Assessment and Management of Atypical Glandular Cells (AGC) on Cervical Cytology

P. Economides, S. Zervoudis, D. Polyzos, V. Tziortzioti, P. Giannou, S. Fotopoulos, G. Iatrakis

Abstract: A 54 year old Gravida 4 Para 2, menopausal woman presented to our clinic complaining of spotting. Her PAP smear that was done during her annual checkup at the same time was consistent with AGC. We present the manage ment of her case. The presence of Atypical Glandular Cells (AGC) which is encountered in less than 0.5% of all Pap smears may be associated with premalignant or malignant lesions of the cervix, the endometrium or other organs in rare cases (ovaries, fallopian tubes, vagina, colon). Based on the patient age, gravidity, parity, weight, menopausal status, smoking history, accompanying symptoms (cycle abnormalities) but most importantly on the coexistence or not of squamous cell cervical pathology, we propose a comprehensive algorithm using the Pap smear, colposcopy with/without directed biopsies, HPV-DNA testing, endocervical curettage, endometrial curettage or pipelle biopsy and cervical conization in order to assess, manage and follow-up these patients.
Keywords: Atypical Glandular Cells (AGC), Atypical Glandular Cells of Undetermined Significance (AGUS), Cervical Glandular Intraepithelial Neoplasia (CGIN), management