THE CYTOLOGIC DIAGNOSIS OF ADENOCARCINOMA INSITU OF THE CERVIX UTERI AND RELATED LESIONS .2. MICROINVASIVE ADENOCARCINOMA

  • 1 May 1988
    • journal article
    • research article
    • Vol. 32  (3) , 318-324
Abstract
Criteria for the cytologic diagnosis of microinvasive adenocarcinoma of the cervix have not been previously established. Such cytologic criteria were evolved through the detailed analysis of cervical smears from 40 histologically confirmed cases. The cellular features of cervical adenocarcinoma in situ (AIS) were always associated with microinvasion. Syncytia of glandular cells, small cells in very crowded sheets and papillary groupings of cells, when seen in conjunction with AIS, were suggestive of microinvasion. Dissociation of cells was common. Nuclear pleomorphism with an irregular chromatin pattern and inconspicuous-to-prominent nuclei was frequently present. In some cases, a tumor diathesis was seen in the smear background. Using these criteria, our predictive accuracy for diagnosing microinvasive cervical adenocarcinoma is improving steadily and now approaches 50%. Ongoing investigation of these cases must include a diagnostic cone biopsy to further improve the predictive accuracy for this lesion.