Cyto - Histo Correlation of Atypical Glandular Cells of Endometrial Origin on Cervical Cytology in Abnormal Uterine Bleeding Cases

Abstract

BACKGROUND: An association has been reported with presence of endometrial cells on cervical smears and clinically significant uterine lesions. Hence for early detection of endometrial pathology, the 2001 Bethesda system has suggested the mandatory reporting of presence of any atypical endometrial cells regardless of age and menstrual status and out of phase normal looking endometrial cells in women aged 40 years or more. OBJECTIVES: To assess the association between atypical glandular cells of endometrial origin in cervical cytology and histopathological findings in abnormal uterine bleeding cases. SETTINGS AND DESIGN: The study was conducted at JSS hospital, Mysore in the department of pathology. This was a descriptive type of study. The sample was collected from patients attending the gynecology OPD with the complaints of abnormal uterine bleeding in JSS hospital. MATERIALS AND METHODS: Smears for cervical cytology are collected using either pap smear or manual liquid based smear from 82 patients in the age group of 20-75 years with complaints of abnormal bleeding history. The results of cervical cytology were compared and confirmed with the endometrial pathology. RESULTS: Out of 82 abnormal uterine bleeding cases 14 showed atypical endometrial cells. On follow up of these cases, the results indicated an association between atypical endometrial cells in cervical cytology with endometrial carcinoma in 8 cases (60%), 1 case with complex hyperplasia with atypia (10%). CONCLUSION: Presence of atypical endometrial cells in all women with abnormal uterine bleeding has considerable clinical implications & further diagnostic evaluation by endometrial sampling is of utmost importance.