Document Detail


Atypical Papanicolaou smear in pregnancy.
MedLine Citation:
PMID:  15962016     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Atypical glandular cells (AGC) in Papanicolaou (Pap) smears can be associated with premalignant and malignant cervical and endometrial lesions. AGC is difficult to diagnose in pregnancy due to confusion with normal cellular changes that accompany graviditas. While guidelines have been established for management of AGC cases in the non-pregnant patient, special considerations are required when this is discovered during a pregnancy. A routine Pap smear performed on a 29-year-old woman being seen for a history of infertility yielded AGC and a high-grade squamous intraepithelial lesion. The patient achieved pregnancy 1 month later. Satisfactory colposcopic exam was performed with cytobrush sampling of the endocervical canal, in addition to 2 exocervical biopsies at 11 weeks gestation. Positive diagnosis of endocervical adenocarcinoma in situ resulted in a risk-informed decision to proceed with a cold knife conization of the cervix. Final pathology showed complete resection of the lesion with negative margins and an additional area of squamous dysplasia (cervical intraepithelial neoplasia, grade II to III). Appropriate follow-up was recommended. AGC found upon Pap smear during a pregnancy can be associated with significant pathology for which an aggressive management approach is warranted.
Authors:
Thomas P Connolly; A C Evans
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical medicine & research     Volume:  3     ISSN:  1539-4182     ISO Abbreviation:  Clin Med Res     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-10-03     Completed Date:  2005-11-23     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  101175887     Medline TA:  Clin Med Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  13-8     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Marshfield Clinic-Wausau Center, 2727 Plaza Drive, Wausau, WI 54401, USA. connolly.thomas@mashfieldclinic.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Biopsy
Carcinoma in Situ / diagnosis*,  surgery
Cervical Intraepithelial Neoplasia / diagnosis
Cervix Uteri / pathology*
Female
Humans
Pregnancy
Pregnancy Complications, Neoplastic / diagnosis,  surgery
Uterine Cervical Neoplasms / diagnosis*,  surgery
Vaginal Smears*
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