Artifactual endocervical atypia induced by endocervical brush collection

Abstract

The cytologic distinctions between artifactual atypia induced by endocervical brush collection, endocervical glandular repair, and endocervical glandular dysplasia or neoplasia are often difficult. This difficulty is amplified by the lack of accepted cytologic criteria for endocervical glandular dysplasia, and the fact that earlier studies defining the significant cytologic features of endocervical adenocarcinoma in situ and endocervical adenocarcinoma (endocervical neoplasia) utilized a swab for endocervical cell retrieval. With the almost universal adoption of the endocervical brush, it is important to redefine those cytologic characteristics that differentiate true endocervical glandular dysplasia or neoplasia from reactive or reparative processes and instrument artifact. From our data, it appears that the classically described cytologic discriminators between a negative smear and smears of endocervical dysplasia or neoplasia are basically unchanged with some minor modifications for endocervical brush-collected samples.

Endocervical reactive atypia: A histologic-cytologic study

“…However, the cells we describe were usually, but not always, seen in clusters. Fiorella et al, 17 in contradiction to the study of Raab et al, 16 found single endocervical cells to indicate a benign process. It is of interest that when the diagnosis of endocervical atypia was made, the vast majority of neoplasms subsequently found on biopsy were of squamous origin.…”

Cytologic features of high‐grade squamous intraepithelial lesions involving endocervical glands on ThinPrep® cytology

“…This can lead to difficulties in interpretation by both cytotechnologists and cytopathologists, who may not be accustomed to seeing increased numbers of endocervical cells on Pap-stained cervical slides. Some authors 19 have cautioned on both the underdiagnosis and overdiagnosis of these cell collections.…”

Adenocarcinoma In Situ in Cervical Smears With a Small Cell (Endometrioid) Pattern:Distinction From Cells Directly Sampled From the Upper Endocervical Canal or Lower Segment of the Endometrium

“…8 In the usual smear with tuboendometrial metaplasia, chromatin is finer than it is in AIS, and cilia may be present. 6 ' 7 However, in spray-fixed smears cilia are difficult to find, 14 and chromatin appears slightly coarse if fixation is not optimal. In cells from the LUS, mitotic figures may be seen, and in the absence of distinct endometrial sheets or tubules, these may be erroneously considered evidence of neoplasia.…”