Sometimes a smear result will come back as atypical glandular cells and the following is an explanation of this.
There are two groups of cells on the cervix – outer cells which are called ectocervical or squamous cells and inner cells also called glandular/ columnar or endocervical cells. Abnormalities can occur in both groups of cells but are much commoner in the outer or squamous cells (called dyskaryosis on smear and CIN on a tissue biopsy).
In the event of having an abnormality in the glandular cells on a smear test (called Atypical Glandular cells on smear), you will be referred either directly by the Laboratory or your smear taker to the Colposcopy clinic.
The colposcopist will perform a colposcopic examination and may or may not perform a biopsy at the time. They may also suggest an ultrasound scan of the pelvis to look at the uterus (womb) as abnormal glandular cells may originally come from there.
Colposcopy assessment is more difficult with atypical glandular cells as sometimes, the abnormality is hidden deep in the tissue or higher up the cervical canal and can be difficult to diagnose.
The Colposcopist will in general, look at the smear at a meeting with the Cytopathologist (the doctors who ‘read’ smears), called a multidisciplinary team meeting or MDT. If they confirm the diagnosis, you will usually be offered a treatment. The treatment can be undertaken as an out-patient procedure, but sometimes the Colposcopist suggests this is undertaken under general anaesthesia and they may consider performing a hysteroscopy [looking at the inside of the uterus (womb) with a telescope] as well in order to check that this is healthy.
You will be told how your results will be sent to you and you may be asked to return for a follow-up discussion. If the histology (tissue removed from the cervix) shows CGIN (cervical glandular intraepithelial neoplasia), then if you still wish to have children, you will have regular follow-up in the Colposcopy clinic.
if your family is complete, your colposcopist will discuss the results with you and you may wish to consider a hysterectomy in order to prevent the glandular abnormality for re-occurring.
Women who have had treatment for glandular abnormalities will not be part of the new follow-up after treatment HPV test, as this may not always be as accurate as in those with follow-up after treatment of squamous abnormalities.