Suresh Pooja K, Kini Hema, Minal Jessica, Dhavalpure Neha, Basavaiah Sridevi H, Adiga Deepa S, Maben Laveena
Department of Pathology, Kasturba Medical College, Manipal University, Mangalore, India.
Acta Cytol. 2017;61(3):199-206. doi: 10.1159/000471916. Epub 2017 May 25.
Glandular lesions of the female genital tract (FGT) are quite uncommon compared to squamous lesions. Their cytological diagnosis is difficult because of their architectural and cytological complexity, as well as the lack of experience of many cytopathologists in this field. The aim of this study was to determine the significance of Papanicolaou (Pap) smears in the diagnosis of glandular FGT lesions.
All Pap smears reported during the period of January 2012 to December 2013 were retrieved. Cytohistopathological correlation was done.
Among 7,609 Pap smears, squamous epithelial abnormalities were seen in 110 cases (1.5%) and glandular cell abnormalities in 32 cases (0.42%). Among the glandular abnormalities, we encountered 18 cases of atypical glandular cells (AGC) not otherwise specified, 4 cases of endocervical-type AGC and 4 cases favoring neoplastic-type AGC, 2 cases of adenocarcinoma of the endocervical type, 3 cases of adenocarcinoma of the endometrial type, and 1 case of extrauterine adenocarcinoma. Histopathological correlation was available in 12 cases (37.5%). Eighty-three percent showed premalignant or malignant lesions on histopathology.
As glandular epithelial lesions are associated with premalignant and malignant FGT lesions, in patients with cytological diagnosis of glandular epithelial abnormalities, it is mandatory to undergo colposcopic examination with endocervical and endometrial curettage.
与鳞状病变相比,女性生殖道(FGT)的腺性病变相当少见。由于其结构和细胞学的复杂性,以及许多细胞病理学家在该领域缺乏经验,其细胞学诊断较为困难。本研究的目的是确定巴氏(Pap)涂片在诊断女性生殖道腺性病变中的意义。
检索2012年1月至2013年12月期间报告的所有巴氏涂片。进行了细胞组织病理学相关性分析。
在7609例巴氏涂片中,110例(1.5%)出现鳞状上皮异常,32例(0.42%)出现腺细胞异常。在腺性异常中,我们遇到18例未另行指定的非典型腺细胞(AGC),4例宫颈内膜型AGC和4例倾向于肿瘤型AGC,2例宫颈内膜型腺癌,3例子宫内膜型腺癌,以及1例子宫外腺癌。12例(37.5%)有组织病理学相关性。83%在组织病理学上显示为癌前或恶性病变。
由于腺上皮病变与女性生殖道癌前和恶性病变相关,对于细胞学诊断为腺上皮异常的患者,必须进行阴道镜检查并取宫颈内膜和子宫内膜组织进行刮宫检查。