Epithelial Abnormalities: Glandular

Wilbur, David C.; Chhieng, David C.; Guidos, Barbara J.; Mody, Dina R.

doi:10.1007/978-3-319-11074-5_6

Cited by 23 publications

(27 citation statements)

References 30 publications

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“…In some older samples, the diagnosis was given according to the Papanicolaou Classification System and those were converted to the corresponding diagnosis according to the Bethesda System for Reporting Cervical Cytology 2014 (5).…”

Section: Methodsmentioning

confidence: 99%

The role of Pap smear in the diagnostics of endocervical adenocarcinoma

Pulkkinen

Huhtala

Kholová

2021

APMIS

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In the high‐income countries, the amount of cervical adenocarcinomas is on the rise. The pap smear sampling has a low sensitivity and a low specificity for endocervical malignancies, and there are only a few cytomorphological features, that are specifically associated with glandular atypia. In this study, 298 pap smears of 60 patients with endocervical adenocarcinoma or adenocarcinoma in situ (AIS) and 30 patients with high‐grade intraepithelial lesion (HSIL) in histology were reviewed. The pap smear type (screening/clinical), the HPV status and the time from sampling to the histological confirmation of diagnosis were recorded for each case. Despite that no cytomorphological features could be associated with adenocarcinoma statistically, 70% of the pap smears were initially correctly diagnosed as an endocervical glandular lesion. Palisading cell borders, nuclear pleomorphism and the lack of single atypical cells present simultaneously were found to be associated with adenocarcinoma and AIS with the corresponding ORs of 5.89 (95% CI 1.96–17.70), 3.71 (95% CI 1.14–12.02) and 10.76 (95% CI 1.20–59.50). This combination of features was seen in smears taken up to 5 years before the histological diagnosis. Of all our screening samples, 10.9% were HPV‐positive. There were no HPV‐negative samples among patients with adenocarcinoma.

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Section: Methodsmentioning

confidence: 99%

The role of Pap smear in the diagnostics of endocervical adenocarcinoma

Pulkkinen

Huhtala

Kholová

2021

APMIS

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“…Pap tests were reviewed by cytopathologists blinded to these proportions. Reviewers were asked to provide a cytologic interpretation according to The Bethesda System (TBS) for reporting cervical cytology [10,11]. For SMILE-dominant (≥50%) cases, a separate review for a defined set of architectural, cellular and background features was performed (W.R.G., Z.G., V.D., H.M.K.…”

Section: Methodsmentioning

confidence: 99%

Stratified Mucin-Producing Intraepithelial Lesion of the Cervix: Subtle Features Not to Be Missed

Schwock

Ko²,

Dubé³

et al. 2016

Acta Cytologica

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Objectives: Stratified mucin-producing intraepithelial lesion (SMILE) is an uncommon premalignant lesion of the uterine cervix. A detailed examination of preinvasive SMILE cases including a comparison of the cytologic features with usual-type adenocarcinoma in situ (AIS) and human papillomavirus (HPV) genotyping was performed. Study Design: Excisions and preceding Papanicolaou (Pap) tests were retrieved from the files of 2 tertiary care centers. Histologic review estimated the lesional SMILE proportion. Pap tests were reviewed and assessed for architectural, cellular and background features. Cobas® HPV test was performed. Results: 13 cases were identified. Mean/median patient age was 35/33 years (range 23-51 years). Concurrent high-grade squamous intraepithelial lesion was found in 10/13 (77%) and AIS in 8/13 (62%) cases. In 6 cases, SMILE was dominant (≥50%) and represented in 5/6 corresponding Pap tests. Cytology interpretations differed more often in the SMILE-dominant group (p < 0.05). SMILE and AIS had overlapping features. Feathering and prominent nucleoli were absent in SMILE. HPV DNA was detected in all 12 cases tested. HPV 18 was most common (7/12). Excisions with positive/suspicious margins were reported in 5/6 SMILE-dominant versus 3/7 nondominant cases. Conclusion: SMILE is best considered as an AIS variant for cytologic, etiologic and management purposes. Cytologic features overlap with AIS, but are more subtle and easily missed. HPV testing may play a role in facilitating SMILE detection.

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“…Cervical cytology preparations may show HCG with atypical features suggestive of malignancy including sheets and strips with nuclear crowding, overlap and/or pseudostratification, rare cell groups with rosettes (gland formations) or feathering, enlarged and elongated nuclei with hyperchromasia, coarse chromatin with heterogeneity, occasional mitoses and/or apoptotic debris, cells with increased nuclear-to-cytoplasmic ratios, and ill-defined cell borders. [ 12 ] The tumor cells usually show abundant intracytoplasmic mucin which may be scant and focal in some cases. [ 13 ]…”

Section: Explanationmentioning

confidence: 99%