Glandular Neoplasia Research Articles

MYBL2 (B-MYB) in Cervical Cancer: Putative Biomarker

Cervical cancer is the second most common cancer affecting women worldwide. It is characterized by chromosomal aberrations and alteration in the expression levels of many cell cycle regulatory proteins. MYBL2 is a member of the MYB proto-oncogene family that encodes DNA binding proteins. These proteins are involved in cell proliferation and control of cellular differentiation. Four established cervical cancer cell lines were examined and compared with normal cervix using gene expression profiling and comparative genomic hybridization, and results were correlated to identify potential novel cervical cancer biomarkers. Results were validated using TaqMan polymerase chain reaction, and the potential role of MYBL2 as a clinical biomarker was then evaluated by immunohistochemistry on 30 tissue samples. MYBL2 was found to be overexpressed in the cervical cancer cell lines by gene expression profiling, and this result was confirmed using TaqMan polymerase chain reaction. Analysis of comparative genomic hybridization data indicated that chromosome 20q13.1, which encodes the MYBL2 gene, was amplified in the human papillomavirus (HPV) type 16-positive CaSki and SiHa cell lines but not in the HPV-18-positive HeLa or HPV-negative C33A cell lines. Although MYBL2 staining was predominantly absent in normal cervical epithelium, strong staining (score of 2 or 3) was identified in all cases of cervical intraepithelial neoplasia, cervical glandular intraepithelial neoplasia, and invasive cancer on immunohistochemistry. In addition, strong staining of a population of diffusely scattered single cells is identified. We postulate that these may represent so-called cancer stem-like cells.

Evaluation of p16INK4a Immunohistochemical Reactivity in Endocervical Glandular Neoplasia

To determine the expression of p16INK4a by immunohistochemistry in endocervical neoplasms. Forty-nine cases of endocervical glandular neoplasia were identified by record review. On histopathologic review of the original and new slides, 16 cases were identified as endocervical adenocarcinoma in situ (AIS), 31 were identified as invasive adenocarcinoma, and 2 had no remaining tumor identified. A representative paraffin block was selected from each case with tumor and sections cut from each block. One section from each case was stained with hematoxylin and eosin, 1 was processed for immunohistochemical study for p16INK4a, and 1 was a negative control. The nuclear immunoreactivity was graded positive, indeterminate, or negative. Cases were classified AIS, adenocarcinoma, or no tumor. Of 16 cases of AIS, 15 (93.01%) cases were immunoreactive to p16INK4a; 1 case was negative. All cases of invasive adenocarcinoma, 31 of 31 cases (100%), were immunoreactive to p16INK4a. p16INK4a reactivity can be used to help identify and assess in situ and invasive endocervical glandular neoplasms.

Glandular neoplasia and borderline endocervical reporting rates before and after conversion to the SurePathTM liquid‐based cytology (LBC) system

Reporting rates for glandular neoplasia in 464,754 cervical samples reported at six laboratories in 12-month periods before and after the implementation of Surepath™ LBC processing are compared. The introduction of LBC processing is seen to have resulted in a significant (P = 0.001) increase in the detection rate for endocervical glandular neoplasia (from 2.2 per 10,000 tests to 3.9 per 10,000) while maintaining high levels of reporting specificity. An observed fall in the number of samples reported as showing borderline glandular neoplasia falls short of statistical significance, and the reporting of possible endometrial and 'other' glandular abnormalities appears to be unaffected. The underlying reasons for the observed improvement in detection of endocervical glandular neoplasia are discussed.

The management of cervical glandular intraepithelial neoplasia during pregnancy

"The management of cervical glandular intraepithelial neoplasia during pregnancy." Journal of Obstetrics and Gynaecology, 30(6), pp. 640–641

HPV genotyping and HPV16 variant analysis in glandular and squamous neoplastic lesions of the uterine cervix

