Wednesday, September 17, 2008

Atypical Glandular Cells (AGC)

Glandular Cell Abnormalities

Glandular cell abnormalities are categorized into four categories: atypical glandular cells (AGC), atypical glandular cells – favor neoplasia, adenocarcinoma in situ and adenocarcinoma. Whenever possible, atypical glandular cells are categorized as to whether they are endocervical or endometrial in origin.

Atypical glandular cells (AGC)

Glandular cytological abnormalities are considerably less common than squamous abnormalities and most cytologists tend to be less comfortable recognizing and diagnosing them. In addition, the criteria used to differentiate reactive endocervical changes from neoplasia are less well established than those used for squamous lesions.Cytologists even have difficulty in differentiating atypical endocervical cells from cases of CIN 2 or CIN 3 that have extended into endocervical crypts. This accounts for the high prevalence of squamous abnormalities (approximately 30%) detected in women referred to colposcopy for AGC (Eddy et al., 1997; Veljovich et al., 1998; Ronnett et al., 1999; Jones & Davey, 2000; Krane et al., 2004).

The cytological features of atypical glandular cells vary depending on the degree of the underlying histopathological abnormality and whether or not the cells are endocervical or endometrial in origin. Atypical glandular cells of endocervical origin frequently form dense two- or three-dimensional aggregates that have minor degrees of nuclear overlapping. In some cases, the chromatin is somewhat granular and nuclear feathering can be seen at the periphery of the cellular aggregates (Figure 39).

In cases interpreted as atypical glandular cells – favor neoplasia, there is more marked cytological abnormality and typically a greater number of abnormal cells.

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