Endocervical reactive atypia: A histologic-cytologic study

Ghorab, Zeina; Mahmood, Shahid; Schinella, Roger

doi:10.1002/(sici)1097-0339(200006)22:6<342::aid-dc3>3.0.co;2-0

Cited by 11 publications

(9 citation statements)

References 12 publications

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“…Similar to these studies, many studies found that increased N/C ratio, nuclear enlargement, loss of polarity, nuclear irregularity, macronucleoli, overlapping, feathering, and papillary clusters were significant factors in terms of malignancy 30,32,37‐40 . On the other hand, some studies have emphasised that some cytomorphological findings (eg, nuclear enlargement, nuclear irregularity, increased N/C ratio, and overlapping) are seen in both reactive and neoplastic processes; for this reason, they cannot be considered as distinctive features for malignant lesions 18,28,41,42 . In addition, Babkowski et al and Levine et al reported that samples from the endocervical canal might contain some cells with nuclear pleomorphism, abnormal chromatin pattern, overlapping, nuclear palisading, feathering, and rosette formation 41,43 …”

Section: Discussionmentioning

confidence: 81%

Atypical glandular cells in Papanicolaou test: Which is more important in the detection of malignancy, architectural or nuclear features?

et al. 2021

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Objective Atypical glandular cells (AGCs) in Pap (Papanicolaou) smears are uncommon but may represent various benign and malignant lesions. The aim of this study was to evaluate the AGC incidence in Pap smears, analyse the relationship between AGC and malignancy, and reveal the importance of architectural and nuclear features observed cytologically in malignancies. Methods Patients diagnosed with AGC on the basis of cervicovaginal cytology between May 2011 and July 2018 were included in this study. All slides were retrospectively reviewed and subclassified according to the Bethesda 2001 classification system. The cytomorphological features observed in the smears were recorded. Cytohistological correlations were evaluated, and the significant clinicopathological findings for malignancy were determined. Results Of 87 536 Pap smears, 195 (0.22%) had AGC results and 156 had tissue follow‐up. Among the 156 smears with AGC, 80 (51.3%) were diagnosed as AGC‐NOS (atypical glandular cells, not otherwise specified) and 76 (48.7%) as AGC‐FN (atypical glandular cells, favour neoplastic). Follow‐up biopsies revealed benign pathologies in 49 cases (31.4%) and malignant pathologies in 107 (68.6%). The rate of malignancy observed in AGC‐FN cases (89.5%) was higher than the rate of malignancy in AGC‐NOS cases (48.8%). Among the cytomorphological features, nuclear irregularity, presence of macronucleoli, feathering, loss of polarity, papillary pattern, and three‐dimensional formation were found to be significant indicators of malignancy. Conclusion As AGC in Pap smear was associated with a clinically significant diagnosis in 68.6% of the cases in our study, we suggest that all patients with AGC should undergo further clinical assessment.

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Section: Discussionmentioning

confidence: 81%

Atypical glandular cells in Papanicolaou test: Which is more important in the detection of malignancy, architectural or nuclear features?

et al. 2021

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“…The presence of neoplastic and nonneoplastic diagnoses in all groups of glandular abnormalities would seem to suggest that the current classification system is not a completely reliable indicator of disease in women with this cytologic diagnosis 1. In fact, cytologic diagnoses have been the subject of a reevaluation based on the experience that has been accumulated with respect to the significance of cytomorphologic criteria 17–20…”

Section: Discussionmentioning

confidence: 99%

“…Tam et al16 reported that an increased nuclear/cytoplasmic ratio, nuclear enlargement, and cell clusters were found in more than 90% of cases with clinically significant histological findings. On the other hand, nuclear enlargement, a variation or irregularity in nuclear shape, increased nuclear/cytoplasmic ratio, and overlapping are criteria suggestive both of reactive and neoplastic processes 17–20…”