Objective The objective of the study was to compare the distribution of HPV genotypes and HPV16 variants in glandular and squamous cervical neoplasia. Methods Cases of endocervical adenocarcinoma in-situ (AIS, n = 33) invasive adenocarcinoma (ADCA, n = 55), cervical intraepithelial neoplasia-3 (CIN3, n = 130) and squamous cell carcinoma (SCC, n = 60) were collected at the New York Hospital and tested for HPV using SPF 10PCR-LIPA 25 (version 1) assays and for HPV16 variants using a multiplex PCR and reverse hybridization assay. Results There was a difference between the spectrum of HPV genotypes detected in glandular and squamous neoplasia: 13 different HPV genotypes were detected in CIN3 as single infections and 11 in SCC, while only 4 single genotypes were detected in AIS and 3 in ADCA. The most common single HPV types in CIN3 were HPV16, 31, and 52 (56.9%, 10%, 8.4%, respectively). In SCC the most common were HPV16, 18 and 31 (70%, 6.5%, 4.9%). In AIS, HPV16, 18, 45 and 35 accounted for 69.7%, 27.2%, 3%, 3% of cases. The three single types in ADCA were HPV16 (43.6%), HPV18 (41.8%) and HPV45 (10.9%). European variants of HPV16 were the most common in CIN3 (83.8%), SCC (71.4%) and AIS (73.9%). In ADCA the Asian American (AA) variant was the most common (41.7%) followed by European variants (33.3%). AA variant was also detected in 17.4%, 4.1%, and 2.4% of HPV16 positive AIS, CIN3 and SCC, respectively. Conclusion Asian American variant of HPV16, HPV18 and HPV45 are preferentially associated with cervical adenocarcinoma as compared to squamous cell carcinoma .

Ancillary testing in liquid based cytology to distinguish cervical glandular neoplasia from tuboendometrial metaplasia in a young woman

A 33-year old woman had a cervical sample taken at colposcopy clinic. Seven years prior to this, at the age of 26, she had had a cytological diagnosis of cervical glandular neoplasia (cytology descriptor indicated cells suspicious of endocervical neoplasia) and severe dyskaryosis. Confirmation and treatment were by LLETZ and knife cone, and, in keeping with England and Wales National Health Service guidelines, this woman was under follow-up by the colposcopy clinic. Intervening cytological follow-up included a number of negative cytological samples interspaced with one equivocal report. A recent repeat cytology which was rather cellular contained several hyperchromatic crowded cell groups (HCCG's). Careful examination revealed benign endometrial clusters, LUS, TEM and endocervical cells in strips showing pseudostratification and loss of polarity. Following an agar block, there was positive staining for p16 and Ki-67 in the abnormal groups whilst the benign TEM cells stained positive for bcl-2.

A clinical review of borderline glandular cells reported on liquid-based cervical cytology

To review the clinical outcome of women presenting with borderline glandular cells on liquid-based cervical cytology (LBC). Design Retrospective review. Women seen at a colposcopy clinic over a 26-month period referred with borderline glandular cells on LBC. Review of the case notes and cytology, pathology and colposcopy databases of all women referred with borderline glandular cells on LBC between June 2006 and August 2008. Final histological diagnosis. Sixty-nine women were identified (0.19% of all smears). Twenty-seven women (39.1%) had premalignant or malignant lesions, five (7.2%) had cancers and 22 (31.9%) had intraepithelial neoplasia, 19 (27.5%) of which were cervical squamous intraepithelial neoplasia (CIN) and three (4.3%) of which were cervical glandular intraepithelial neoplasia (CGIN). No women under 35 years of age with normal and satisfactory colposcopy had premalignant or malignant lesions. Despite normal and satisfactory colposcopy, three women over 35 years had significant lesions: one high-grade CIN, one CGIN and one squamous cell carcinoma. On the basis of our results, it would be considered acceptable to manage women under 35 years of age with normal and satisfactory colposcopy conservatively. In women above 35 years of age, we would recommend a diagnostic 'large loop excision of the transformation zone' procedure, irrespective of the colposcopic findings.

Outcomes of cervical liquid‐based cytology suggesting a glandular abnormality

To ascertain the positive predictive value of both ?glandular neoplasia (national standard code 6) and borderline change (national standard code 8) in glandular cells in liquid-based cervical cytology specimens in Cardiff and Vale NHS Trust and to outline the histological outcomes of these cases. Eighty-nine liquid-based (Surepath) cervical cytology cases were retrospectively identified from a 2-year period (January 2005 to December 2006) and correlated with histopathological diagnoses. Initial punch biopsy histology revealed 18 cases (21%) of cervical glandular intraepithelial neoplasia (CGIN). A further nine cases (10%) of CGIN were identified following local excision or hysterectomy. Ten cases of invasive malignancy were identified: four endocervical adenocarcinomas (all node negative, TNM stage T1b1), five endometrial adenocarcinomas and one squamous cell carcinoma. There were 10 with high-grade cervical intraepithelial neoplasia (CIN) alone. Women diagnosed with endometrial malignancy presented later with an average age of 64.6 years compared with 34.9 years for endocervical lesions. Taking high-grade CIN or worse as a positive outcome, the overall positive predictive value (PPV) of glandular abnormalities on cytology (both code 6 and 8) was 58.1% [95% confidence interval (CI) 47.8, 68.4]. PPV for borderline change in glandular cells alone was 24.1% (95% CI 8.5, 39.6) and for ?glandular neoplasia alone 75.4% (95% CI 64.3, 86.5). With our interpretation of the classification, women with cytological diagnoses of glandular neoplasia of the cervix should initially be investigated by local resection rather than punch biopsy, and those with borderline change in glandular cells with repeat cytology.

