Your pathology report for atypical glandular cells on a Pap smear

By Jason Wasserman MD PhD FRCPC
August 29, 2025

A result of atypical glandular cells (AGC) on a Pap smear means that some of the glandular cells collected from your cervix or uterus look abnormal when examined under the microscope.

Glandular cells normally line the inner canal of the cervix (endocervix) and the inner lining of the uterus (endometrium). When these cells look unusual, it raises the possibility of conditions ranging from infection and inflammation to precancerous changes or, less commonly, cancer.

What do glandular cells normally do?

Glandular cells produce mucus that helps protect and lubricate the cervix and uterus. In a normal Pap smear, most of the cells seen are squamous cells (the flat cells covering the outside of the cervix), but small groups of glandular cells from the cervix or uterus may also be present.

  • Finding a few endocervical glandular cells is normal at any age.

  • Finding endometrial cells (from the uterus) is normal in younger women but can be abnormal in women who are postmenopausal.

What do atypical glandular cells look like under the microscope?

Pathologists use the word atypical to describe cells that look different from normal healthy cells. Under the microscope, atypical glandular cells:

  • Are larger than normal glandular cells.

  • Have nuclei (the part of the cell that contains genetic material) that look darker than usual, a feature called hyperchromasia.

  • Show more variation in size and shape of the nucleus compared to normal glandular cells.

When atypical glandular cells are seen, the pathologist will try to decide whether they come from the endocervix (the cervix) or the endometrium (the uterus). Sometimes this is not possible, which is why the report may simply say “atypical glandular cells.”

Do atypical glandular cells mean cancer?

Not necessarily. While atypical glandular cells can be a sign of precancerous changes or cancer, there are many other possible causes, including:

  • Infection.

  • Inflammation.

  • Pregnancy-related changes.

  • Prior radiation treatment to the cervix or uterus.

Because atypical glandular cells can sometimes be associated with serious conditions, additional testing is usually recommended to find out more.

What additional tests may be recommended?

If atypical glandular cells are found, your doctor may recommend:

  • HPV testing – Because human papillomavirus (HPV) infection increases the risk of cervical cancer, your sample may be tested for the virus.

  • Colposcopy – A procedure where the cervix is examined under magnification and small biopsies are taken.

  • Endometrial biopsy – Especially for women over 35 or those who are postmenopausal, a sample from the uterus may be taken to look for abnormalities.

  • Further imaging or testing – In some cases, ultrasound or other procedures may be suggested.

What does it mean if my report says favor neoplasm?

If the pathologist thinks the atypical glandular cells are most likely due to a tumor but cannot make a definite diagnosis from the Pap smear alone, the report may say “favor neoplasm.”

  • Neoplasm is a medical term that means an abnormal growth of cells. It can be benign (noncancerous) or malignant (cancerous).

  • In this setting, it means the pathologist is concerned about cancer but more testing is needed to be certain.

Questions to ask your doctor

  • What further tests do I need after this Pap smear result?

  • Were the atypical glandular cells thought to come from my cervix or my uterus?

  • Do I need an HPV test, colposcopy, or endometrial biopsy?

  • What symptoms should I watch for while waiting for more tests?

  • What does “favor neoplasm” mean in my report, and how does it change the next steps?

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