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.