Atypical glandular cells
in conventional cervical smears: Incidence and follow EJC 2000, 36: 2240-2243.
Any woman with a cytologic diagnosis of Atypical Glandular cells
: NOS or Atypical Endometrial cells: NOS should be closely followed, as a significant proportion of such cases are found to have neoplastic cervical and uterine pathology subsequently.
Clinical significance of atypical glandular cells
in Pap tests: an analysis of more than 3000 cases at a large academic women's center.
Atypical glandular cell
(AGC) reporting rates for both LBC and CPT were less than 0.1%.
The 2006 ASCCP guidelines suggest 3 possible options for the management of a patient with an Atypical Glandular Cells
Papanicolaou test with colposcopic biopsy showing CIN 1 and a negative endocervical curettage: (1) excisional procedure; (2) review of all findings; or (3) follow-up with subsequent Papanicolaou and colposcopy in 6 months.
(9) These aggregated lymphocytes can also lead to potential misinterpretation as atypical glandular cells
or as adenocarcinoma.
Patients with either prior atypical glandular cells
results or both LSIL and ASC-H results were listed separately.
Cytologic diagnoses included 10 cases (5.3%) of ASC-US, 55 cases (29.1%) of LSIL, 31 cases (16.4%) of LSIL-H, 21 cases (11.1%) of ASC-H, 68 cases (36.0%) of HSIL, 1 case (0.5%) of atypical glandular cells
(AGCs), 1 case (0.5%) of adenocarcinoma in situ (AIS), and 2 cases (1.1%) of squamous cell carcinoma (SCCA) (Figure 2).
When asked which interpretive rates were felt to not be useful, most comments included relatively rare but significant interpretations such as atypical glandular cells
, atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H), and cancer.
Most laboratories (71.4%) responded that only HSIL+ or adenocarcinoma in situ+ prompt a 5-year review, while 15% of laboratories also rescreen Pap tests from patients with atypical glandular cells
. Smaller percentages of laboratories review Pap tests from patients with low-grade squamous intraepithelial lesion (LSIL) (8.6%); atypical squamous cells, undetermined significance (ASCUS) (6.8%); and atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) (2.3%).
When asked about the type of discrepancy that prompts a comment in the biopsy report, 89% (235 of 264) use a normal biopsy result and an HSIL Pap test result, 70.8% (187 of 264) consider NILM and CIN 2-3 worthy of comment, 71.6% (189 of 264) comment on a normal biopsy result with an LSIL result, 60.2% (159 of 264) comment on NILM results with a CIN 1 biopsy, 62.5% (165 of 264) comment on ASC-H and a normal biopsy result, and 62.1% (164 of 264) remark on atypical glandular cells
(AGC) or cancer on a biopsy when the Pap test result is NILM (Table 5).