Endocervical columnar cell intraepithelial neoplasia. II. Grades of expression of cytomorphologic criteria.
OBJECTIVE
To determine the relationship between the grade of expression of discriminating cytomorphologic architectural, cellular and nuclear features and the degree of endocervical columnar cell atypia.


METHODS
The study group consisted of 55 smears from 53 women known to have endocervical columnar cell atypias of variable severity. The smears were reviewed by five observers by means of 46 architectural, cellular and nuclear features. Seventeen of the 46 evaluated features were scored as revealing three grades of expression: slight, moderate and marked.


RESULTS
Grades of expression of cellular and nuclear characteristics used in the evaluation of endocervical columnar cell abnormalities were identical to the characteristics used in the diagnosis of squamous (metaplastic) lesions. As such the features were extremely useful, with the exception of hyperchromasia, which was less prominently expressed. Furthermore, the results on architectural features revealed that the expression grades slight and moderate were indicative of mild and moderate endocervical columnar cell atypia, whereas the marked expression grade was strongly related to the severe intraepithelial lesions and adenocarcinoma.


CONCLUSIONS
Characteristic cytomorphologic features at different grades of expression proved to be reliable light microscopic parameters in the diagnosis of different grades of endocervical columnar cell abnormalities. The accuracy of diagnosis at least equaled that of detecting squamous (metaplastic) lesions.
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000473:pathology; D002467:Cell Nucleus / Q000473:pathology; D002584:Cervix Uteri / Q000473:pathology* / Q000648:ultrastructure; D002843:Chromatin / Q000473:pathology; D005260:Female; D006801:Humans; D008679:Metaplasia / Q000175:diagnosis / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology
D002843:Chromatin