P14.04: Atypical glandular cells and ultrasound changes: is there a relationship?

Abstract

The purpose of this work was to assess the existence of a connection between the atypical glandular cells (AGC) on cervical smears and gynecological changes on ultrasound. A random sample of 60 women with AGC was selected between 143 cases detected in a tertiary care hospital between 2012 and 2016. Pelvic ultrasounds were analysed to determine whether there were any changes. Of the 58 women, 13 were excluded due to insufficient information and 1 awaits investigation. A total of 44 cases was considered. The mean age was 50,7+/-13,0 years old (31-88), the majority of women was Caucasian (84,1%), and 75,0% had vaginal deliveries. 40,9% was menopausal at the time of smear collection. On the ultrasound evaluation, 7 women (15,9%) had an endometrial thickening, suspect of malignancy, and in 5 of these (11,4%) endometrial adenocarcinoma was confirmed in the hystological analysis, having been treated accordingly. As far as benign pathology was concerned, the most common finding was adenomyosis, present in 75,0% of women (n=33), including 3 of the ones with malignancy. Some of these women had other myometrial findings, such as fibromyomas, but the majority (63,6% n=21) only had adenomyosis. Some women had other ultrasound features apart from adenomyosis, which varied from small benign ovarian cysts to endocervical cysts, endometrial polyps and other findings. Most women repeated the cervical smear and had normal results on follow-up. Since some women with AGC have malignant pathology, it is of the utmost importance to investigate the cervix, endometrium and adnexa thoroughly. Fortunately, the majority of women with AGC only has benign pathology, such as adenomyosis. After discarding malignancy, adenomyosis seems to be the most consistent change throughout the sample. Since these findings are based on a small sample, further studies are warranted in order to better determine whether there are any consistent sonographic changes associated with AGC.