Cytology-histology correlation of atypical glandular cells on cervical Papanicolaou tests: A study of 628 cases

Abstract

IntroductionThe finding of atypical glandular cells on Pap test is becoming more important as the incidence of squamous intraepithelial lesions decreases in recent decades. Therefore, the interpretation and follow-up of patients with AGC are particularly important. The aim of our study was to assess the histologic findings and clinical correlations in patients with atypical glandular cells identified on Pap test. Materials and methodsA total of 714 patients with atypical glandular cells identified on cervical Pap tests were studied for their clinicopathologic features, such as follow-up histology and pateints’ age. We investigated the histologic follow-up results for each individual subcategories of atypical glandular cells and their correlation with patients’ age. ResultsMost of the glandular cell abnormalities (80.0%) in the study group were classified as “atypical glandular cells, NOS”. About 28.9% of patients’ follow-up histology showed malignant or precancerous lesions. The mean age of patients with malignant or precancerous lesions was significantly higher than that of patients with benign or non-precancerous lesions. The malignant histologies included 52 cases of endometrial cancers and 31 cases of cervical carcinomas. The second most common subcategory was “atypical glandular cells, favor neoplastic” (5.0%), while “atypical endocervical cells, favor neoplastic” comprised about 2.7% of cases in our study. The average age of patients with “atypical glandular cells, favor neoplastic” was significantly higher than that of patients with “atypical endocervical cells, favor neoplastic”. The follow-up histology of about 82.1% of “atypical glandular cells, favor neoplastic” showed endometrial (73.9%) or cervical malignancies (26.1%). The follow-up histology of about 70.6% of “atypical endocervical cells, favor neoplastic” showed endometrial (50.0%) or cervical cancers (50.0%). Other glandular abnormalities included 25/714 cases of “atypical endometrial cells” (3.5%) and 6/714 cases of “atypical endocervical cells” (0.8%). ConclusionBased on our data, we have observed significantly more endometrial malignancies in both “atypical glandular cells, NOS” and “atypical glandular cells, favor neoplastic” subcategories and even some in “atypical endocervical cells, favor neoplastic” category. This predominance of endometrial malignancies is also associated with patients’ age and tumor types.