title: Atypical glandular cells of undetermined significance favor endometrial origin. Criteria for separating low grade endometrial adenocarcinoma from benign endometrial lesions.
abstract: OBJECTIVE
  To evaluate cytologic criteria for separating atypical glandular cells of undetermined significance favor endometrial origin (AGUS-EM), on Papanicolaou-stained (Pap) smears into favor benign and favor malignant categories.
  
  
  METHODS
  All patients who had a Pap smear diagnosis of AGUS-EM, not further qualified, followed by tissue follow-up were identified from the surgical pathology and cytopathology files from January 1992 through December 1996. The Pap smears were scored blindly for the presence or absence of 40 cytologic criteria, and univariate analysis was performed to determine which criteria were most indicative of malignancy by tissue follow-up.
  
  
  RESULTS
  The presence of an atrophic smear, nuclear size greater than twice that of an intermediate cell nucleus and absence of clusters with irregular borders were highly indicative of adenocarcinoma, although other criteria were also helpful in identifying malignancy.
  
  
  CONCLUSIONS
  There are no combinations of cytologic criteria that definitely separate AGUS-EM cases into those with benign or malignant findings on follow-up. However, some isolated criteria were useful in the differential diagnosis in a [table: see text] significant number of cases.
authors.affiliation: Department of Pathology, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Diva R
authors.initials: DR
authors.lastname: Salomão
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Hughes
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Raab
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology; D000328:Adult; D000368:Aged; D001706:Biopsy; D002467:Cell Nucleus / Q000473:pathology; D003937:Diagnosis, Differential; D004107:Dilatation and Curettage; D016889:Endometrial Neoplasms / Q000473:pathology; D004717:Endometrium / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D065006:Papanicolaou Test; D011230:Precancerous Conditions / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D002577:Uterine Cervical Diseases / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000473:pathology; D014591:Uterine Diseases / Q000473:pathology*; D014626:Vaginal Smears / Q000379:methods*