33岁，月经紊乱，不规则出血史。该病例在宫颈细胞学较为罕见，请大家欣赏！

 谢谢楼主和各位老师的热烈讨论！

考虑AGC，不排除腺癌，如赵老师所讲，做细胞块和IHC就明了。

期待最后结果。。。

等待中。。。。。。

 Read photos again. generally speaking , clear cell carcinomas have more ugly cytology, but these cells are relative bland even though we can appreciate the pleomorphism of cells. So endometrioid carcinoma???

zhangjianxin 

Thank for the interesting case. We are waiting for your surgical results.

Do you have residule fluid? You can ask Lab to make a cell block if you have. It may be helpful. My feeling is there are many clusters of cells in the fluid.

虽然中国改革的春风吹了多年，但是细胞病理的春天还没有到；不知道我们能否等到。幸运的是 每次看到赵老师的回帖都如沫春风，心情暖和许多。

   这个病例个人观点如下：

   1、细胞成团或簇并极性消失，成立体结构（3D）

   2、核异性、大小不等；核仁明显

   3、部分胞浆较为丰富，并呈透明样

   4、细胞团明显不跟鳞状上皮在一个平面上（模糊的鳞状上皮），证明细胞团三维结构（颈管来源的腺细胞相对立体感没有那么强），倾向来源于内膜；当然也有可能象赵老师说的颈管或者转移。不过个人观点；不对之处，请各位老师指正。

   如果要我签发报告我会诊断：AGC-FN ；如果这里讨论的话，我认为是来源内膜的透明细胞腺癌。等待中......

Cellular specimen with cluster highly atypical cells showing pleomorphism, prominnat nuclei, and abundant cytoplasm with clear appearance in some cells.

Agree with above. It looks like adenocarcinoma. It  can be endocercial or endometrial origins or metastatic tumor.

Tumor type can be clear cell carcinoma or other. Based on age and cytology, It can be endometrial endometrioid carcinoma. secretory variant. Remeber that I say "can" be....

Anyway in the Pap test it is good enough if you report adenocarcinoma or AGC favor neoplasma if you want to leave some space for you. For this case, it may provde you more information if you can prepare a cell block or do some IHC if you have a good cell block.

I mentioned here many times that Pap test is a screening test. We should keep this priciple in our mind when we evaluate Pap test.

Thank for the excellent case and photos. Waiting for your final histologic results.

        该病例比较特殊，希望大家参与讨论！我觉得华夏病理网给我们这么好的交流平台，就是希望大家在平时忙碌得工作中，遇到的特殊病理拿出来一块交流，共同提高。

        该病例之所以特殊：1、细胞之间的结构较为松散。2、部分细胞胞浆比较丰富。3、部分细胞有透亮的胞浆。所以我觉得该病例的分型值得我们推敲！