Interpretation and management of AGC cytology

Background Cervical cytology has continually evolved. Nowadays, the category of atypical glandular cells (AGC) is less frequent than atypical squamous cells (ASC), associating poorlyreproducible inter-observer interpretation. Cellular characters sometimes surpass benign reparatory processes or associate high-grade squamous precursor lesions, glandular neoplasia, including cervical adenocarcinoma, endometrial neoplasm and even extrauterine adenocarcinomas. Therefore, AGC needs special attention and aggressive diagnostic procedures. Nevertheless, the most common viral infection of the reproductive tract, the human-papillomavirus (HPV) infection, shouldn’t be underestimated, as about 30% of AGC cases are HPV-positive. The presence of HPV in AGC patients identifies a group at higher-risk for developing cervical neoplasia. Studies show that 70% of AGCHPV-negative patients have no evidence of cervical cancer, and 76% of AGC-HPV-positive results may present glandular or squamous neoplasia.