A clinical review of borderline glandular cells on cervical cytology

Objective To review the diagnoses and diagnostic pathway of women presentin g with borderline glandular cells on cervical cytology. To outline the basi s of clinical approach of these women. Design Retrospective review. Population Forty-three women referred to the hospital department over a 32- month period. Methods Review of the casenotes for the demographic data, previous cervical cytology and/or histology report, indication for the smear resulting in bo rderline glandular cells, colposcopic findings, diagnostic and/or treatment procedures, final diagnosis and current status. Results The average age was 36.7 years. Twenty-four women (56%) had clinica lly significant lesions: seven women (16%) presented with cancers, of which one was endometrial in origin, and 17 (40%) with intraepithelial neoplasia (CIN and cervical glandular intraepithelial neoplasia (CGIN)). Sixty-seven percent of all clinically significant lesions were of squamous origin. Thi rty-seven had histological diagnosis, while six went on to cytological surv eillance. Colposcopy was the most significant predictor for clinically sign ificant lesions (P < 0.05). Punch biopsies and loop excisions were diagnost ic when based on abnormal colposcopic findings. Brush cytology was appropri ate follow up for asymptomatic, premenopausal women with no colposcopic abn ormality. In addition, endometrial sampling was recommended in the peri- an d postmenopausal women. Conclusion Borderline glandular cells have a high incidence of clinically s ignificant lesions. Immediate referral for colposcopy and assessment is str ongly recommended in women with two borderline glandular smears to avoid de lays in potential cancer diagnosis.