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A Journal on Obstetrics and Gynecology

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Minerva Ginecologica 2001 February;53(1):57-62

language: Italian

Controversial categories in cytopathology of the uterine cervix. II. AGUS: atypical glandular cells of undetermined significance

Cenci M., Chieppa A., Vecchione A.


AGUS (Atypical Glandular Cells of Undetermined Significance), or AGCUS, is a category for reporting doubtful or suspicious glandular changes of the uterine cervix. Glandular lesions are not well known by the cytopathologist and their cytologic criteria are not completely reproducible. Only with the introduction of The Bethesda System (TBS) in 1988, the presence of endocervical cells is considered essential to correctly evaluate a cervical specimen. The origin of atypical glandular cells, endometrial or endocervical, should be distinguished. Moreover, endocervical AGUS should be further qualified as ''favor reactive'' or ''favor neoplastic or Adeno-carcinoma in situ (AIS)''. Recently, it has been proposed to classify endocervical AGUS in a) AIS; and b) AGUS ''that cannot rule out AIS'' when incomplete criteria of AIS are present. Moreover, the origin of AGUS is sometimes impossible to know. In these cases, the diagnosis is AGUS not otherwise specified (NOS). The clinical management of AGUS presents different options depending on its origin or its further qualification: cytologic follow-up, colposcopy and eventual biopsy, endocervical or endometrial curettage, hysteroscopy, human papillomavirus typing, etc. including conization and hysterectomy. In conclusion, an appropriate clinical management is needed to detect glandular or squamous lesions that can be frequently identified in the AGUS follow-up.

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