Significance of Atypical Squamous Cells and Atypical Glandular Cells: Similar but Dissimilar

Abstract

Since 1988 when the Bethesda System (TBS) was first adopted(1), two modifications were subsequently carried out in 1991 and 2001(2,3). One of the major changes in TBS 2001 is the revision of a terminology used for atypical squamous and glandular cells. TBS 2001 replaced “atypical squamous cells of undetermined significance (ASCUS)” and “atypical glandular cells of undetermined significance (AGUS or AGCUS)” in TBS 1988 and 1991 with simply “atypical squamous cells (ASC)” and “atypical glandular cells (AGC)”, respectively. Attempts have always been made to qualify or subcategorize these equivocal diagnoses in a manner to indicate that it can define a patient at increased risk of significant clinical lesions which generally include high grade pre-invasive and invasive cancers. These two acronyms are similar for being classified as cells which are more atypical than reactive response but are not justified to be classified as preinvasive or invasive lesions. However, they are dissimilar in terms of having different cytologic backgrounds and underlying histopathology as well as clinical implication. When these abnormal cytologic diagnoses and their qualifiers or subcategories are given, a gynecologist who confronts with the women should thoroughly understand the messages from a cytopathologist through his/ her report of these cytologic interpretations. Some important issues of these two particular cytologic abnormalities will be briefly pointed out here in a light of hope that this will lead to an optimal management for a woman.

Keywords

• Atypical Squamous Cells
• Atypical Glandular Cells