Adenocarcinoma in situ

A. The Bethesda 2001 system classifies glandular cell abnormalities into four subcategories: 1. Atypical glandular cells (AGC): endocervical, endometrial, or glandular cells not otherwise specified (NOS).

2. AGC, favor neoplastic, endocervical, endometrial, or NOS.

3. Endocervical adenocarcinoma in situ (AIS).

4. Adenocarcinoma.

B. Cold-knife conization is the best method for diagnosis of AIS. Adenocarcinoma in situ (AIS) of the cervix is characterized by endocervical glands lined by atypical columnar epithelial cells.

C. If conization margins are positive, repeat conization should be performed in patients who wish to maintain fertility and who understand the risk of leaving residual disease. Repeat conizations should also be considered if cone margins are negative in the setting of a positive ECC. If fertility is not desired, hysterectomy should be performed.

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