Learn about your pathology report:

Atypical glandular cells

What does the result atypical glandular cells mean?

The result atypical glandular cells means that abnormal-looking cells were seen on your Pap test. This result is preliminary and not a final diagnosis. The abnormal cells may have come from the tissue lining the inside of the endometrium or the cervix. Conditions associated with this result include cancer, infection, inflammation, pregnancy, or previous radiation.

Continue reading to learn more about your pathology report for atypical glandular cells.

The cervix

The cervix is part of the female genital tract. It is found at the bottom of the uterus where it forms an opening into the endometrial cavity. The narrow passage that runs through the cervix from the endometrium to the vagina is called the endocervical canal.

The part of the cervix inside the vagina is called the exocervix. It is covered by special cells called squamous cells. These cells form a barrier called the epithelium that protects the cervix. The endocervical canal is covered by different kinds of cells that connect to make glands. These glands are called endocervical glands.

The inside of the endometrial cavity is called the endometrium. The endometrium is also covered by cells that connect to form glands. These glands are called endometrial glands. Atypical glandular cells can come from either the endocervical glands or the endometrial glands.

What do the abnormal cells look like under the microscope?

Pathologists use the word atypical to describe cells that look abnormal when examined under the microscope. These cells may be abnormal because they are different in shape, size, or color compared to the normal, healthy cells usually found in that area of the body.

Atypical glandular cells are larger than normal cells and the nucleus of the cell (the part of the cell that holds the genetic material) is darker. Pathologists call these cells hyperchromatic. There also tends to be greater variation in the size and shape of the nucleus between cells. In contrast, normal, healthy glandular cells all tend to be around the same size and shape.

When atypical glandular cells are seen, your pathologist will try to decide if the glandular cells are from the endocervix or the endometrium. If your pathologist is able to determine where the cells come from, it will be described in your report. The result atypical glandular cells typically means that your pathologist was unable to tell if the cells came from the endocervix or the endometrium.

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Is it normal to see glandular cells on a Pap test?

A normal Pap test will show mostly squamous cells although it is normal to find small groups of glandular cells from the endocervix. Some Pap tests will also show small groups of glandular cells from the endometrium. This is considered normal in younger women. However, seeing endometrial cells on a Pap test from a postmenopausal woman is considered abnormal.  For these women, an endometrial biopsy is recommended to investigate the source of the cells.

Do atypical glandular cells mean cancer?

Not necessarily. There are many reasons why glandular cells can become atypical including cancer, infection, inflammation, pregnancy, or previous radiation to the cervix or endometrium. The term atypical glandular cells is used when your pathologist does not have enough information to decide if the abnormal groups of cells are cancerous or not.

What does favor neoplasm mean?

If after examining the tissue, your pathologist is still unable to decide the cause of the atypical glandular cells but thinks that the cells are most likely cancer cells, your report will also say “favor neoplasm”. Neoplasm is word pathologists use to describe an abnormal growth of cells and is similar to the word tumour.

Next steps

After an atypical glandular cells result, your doctor should plan to see you again within 6 months or should refer you to a specialist for additional tests.  Depending on where you live, these additional tests may include:

  • Colposcopy – This procedure allows your doctor to see the entire outer surface of the cervix. During the colposcopy, the doctor will be looking for any areas that look abnormal on the surface of the cervix. If an abnormality is found, the doctor may decide to take a small sample of tissue called a biopsy to look for pre-cancerous and cancerous changes
  • Endocervical curetting – During this procedure, the outside of the cervical canal is scraped using a spoon-shaped instrument called a curette. The sample is then examined under the microscope by a pathologist. The main purpose of this procedure is to show the presence of any abnormalities within the endocervical canal.
  • Endometrial biopsy – This procedure is performed to obtain a small tissue sample from the lining of the uterus, called the endometrium. The main purpose of this procedure is to show the presence of any abnormalities within the uterus.
  • Ultrasound – This procedure may be performed to look for abnormalities within either uterus or cervix. The ultrasound may be useful in detecting an increased thickening of the endometrium and/or presence of masses within the endometrial and endocervical cavity, and in the pelvis.

Compared to the Pap test, these tests take a closer look at your cervix and endometrium. They will help your doctors decide what caused the atypical glandular cells.

by Adnan Karavelic MD FRCPC (updated December 13, 2021)
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