A 67-year-old male patient presented to our surgical oncology outpatient department, with lower abdominal pain and right scrotal swelling, gradually increasing in size for two months duration. He gave a history of reduced appetite and weight loss with regular bowel and bladder habits. He was on steroid inhalers and long acting β agonist for more than five years as treatment for Chronic Obstructive Airway Disease (COPD).

Background: Endometrial aspiration cytology is the latest available modality for the study of endometrial diseases. A large range of diseases like atypia's, malignancies, and infective changes can be diagnosed using a cytological examination. Aim and Objectives: To assess the adequacy of the aspirate of endometrium for cytological examination and correlating the diagnosing efficiency with frozen section and histopathology. Methods: A cross sectional study was conducted at department of pathology, tertiary care health center in Pondicherry. Endometrial aspiration and Curettage were done in 58 perimenopausal women with abnormal uterine bleeding. Endometrial aspiration sample were subjected for cytological examination by Papanicolaou staining and May-Grunewald-Gimesa staining, frozen section and histopathology examination with Hematoxalin & Eosin staining. Diagnostic accuracy was compared with gold standard histopathological examination. Sensitivity, specificity and predictive values were calculated. Results: Among 58 participants, the mean age was 45.02 ± 4.12 years. Majority (63.79%) of the participants had menorrhagia. High cellularity was seen in 58.62%. Sheets were the most commonly observed pattern on cytology (65.52%). The cytological diagnosis of simple hyperplasia had sensitivity of 100% and specificity was 94.44%in predicting HPE diagnosis. The frozen section of simple hyperplasia had sensitivity of 100%in predicting HPE diagnosis. Conclusion: Endometrial aspiration cytology and frozen section are useful and minimally invasive techniques that can be utilized for the diagnosis of endometrial pathologies at par with the efficiency of histopathological examination.