Detecting and interpreting glandular lesions in cervical cytology

Abstract 

Abnormal glandular cells can appear in cervical samples not only from the cervix but from the whole of the genital tract from the fallopian tubes to the vulva, and from extra-uterine sources including primary tumours of the peritoneal cavity and metastases from distant sites. There is also a wide variation in morphology in benign, pre-malignant and malignant entities which on occasion challenge even the most experienced microscopist. This review outlines areas of difficulty with particular reference to liquid-based cytology, and provides guidance on how to approach a sample which has been identified by the primary screener as showing possible glandular abnormality.

Keywords: adenocarcinoma, adenocarcinoma in situ, cervix, cervical glandular intraepithelial neoplasia, endometrial neoplasia, extra-uterine neoplasia, glandular neoplasia, liquid-based cytology, lower uterine segment sampling, malignant glandular cells, tubo-endometrioid metaplasia