Symposium part 4: Should pathologists diagnose endocervical preneoplastic lesions "less than" adenocarcinoma in situ?: Counterpoint.
Adenocarcinoma in situ (AIS) is the acknowledged precursor to most cases of invasive adenocarcinoma of the cervix. However, diagnostic terminology for lesions that do not fulfill all of the published criteria for AIS has not been standardized. Some have used the terms "glandular dysplasia" or " atypical hyperplasia" for purported antecedents of AIS, whereas others have adopted the term "cervical intraepithelial glandular neoplasia" (CIGN) for the entire spectrum of endocervical atypicality including AIS, with subcategories of "low-grade" and "high-grade" CIGN. In this article the appropriateness of using these terms in diagnostic reports (versus the use of AIS to include some or most of the lesions encompassed by them, with nonspecific terminology for the remainder) is examined in the light of the relevant objective studies bearing on this question. An opinion is offered favoring the latter approach.
Lee
Kenneth R
KR
Department of Pathology, Brigham & Women's Hospital, Boston, Massachusetts 02115, USA.
D000230:Adenocarcinoma / Q000473:pathology*; D002278:Carcinoma in Situ / Q000473:pathology*; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D010338:Pathology, Clinical / Q000592:standards*; D015203:Reproducibility of Results; D002578:Uterine Cervical Dysplasia / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology*