Science Journal of Clinical Medicine

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Significance of Endometrial Cells in Cervical Cytology (by Conventional Pap & Manual Liquid Based Cytology) in Abnormal Uterine Bleeding Cases

Received: 31 January 2015    Accepted: 01 February 2015    Published: 03 August 2015
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Abstract

Abnormal uterine bleeding is common gynaecologic complaint. Causes may vary with age, the most worrisome cause is malignancy of endometrium. No widely accepted screening test for endometrial carcinoma exists, but cervical cytology has been found to be of some use in detecting endometrial diseases. Guidelines from the 2001 Bethesda system, in addition to reporting of atypical glandular cells (AGC) and adenocarcinoma, requires the reporting of benign appearing endometrial cells in women aged above 40 years. Smears for cervical cytology are collected from 80 patients in the age group of 20-75 years with complaints of bleeding per vagina. Cyto-histological correlation is attempted in which D&C or hysterectomy specimen is sent. Manual Liquid Based Cytology is strongly advocated as it improves sample quality by removing obscuring factors. Out of 80 abnormal uterine bleeding cases 52 showed endometrial cells (10 atypical glandular cells & 42 benign endometrial cells) & 39 had further diagnostic evaluation of endometrium. The results indicated an association between endometrial cells in cervical cytology with carcinoma in 6 cases(15.4%), 1 case with complex hyperplasia with atypia(0.03%) ,while remaining 84.6% had benign endometrial pathology. Hence we concluded that presence of atypical endometrial cells in all women & benign endometrial cells in post menopausal women(>40yr)has considerable clinical implications & further diagnostic evaluation for endometrial sampling is of utmost importance.

DOI 10.11648/j.sjcm.s.2015040401.12
Published in Science Journal of Clinical Medicine (Volume 4, Issue 4-1, July 2015)

This article belongs to the Special Issue Latest Different Concepts of Gynaecology

Page(s) 6-10
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Endometrium, pap smear, manual liquid based cytology

References
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[2] Nagele F, O’Connor H, Baskett TF et al. Hysteroscopy in women with abnormal uterine bleeding on hormone replacement therapy: a comparison with postmenopausal bleeding. Fertil Steril 1996;65:1145-50.
[3] Remondi C, Sesti F, Bonanno E, Pietropolli A, Piccione E. Diagnostic accuracy of liquid-based endometrial cytology in the evaluation of endometrial pathology in postmenopausal women.Cytopathology 2013;24:365-71.
[4] Vuento MH, Pirhonen JP, Makinen JI et al. Screening for endometrial cancer in asymptomatic postmenopausal women with conventional and colour Doppler sonography. Br J Obstet Gynaecol 1999;106:348-53.
[5] Wu HH, Schuetz MJ, Cramer H. Significance of benign endometrial cells in Pap smears from postmenopausal women.J Reprod Med. 2001;46:795-798.
[6] Papanicolaou GN,Traut HF. Diagnosis of Uterine Cancer by the Vaginal Smear. New York, NY: The Commonwealth Fund; 1943.
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[8] Thrall M, Kjeldahl K, Gulbahce HE, Pambuccian SE. Liquid-based Papanicolaou test (SurePath) interpretations before histologic diagnosis of endometrial hyperplasias and carcinomas. Cancer Cytopathology 2007;111(4):217–23.
[9] Greenspan DL, Cardillo M ,Davey DD, Heller DS, Moriarty AT.Endometrial Cells in Cervical Cytology: Review of Cytological Features and Clinical Assessment . American Society for Colposcopy and Cervical Pathology Journal of Lower Genital Tract Disease2006; 10(2): 111-22.
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[13] Lee, Kelly D, Gravitt PE, Fansler Matosem JA, Clark DP. Validation of a low-cost, liquid based screening method of cervical intraepithelial neoplasia. Am J Obstet and Gynecol 2006. 195,965-70.
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[17] Wu HH, Schuetz MJ, Cramer H. Significance of benign endometrial cells in Pap smears from postmenopausal women.J Reprod Med. 2001;46:795-798.
[18] Montz FJ. Significance of ‘normal endometrial cells in cervical cytology from asymptomatic postmenopausal women receiving hormone replacement therapy. Gynecol Oncol 2001;81:33-9.
[19] Brogi E, Tambouret R, Bell DA. Classification of benign endometrial glandular cells in cervical smears from postmenopausal women. Cancer. 2002;96:60-66.
[20] Karim BO, Burroughs FH, Rosenthal DL, et al. Endometrialtype cells in cervico-vaginal smears: clinical significance and cytopathologic correlates. Diagn Cytopathol. 2002;26:123- 127.
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Author Information
  • Department of Pathology, JSS medical college, A Constituent of JSS University, Mysore, India

  • Department of Pathology, JSS medical college, A Constituent of JSS University, Mysore, India

  • Department of OBG, JSS Medical College, a constituent of JSS University, Mysore, India

