Histologic Correlation of Atypical Glandular Cells in Cervical Smears

BACKGROUND: The study evaluated the histologic correlation and clinical significance of atypical glandular cells (AGC) detected either on conventional smears (CS) or liquid-based cytology (LBC). METHODS: Two hundred and seventy-seven (0.11%) of 261,925 cervical smears were interpreted as AGC by the Bethesda system 2001 from January 2006 to December 2008. Cytohistological correlation was performed on 192 cases. RESULTS: The prevalence of AGC was 0.07% and 0.13% for CS and LBC smears, respectively. Distribution of AGC subcategories were as follows: atypical endometrial cells 53.8%, atypical endocervical cells 22.7%, atypical glandular cells 19.5%, atypical endocervical cells favoring neoplasia 2.2%, and atypical glandular cells favoring neoplasia 1.8%. Fifty-nine (27.4%) of 192 patients were confirmed as having clinically significant lesions comprising endometrial adenocarcinoma (12.5%), endometrial hyperplasia (6.0%), cervical adenocarcinoma (2.3%), high-grade squamous intraepithelial lesion (HSIL) (1.9%), low-grade SIL (1.9%), adenocarcinoma in situ (1.4%), or ovarian metastasis (1.4%). Conclusion: Compared with CS, LBC was presently associated with a higher prevalence of AGC. Histologic follow-up showed a very low HSIL rate compared to other studies. Endometrial adenocarcinoma was the most common malignant lesion detected because of increasing prevalence of endometrial adenocarcinoma, concentration on endometrial cytology, and introduction of LBC.

Cytohistologic Correlation and Clinical Significance of ASCUS, LSIL, and HSIL / 대한산부인과학회잡지

OBJECTIVE: To evaluate the cytohistologic correlation and the clinical significance among patients with atypical squamous cells of undetermined significance(ASCUS), low-grade squamous intraepithelial lesion(LSIL), and high-grade squamous intraepithelial lesion(HSIL) identified on cervical Pap smear screening. MATERIALS AND METHODS: Pathologic reports of patients who have underwent cervical Pap smear screening at Korea university Ansan hospital from January 1997 to December 1998 were evaluated. Cytologic diagnosis was classified by the Bethesda System (TBS). Among these patients, the patients whose histologic diagnosis was established by cervical punch biopsy, LEEP, conization, and hysterectomy were targetted. Cytohistologic correlation were analysed in ASCUS, LSIL, and HSIL respectively. RESULTS: During 2 year period (1997-1998), total 3587 Pap smears were taken. The median rate of abnormal cytology was 7.2%, with 4.6% of ASCUS, 0.8% of LSIL, 1.3% of HSIL, and 0.5% of squamous cell carcinoma. The median ratio of ASCUS versus SIL was 2.2. Smears with ASCUS showed 46.9% with chronic cervicitis, 40.6% with LSIL(35.9% with koilocytotic atypia, 4.7% with mild dysplasia), 10.9% with HISL, and 1.6% with invasve squamous cell carcinoma on biopsy. Smears with LSIL showed 38.1% with LSIL(9.5% with koilocytotic atypia, 28.6% with mild dysplasia), and 28.6% with HSIL on biopsy. Smears with HSIL showed 27.8% with LSIL, 63.9% with HSIL, and 8.3% with invasive squamous cell carcinoma on biopsy. CONCLUSIONS: Smears with ASCUS showed 53.1% with SIL and cancer on biopsy. But most of theses cases revealed koilocytotic atypia rather than dysplasia, so conservative management such as repeated Pap smear is desirable. On the other hand, because smears with LSIL showed dysplasia rather than koilocytotic atypia on biopsy, more active management such as colposcopic directed biopsy is required.

Cytologic Features and Distribution of Primary Sites of Malignant Cells in Body Cavity Fluids / 대한세포병리학회지

The authors reviewed 167 malignant effusions from 110 patients, of which the primary site was established on the basis of either biopsy or surgical resection of the primary neoplasm. Main factors analysed were the distribution of primary organs and the cytohistologic correlation of body cavity effusions. The 167 fluid specimens from 110 patients consisted of 90 cases(53.9%) of pleural, 68(40.7%) of peritoneal, and 9(5.4%) of pericardial origins. Histologically they consisted of 82 cases(74.5%) of adenocarcinoma, 8(7.3%) of malignant lymphoma, 6(5.5%) of squamous cell carcinoma, and 3(2.7%) of small cell carcinoma. The most common site among the primary lesions was the stomach in 25 cases(22.7%) followed by the lung in 21 (19.1%), ovary in 17(15.5%), and breast in 7(6.4%). As for the distribution of primary tumors in adenocarcinoma, the most common site was lung in 16 cases (48.5%) in pleural fluid and stomach in 22(48.9%) in peritoneal fluid. In pericardial effusions, all 5 cases were from the lung. As a whole, the cytologic findings of malignant effusion were fairly representative of histologic characteristics of primary lesions. Thus, when the primary lesion is unknown, careful evaluation of effusion cytology is presumed to be a helpful tool for tracing the primary tumor.

Analysis of Transthoracic Fine Needle Aspiration Cytologic Diagnoses of Pulmonary Nodules / 대한세포병리학회지

To evaluate the sensitivity and specificity of transthoracic fine needle aspiration cytology(TFNAC) in the preoperative diagnosis of pulmonary nodules, a retrospective analysis was carried out on a consecutive series of 200 TFNACs. They included 186 primary malignant tumors, 66 squamous cell carcinomas, 65 adenocarcinomas, 36 small cell carcinomas, 7 large cell carcinomas, 4 carcinoids, 8 others, 9 metastatic tumors, and 5 benign tumors. On cytohistologic correlation of malignant pulmonary tumors, the procedure had a sensitivity of 97.3% and a specificity of 100%. A 86.6% correct correlation between the cytologic and histologic diagnoses was achieved. Five out of the 7 undifferentiated large cell carcinomas, 10 out of the 65 adenocarcinomas, 2 out of the 36 small cell carcinomas, and 2 out of the 66 squamous cell carcinomas were turned out to be mistyped in cytologic diagnosis. We concluded that TFNAC is a highly sensitive and specific preoperative diagnostic procedure in the investigation of patients with discrete pulmonary nodules in whom the specific cell type of the malignant neoplasm has important implications in treatment modality and prognosis.