INVASIVE ENDOCERVICAL ADENOCARCINOMA
Columnar cells possess cytoplasmic vacuoles, nuclear enlargement, eccentric nuclei, large eosinophilic nucleoli, multiple nucleoli and papillary spherical clusters. There is overlapping of nuclei and clusters may have a lumen (rosette or glands). Such cells are seen in adenocarcinoma, squamous cell carcinoma and HGSIL.
It is difficult to differentiate between dysplastic and malignant endocervical cells. However, in adenocar- cinoma, smear shows necrotic and bloody background.
Signet ring cells may be present. Mitotic figures and apoptotic nuclei are present. A few dysplastic squamous cells may be seen (Fig. 16.38).
This category is created for reporting normal or abnormal endometrial cells in women who are 40 years or older, as the presence of even benign-appearing endometrial cells on cervical cytology in women who are at least 45 years of age is more often associated with endometrial adenocarcinoma and endometrial hyper- plasia than with benign endometrium. However, since cervical cytology is primarily a screening test for squamous epithelial lesions and squamous cancer, it is not reliable for detection of endometrial lesions.
ANCILLARY TESTING AND EDUCATIONAL NOTES
If slides are scanned by automated computer systems, the type of system used should be reported with the result. Ancillary testing such as HPV DNA is performed, if appropriate, and reported with the cytology results.
Written comments regarding the interpretation of a cytologic specimen are optional and may be conveyed to the clinician by the pathologist as a means of clarification and information.