A study of hormon-disordered cases suspected endometrial hyperplasia on cytology

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Objectives: With endometrial carcinoma increasing, the accurate diagnosis of premalignant endometrial hyperplasia by cytological smear could prove extremely useful in detecting endometrial carcinoma early. The precision of diagnosis by cytology, however, remains to poor for protical use. We report our findings on decreasing false-positives in hormone-disordered endometrium associated with anovalation to differentiate it from endometrial hyperplasia. Study Design: Cytology smears were examined in 33 cases, involving endometrial glandular and stromal breakdown by Kurman ("breakdown") and disordered proliferative phase ("disordered") endometrium. Results: Breakdown cases evidenced significant numbers of stromal cells condensed and forming compact nests with hyperchromatic nuclei and little or no cytoplasm. They were often associated with fragmented endometrial glands. These abnormal cell clusters disappeared during follow-up. Disordered cases evidenced the same cytological findings as simple hyperplasia of the endometrium. Conclusion: To decrease the number of false-positives, it is important that breakdown endometrium cytology be diagnosed as negative and followed up.
特定非営利活動法人日本臨床細胞学会の論文