Diverse glandular pathologies coexist with high-grade squamous intraepithelial lesion in cyto-histological review of atypical glandular cells on ThinPrep specimens.

Détails

ID Serval
serval:BIB_94372CEAFB17
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Diverse glandular pathologies coexist with high-grade squamous intraepithelial lesion in cyto-histological review of atypical glandular cells on ThinPrep specimens.
Périodique
Cytopathology
Auteur(s)
Kumar N., Bongiovanni M., Molliet M.J., Pelte M.F., Egger J.F., Pache J.C.
ISSN
1365-2303 (Electronic)
ISSN-L
0956-5507
Statut éditorial
Publié
Date de publication
2009
Volume
20
Numéro
6
Pages
351-358
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: ppublish
Résumé
OBJECTIVE: To identify in cytology, high-grade squamous intraepithelial lesions with endocervical glandular extension in cases previously diagnosed as atypical glandular cells (AGC), analyse possible reasons for the diagnostic pitfall and document the frequency of glandular pathology coexisting with high-grade cervical intraepithelial lesion in histology.
METHODS: Thirty-nine ThinPrep cervical smear (Pap) tests reported as AGC of undetermined significance and showing high-grade lesions on histology [cervical intraepithelial neoplasia (CIN) 2 or 3, endometrial or extrauterine adenocarcinoma] were reviewed retrospectively to identify the cases of high-grade squamous intraepithelial lesion with endocervical glandular extension, using the Bethesda 2001 system. Cyto-histological correlation was performed.
RESULTS: A high frequency of diverse glandular pathologies coexisted with high-grade cervical intraepithelial lesions on histology. This included endocervical glandular extension in 63%, benign glandular pathology in 33% and pre-neoplastic or malignant glandular pathology (endocervical glandular dysplasia, adenocarcinoma in situ and metastatic breast carcinoma) in 17% cases. On cytology, the sensitivity was 40%, specificity was 80% and positive predictive value was 86% for endocervical gland extension in high-grade squamous intraepithelial lesions.
CONCLUSIONS: Special efforts to recognize endocervical glandular extension in high-grade squamous intraepithelial lesions and glandular neoplasia coexisting with squamous intraepithelial lesions from the heterogeneous category of AGC can contribute to increasing the diagnostic accuracy. The identification of endocervical glandular extension on cervical cytology would alert the gynaecologist to perform a thorough assessment of the endocervix during colposcopy. This could also help to decide on the need to perform deeper conization rather than loop electrosurgical excision procedure to ensure negative margins when colposcopic biopsy shows CIN 2 or 3.
Mots-clé
Adenocarcinoma/diagnosis, Adenocarcinoma/pathology, Adult, Aged, Aged, 80 and over, Cervical Intraepithelial Neoplasia/diagnosis, Cervical Intraepithelial Neoplasia/pathology, Cervix Uteri/pathology, Cytological Techniques, Female, Humans, Middle Aged, Neoplasms, Glandular and Epithelial/diagnosis, Neoplasms, Glandular and Epithelial/pathology, Precancerous Conditions/diagnosis, Precancerous Conditions/pathology, Retrospective Studies, Sensitivity and Specificity, Uterine Cervical Neoplasms/diagnosis, Uterine Cervical Neoplasms/pathology, Young Adult
Pubmed
Web of science
Création de la notice
05/02/2015 12:05
Dernière modification de la notice
03/03/2018 19:37
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