Atypical Findings on Cervicovaginal Smears Correlate with Cervical Involvement by Malignant Mixed Müllerian Tumors of the Uterus

2015 ◽  
Vol 59 (4) ◽  
pp. 319-324 ◽  
Author(s):  
Krisztina Z. Hanley ◽  
Gabriela Oprea-Ilies ◽  
Claudia Ormenisan ◽  
Shabnam Seydafkan ◽  
Marina B. Mosunjac
Keyword(s):  
Pap Smear ◽  
Pap Test ◽  
Pap Smears ◽  
High Grade ◽  
Histological Findings ◽  
Pap Tests ◽  
Glandular Cells ◽  
Atypical Glandular Cells ◽  
Abnormal Pap Tests ◽  
Cervical Involvement

Objective: A malignant mixed müllerian tumor (MMMT) is a high-grade neoplasm commonly arising from the uterus. Patients present with bleeding and a mass protruding from the cervix. This study was designed to correlate Papanicolaou (Pap) smear findings with histological findings in women diagnosed with MMMT. Study Design: Women diagnosed with MMMT were identified. Preoperative Pap tests were correlated with histological findings. Statistical analysis was performed to assess associations between abnormal Pap tests and histological findings. Results: Forty patients with MMMT were included in the study. Age ranged from 37-85 years and tumor size ranged from 1.2 to 21 cm. In presurgical Pap tests (4 conventional and 36 liquid based), 11 smears (27.5%) were diagnosed as negative, 5 (12.5%) as atypical squamous cells of undetermined significance, 6 (15%) as atypical glandular cells, 16 (40%) as malignant and 2 (5%) as high-grade squamous intraepithelial lesion. Malignant cells detected on Pap smears showed a strong correlation with endocervical involvement by MMMT (p = 0.002). Larger tumors were more likely to involve the cervix (p = 0.0115). Conclusions: The Pap test can predict cervical involvement by MMMT. On Pap smears, MMMT cells showed no correlation with other adverse histological features (lymphovascular invasion, myoinvasion or adnexal involvement).

Human papillomavirus DNA detection and histological findings in women referred for atypical glandular cells or adenocarcinoma in situ in their Pap smears

2004 ◽  
Vol 95 (3) ◽  
pp. 618-623 ◽  
Author(s):  
Sophie Françoise Mauricette Derchain ◽  
Silvia Helena Rabelo-Santos ◽  
Luis Otávio Sarian ◽  
Luiz Carlos Zeferino ◽  
Eliane Regina de Oliveira Zambeli ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Dna Detection ◽  
Pap Smears ◽  
Adenocarcinoma In Situ ◽  
Histological Findings ◽  
Glandular Cells ◽  
Atypical Glandular Cells ◽  
Papillomavirus Dna

The Diagnostic Value of Routine Papanicolaou Smears for Detecting Endometrial Cancers: An Update

2015 ◽  
Vol 59 (4) ◽  
pp. 315-318 ◽  
Author(s):  
Chiung-Ru Lai ◽  
Chih-Yi Hsu ◽  
Jen-Fan Hang ◽  
Anna Fen-Yau Li
Keyword(s):  
Pap Smear ◽  
Diagnostic Value ◽  
Routine Screening ◽  
Pap Smears ◽  
Cervical Lesions ◽  
Endometrial Cells ◽  
Glandular Cells ◽  
Atypical Glandular Cells ◽  
Endometrial Cancers ◽  
New Criteria

Objective: The presence of degenerative endometrial debris and abnormal endometrial cells is considered to be the hint for endometrial pathology. The purpose of this study was to evaluate the efficacy of Papanicolaou (Pap) smears in detecting endometrial cancers. Study Design: There were 146 cases of endometrial cancer diagnosed at our institute in 2000-2002 and 271 in 2010-2012. Among them, 57 and 95 relevant reports of Pap smears 6 months prior to the histology diagnosis were retrieved for this study, respectively. In the first time period, new criteria for detecting endometrial lesions had not yet been incorporated into routine screening. Results: Twenty cases (21%) of adenocarcinoma, 12 (13%) of atypical glandular cells, 4 (4%) of endometrial debris and 59 (62%) negative reports were found among the more recent 95 relevant Pap smears. The overall efficacy of the Pap smear for detecting endometrial malignancy was 38%, higher than 10 years previously (30%). Conclusion: Although the Pap smear was originally designed to screen cervical lesions, more effective detection of endometrial lesions could be achieved by adding new criteria to the routine screening.

