The Cytologic Diagnosis of Adenocarcinoma in Situ of the Cervix Uteri

Cytologic features of endocervical glandular lesions: Comparison of SurePath, ThinPrep, and conventional smear specimen preparations

“…The first nearly complete description of the cytology of endocervical adenocarcinoma in situ (AIS) and early invasive adenocarcinoma appeared in 1977 with a report of 11 cases from a laboratory in Australia, followed by a description of an additional 52 cases from the same lab in 1980. 1,2 These cytologists were the first to describe the classic architectural features associated with AIS, including feathering of naked nuclei projecting from the edge of a crowded strip or group of pseudostratified endocervical cells, the formation of rosettes, the loss of a honeycomb pattern, oval hyperchromatic nuclei, and the presence of mitoses in every case. The authors also noted that single abnormal cells were not a prominent feature of AIS.…”

The morphogenesis of adenocarcinoma of the cervix—a complex pathological entity

“…The cytological criteria used for the identification of atypia of the columnar epithelium have been previously described (Krumins et al 1977, Bousfield et al 1980)~ and can be summarized as follows: with increasing severity of atypia there is an increasing degree of anisokaryosis and hyperchromasia of the nuclei, with coarsening of the chromatin pattern and elongation of nuclei. In adenocarcinoma these changes are more pronounced (especially the hyperchromasia and nuclear elongation) and the malignant cells are arranged in papillary tufts, rosettes and columns often of more than 20 cells and commonly forming a chaotic 'honeycomb' pattern (as distinct from the regular 'honeycomb' appearance shown by normal endocervical cells) due to the cytoplasm of the cells containing varying amounts of mucin ( Figures I & 2).…”

Atypical Glandular Cells of Undetermined Significance in Cervical Smears After Conization

“…Since the first paper on the cytologic criteria of AIS of the uterine cervix was published, by Krumins et al 6 in 1977, the largest and most comprehensive review of AIS cervical smears was by Ayer et al 5 Using the criteria of these and other authors, we tried to clarify the cytologic features of AIS and to evaluate postcone AGUS smears through a comparison with AIS. In this study AIS smears were characterized by many crowded, hyperchromatic glandular cells with a high N/C ratio.…”

“…2,3 The cytologic features of adenocarcinoma in situ (AIS) of the cervix have been well described. 2,[4][5][6] However, atypical glandular cells of undetermined significance (AGUS) in cervical smears with a history of conization may occasionally be confused with AIS. In order to evaluate the cytologic features of cervical smears following conization and to further clarify the cytologic findings of AIS, we studied AGUS smears following conization and compared the findings with those of AIS.…”