Atypical glandular cells on a Pap smear of the cervix

by Adnan Karavelic MD FRCPC
March 28, 2022

What does the result atypical glandular cells on a Pap smear of the cervix mean?

Atypical glandular cells means that abnormal-looking cells were seen on your Pap smear. 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.

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.

This picture is an example of atypical glandular cells seen on a Pap smear of the cervix.
Is it normal to see glandular cells on a Pap smear?

A normal Pap smear 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 it mean if my report says favor neoplasm?

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.

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