scholarly journals The value of Pap test in women with endometrial cancer

2011 ◽  
Vol 1 (3) ◽  
pp. 122-125
Author(s):  
Aleksandra Petrić ◽  
Vekoslav Lilić ◽  
Radomir Živadinović ◽  
Predrag Vukomanović ◽  
Olivera Dunjić ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Pap Smear ◽  
Statistical Significance ◽  
Menopausal Status ◽  
Screening Method ◽  
Pap Test ◽  
Transvaginal Sonography ◽  
Glandular Cells ◽  
Atypical Glandular Cells ◽  
The Difference

Introduction: Endometrial cancer is the second most common gynecological tumor. There is still no recommended screening method for endometrial cancer. The application of transvaginal sonography, hysteroscopy and Pap test may prove useful in screening for this disease. Atypical glandular cells represent an important finding in Pap tests and they are related to histopathological verification of the endometrium. The aim of the study was to determine the usefulness of the Pap test in assessing the cervical infiltration, as well as to determine the significance of hormonal status and histopathological type of tumor in a pathological Pap test in patients with endometrial cancer.Methods: The study was retrospective. The analysis included the data obtained from 62 operated patients diagnosed with enometrial cancer, medical history (menopausal status), histopathological findings after surgery (type and stage of the disease) and a preoperative Pap smear. The chi squared and Fisher’s test were used.Results: The difference in the prevalence of pathological Pap test in premenopausal and postmenopausal group of patients was not statistically significant. The difference in the prevalence of pathological Pap test in the group of endometrioid and non-endometrioid tumours of the uterine corpus had statistical significance. The difference in the prevalence of pathological Pap test compared to the present stage (I and II) was not statistically significant.Conclusion: Pap smear does not correlate with menopausal status in women with endometrial carcinoma. Abnormal Pap test is more commonly found in cases of non-endometroid tumours. Pap smears cannot beused to assess cervical involvement.

scholarly journals Atypical endometrial cells and atypical glandular cells favor endometrial origin in Papanicolaou cervicovaginal tests: Correlation with histologic follow-up and abnormal clinical presentations

CytoJournal ◽  
2014 ◽  
Vol 11 ◽  
pp. 29 ◽  
Author(s):  
Longwen Chen ◽  
Christine N. Booth ◽  
Julie A. Shorie ◽  
Jennifer A. Brainard ◽  
Matthew A. Zarka
Keyword(s):  
Vaginal Bleeding ◽  
Pap Test ◽  
Pap Tests ◽  
Endometrial Cells ◽  
Clinical Presentations ◽  
Glandular Cells ◽  
Atypical Glandular Cells ◽  
Abnormal Vaginal Bleeding ◽  
Endometrial Pathology

