Histologic implications of Pap smears classified as atypical glandular cells.

Abstract

OBJECTIVE To evaluate the histologic outcome of Pap smears reported as atypical glandular cells (AGC). STUDY DESIGN Cervical cytology smears reported as AGC were reviewed and correlated with histologic follow-up. RESULTS Of a total of 41,500 Pap smears performed at Alexandra Hospital during 2000-2002, 113 (0.2%) were reported as AGC. Of these, 64 were classified as AGC not otherwise specified (NOS) (56.6%), 48 AGC favor neoplasia (42.5%) and 1 (0.9%) adenocarcinoma in situ. All these women underwent histological evaluation. The mean age of the patients was 52 years. Significant abnormality was found in 30 women (26.5%). Eleven percent of women with smears reported as AGC NOS and 45.8% of those with AGC favor neoplasia had significant abnormality. Of these patients, 14 (12.4%) had endometrial involvement, whereas cervical abnormalities were identified in the remaining 16 (14.1%). Older women were more likely to have involvement of the endometrium and younger women, involvement of the cervix. CONCLUSION Cytologic criteria and patient age might effectively direct the clinician toward the likely origin of AGC.