Obstet Gynecol Sci.  2013 Mar;56(2):76-83. 10.5468/OGS.2013.56.2.76.

Clinicopathological significance of atypical glandular cells on Pap smear

• Kim SS
• Suh DS
• Kim KH
• Yoon MS
• Choi KU

• KMID: 1425654
• DOI: http://doi.org/10.5468/OGS.2013.56.2.76

Abstract

OBJECTIVE
To investigate the clinical significance of atypical glandular cells (AGC) by analyzing the prevalence and histologic outcomes of patients with AGC according to Pap smear.
METHODS
The medical records of 83 patients who were diagnosed AGC on Pap tests at the Pusan National University Hospital outpatient department and health care center from January 1998 to March 2006 were reviewed.
RESULTS
The prevalence of AGC was 55 of 54,160 (0.10%) and 28 of 54,160 (0.05%) for AGC-not otherwise specified (NOS) and neoplastic associated AGC, respectively. The histopathologic results of the AGC-NOS group (n=55) were as follows: low-grade squamous intraepithelial lesion, 7 (12.7%); high-grade squamous intraepithelial lesion, 4 (7.2%); adenocarcinoma of cervix, 3 (5.4%); endometrial carcinoma, 2 (3.6%); and other malignancies including 2 ovarian cancer cases and 1 breast cancer case, 3 (5.4%). The histopathologic results for the AGC-associated neoplastic group (n=28) were as follows: low-grade squamous intraepithelial lesion, 1 (3.5%); high-grade squamous intraepithelial lesion, 3 (10.7%); adenocarcinoma of cervix, 5 (17.8%); endometrial carcinoma, 4 (4.8%); and additional malignancies including 3 stomach cancer cases, 2 ovarian cancer cases, and 2 breast cancer cases; 7 (25%).
CONCLUSION
AGCs may represent a variety of benign and malignant lesions. AGC-associated neoplastic findings may be related to gynecological or extrauterine malignancies. Thus, when AGCs, especially neoplastic AGCs, are encountered, it is best to evaluate the cervix not only for typical maladies, but also for gynecological and non-gynecological malignancies.

Keyword

Atypical glandular cell; Pap smear

MeSH Terms

Adenocarcinoma
Breast Neoplasms
Cervix Uteri
Delivery of Health Care
Endometrial Neoplasms
Female
Humans
Medical Records
Outpatients
Ovarian Neoplasms
Prevalence
Stomach Neoplasms

Figure

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  Fig. 1 (A) Atypical endocervical cells, not otherwise specified (cervical smears by Pap stain, 34-year-old woman). Groups of cells show round to oval nuclei with nuclear enlargement, small nucleoli, and smooth nuclear membrane. Follow-up revealed chronic cervicitis (×400). (B) Atypical endocervical cells, favor neoplastic (cervical smears by Pap stain, 67-year-old woman). Sheet of cells show enlarged nuclei with hyperchromasia, some variation in nuclear size, small nucleoli, and feathering. Follow-up revealed endocervical adenocarcinoma (×400). (C) Atypical endometrial cells, favor neoplastic (cervical smears by Pap stain, 53-year-old woman). A small group of cells have mildly hyperchromatic nuclei, small nucleoli, and a vacuolated cytoplasm. Histologic diagnosis was endometrial adenocarcinoma (×400).

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  Fig. 2 Relative distribution of benign pathology, pre-malignant diseases, and malignant diseases after clinical follow-up in AGC-NOS (A) and AGC-favor neoplastic (B). AGC, atypical glandular cell; NOS, not otherwise specified.

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  Fig. 3 Relative distribution of malignancies after clinical follow-up in AGC-NOS (A) and AGC-favor neoplastic (B). AGC, atypical glandular cell; NOS, not otherwise specified.

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