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Atypical glandular cells on cervical smears
C I Parellada1, P L Schivartche, E A Pereyra
1Department of Obstetrics and Gynecology, University of São Paulo Medical School, São Paulo, Brazil. parellada@uol.com.br
Summary
Atypical glandular cells in cervical smears indicate significant cervical or endometrial lesions in over half of cases. Further investigation, including colposcopy and uterine cavity assessment for women over 40, is crucial.
Area of Science:
- Gynecologic pathology
- Cervical cytology
- Oncology
Background:
- Atypical glandular cells (AGCs) in cervical smears are a cytologic finding requiring further investigation.
- The clinical significance of AGCs can range from benign reactive changes to high-grade malignancies.
Purpose of the Study:
- To determine the clinical significance of cervical smears reporting atypical glandular cells.
- To establish appropriate diagnostic and management pathways for women with AGCs.
Main Methods:
- Retrospective analysis of 8,807 women over 5 years.
- 57 women (0.65%) with AGCs underwent colposcopy and hysteroscopy.
- 12-month follow-up with conization or hysterectomy if initial exams were negative.
Main Results:
- A clinically significant lesion of the cervix and/or endometrium was diagnosed in 59.5% of cases.
- Lesions were confined to the cervix in women <40 years.
- Lesions involved the uterine body in women ≥40 years.
Conclusions:
- Colposcopic evaluation is essential for all women with AGCs.
- Endometrial evaluation (uterine cavity study) is necessary for women aged 40 years and older with AGCs.
- Age-stratified management is indicated for AGCs based on lesion location.