The 2001 Bethesda system recommends further classifying atypical glandular cells (AGCs) as either endocervical or endometrial origin. Numerous studies have investigated the clinical significance of AGC. In this study, we investigated the incidence of clinically significant lesions among women with liquid-based Papanicolaou cervicovaginal (Pap) interpretations of atypical endometrial cells (AEMs) or AGC favor endometrial origin (AGC-EM). More importantly, we correlated patients of AEM or AGC-EM with their clinical presentations to determine if AEM/AGC-EM combined with abnormal vaginal bleeding is associated with a higher incidence of significant endometrial pathology. All liquid-based Pap tests with an interpretation of AEM and AGC-EM from July, 2004 through June, 2009 were retrieved from the database. Women with an interpretation of atypical endocervical cells, AGC, favor endocervical origin or AGC, favor neoplastic were not included in the study. The most severe subsequent histologic diagnoses were recorded for each patient. During this 5-year period, we accessioned 332,470 Pap tests of which 169 (0.05%) were interpreted as either AEM or AGC-EM. Of the 169 patients, 133 had histologic follow-up within the health care system. The patients ranged in age from 21 to 71 years old (mean 49.7). On follow-up histology, 27 (20.3%) had neoplastic/preneoplastic uterine lesions. Among them, 20 patients were diagnosed with adenocarcinoma (18 endometrial, 1 endocervical, and 1 metastatic colorectal), 3 with atypical endometrial hyperplasia, and 4 with endometrial hyperplasia without atypia. All patients with significant endometrial pathology, except one, were over 40 years old, and 22 of 25 patients reported abnormal vaginal bleeding at the time of endometrial biopsy or curettage. This study represents a large series of women with liquid-based Pap test interpretations of AEM and AGC-EM with clinical follow-up. Significant preneoplastic or neoplastic endometrial lesions were identified in 20.3% of patients. Patients with Pap test interpretations of AEM or AGC-EM and the clinical presentation of abnormal vaginal bleeding should be followed closely.

Cytologic and histologic review of atypical glandular cells (AGC) detected during cervical cytology screening

2003 ◽  
Vol 13 (4) ◽  
pp. 518-521 ◽  
Author(s):  
C.-J. Jeng ◽  
H.-S. Liang ◽  
T.-Y. Wang ◽  
J. Shen ◽  
Y.-C. Yang ◽  
...  
Keyword(s):  
Pap Smear ◽  
Intraepithelial Neoplasia ◽  
Endometrial Biopsy ◽  
High Grade ◽  
Cytologic Diagnosis ◽  
Histologic Diagnosis ◽  
Pap Smear Screening ◽  
Glandular Cells ◽  
Atypical Glandular Cells ◽  
Underlying Pathology

This article is to determine the clinical significance and underlying pathology among patients with atypical glandular cells (AGC) identified during cervical Papanicolau (Pap) smear screening. AGC slides were searched from 51,412 computerized files of the cytology laboratory of Mackay Memorial Hospital during a 29-month period. The results of clinical evaluations were reviewed and an experienced gynecologic cytopathologist who was not involved in the original cytologic diagnosis and was not aware of the clinical results of the follow-up examinations rechecked all AGC slides. We used the z score to determine whether different results were achieved after the gynecologic cytopathologist rechecked the slides. We further analyzed all slides with different cytologic diagnoses and compared results with the histologic diagnoses. Forty-nine cases were initially identified as AGC. Among these, 29 were reviewed and identified as AGC again, and the result of biopsies revealed that they were all chronic cervicitis, ie, negative for malignancy or premalignancy. The other 20 cases were reviewed and diagnosed as non-AGC. Among the results of cytologic examinations, seven had inflammation, two had atypical squamous cells of undetermined significance (ASC-US), ten had high-grade cervical intraepithelial neoplasia (CIN), and one had adenocarcinoma. The results of histologic diagnosis included eight cases with normal tissue, two with CIN grade 1, eight with high-grade CIN, one with microinvasive squamous cell carcinoma, and one with adenocarcinoma. Histologic results revealed 20.4%1 (10/49) and 50% (10/20) at initial cytologic diagnosis of AGC and expert-reviewed non-AGC, respectively, which were finally at least high-grade CIN. According to the gynecologic cytopathologist's diagnosis, 59.2%1 (29/49) of cases would have eliminated unnecessary histologically diagnostic procedures. In conclusion, clinicians should be careful about the significance of the cytologic diagnosis of AGC, because there may actually be an underlying pathology, which can be identified by a pathologist who is an expert in gynecologic cytopathology. The interobserver variation in diagnosing AGC favors specialized training in gynecologic cytopathology. In addition, prompt diagnostic interventions, including colposcopy, endocervical curettage, and/or endometrial biopsy, should be performed after confirmation of the diagnosis of non-AGC by an experienced gynecologic cytopathologist.

