Cytohistologic Correlation Between AGUS and Biopsy-Detected Lesions in Postmenopausal Women

摘要

From a review of the 153,916 cervicovaginal cytologic specimens obtained at the William-Knighton Medical Center over a 4-year period, 60 patients older than 50 years of age with a diagnosis of atypical glandular cells of undetermined significance (AGUS) with no associated squamous atypia were identified. Thirty of these women underwent biopsy or hysterectomy within 12 months of the cytologic examination. For this study, the histologic findings from these specimens were correlated according to subtype (AGUS, favor reactive changes; AGUS, favor dysplasia; AGUS, favor endometrial cells; or AGUS, unclassified) with the original cervical smear diagnoses.One of the 60 women was premenopausal at the time the cervical smear was taken. The records did not indicate whether any of the remaining 59 postmenopausal women were using hormone replacement therapy. Four of the 30 women with histologic diagnoses available underwent cervical biopsy, 1 had a cervical conization, 18 had endometrial biopsy, 6 underwent hysterectomy, and 1 had an omental biopsy. According to subtype, biopsy or hysterectomy was performed in 17 of the 39 women with a diagnosis of AGUS, favor endometrial cells; 2 of 2 with AGUS, favor dysplasia; and 5 of 8 with AGUS, favor reactive changes.One endometrial carcinoma was found in the 30 patients with histologic diagnoses. One woman was diagnosed with invasive squamous carcinoma of the cervix, and one woman had metastatic cancer thought to originate from the ovary. Ten patients (30 percent) were found to have endometrial polyps, and three others had endocervical polyps. Other diagnoses included endometrial hyperplasia (N equals; 3), adenomyosis (N equals; 3), and squamous intraepithelial lesion (N equals; 2).The histologic diagnoses were correlated with AGUS subtype. Of the five women with AGUS, favor reactive, one had negative or reactive histologic findings, three had an endometrial polyp, and one had a nonendometrial cancer. The two women with AGUS, favor dysplasia, were the two patients found to have squamous intraepithelial lesions. Seventeen of the 30 women had a diagnosis of AGUS, favor endometrial cells; 1 of these patients had cancer. Among them were one endocervical polyp, six endometrial polyps, and three endometrial hyperplasias. Three women had adenomyosis, and four had negative or reactive findings. Six of the diagnoses of AGUS were unclassified.Acta Cytol 2000;44colon;41ndash;45