Clinical significance of atypical glandular cells by the 2001 Bethesda System in cytohistologic correlation.
OBJECTIVE
To evaluate incidence, cytology findings and pathology outcome of atypical glandular cells (AGC) in Pap smears according to the 2001 Bethesda criteria.


METHODS
From 103,073 consecutive Pap smears, 113 (0.1%) AGC cases were identified. Of these, 91 (80%) had adequate histologic evaluation included in this study.


RESULTS
Abnormal histology findings were seen in 38 patients (42%). Final pathology results revealed 14 endometrial adenocarcinomas, 5 endocervical adenocarcinomas, 1 cervical squamous cell carcinoma, 1 endometrial stromal sarcoma, 6 other malignancies, 4 endocervical adenocarcinomas in situ, 4 cases ofendometrial complex byperplasia, 1 case of endocervical glandular dysplasia and 2 cases of cervical intraepithelial neoplasia 3 with glandular involvement. Women with AGC, favor neoplasia, were more likely to have significant pathology than those with AGC, not otherwise specified, 74% vs. 33% (p = 0.002). Some characteristic background cytologic findings were also noticed in most cases of endometrial, fallopian tube and endocervical adenocarcinoma.


CONCLUSIONS
A diagnosis of AGC is more clinically significant by the 2001 Bethesda System, especially the "AGC, favor neoplastic" category. Some background cytologic features are important because they are indicators of malignancy.
Lai
Chiung-Ru
CR
Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan. crlai@vghtpe.gov.tw
Hsu
Chih-Yi
CY
Tsay
Shyh-Hawtsay
SH
Li
Anna Fen-Yau
AF
D000230:Adenocarcinoma / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D016889:Endometrial Neoplasms / Q000473:pathology*; D005185:Fallopian Tube Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology*; D065006:Papanicolaou Test; D011230:Precancerous Conditions / Q000473:pathology*; D012004:Rectal Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D018203:Sarcoma, Endometrial Stromal / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears / Q000379:methods