Management of glandular cell abnormalities

A. Endometrial cells on Pap smear. When a Pap smear is performed during menstruation, endometrial cells may be present. However, endometrial cells on a Pap smear performed during the second half of the menstrual cycle or in a post-menopausal patient may indicate the presence of polyps, hyperplasia, or endometrial adenocarcinoma. An endometrial biopsy should be considered in these women.

B. Atypical glandular cells of undetermined significance (AGUS). Colposcopically directed biopsy and endocervical curettage is recommended in all women with AGUS smears, and abnormal endometrial cells should be investigated by endometrial biopsy, fractional curettage, or hysteroscopy.

C. Adenocarcinoma. This diagnosis requires endocervical curettage, cone biopsy, and/or endometrial biopsy.

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