Clinical and histological significance of atypical glandular cell on Pap smear

Aust N Z J Obstet Gynaecol. 2007 Feb;47(1):46-9. doi: 10.1111/j.1479-828X.2006.00678.x.

Abstract

Background: Atypical glandular cell (AGC) on Pap smear is uncommon but may represent a variety of benign and malignant lesions.

Aim: The aim of this study was to evaluate the association between AGC on Pap smear and significant pathological finding to tailor management protocols.

Methods: Between 2002 and 2005, 60 women with AGC on Pap smears were referred to our colposcopy clinic. Forty-one women underwent colposcopy-directed biopsy, endocervical curettage, endometrial sampling and cervical conisation to determine the cytological and histological correlations of AGC on Pap smears.

Results: The mean age of the patients was 46.9 +/- 11.5 years (range, 23-80 years). Of these patients 13 patients (31.7%) were postmenopause and 28 patients (68.2%) were in reproductive age. We found eight (19.5%) significant pathological findings including four (9.7%) high-grade squamous intraepithelial lesion, one (2.4%) adenocarcinoma of uterus, one (2.4%) adenocarcinoma of cervix, one (2.4%) squamous cell carcinoma of cervix and one (2.4%) papillary serous tumour of ovary.

Conclusion: AGC on Pap smear was associated with a clinically significant diagnosis in approximately 20% of our cases. The women with a diagnosis of AGC on cervicovaginal smear are needed to be evaluated at least with colposcopy, endocervical and endometrial curettage. Clinicians should be careful about the significance of AGC on Pap smears.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Cervix Uteri / pathology
  • Colposcopy
  • Conization
  • Dilatation and Curettage
  • Endometrium / pathology
  • Female
  • Humans
  • Iran
  • Middle Aged
  • Papanicolaou Test*
  • Prospective Studies
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / pathology*
  • Vaginal Smears*