The role of cervical cytology and colposcopy in detecting cervical glandular neoplasia

To determine the role of cervical cytology and colposcopy in the management of endocervical neoplasia. Colposcopy unit and cytology laboratory in a teaching hospital. Group 1 included 184 smears showing endocervical glandular neoplasia from 129 patients and group 2 included 101 patients with histology showing endocervical abnormalities in a 6-year period (1993-1998). Follow-up of 6-11 years to 2004 was available. Group 1 were identified from the cytology computer records. Group 2 were identified from histology records on the cytology database and a record of histology cases kept for audit purposes. The clinical records were examined retrospectively. The positive predictive value (PPV) of abnormal endocervical cells in smears was 81.1% for significant glandular/squamous [cervical glandular intraepithelial neoplasia (CGIN)/cervical intraepithelial neoplasia grade2 (CIN2 or worse)] lesions. The PPV of colposcopy was 93.5% for significant glandular/squamous lesions of the cervix. The postcolposcopy probability of a significant lesion when colposcopy was normal was 87.5%. The sensitivity of colposcopy in detecting endocervical lesions was 9.8%. The sensitivity of cervical smears in detecting a significant endocervical abnormality (CGIN or worse) was 66.3%. The false negative rate for cytology of endocervical glandular lesions was 4.0%. Endocervical glandular neoplasia detected on cytology is predictive of significant cervical pathology even when colposcopy is normal, which supports excisional biopsy in the primary assessment of these smears. The high concomitant squamous abnormality rate justifies the use of colposcopy to direct biopsies from the ectocervix. Cervical cytology is the only current screening method for cervical glandular abnormalities but sensitivity is poor.

Endometrial carcinoma detected with SurePath liquid‐based cervical cytology: comparison with conventional cytology

Conventional Pap smears (CPS) have little impact on the detection of endometrial carcinoma. Although liquid-based cytology (LBC) is replacing CPS in the UK, experience with identification of endometrial cancers with this technique is limited. To compare the accuracy of the SurePath LBC with that of CPS for detection of endometrial cancers. Our study group comprised SurePath LBC samples reported as atypical endometrial cells and endometrial adenocarcinoma (classified respectively as borderline, code 8 and ?glandular neoplasia, code 6 for the NHS Cervical Screening Programme statistics) in 2004-2005. CPS reported as atypical endometrial cells or adenocarcinoma in 1993-1998 comprised the control group. Histological follow-up was obtained. Endometrial abnormalities were reported in 95 (0.073%) of 130 352 LBC samples, comprising 75 (0.058%) atypical endometrial cells and 20 (0.015%) endometrial adenocarcinoma reports. Of 409 495 CPS, 117 (0.029%) were diagnosed as endometrial abnormalities, comprising 59 (0.014%) atypical endometrial cells and 58 (0.014%) endometrial adenocarcinoma reports. Thus, the endometrial adenocarcinoma reporting rate was similar in both groups, but that for atypical endometrial cells was higher with LBC (P < 0.001). The positive predictive value for endometrial cancer of endometrial adenocarcinoma and atypical endometrial cell reports in the LBC group was 73.3 and 18.8%, respectively, compared with 42.3 and 6.7% in the CPS group. The endometrial adenocarcinoma patients in CPS group were older (mean age 62.5 years versus 56.5 years) and most (22/25) were symptomatic, whereas most (13/17) patients in the LBC group were asymptomatic at the time of sampling (P < 0.001). SurePath LBC is at least as accurate a method for detecting endometrial cancer as CPS. SurePath LBC demonstrates enhanced identification of endometrial pathology in asymptomatic women in the cervical screening programme.

