Cervix - Cytology
Atypia / premalignant / preinvasive lesions
Adenocarcinoma in situ (AIS)

Author: Marilin Rosa, M.D. (see Authors page)

Revised: 21 April 2017, last major update June 2011

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PubMed search: adenocarcinoma in situ [title] (AIS)

Cite this page: Adenocarcinoma in situ (AIS). PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cervixcytologyAIS.html. Accessed May 23rd, 2017.
Definition / general
Etiology
  • HPV infection is necessary for development of AIS
Clinical features
  • Generally asymptomatic
Treatment
  • Colposcopy with endocervical sampling is recommended for women with AIS
  • Endometrial sampling is recommended in conjunction with colposcopy and endocervical sampling in women 35 years and older (J Low Genit Tract Dis 2007;11:201)
  • Cold knife conization is recommended to preserve specimen orientation and permit optimal interpretation of histology and margin status
  • LEEP is not recommended due to its association with positive margins (Gynecol Oncol 2002;86:361)
Cytology description
  • Tightly crowded sheets of abnormal glandular cells with architectural disarray, often with short strips of pseudostratified columnar cells near edges
  • Nuclei may be partially denuded, causing a feathered appearance; nuclei are enlarged, usually oval and hyperchromatic
  • Often prominent nucleoli
  • No tumor diathesis
  • For endometrioid AIS, most useful criteria for diagnosis are predominance of groups with marked crowding, focal feathering, nuclear hyperchromatism with coarsening of chromatin and occasional mitotic figures
  • Features favoring a benign diagnosis are sheets of cells, endometrial tubules and endometrial stroma
Cytology images

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Various Images

Positive stains
  • p16 can be use to discriminate endocervical adenocarcinomas from benign lesions and from endometrioid adenocarcinomas of the uterine corpus (Virchows Arch 2006;448:597)