scholarly journals Cytomorphologic Features of Gastric-Type Endocervical Adenocarcinoma in Liquid-Based Preparations

2020 ◽  
pp. 1-11
Author(s):  
Joerg Schwock ◽  
Blerta Starova ◽  
Zanobia F. Khan ◽  
Jelena Mirkovic ◽  
Carlos Parra-Herran ◽  
...  
Keyword(s):  
False Negative ◽  
Pap Test ◽  
Glandular Cell ◽  
Adenocarcinoma In Situ ◽  
Tumor Type ◽  
Nuclear Area ◽  
Endocervical Adenocarcinoma ◽  
Gastric Type ◽  
Glandular Cells ◽  
Nuclear Enlargement

<b><i>Objective:</i></b> Gastric-type endocervical adenocarcinoma (GAS) is a recently described, uncommon, and aggressive tumor with distinct morphologic features and HPV-independent etiology. Data on GAS in liquid-based cytology (LBC) Papanicolaou (Pap) test preparations from a North American patient population are scant. We systematically assessed the cytomorphologic characteristics of GAS in LBC from patients in Ontario and examined if glandular cell nuclear area could represent a readily assessable feature which may aid in GAS detection. <b><i>Study Design:</i></b> Pap test slides preceding the diagnosis of GAS were retrieved locally or requested from outside laboratories. A structured review of 15 cytomorphologic features was performed using the available LBC Pap test slides of GAS and a set of usual-type endocervical adenocarcinomas (UEA). Morphometry of the glandular cell nuclear area was performed, and normalized values were compared to UEA and benign endocervical cells. <b><i>Results:</i></b> At least 1 Pap test (5 ThinPrep®, 11 SurePath®, and 1 direct smear) was available for 14 patients. Original LBC Pap test diagnoses were negative for intraepithelial lesion or malignancy (NILM) (7), adenocarcinoma/carcinoma (6), atypical glandular cells (2), and adenocarcinoma in situ (1). Review detected abnormal glandular cells in 6/7 NILM cases. Honeycomb-like sheets, nuclear enlargement, and microvesicular cytoplasm were the single most common architectural, nuclear, and cytoplasmic features, respectively. Microvesicular cytoplasm (100 vs. 17%), honeycomb-like sheets (87 vs. 8%), prominent nucleoli (93 vs. 25%), and anisonucleosis (93 vs. 50%) were most discriminatory for GAS versus UEA, respectively. Yellow mucin, intranuclear cytoplasmic pseudoinclusions, and goblet/Paneth-like cells were uncommon, but unique for GAS. Glandular cell nuclear area normalized to neutrophils was found to be significantly increased in GAS compared to benign endocervical cells. <b><i>Conclusions:</i></b> GAS is under-recognized and may mimic reactive endocervical cells. Awareness of the tumor type and its cytomorphology is critical for early detection. Identification of glandular cells with uniform nuclear enlargement in conjunction with any of the other cytologic features may help avoid false-negative Pap results. Neutrophils may serve as convenient size reference and visual aid.

The Effect of Continuous Monitoring of Cytologic-Histologic Correlation Data on Cervical Cancer Screening Performance

2008 ◽  
Vol 132 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Stephen S. Raab ◽  
Bruce A. Jones ◽  
Rhona Souers ◽  
Joseph A. Tworek
Keyword(s):  
Predictive Value ◽  
Continuous Monitoring ◽  
False Negative ◽  
Pap Test ◽  
Mixed Linear Model ◽  
Squamous Cells ◽  
Test Sensitivity ◽  
Correlation Data ◽  
Glandular Cells ◽  
Atypical Glandular Cells

Abstract Context.—The use of Papanicolaou (Pap) test cytologic-histologic correlation in quality improvement activities is not well studied. Objective.—To determine if continuous monitoring of correlation data improves performance. Design.—Participants in the College of American Pathologists Q-Tracks program (213 laboratories) self-reported the number of Pap test–histologic biopsy correlation discrepancies every quarter for up to 8 years. A mixed linear model determined if the length of participation in the Q-Tracks program was associated with improved performance. Main outcome measures were predictive value of a positive Pap test, Pap test sensitivity, sampling sensitivity, and proportion of positive histologic diagnoses following a Pap test diagnosis of atypical squamous cells or atypical glandular cells. Results.—Institutions evaluated 287 570 paired Pap test– histologic correlation specimens and found 98 424 (34.2%) true-positive Pap test correlations, 19 006 (6.6%) false-positive Pap test correlations, and 6575 (2.3%) false-negative Pap test correlations. The mean predictive value of a positive Pap test, sensitivity, screening and interpretive sensitivity, sampling sensitivity, and proportion of positive histologic diagnoses following a Pap test diagnosis of atypical squamous or glandular cells were 83.6%, 93.7%, 99.2%, 94.2%, 60.3%, and 38.8%, respectively. Longer participation was significantly associated with a higher predictive value of a positive Pap test (P = .01), higher Pap test sensitivity (P = .002), higher Pap test sampling sensitivity (P = .03), and higher proportion of positive histologic diagnoses for a Pap test diagnosis of atypical squamous cells (P &lt; .001). Conclusions.—Long-term monitoring of cytologic-histologic correlation is associated with improvement in cytologic-histologic correlation performance.