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    Lopa Mudra kakoti, Nandini N. Manoli, Nandish S. Manoli. (2015). Significance of Endometrial Cells in Cervical Cytology (by Conventional Pap & Manual Liquid Based Cytology) in Abnormal Uterine Bleeding Cases. Science Journal of Clinical Medicine, 4(4-1), 6-10. https://doi.org/10.11648/j.sjcm.s.2015040401.12

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    ACS Style

    Lopa Mudra kakoti; Nandini N. Manoli; Nandish S. Manoli. Significance of Endometrial Cells in Cervical Cytology (by Conventional Pap & Manual Liquid Based Cytology) in Abnormal Uterine Bleeding Cases. Sci. J. Clin. Med. 2015, 4(4-1), 6-10. doi: 10.11648/j.sjcm.s.2015040401.12

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    AMA Style

    Lopa Mudra kakoti, Nandini N. Manoli, Nandish S. Manoli. Significance of Endometrial Cells in Cervical Cytology (by Conventional Pap & Manual Liquid Based Cytology) in Abnormal Uterine Bleeding Cases. Sci J Clin Med. 2015;4(4-1):6-10. doi: 10.11648/j.sjcm.s.2015040401.12

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  • @article{10.11648/j.sjcm.s.2015040401.12,
      author = {Lopa Mudra kakoti and Nandini N. Manoli and Nandish S. Manoli},
      title = {Significance of Endometrial Cells in Cervical Cytology (by Conventional Pap & Manual Liquid Based Cytology) in Abnormal Uterine Bleeding Cases},
      journal = {Science Journal of Clinical Medicine},
      volume = {4},
      number = {4-1},
      pages = {6-10},
      doi = {10.11648/j.sjcm.s.2015040401.12},
      url = {https://doi.org/10.11648/j.sjcm.s.2015040401.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.sjcm.s.2015040401.12},
      abstract = {Abnormal uterine bleeding is common gynaecologic complaint. Causes may vary with age, the most worrisome cause is malignancy of endometrium. No widely accepted screening test for endometrial carcinoma exists, but cervical cytology has been found to be of some use in detecting endometrial diseases. Guidelines from the 2001 Bethesda system, in addition to reporting of atypical glandular cells (AGC) and adenocarcinoma, requires the reporting of benign appearing endometrial cells in women aged above 40 years. Smears for cervical cytology are collected from 80 patients in the age group of 20-75 years with complaints of bleeding per vagina. Cyto-histological correlation is attempted in which D&C or hysterectomy specimen is sent. Manual Liquid Based Cytology is strongly advocated as it improves sample quality by removing obscuring factors. Out of 80 abnormal uterine bleeding cases 52 showed endometrial cells (10 atypical glandular cells & 42 benign endometrial cells) & 39 had further diagnostic evaluation of endometrium. The results indicated an association between endometrial cells in cervical cytology with carcinoma in 6 cases(15.4%), 1 case with complex hyperplasia with atypia(0.03%) ,while remaining 84.6% had benign endometrial pathology. Hence we concluded that presence of atypical endometrial cells in all women & benign endometrial cells in post menopausal women(>40yr)has considerable clinical implications & further diagnostic evaluation for endometrial sampling is of utmost importance.},
     year = {2015}
    }
    

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    T1  - Significance of Endometrial Cells in Cervical Cytology (by Conventional Pap & Manual Liquid Based Cytology) in Abnormal Uterine Bleeding Cases
    AU  - Lopa Mudra kakoti
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    AB  - Abnormal uterine bleeding is common gynaecologic complaint. Causes may vary with age, the most worrisome cause is malignancy of endometrium. No widely accepted screening test for endometrial carcinoma exists, but cervical cytology has been found to be of some use in detecting endometrial diseases. Guidelines from the 2001 Bethesda system, in addition to reporting of atypical glandular cells (AGC) and adenocarcinoma, requires the reporting of benign appearing endometrial cells in women aged above 40 years. Smears for cervical cytology are collected from 80 patients in the age group of 20-75 years with complaints of bleeding per vagina. Cyto-histological correlation is attempted in which D&C or hysterectomy specimen is sent. Manual Liquid Based Cytology is strongly advocated as it improves sample quality by removing obscuring factors. Out of 80 abnormal uterine bleeding cases 52 showed endometrial cells (10 atypical glandular cells & 42 benign endometrial cells) & 39 had further diagnostic evaluation of endometrium. The results indicated an association between endometrial cells in cervical cytology with carcinoma in 6 cases(15.4%), 1 case with complex hyperplasia with atypia(0.03%) ,while remaining 84.6% had benign endometrial pathology. Hence we concluded that presence of atypical endometrial cells in all women & benign endometrial cells in post menopausal women(>40yr)has considerable clinical implications & further diagnostic evaluation for endometrial sampling is of utmost importance.
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