Section: Discussionmentioning

confidence: 99%

“…Overlapping represents a significant cytomorphological criterion according to Bose et al,18 who considered endocervical cells in a monolayer to be indicative of benign abnormalities. Nevertheless, there are various benign and reactive conditions in which overlapping cells mimic glandular abnormalities 17–19. Loss of polarity was detected more frequently in smears from women with a histological diagnosis of neoplasia.…”

Section: Discussionmentioning

confidence: 99%

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Cytomorphological criteria, subclassifications of endocervical glandular cell abnormalities, and histopathological outcome: A frequency study

Nora

Ázara

Pace

et al. 2010

Diagnostic Cytopathology

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The objective of this study was to evaluate the frequency and the significance of cytomorphological criteria defined in studies as being predictive of neoplasia in cervical smears of women with a cytological diagnosis of atypical glandular cells (AGC) or adenocarcinoma in situ (AIS). Women (n = 103) with cytological findings suggestive of AGC or AIS, whose diagnoses were later established by histopathology, were included in the study. The criteria analyzed and classified as present or absent in cervical smears previously classified as AGC-NOS (not otherwise specified), AGC-FN (favor neoplasia), or AIS were as follows: irregular nuclear membranes; scanty cytoplasm; dyskeratotic cells; increased nuclear/cytoplasmic ratio; nucleoli; overlapping; papillary clusters, feathering; loss of polarity; nuclear enlargement; coarsely granular chromatin; and pseudostratified strips. Histopathology resulted in neoplastic diagnoses in 55 cases (53.3%) and nonneoplastic diagnoses in 48 cases (46.6%). Coarsely granular chromatin was observed in 62.5% of cases with a diagnosis of neoplasia. Feathering was present in 80% of cases of histopathological AIS. Loss of polarity and coarsely granular chromatin were significantly associated with neoplastic diagnosis considering all subcategories of glandular abnormalities diagnosis. In AGC-SOE subclassification, coarsely granular chromatin was significantly associated with neoplastic diagnosis. The presence of nucleoli was significantly associated with neoplastic diagnosis in cervical smears qualified as AGC-FN and AIS. Nuclear enlargement, increased nuclear/cytoplasmic ratio, coarsely granular chromatin and overlapping cells were found in all the subclassifications of glandular cell abnormalities irrespective of the histopathological results. Chromatin aspects, polarity, and presence of nucleoli can predict neoplasia.

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“…As mentioned, similar cellular or nuclear changes are encountered in CLT and can be mistaken for PTC. 10, [94][95][96][97][98][99][100] Follicular cells along the FNA-needle tracks can demonstrate nuclear enlargement and marked nuclear chromatin clearing. In some cases, the FNA track is sclerosed if there is enough time for it to heal.…”

Section: Post-fna Histologic Alterationsmentioning

confidence: 99%

Cytologic and Architectural Mimics of Papillary Thyroid Carcinoma

Baloch

LiVolsi

2006

Pathology Patterns Reviews

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In this paper, we review those pathologic entities that may mimic papillary thyroid carcinoma. These include specimen preparation and handling issues such as decalcification, frozen section, and artifacts occurring following fine-needle aspiration (FNA). Also discussed are true disease entities, including chronic lymphocytic thyroidits, benign papillary hyperplastic lesions, hyalinizing trabecular neoplasm, and post-FNA changes. Both the cytologic and histopathologic preparations containing these changes are reviewed and illustrated; guidelines for distinctions among these entities are provided.

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Endocervical reactive atypia: A histologic-cytologic study

Cited by 11 publications

References 12 publications

Atypical glandular cells in Papanicolaou test: Which is more important in the detection of malignancy, architectural or nuclear features?

Atypical glandular cells in Papanicolaou test: Which is more important in the detection of malignancy, architectural or nuclear features?

Cytomorphological criteria, subclassifications of endocervical glandular cell abnormalities, and histopathological outcome: A frequency study

Cytologic and Architectural Mimics of Papillary Thyroid Carcinoma

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