Diverse glandular pathologies coexist with high‐grade squamous intraepithelial lesion in cyto‐histological review of atypical glandular cells on ThinPrep specimens

To identify in cytology, high-grade squamous intraepithelial lesions with endocervical glandular extension in cases previously diagnosed as atypical glandular cells (AGC), analyse possible reasons for the diagnostic pitfall and document the frequency of glandular pathology coexisting with high-grade cervical intraepithelial lesion in histology. Thirty-nine ThinPrep cervical smear (Pap) tests reported as AGC of undetermined significance and showing high-grade lesions on histology [cervical intraepithelial neoplasia (CIN) 2 or 3, endometrial or extrauterine adenocarcinoma] were reviewed retrospectively to identify the cases of high-grade squamous intraepithelial lesion with endocervical glandular extension, using the Bethesda 2001 system. Cyto-histological correlation was performed. A high frequency of diverse glandular pathologies coexisted with high-grade cervical intraepithelial lesions on histology. This included endocervical glandular extension in 63%, benign glandular pathology in 33% and pre-neoplastic or malignant glandular pathology (endocervical glandular dysplasia, adenocarcinoma in situ and metastatic breast carcinoma) in 17% cases. On cytology, the sensitivity was 40%, specificity was 80% and positive predictive value was 86% for endocervical gland extension in high-grade squamous intraepithelial lesions. Special efforts to recognize endocervical glandular extension in high-grade squamous intraepithelial lesions and glandular neoplasia coexisting with squamous intraepithelial lesions from the heterogeneous category of AGC can contribute to increasing the diagnostic accuracy. The identification of endocervical glandular extension on cervical cytology would alert the gynaecologist to perform a thorough assessment of the endocervix during colposcopy. This could also help to decide on the need to perform deeper conization rather than loop electrosurgical excision procedure to ensure negative margins when colposcopic biopsy shows CIN 2 or 3.

An audit of liquid-based cervical cytology screening samples (ThinPrep and SurePath) reported as glandular neoplasia

The aims of this study were to assess the number of cases diagnosed as glandular neoplasia (national report code 6) of cervical (6A) and non-cervical (6B) types on ThinPrep (TP) and SurePath (SP) liquid-based cytology (LBC) samples and to calculate the positive predictive value (PPV) of these diagnoses for significant glandular and/or squamous pathology for local audit and as a contribution to national data on glandular neoplasia. A computerized search identified all screening LBC samples reported as glandular neoplasia during the 24-month period from January 2006 to December 2007. Corresponding histology samples were identified, with a minimum follow-up period of 6 months for each case. A total of 70 samples, representing 70 patients, were reported as glandular neoplasia, 39 TP (55.7%) and 31 SP (44.3%), with 46 samples (31 TP, 15 SP) reported as 6A and 24 samples (eight TP, 16 SP) as 6B. PPV of glandular neoplasia was calculated for a biopsy diagnosis of cervical glandular intraepithelial neoplasia/adenocarcinoma and/or cervical intraepithelial neoplasia (CIN) 2 or worse. The PPV of 6A was 100% for both TP and SP. The PPV of 6B for adenocarcinoma was 62.5% for TP and 66.7% for SP. The combined PPV for 6A + 6B was 92.3% for TP, 83.3% for SP and 88.4% combined. The overall pick-up rates for the two methods were significantly different (TP 0.031%, SP 0.052%; P = 0.014). Histology showed only CIN3 with endocervical crypt involvement in nine TP cases and one SP case.

P1018 High grade cervical intraepithelial neoplasia (CIN) and glandular intraepithelial neoplasia (CGIN) detection: a comparison of liquid based cytology and Pap smears

International Journal of Gynecology & ObstetricsVolume 107, Issue S2 p. S699-S699 Poster presentations P1018 High grade cervical intraepithelial neoplasia (CIN) and glandular intraepithelial neoplasia (CGIN) detection: a comparison of liquid based cytology and Pap smears K. Haldar, K. HaldarSearch for more papers by this authorJ. Lam, J. LamSearch for more papers by this authorF. Sanuai, F. SanuaiSearch for more papers by this author K. Haldar, K. HaldarSearch for more papers by this authorJ. Lam, J. LamSearch for more papers by this authorF. Sanuai, F. SanuaiSearch for more papers by this author First published: 20 November 2009 https://doi.org/10.1016/S0020-7292(09)62504-2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume107, IssueS2Abstracts of XIX FIGO World Congress of Gynecology and ObstetricsOctober 2009Pages S699-S699 RelatedInformation

Histologic and colposcopic correlation of cervical cytology showing “? glandular neoplasia”

