With the newest iteration of the Bethesda System in place—the second revision in 10 years—the clinician is again asked to learn new classifications of cervical cytology and the attendant management protocols. Atypical glandular cells of undetermined significance AGUS also have been subclassified. The reason: To create specific readings of cell changes, as atypical cells often are seen prior to dysplasia. While the terminology has been tightened, cytologic laboratories still lack uniformity in their reporting of atypical cells. When reviewed by consulting cytopathologists, a significant percentage of these smears are reclassified as normal. But, since clinical management decisions are based on the original cytology, there is the possibility of both false-negative and false-positive Pap test results.

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AGUS subgroups may be subcategorized in endometrial or endocervical on the basis of origin. Endocervical AGUS should be further qualified, but the analysis of atypical glandular cells may be really difficult and the conclusive diagnosis is frequently "AGUS not otherwise specified".

The subclassification of ASCUS and AGUS is useful for an appropriate clinical management, but pertinent patient information such as age, date of last menstrual period, mechanical therapies, tamoxifen therapy, and others is needed to avoid an overdiagnosis and consequently an overtreatment. In fact various subgroups require different clinical management. Therefore, an effective communication between cytopathologists and referring physicians is essential in the analysis of squamous and glandular atypias.

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Send even when there aren't any new results. Optional text in email:. Save Cancel. Create a file for external citation management software Create file Cancel. Cite Favorites. Similar articles [Controversial categories in cytopathology of the uterine cervix. AGUS: atypical glandular cells of undetermined significance]. Cenci M, et al. Minerva Ginecol. PMID: Italian. Clinical evaluation of follow-up methods and results of atypical glandular cells of undetermined significance AGUS detected on cervicovaginal Pap smears.

Kim TJ, et al. Gynecol Oncol. PMID: ASCUS: atypical squamous cells of undetermined significance]. Clinical significance of atypical glandular cells on cervical cytology.

Schnatz PF, et al. Obstet Gynecol. PMID: Review. International Academy of Cytology Task Force summary. Solomon D, et al. Acta Cytol. Show more similar articles See all similar articles.

Publication types Review Actions. MeSH terms Atrophy Actions. Estrogen Replacement Therapy Actions. Female Actions. Humans Actions. Metaplasia Actions. Postmenopause Actions. Vaginal Smears Actions. Copy Download.


Managing ASCUS and AGUS Pap smears








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