Diagnostic accuracy of endometrial biopsy in relation to the amount of tissue

Reijnen, Casper; Visser, Nicole C.M.; Bulten, Johan; Massuger, Leon F.A.G.; Putten, Louis J.M. van der; Pijnenborg, Johanna M.A.

doi:10.1136/jclinpath-2017-204338

Cited by 20 publications

(12 citation statements)

References 21 publications

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“…A tendency to over-investigate patients younger than 40 with abnormal bleeding has been shown. 10 Furthermore, sampling of the endometrium without a clear indication may contribute to higher failure rates.…”

Section: Discussionmentioning

confidence: 99%

“…In the current study, hyperplasia or malignancy were diagnosed in 113 (11.37%) of postmenopausal women, which is in keeping with other studies. 10 , 16 …”

Section: Discussionmentioning

confidence: 99%

“…In the current study, hyperplasia or malignancy were diagnosed in 113 (11.37%) of postmenopausal women, which is in keeping with other studies. 10,16 Cytomegalovirus endometritis and endometrial involvement by non-Hodgkin lymphoma were two interesting cases encountered. Isolated case reports of cytomegalovirus endometritis from the 1990s have been noted, but the most recent report was in a postpartum uterus specimen.…”

Section: Discussionmentioning

confidence: 99%

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Endometrial sampling at an academic hospital in South Africa: Histological findings, lessons learnt and interesting surprises

Mohanlal

2020

African Journal of Laboratory Medicine

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Background: Outpatient sampling is used to investigate endometrial pathology. Little is known about practice habits and local failure rates at Chris Hani Baragwanath Academic Hospital in Johannesburg, South Africa.Objective: This study assessed the frequency of samples that showed no or limited histological representation of endometrium, and described demographic and pathological features.Methods: All endometrial sample histology reports from the National Health Laboratory Services at the hospital from 01 July 2013 to 31 May 2017 were retrieved by searching the laboratory’s information system. Clinical variables (age, menopausal state, indication for biopsy, endometrial thickness on ultrasound) and pathological findings (macroscopic amount of tissue, histological diagnosis, microscopic presence of endometrial tissue) were extracted and statistically analysed.Results: A total of 1926 samples were included, 91% of which were submitted for abnormal or postmenopausal bleeding. No endometrium was observed in 25% of samples and 13% showed limited endometrium. Benign diagnoses (86%) were most common, with proliferative or secretory changes, endometrial polyps and endometritis accounting for most of these. Associations between the amount of sample received and the presence of endometrial tissue (p ≤ 0.001) and benign versus malignant diagnoses (p ≤ 0.001) were noted. The greater the endometrial thickness, the greater the likelihood of obtaining more sample (bulky vs scant p 0.001) and making a malignant versus benign diagnosis (p = 0.005).Conclusion: These findings are in keeping with literature outside Africa. Histology reports should be explicit when terms such as ‘inadequate’ or ‘insufficient’ are used, in order to facilitate clinical decision-making.

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Section: Discussionmentioning

confidence: 99%

“…In the current study, hyperplasia or malignancy were diagnosed in 113 (11.37%) of postmenopausal women, which is in keeping with other studies. 10 , 16 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Endometrial sampling at an academic hospital in South Africa: Histological findings, lessons learnt and interesting surprises

Mohanlal

2020

African Journal of Laboratory Medicine

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“…1 Sensitivity of pipelle to diagnose endometrial cancer ranges from 62% to 99%, 11 while agreement rates on tumor grade and pathology diagnosis are moderate (67 and 73%, respectively). 12 Limitations include sample insufficiency in 20-30% of the cases, 13 unsuccessful insertions (in occasions due to cervical stenosis or prolapse), and as well an abnormal sonographic appearance of the endometrium. 11,14 The different types of endometrial cancers derive from different precursor lesions (screening criterion 4; Table 1 and Fig.…”

Section: Natural History Of Endometrial Cancermentioning

confidence: 99%

New perspectives on screening and early detection of endometrial cancer

Costas

Frias-Gomez

Guardiola

et al. 2019

Intl Journal of Cancer

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Due to the anatomical continuity of the uterine cavity with the cervix, genomic exploitation of material from routine Pap smears and other noninvasive sampling methods represent a unique opportunity to detect signs of disease using biological material shed from the upper genital tract. Recent research findings offer a promising perspective in the detection of endometrial cancer, but certain questions need to be addressed in order to accelerate the implementation of novel technologies in a routine screening or clinical setting. We discuss here new perspectives on detection of endometrial cancer using genomic and other biomarkers in minimally invasive sampling methods with a special focus on public health classic screening criteria, highlighting current gaps in knowledge.

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“…In clinical practice, it is not uncommon that the pathologic results from the hysterectomy specimens would be different from that of the endometrial tissue biopsy/ curettage [2,3]. Examples are the changes of tumor grading, histologic types, or finding of other histopathologic components [4,5]. An even less common phenomenon was the absence of the tumor in hysterectomy specimen of the patients diagnosed preoperatively as EMC, so called 'vanishing carcinoma' [6].…”

Section: Introductionmentioning

confidence: 99%

Clinico-pathological aspects of vanishing endometrial cancer

Srijaipracharoen¹,

Tangjitgamol²

2020

Clin Obstet Gynecol Reprod Med

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Aims: To assess the prevalence, pre-operative findings, and clinical outcomes of endometrial cancer (EMC) patients who had vanishing cancer. Methods:Patients who had pre-operative tissue diagnosis of EMC, and had surgical treatment including hysterectomy in the institution between 1995 and 2015 were identified. The patients who had no residual carcinoma in all pathologic specimens including the uterus were included. Pre-and post-operative clinico-pathological data were collected. Clinical outcomes including recurrence and survival of the patients were studied.Results: Among 422 patients who had tissue diagnosis of endometrial cancer, twenty patients had no residual cancer in the hysterectomy specimens. Three patients who had pre-operative radiation therapy or had evidence of endometrial cancer outside the uterus were excluded, so 17 patients (3.8%) were diagnosed as having vanishing cancer. One of the 17 patients, who had pre-operative endometrioid endometrial cancer, had adjuvant chemotherapy for synchronous serous carcinoma of fallopian tube. From a follow-up period of 62.7 months (range, 6.8-184.4 months), no recurrences were found. Only 2 patients were dead of other diseases. Conclusion:Patients with vanishing endometrial cancer had excellent prognosis. Adjuvant treatment may not be needed. However, periodic surveillance was still recommended because data were derived from only small number of patients.

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Diagnostic accuracy of endometrial biopsy in relation to the amount of tissue

Cited by 20 publications

References 21 publications

Endometrial sampling at an academic hospital in South Africa: Histological findings, lessons learnt and interesting surprises

Endometrial sampling at an academic hospital in South Africa: Histological findings, lessons learnt and interesting surprises

New perspectives on screening and early detection of endometrial cancer

Clinico-pathological aspects of vanishing endometrial cancer

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