Prediction of high-grade cervical disease with human papillomavirus detection in women with glandular and squamous cytologic abnormalities

2006 ◽  
Vol 16 (3) ◽  
pp. 1055-1062 ◽  
Author(s):  
E. R.Z.M. De Oliveira ◽  
S. F.M. Derchain ◽  
L. O.Z. Sarian ◽  
S. H. Rabelo-Santos ◽  
R. C. Gontijo ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Pap Smears ◽  
High Grade ◽  
Strongly Correlated ◽  
Cervical Lesions ◽  
Cervical Disease ◽  
Glandular Cells ◽  
Atypical Glandular Cells ◽  
High Risk Hpv

The objective of this study was to assess whether human papillomavirus (HPV) detection with hybrid capture II (HC II) can help predict the presence and the nature, glandular or squamous, of histologic cervical lesions in women referred due to atypical glandular cells (AGC) or high-grade squamous intraepithelial lesion (HSIL). A total of 247 women were included. Referral Pap smears comprised AGC (51 cases), AGC plus HSIL (28 cases), adenocarcinoma in situ (10 cases), and HSIL (158 cases). All patients were tested for high-risk HPV with HC II and had a histologic assessment of their cervix. Histologic analysis showed 38 women with (15.3%) cervicitis, 194 with (75.5%) squamous lesions, and 15 with (9.2%) glandular neoplasia. The overall rate of high-risk HPV detection was 77%. Almost 70% of AGC-HPV–negative patients did not have a pathologically proven cervical neoplasia, whereas 76% of women with AGC-HPV–positive result were diagnosed with a squamous or glandular neoplasia. Most (95%) of the lesions in patients with AGC-HSIL were of squamous nature, and HPV detection did not contribute to their differentiation from glandular lesions. We conclude that in women with AGC, HPV positivity strongly correlated with the presence of glandular or squamous cervical lesion but did not help distinguishing women with squamous from those with glandular neoplasia.

Pap Test Reporting Rates for Conventional Smear and Liquid-Based Cervical Cytology from the Largest Academic Women's Hospital in China: Analysis of 1,248,785 Pap Test Reports

2015 ◽  
Vol 59 (6) ◽  
pp. 445-451 ◽  
Author(s):  
Xiang Tao ◽  
R. Marshall Austin ◽  
Hao Zhang ◽  
Lihong Zhang ◽  
Jianan Xiao ◽  
...  
Keyword(s):  
Cervical Screening ◽  
Pap Test ◽  
Major Change ◽  
Cervical Cytology ◽  
Pap Smears ◽  
Pap Tests ◽  
Bethesda System ◽  
Liquid Based Cytology ◽  
The Bethesda System ◽  
Reporting Rates

Objective: The Obstetrics and Gynecology Hospital of Fudan University (OGHFU) in Shanghai is the largest academic women's hospital in China. Between 2009 and 2014, the use of liquid-based cytology (LBC) significantly increased while gradually adopting the Bethesda System (TBS), and in 2012 local regulations mandated that pathologists replace technicians to sign out Pap tests. Design: A retrospective OGHFU database search documented all Pap test reports between 2009 and 2014 by specimen type, either LBC or conventional Pap smears (CPS), and final reporting category. A total of 1,224,785 Pap reports were analyzed to document variations in Pap test reporting during a period of major change in cervical screening in China. Results: LBC gradually replaced CPS, which declined from over 65% of Pap tests in 2010 to 6.4% in 2014. Of 514,811 Pap reports using the traditional class system, class I (negative) reports accounted for 98.3% of results. With the introduction of TBS reporting, pathologist reviews and substantial replacement of CPS by LBC, the laboratory abnormal Pap test rate increased significantly to almost 5%. Conclusions: Changes in cervical cytology reporting between 2009 and 2014 in China's largest academic women's hospital reflected both increased use of LBC and the introduction of pathologist TBS reporting. Abnormality rates increased significantly and fell within CAP benchmark ranges.

scholarly journals The Cervical pap smear cytological changes with clinicopathological correlation in a sample of Iraqi patients

