Endocervical glandular atypia and adenocarcinoma: a correlation of cytology and histology.

Of the 34,384 cervical smears sampled by cervical scraping and Cytobrush, reactive glandular atypia was found in 1.7%, low-grade glandular atypia in 0.08%, and high-grade glandular atypia/adenocarcinoma in 0.05%. Cells of reactive glandular atypia and low-grade atypia could be distinguished from those of high-grade atypia/adenocarcinoma by the architecture of the cellular aggregates, nuclear morphology, and nuclear-cytoplasmic ratios. Further histologic studies found that most reactive and low-grade atypias were associated with condyloma, squamous dysplasia, carcinoma in situ, and cervicitis. Eighty-two percent of women with cellular evidence of high-grade atypia/adenocarcinoma were confirmed to have in situ or invasive adenocarcinoma of the cervix. Although Cytobrush samples seem to improve the detection of early-stage glandular neoplasms, many minor atypias unrelated to cervical carcinogenesis are also detected.