scholarly journals Detection of in situ and invasive endocervical adenocarcinoma on ThinPrep Pap Test: Morphologic analysis of false negative cases

CytoJournal ◽  
2016 ◽  
Vol 13 ◽  
pp. 28 ◽  
Author(s):  
Michael Chaump ◽  
Edyta C. Pirog ◽  
Vinicius J. A. Panico ◽  
Alexandre Buckley d Meritens ◽  
Kevin Holcomb ◽  
...  
Keyword(s):  
Squamous Cell ◽  
False Negative ◽  
Significant Proportion ◽  
Three Dimensional ◽  
Pap Test ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Endocervical Adenocarcinoma ◽  
Intraepithelial Lesion

Background: The goal of this study was to calculate the sensitivity and false negative (FN) rate of ThinPrep Pap Test (TPPT) and carefully analyze missed cases for educational purposes. Materials and Methods: Patients with histologically proven adenocarcinoma in-situ (AIS) or invasive endocervical adenocarcinoma (EAC) over a 17-year-period (1998-2015) were identified. The TPPT immediately preceding the histological diagnosis of AIS/ECA was designated as index Pap (IP). Paps up to 122 months before histologic diagnosis of AIS/ECA were considered for this study. All available negative and unsatisfactory TPPT were re-reviewed. Results: There were 78 patients with histologically-proven AIS (56) or ECA (22) with 184 TPPTs, and 95 of these TPPTs were abnormal. Of the abnormal cases, 55.7% TPPTs were diagnosed as endocervical cell abnormality (atypical endocervical cells/AIS/ECA). Notably, 44.2% of abnormal TPPTs were diagnosed as squamous cell abnormality (atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion/high grade squamous intraepithelial lesion). Including the diagnoses of squamous cell abnormality, the sensitivity of index TPPT for histologically-confirmed AIS/ECA was 88%. Eighty-eight of 184 TPPT, including 10 IP, were negative = 87, or unsatisfactory = 1. Forty-two of these slides were available for re-review. Upon review, 21 TPPT (50%) were confirmed negative and 21 TPPT (50%) were reclassified as abnormal = 20, or unsatisfactory = 1. Of the FN cases, the main difficulty in correct diagnosis was the presence of few diagnostic cell clusters which had less feathering, and consisted of smaller, rounder cells in small and tighter clusters, with nuclear overlap. In particular, nuclear overlap in three-dimensional groups precluded the accurate diagnosis. Rare FN cases showed squamous cell abnormality on re-review, and rare cases showed obscuring blood or inflammation. Conclusion: A significant proportion of AIS/EAC is discovered after Pap showing squamous cell abnormality. FN cases were most commonly related to nuclear overlap in tight three-dimensional clusters.

Cytological Diagnoses of Adenocarcinoma in situ of the Cervix: Common Misdiagnoses

2015 ◽  
Vol 59 (1) ◽  
pp. 91-96
Author(s):  
Shuxia Li ◽  
Dan Tian ◽  
Ying Li
Keyword(s):  
False Negative ◽  
Adenocarcinoma In Situ ◽  
Small Cell Neuroendocrine Carcinoma ◽  
Squamous Cells ◽  
Not Otherwise Specified ◽  
Glandular Cells ◽  
Atypical Glandular Cells ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions

