Clinical significance of atypical glandular cells by the 2001 Bethesda system in cytohistologic correlation

Objective To evaluate incidence, cytology findings and pathology outcome of atypical glandular cells (AGC) in Pap smears according to the 2001 Bethesda criteria. Study Design From 103,073 consecutive Pap smears, 113 (0.1%) AGC cases were identified. Of these, 91 (80%) had adequate histologic evaluation included in this study. Results Abnormal histology findings were seen in 38 patients (42%). Final pathology results revealed 14 endometrial adenocarcinomas, 5 endocervical squamous cell carcinoma, 1 endometria stromal sarcoma, 6 other malignancies, 4 endocervical adenocarcinomas in situ, 4 cases of endometrial complex hyperplasia, 1 case of endocervical glandular dysplasia and 2 cases of cervical intraepithelial neoplasia 3 with glandular involvement. Women with AGC, favor neoplasia, were more likely to have significant pathology than those with AGC, not others wise specified, 74 % vs. 33) % (p = 0.002). Some characteristic background cytologic findings were also noticed in most cases of endometrial, fallopian tube and endocervical adenocarcinoma. Conclusion A diagnosis of AGC is more clinically significant by the 2001 Bethesda System, especially the "AGC, favor neoplastic" catogory. Some background cytologic features are important because they are indicators of malignancy.