeng et al [13] 51,419 49 0.09 Scheiden et al [14] 522 adenosquamous carcinoma on histopathology. This was due to the presence of only malignant squamous cells on cytology ( Fig.…”

Section: Discussionmentioning

confidence: 99%

The Significance of Glandular Cells on Conventional Cervicovaginal Smears: Experience from a Tertiary Care Hospital in Coastal India

Suresh

Kini

Minal³

et al. 2017

Acta Cytologica

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Introduction: Glandular lesions of the female genital tract (FGT) are quite uncommon compared to squamous lesions. Their cytological diagnosis is difficult because of their architectural and cytological complexity, as well as the lack of experience of many cytopathologists in this field. The aim of this study was to determine the significance of Papanicolaou (Pap) smears in the diagnosis of glandular FGT lesions. Methodology: All Pap smears reported during the period of January 2012 to December 2013 were retrieved. Cytohistopathological correlation was done. Results: Among 7,609 Pap smears, squamous epithelial abnormalities were seen in 110 cases (1.5%) and glandular cell abnormalities in 32 cases (0.42%). Among the glandular abnormalities, we encountered 18 cases of atypical glandular cells (AGC) not otherwise specified, 4 cases of endocervical-type AGC and 4 cases favoring neoplastic-type AGC, 2 cases of adenocarcinoma of the endocervical type, 3 cases of adenocarcinoma of the endometrial type, and 1 case of extrauterine adenocarcinoma. Histopathological correlation was available in 12 cases (37.5%). Eighty-three percent showed premalignant or malignant lesions on histopathology. Conclusion: As glandular epithelial lesions are associated with premalignant and malignant FGT lesions, in patients with cytological diagnosis of glandular epithelial abnormalities, it is mandatory to undergo colposcopic examination with endocervical and endometrial curettage.

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“…9 René Scheiden et al had 56% of the patients with significant cancerous and precancerous conditions emphasising the requirement of complete and careful evaluation. 10 Our study revealed 9cases (64.3%) with significant precancerous (1case) and cancerous lesions (8 cases) on histopathology follow up, out of 14 atypical endometrial cells in cytology. Increased rate of detection of precancerous and cancerous lesion was because we included only symptomatic patients as study group.…”

Section: Discussionmentioning

confidence: 51%

Cyto - Histo Correlation of Atypical Glandular Cells of Endometrial Origin on Cervical Cytology in Abnormal Uterine Bleeding Cases

Kakoti¹,

Manoli²,

Manoli³

2015

jemds

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BACKGROUND: An association has been reported with presence of endometrial cells on cervical smears and clinically significant uterine lesions. Hence for early detection of endometrial pathology, the 2001 Bethesda system has suggested the mandatory reporting of presence of any atypical endometrial cells regardless of age and menstrual status and out of phase normal looking endometrial cells in women aged 40 years or more. OBJECTIVES: To assess the association between atypical glandular cells of endometrial origin in cervical cytology and histopathological findings in abnormal uterine bleeding cases. SETTINGS AND DESIGN: The study was conducted at JSS hospital, Mysore in the department of pathology. This was a descriptive type of study. The sample was collected from patients attending the gynecology OPD with the complaints of abnormal uterine bleeding in JSS hospital. MATERIALS AND METHODS: Smears for cervical cytology are collected using either pap smear or manual liquid based smear from 82 patients in the age group of 20-75 years with complaints of abnormal bleeding history. The results of cervical cytology were compared and confirmed with the endometrial pathology. RESULTS: Out of 82 abnormal uterine bleeding cases 14 showed atypical endometrial cells. On follow up of these cases, the results indicated an association between atypical endometrial cells in cervical cytology with endometrial carcinoma in 8 cases (60%), 1 case with complex hyperplasia with atypia (10%). CONCLUSION: Presence of atypical endometrial cells in all women with abnormal uterine bleeding has considerable clinical implications & further diagnostic evaluation by endometrial sampling is of utmost importance.

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Atypical glandular cells in conventional cervical smears: Incidence and follow-up

Cited by 38 publications

References 36 publications

Obstacles to the Early Detection of Endocervical Adenocarcinoma

Obstacles to the Early Detection of Endocervical Adenocarcinoma

The Significance of Glandular Cells on Conventional Cervicovaginal Smears: Experience from a Tertiary Care Hospital in Coastal India

Cyto - Histo Correlation of Atypical Glandular Cells of Endometrial Origin on Cervical Cytology in Abnormal Uterine Bleeding Cases

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