To evaluate the role of cervical cytology and colposcopy in the management of patients with cervical smear reported "? glandular neoplasia". A retrospective study of 116 patients referred to the colposcopy clinic with cytology samples showing "? glandular neoplasia". Histological results were available for 114 patients; of those, 103 had cervical biopsy, 52 had endometrial biopsy and 41 patients had both. 17 (15.5%) had invasive disease, 12 cervical carcinoma (11 adenocarcinoma and one squamous cell carcinoma) and 5 endometrial adenocarcinoma. 12 (10.5%) had high-grade cervical glandular intra-epithelial neoplasia (HG CGIN). 23 (20.2%) had high-grade cervical intra-epithelial neoplasia (HG CIN). None of the patients in whom colposcopy was normal were found to have invasive cervical disease. All the patients with endometrial carcinoma were above the age of 50 years, and none of the patients with cervical carcinoma was above this age. Cytology samples with "? glandular neoplasia" are associated with significant pathology. Colposcopy is important in the assessment of this group of patients. Endometrial assessment should be offered to all patients above the age of 50 years or postmenopausal presenting with such cytology.

Histologic follow-up results in 662 patients with Pap test findings of atypical glandular cells: Results from a large academic womens hospital laboratory employing sensitive screening methods

Objective Atypical glandular cell (AGC) Pap interpretations and screening for glandular neoplasias remain major challenges. We document the largest reported AGC histopathologic follow-up experience and include verification bias-adjusted data on laboratory screening sensitivity. Methods AGC Pap tests of endocervical origin (AGC-EC), endometrial origin (AGC-EM), and not otherwise specified (AGC-NOS) were documented at a center serving an older low risk population. 98% of Pap tests were liquid-based cytology (LBC) specimens screened using computer-assisted screening. Follow-up diagnoses were correlated with cytology and stratified into age groups. Screening sensitivity was assessed by examining Pap results during 1 year preceding neoplastic diagnoses. Verification bias was adjusted with findings in over 2000 patients with hysterectomies. Results Of 247,131 Pap tests, 1021 (0.41%) reported AGC results and 662 cases had tissue follow-up. Precancerous or malignant neoplastic histologic outcomes were documented in 101 patients (15.3%), including 8.3% cervical, 6.3% endometrial, and 0.6% ovarian. AGC results were most often associated with neoplastic cervical outcomes in women younger than 40 and with neoplastic endometrial outcomes in women 50 or older. AGC-NOS with a squamous cell abnormality and AGC-EC results suggested cervical neoplasia, while AGC-EM results suggested endometrial neoplasia. Conclusions AGC Pap results detected significant numbers of cervical and non-cervical neoplasias. Since 38 of 44 (86%) of AGC-detected carcinomas were endometrial or ovarian, HPV co-testing would not have aided screening in detecting the majority of malignancies diagnosed after AGC Pap results. Verification bias-adjusted Pap screening sensitivity in the laboratory for detection of significant neoplastic cervical disease was 93%.

Mutation and protein expression of PTEN gene in cervical adenocarcinoma and glandular intraepithelial neoplasia

To investigate PTEN expression and mutation status in the development of cervical adenocarcinoma. Immunohistochemistry study of PTEN protein was performed on 42 cases of cervical adenocarcinoma, 20 cases of cervical glandular intraepithelial neoplasia and 28 cases of normal cervix tissue samples. Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was used to detect the presence of mutation of exons 5 and 8 of PTEN gene. Positive expression rates of PTEN protein were 54.8% (23/42), 25.0% (5/20) and 100% (28/28) in cervical adenocarcinoma, cervical glandular intraepithelial neoplasia and normal cervix tissues, respectively. There were significant differences among the 3 groups (P < 0.05). Positive expression rates of PTEN protein were 47.4% (9/19), 20.0% (2/10) and 92.3% (12/13) in mucinous, endometrioid and the other variants of cervical adenocarcinoma, respectively. Mutation rates at exon 5 and exon 8 of PTEN gene were 19.0% (8/42), 45.0% (9/20) and 0 in cervical adenocarcinoma, cervical glandular intraepithelial neoplasia and normal cervix tissue, respectively. There were significant differences among 3 groups (chi(2) = 4.29, chi(2) = 12.70; P < 0.05). The mutation rates were 21.1% (4/19) and 40.0% (4/10) in mucinous and endometrioid variants of cervical adenocarcinoma, respectively. There was no mutation at exons 5 and 8 of PTEN gene detected in other variants of cervical adenocarcinoma. The development of cervical adenocarcionomas is correlated with the mutation and absence of the protein expression of PTEN, likely in the early phase of their carcinogenesis.

