The Significance of Glandular Cells on Conventional Cervicovaginal Smears: Experience from a Tertiary Care Hospital in Coastal India

Abstract

Introduction: Glandular lesions of the female genital tract (FGT) are quite uncommon compared to squamous lesions. Their cytological diagnosis is difficult because of their architectural and cytological complexity, as well as the lack of experience of many cytopathologists in this field. The aim of this study was to determine the significance of Papanicolaou (Pap) smears in the diagnosis of glandular FGT lesions. Methodology: All Pap smears reported during the period of January 2012 to December 2013 were retrieved. Cytohistopathological correlation was done. Results: Among 7,609 Pap smears, squamous epithelial abnormalities were seen in 110 cases (1.5%) and glandular cell abnormalities in 32 cases (0.42%). Among the glandular abnormalities, we encountered 18 cases of atypical glandular cells (AGC) not otherwise specified, 4 cases of endocervical-type AGC and 4 cases favoring neoplastic-type AGC, 2 cases of adenocarcinoma of the endocervical type, 3 cases of adenocarcinoma of the endometrial type, and 1 case of extrauterine adenocarcinoma. Histopathological correlation was available in 12 cases (37.5%). Eighty-three percent showed premalignant or malignant lesions on histopathology. Conclusion: As glandular epithelial lesions are associated with premalignant and malignant FGT lesions, in patients with cytological diagnosis of glandular epithelial abnormalities, it is mandatory to undergo colposcopic examination with endocervical and endometrial curettage.

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

“…Some studies also reported higher malignancy rates than expected in AGC cases. Suresh et al reported a 66.7% malignancy rate, while Selvaggi and Kirwan reported malignancy rates of 78% and 81.6%, respectively, but similar with other studies, our study showed that endometrial cancer was the most common cancer 21‐23 . The most common primary sites for metastatic tumours in AGC cases have been reported to be the colon and breast in the literature 8,12,13,20 …”

“…Although our results highly correlated with those reported in the literature, two points slightly differed. One difference was that our malignancy rate was slightly higher, although similar studies have been reported in the literature, albeit in small numbers 21‐23 . Another was that in the literature, the second most common tumour location in almost all of the studies was the cervix after the endometrium; however, the ovary was the second most common tumour site, followed by the cervix, in our study.…”

Atypical glandular cells and predictive features of malignancy in Pap smears: A retrospective monocentric study

“…The malignancy rate recorded by Suresh et al. was 66.7%, 17 whereas the rates reported by Selvaggi et al. and Kirwan et al.…”

Cytologic Parameters in Predicting the Outcome of Atypical Glandular Cells on Papanicolaou Smears: A Single-Institutional Experience

“…The incidence of AGC on cytology in our study was 1.86%, similar to the 0.08% to 2.1% incidence quoted in international literature. [ 5 6 7 8 9 10 11 ] As per Suresh et al .,[ 12 ] the rate of atypical glandular cells turning out to be malignant was 66.7%, whereas Selvaggi[ 13 ] and Kirwan et al . [ 14 ] reported malignancy rates of 78% and 81.6%, respectively.…”