2021 ◽  
Vol 5 (3) ◽  
Keyword(s):  
Vaginal Discharge ◽  
Pap Smear ◽  
Histopathological Examination ◽  
Pap Test ◽  
Pap Smears ◽  
Postmenopausal Bleeding ◽  
Parity Number ◽  
Medical City ◽  
Chief Complaints ◽  
Iraqi Women

Objectives: This study aimed to evaluate the role of Pap test in detecting pre-cancerous lesions in Iraqi women aged 45 years to 85 years, correlate the pap result with patient’s age, parity, number of births, number of abortions, chief complaint, and clinical cervical exam, and to evaluate the diagnostic accuracy of the pap test in correlation to histopathological examination. Methods: Women who attended the outpatient gynaecological clinic of the Department of Obstetrics and Gynaecology at Baghdad medical city, Baghdad, Iraq, from January 2019 to January 2020 who had different chief complaints were selected for the study. Women who are 45 years to 85 years old were included in the study. A Pap smear was used for all women to screen for cervical cancer and the results were reported according to the 2014 Bethesda system. The data analysis was done utilizing statistical package for social sciences version 24 (SPSS v24). Results: Total number of pap smears analyzed were 510, NILM (negative for intraepithelial lesions or malignancy) constituted major group 464/510 (91%) and epithelial cell abnormality were 46/510 (9%), age is significantly correlated with increasing rate of pre-neoplastic and neoplastic lesions in women and the significance of vaginal discharge & postmenopausal bleeding and its association with premalignant changes in the cervix. The sensitivity of Pap test is 94%, the Specificity was 60% and accuracy rate 74%. Conclusion: There is significant correlation between Pap smear abnormality and increasing age, vaginal discharge and postmenopausal bleeding, were evident in this study.

scholarly journals More focus on atypical glandular cells in cervical screening: Risk of significant abnormalities and low histological follow-up rate

CytoJournal ◽  
2020 ◽  
Vol 17 ◽  
pp. 22
Author(s):  
Pingping Zhong ◽  
Chenghong Yin ◽  
Yulan Jin ◽  
Tianbao Chen ◽  
Yang Zhan ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Cervical Screening ◽  
Close Relation ◽  
Prior History ◽  
Pap Smears ◽  
Chi Square ◽  
Glandular Cells ◽  
Atypical Glandular Cells ◽  
Chi Square Test

Objectives: Atypical glandular cells (AGC) detected by Papanicolaou (Pap) smears are in close relation with adenocarcinoma and precursors detected by histopathology. Yet, sometimes the cytological diagnosis of AGC has been neglected. With increase of adenocarcinoma and precursors, we need more focus on glandular abnormalities. Material and Methods: Clinicopathological data of patients who had AGC on Pap smears between April 2015 and October 2018 and underwent histological follow-up were retrieved from the computerized database of Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Patients with a prior history of cancer were excluded from the study. Statistical analyses were performed using Pearson’s Chi-square test in SPSS software version 23. P < 0.05 (two sided) was considered as statistical significance. Results: Liquid-based cytological examination of the uterine cervix was carried out in 164,080 women. Five hundred and twenty-five women were diagnosed with AGC, 314 with not otherwise specified (AGC-NOS), and 211 with favor neoplastic (AGC-FN). Only 310 cases had histological follow-up, 168 women (168/314, 53.5%) originally with AGC-NOS on Pap smears, and 142 (142/211, 67.3%) with AGC-FN. The median age of histological significant abnormalities was 46.7 years, and 126 women (126/162, 77.8%) were postmenopausal. Sixty-six cases (66/168, 39.3%) of AGC-NOS had significant abnormalities (96/142, 67.6%, AGC-FN). One hundred and sixty-two cases of significant abnormalities included 40 high-grade squamous abnormalities and 122 glandular abnormalities. AGC-FN was more likely to be associated with a clinically significant abnormalities (P < 0.001) compared to AGC-NOS. Conclusions: Patients with AGC on Pap smears are in close relation with significant abnormalities, especially with significant glandular abnormalities on histopathology slices. AGC should be evaluated vigilantly with histological workup, especially if patients are diagnosed with AGC-FN and are aged 41–60 years. We need more focus on AGC.

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