Human Papillomavirus-specific Genotypes in Cervical Lesions of Women Referred for Smears With Atypical Glandular Cells or Adenocarcinoma In Situ

This study was designed to analyze whether specific human papillomavirus (HPV) genotypes may predict histologic outcomes in women with glandular abnormalities in their cervical smears. Of the 160 women included, 111 were diagnosed with atypical glandular cells, 35 had both atypical glandular cells and high-grade squamous intraepithelial lesions, whereas 14 women had AIS, in 1 case associated with high-grade squamous intraepithelial lesions. All women underwent colposcopic examinations and biopsy was performed in 129/160 (80.6%). Thirty-one women (19.3%) were considered negative for neoplasia and scheduled for follow-up. All specimens were tested for 27 HPV genotypes by Roche's polymerase chain reaction-reverse line blot assay. Histologic diagnoses were either cervical intraepithelial neoplasia or invasive carcinoma in 75 (58%) women, and negative for neoplasia in 54 (42%). The overall prevalence of HPV was 43%. HPV 16 was the most prevalent type followed by HPV 18. HPV 16 was significantly associated with squamous and glandular neoplasia and HPV 18 with glandular neoplasia. In women with cervical intraepithelial neoplasia 2 or 3, 11 different HPV genotypes were found, whereas in those who had invasive glandular or invasive carcinoma HPV 16 and HPV 18 were found predominantly. The detection of HPV 16 in women with glandular abnormalities in cervical smears did not help differentiating squamous from glandular lesions. However, the detection of HPV 53 in abnormal smears can predict squamous neoplasia, whereas HPV 18 can predict glandular neoplasia as histologic diagnoses.

Differentiating between endocervical glandular neoplasia and high grade squamous intraepithelial lesions in endocervical crypts: Cytological features in ThinPrep and SurePath cervical cytology samples

A recent audit at our institution revealed a higher number of cases diagnosed as endocervical glandular neoplasia on ThinPrep (TP) cervical cytology samples (9 cases) as opposed to SurePath (SP) (1 case), which on histology showed only high-grade cervical intraepithelial neoplasia (CIN) with endocervical crypt involvement (CI). We attempted to ascertain the reasons for this finding by reviewing the available slides of these cases, as well as slides of cases diagnosed as glandular neoplasia on cytology and histology; cases diagnosed as high-grade squamous intraepithelial lesions (HSIL) on cytology which had CIN with CI on histology and cases with mixed glandular and squamous abnormalities diagnosed both cytologically and histologically. Single neoplastic glandular cells and short pseudostratified strips were more prevalent in SP than TP with the cell clusters in glandular neoplasia 3-4 cells thick, in contrast to the dense crowded centre of cell groups in HSIL with CI. The cells at the periphery of groups can be misleading. Cases with HSIL and glandular neoplasia have a combination of the features of each entity in isolation. The diagnosis of glandular neoplasia remains challenging and conversion from conventional to liquid based cervical cytology requires a period of learning and adaptation, which can be facilitated by local audit and review of the cytology slides in cases with a cytology-histology mismatch.

A Model of the Differentiation and Relative Incidence of Glandular Versus Squamous Cell Neoplasia of the Uterine Cervix: Connection Between Incidence and Etiology

A Model of the Differentiation and Relative Incidence of Glandular Versus Squamous Cell Neoplasia of the Uterine Cervix: Connection Between Incidence and Etiology

Carcinoma adenóide quístico recorrente. Revisão a propósito de um caso clínico

The adenoid cystic carcinoma is a malignant epithelial glandular type neoplasia, occurring frequently in the salivary and mammary glands, and rarely in the lung, and is responsible for 0.2% of lung tumours.These tumours present a slow growth and prolonged clinical course, and are characterised by their infiltrative nature and tendency towards late local recurrence.The authors present a case of a woman with adenoid cystic lung carcinoma diagnosed after investigation of a lung nodule, submitted to surgical resection with curative intention, whose follow-up identified late recurrence, 9 years after surgery.The present case emphasises the need for a prolonged surveillance, due to the potential late recurrence of this kind of tumour. The article reviews clinical and pathological features of lung adenoid cystic carcinoma, as well as therapeutic options, namely for prevention of recurrence.Rev Port Pneumol 2009; XV (1): 101-107