Glandular epithelial abnormalities on thinprep® pap tests: Clinical and cytohistologic correlation

Although the incidence of glandular epithelial abnormalities on cervical cytology is low, the clinical and histologic findings are often significant. The laboratory's 12-year experience is reported.

from January 1, 2003 to December 31, 2014, the Cytopathology Laboratory of the University of Wisconsin Hospital and Clinics processed 191,087 ThinPrep(®) Pap Tests of which 184 (0.1%) were reported as glandular epithelial abnormalities. One hundred forty-three (78%) of these cases had histologic follow-up and form the basis of this study. Of the 143 women (mean age, 52; median, 50), 45% presented with vaginal bleeding and 55% were asymptomatic. The cytologic groups included atypical glandular cells, atypical glandular cells; favor a neoplastic process, atypical endocervical cells, atypical endocervical cells; favor a neoplastic process, endocervical adenocarcinoma in situ, atypical endometrial cells and adenocarcinoma, NOS.

Overall, the histologic follow-up showed epithelial abnormalities including endometrial and endocervical carcinoma, endocervical adenocarcinoma in situ, CIN 3 involving endocervical glands and metastatic carcinoma in 78% of the cases. The diagnoses were age-dependent and influenced by clinical symptomatology.

Glandular epithelial abnormalities on Pap tests warrant further clinical investigation.