The prevalence and spectrum of atypical glandular cells in Dubai hospital: A local experience

Abstract

Objective : This study was undertaken to analyze the prevalence and spectrum of atypical glandular cells to investigate its clinical significance in our population.

Study design : A 5 year retrospective review of atypical glandular cells diagnosed on ThinPrep pap test was performed. AGC were reported in 40 patients, who underwent colposcopy- directed biopsy, endocervical curettage and endometrial curettage to determine the cytological and histological correlations of AGC.

Results : The prevalence of AGC was 0.2% out of 19836 patients. The patients age ranged from 29 to 81 years (mean age 49.4 years). Significant lesions were defined as Squamous Intraepithelial lesion (SIL), adenocarcinoma in situ (AIS) or invasive carcinoma. This included 2 invasive squamous cell carcinoma of the cervix, 2 high grade squamous intraepithelial lesions, 2 AIS, 5 adenocarcinoma of the cervix, two of which had low grade and high grade squamous intraepithelial lesions one of which was consistent with metastastic colonic carcinoma and 5 endometrial adenocarcinoma, one of which was suspicious of breast carcinoma. The chi-square value was significant at 99% confidence interval.

Conclusion : AGC were associated with clinically significant lesions in 40% of our cases.. Significant endocervical glandular lesions occurred in younger women whereas the older women had endometrial lesions.. Patients with AGC should be followed up for a substantial period despite initial negative histological findings.

  • Page Number : 43-55

  • Keywords
    The Bethesda system, Atypical glandular cells, ThinPrep Pap test, Adenocarcinoma.

  • DOI Number
    https://doi.org/10.15415/jmrh.2016.31006

  • Authors
    Ravirani Samuel, Manal M.M. Abdulrazzaq, Badr Abdullgaffar, Hassan y. Hotait, Mouza Al-Sharhan

References

  • The 1988 Bethesda System for reporting cervical/vaginal cytological diagnoses. National Cancer Institute Workshop. JAMA 1989; 262:931–4.
  • Solomon D, Davey D, Kurman R, et al; Forum group mem bers;: Bethesda 2001 Workshop. The 2001 Bethesda system terminology for reporting results of cervical cytology. JAMA 2002; 287(16)2114–2119.
  • Kim TJ, Kim HS, Park CT, Park IS. Hong SR, Park JS, et al. Clinical evaluation of follow-up methods and results of atypical glandular cells of undetermined significance (AGUS) detected on cervicovaginal pap smears. Gynecol Oncol 1999; 73: 292–8.
  • Meath AJ,.Carley M.E, Wilson TO, Atypical glandular cells of undetermined significance.Review of final histologic diagnoses. J Reprod Med. 2002;(47)4: 249–252.
  • Medalie NS Wasserman P. Atypical glandular cells of undetermined significance: the experience at Long Island Jewish Hospital. J Lower Gen Tract Dis 1998; 2:127–31.
  • Koonings PP, Price JH. Evaluation of atypical glandular cells of undetermined significance. Is age important ? Am J Obstet Gynecol 2001;184(7):1457–1459
  • Cox JT, Guintoli R Sr, Lonky N, Newkirk G, Suggs C, Tedeschi C ,et al.ASSCP practice guideline management of glandular abnormality cervical smear. J Lower Gen Tract Dis. 1997;1:41–5.
  • Lee KR, Flynn CE. Early invasive adenocarcinoma of the cervix: a histopathologic analysis of 40 cases with observations concerning histogenesis. Cancer. 2000; 89:1048–55.
  • Kim TJ, Kim HS, Park CT, Park IS. Hong SR, Park JS,et al. Clinical evaluation of follow-up methods and results of atypical glandular cells of undetermined significance (AGUS) detected on cervicovaginal pap smears. Gynecol Oncol 1999; 73: 292–8.
  • Lee KR, Manna EA, ST. John T. Atypical endocervical glandular cells: accuracy of cytologic diagnosis. Diagn Cytopathol 1995; 13: 202–8.
  • Kennedy AW, Salmieri SS, Wirth SL, Biscotti CV, Tuason LJ, Travarca MJ. Results of the clinical evaluation of atypical glandular cells of undetermined significance (AGCUS) detected on cervical cytology screening. Gynecol Oncol 1996; 63:14–8.
  • Eddy GL, Strumpf KB, Wojtowycz MA, Piraino PS, Mazur MT. Biopsy findings in five hundred thirty- one patients with atypical glandular cells of uncertain significance as defined by the Bethesda system. Am J Obstet Gynecol 1997; 177: 1188–95.
  • Duska LR, Flynn CF, Chen A, Whall-Strojwas D, Goodman A. Clinical evaluation of atypical glandular cells of undetermined significance on Cervical cytology. Obstet Gynecol 1998; 91: 278–82.
  •  Chhieng Dc, Elgert PA, Cangierella JF. Cohen JM Clinical significance of atypical glandular cells of undetermined significance. A follow-up Study from an academic medical center.Acta Cytol 2000; 44:557–66.
  • Soofer SB, Sidway MK. Atypical glandular cells of undetermined significance: clinically significant lesions and means of patient follow- up.Cancer 2000; 90:207–14.
  • Jawroski RC, Endocervical glandular dysplasia, adenocarcinoma in situ, and early invasive (microinvasive) adenocarcinoma of the uterine cervix. Seminars in Diagnostic Pathology 1990, 7:190–204.
  • Zweizig S, Noller K, Reale F, Collis S. Resseguie L. Neoplasia associated with atypical glandular cells of undetermined significance on cervical Cytology. Gynecol Oncol 1997; 65:314–8.
  •  Chin AB, Bristow RE, Korst LM, Walts A, Laggase LD (2000) The significance of atypical glandular cells on routine cervical cytologic testing in a Community- based Population. Am J Obstet Gynecol 182, 1278–1282.
  • Veljovich DS, Stoler MH, Anderson WA, Covel JL, Rice LW. Atypical glandular cells of undetermined significance: A five-year retrospective Histopathologic study. Am J Obstet Gynecol 1998:179:382–390.
  • Garcia MT, Acar BC, Jorda M, et al.: Use of p 63 for distinction of glandular versus squamous lesions in cervicovaginal specimens. Cancer 2007; 111(1) 54–57.
  • Cooper K, Hennington CS, Lo ES, Evans MF, McGee JO. Integration of human papilloma virus types 16 and 18 in cervical adenocarcinoma J Clin.Pathol 1992; 45: 382–4.
  • DerchainSF, Rabelo-Santos SH, Sarian LO et. Human Papilloma Virus DNA detection and histological findings in women referred for atypical glandular cells or adenocarcinoma in situ in their pap smears. Gynecol Oncol.2004; 95(3):618–623.
  • Chhieng DC, Gallapsy S, Yang H, Roberson J, Eltoum I. Women with atypical glandular cells, a long- term follow up study in a high risk Population. Am.J Clin Pathol. 2004; 122(4):575–9.
  • Levine L Lucci JA 3rd, Dinh TV. Atypical glandular cells: new Bethesda Terminology and Management Guidelines, Obstet Gynecol Surv. 2003; 58(6): 399–406
  • Raab SS. Geisinger KR, Silverman HF,.et.al. Interobserver variability of Papanicolaou smear diagnosis of atypical glandular cells of undetermined significance. Am J Clin Pathol 1998, 110:653–659

  • Published Date : 2016-10-03