Objective: In routine screening, glandular lesions have high false-negative and false-positive rates. Our study sought to improve the cytological diagnoses and differentiation of glandular lesions. Study Design: A total of 24 cytology slides were retrospectively reviewed. Among these slides, 15 were confirmed via histology to have varying amounts of adenocarcinoma in situ (AIS) components. The other 9 cytology slides exhibited AIS mimics that had been originally considered to be AIS or atypical glandular cells (AGCs) and were selected for differentiation from AIS. Results: Overall, 12 of the 15 cytological slides exhibited significant atypical glandular features that met the criteria for AIS. However, the original cytological diagnoses included 2 cases of AIS, 3 AGCs-favor neoplasia (AGC-FN), 2 AGCs, 1 case that was not otherwise specified (AGC-NOS), 1 NILM (negative for intraepithelial lesion and malignancy), 3 HSILs (high-grade squamous intraepithelial lesions), and 2 ASC-Hs (atypical squamous cells, cannot exclude HSIL). The latter 9 cytological slides were subsequently histologically confirmed to be 2 metaplasias, 2 reactive lesions, 1 decidual change, 3 serous adenocarcinomas, and 1 SCNEC (small-cell neuroendocrine carcinoma). Conclusion: Cytological screening will be valuable for identifying glandular lesions as effectively as squamous lesions if the doubly high false rates can be decreased.

Glandular Cell Abnormalities on SurePath Preparations: A Retrospective Review with Cytology-Histology Correlations

2018 ◽  
Vol 62 (5-6) ◽  
pp. 423-429 ◽  
Author(s):  
Gabor Fischer ◽  
Karen Cormier
Keyword(s):  
Pap Test ◽  
Test Methods ◽  
Glandular Cell ◽  
Histologic Diagnosis ◽  
Detection Rates ◽  
Diagnostic Categories ◽  
Glandular Cells ◽  
Atypical Glandular Cells ◽  
Malignant Lesions

Objective: Detecting glandular lesions is challenging by all Pap test methodologies. As the availability of data on identifying glandular abnormalities by SurePath is scarce, we investigated the detection rates and the correlation with histology follow-up. Study Design: A total of 105,927 cases (SurePath and conventional) were searched for the diagnosis of atypical glandular cells or higher glandular abnormalities (AGC+) with the corresponding histologic diagnosis. The associations between the Pap test methods and diagnostic categories were assessed by χ2 test. Results: Overall, 0.32% of SurePath (159/49,375) and 0.29% of conventional (164/56,552) cases showed AGC+ (p = 0.38). Histology confirmed significant abnormalities in 42 versus 53.5% of the cases, respectively (p = 0.064); 72.7% (SurePath) versus 65.2% (conventional) of these were glandular in nature (p = 0.37). The diagnosis of neoplasia (favored or definitive) showed malignancy on follow-up in 100% of SurePath cases (12/12). In contrast, 82.1% of these conventional cases disclosed premalignant or malignant lesions by histology (p = 0.12). Conclusions: AGC+ cases showed higher prevalence on SurePath preparations. Conventional cases had more abnormalities on follow-up, while glandular lesions represented a higher proportion of abnormal histologies following SurePath AGC+s. The positive predictive value of favored or definite neoplasia was higher in SurePath cases. Overall, these differences were not statistically significant.

Isolated Ovarian Recurrence of Endocervical Adenocarcinoma In Situ

2016 ◽  
Vol 32 (3) ◽  
pp. 189-192 ◽  
Author(s):  
Elena B. Pereira ◽  
Lena El Hachem ◽  
Mazdak Momeni ◽  
Richard Eisen ◽  
Herbert Gretz
Keyword(s):  
Adenocarcinoma In Situ ◽  
Endocervical Adenocarcinoma

scholarly journals Role of Protein Biomarkers in the Detection of High-Grade Disease in Cervical Cancer Screening Programs

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Charlotte A. Brown ◽  
Johnannes Bogers ◽  
Shaira Sahebali ◽  
Christophe E. Depuydt ◽  
Frans De Prins ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
False Negative ◽  
Pap Test ◽  
Developed Countries ◽  
Protein Biomarkers ◽  
Ki 67 ◽  
Screening Programs

Since the Pap test was introduced in the 1940s, there has been an approximately 70% reduction in the incidence of squamous cell cervical cancers in many developed countries by the application of organized and opportunistic screening programs. The efficacy of the Pap test, however, is hampered by high interobserver variability and high false-negative and false-positive rates. The use of biomarkers has demonstrated the ability to overcome these issues, leading to improved positive predictive value of cervical screening results. In addition, the introduction of HPV primary screening programs will necessitate the use of a follow-up test with high specificity to triage the high number of HPV-positive tests. This paper will focus on protein biomarkers currently available for use in cervical cancer screening, which appear to improve the detection of women at greatest risk for developing cervical cancer, including Ki-67,p16INK4a, BD ProEx C, and Cytoactiv HPV L1.

Sign in / Sign up

Export Citation Format

Share Document