In Papanicolaou smears, benign appearing endometrial cells bear no significance in predicting uterine endometrial adenocarcinomas

Abstract

Reporting of benign appearing endometrial cells (BECs) in the Papanicolaou smears of women aging 40 years or older was mandated in the Bethesda System 2001 aiming at predicting the uterine pathology. The purpose of this study was to determine the clinical significance of the BECs in patients in our Medical Center. A two-arm study was designed in ≥40-years-old women with BECs and without BECs in their Pap smears from January 2002 to December 2004. Of 21,965 patients, 882 had BECs in their Pap smears and the rest did not. Among the patients with BECs, 186 (study group) and among those without BECs, 2,064 (control group) had histopathologic follow-ups. There were 4 patients in the study and 47 in the control groups who had uterine adenocarcinoma. The Chi-square P-value for adenocarcinoma between the two groups was 0.91; indicating insignificant differences between the two groups. We conclude that presence of BECs in the Pap smears of ≥40-years-old women signal no significance as a harbinger of endometrial adenocarcinoma.

Treatment of Kaposi Sarcoma-Associated Herpesvirus-Associated Cancers

“…Primary effusion lymphoma can also occur in unusual sites (Said et al, 1996; Moatamed et al, 2011) and solid variants have been described as well. These variants also carry the KSHV genome and express at least the KSHV latent genes (Nador et al, 1996; Said et al, 1996; Engels et al, 2003; Chadburn et al, 2004; Carbone et al, 2005; Deloose et al, 2005).…”

Age cut-off for reporting endometrial cells on a Papanicolaou test: 50 years may be more appropriate than 45 years

“…Therefore, while documentation of E40 (and most recently E45) on Pap tests is the current standard practice, this diagnostic category may not always be clinically relevant. Many women greater than or equal to 40 years are still menstruating or are peri‐menopausal, making the presence of endometrial cells acceptable and likely not pathological . Routine biopsy after E40 may lead to unnecessary procedures, risks for the patient and healthcare costs .…”

“…Routine biopsy after E40 may lead to unnecessary procedures, risks for the patient and healthcare costs . Establishing a different age threshold in combination with other clinical findings was raised by many studies including the current one that may help to avoid unnecessary procedures and guide management and follow‐up . In fact, many clinicians feel that this diagnosis creates confusion and management challenges …”

“…Many women greater than or equal to 40 years are still menstruating or are perimenopausal, making the presence of endometrial cells acceptable and likely not pathological. 15 Routine biopsy after E40 may lead to unnecessary procedures, risks for the patient and healthcare costs. 16 Establishing a different age threshold in combination with other clinical findings was raised by many studies including the current one that may help to avoid unnecessary procedures and guide management and follow-up.…”

“…16 Establishing a different age threshold in combination with other clinical findings was raised by many studies including the current one that may help to avoid unnecessary procedures and guide management and follow-up. 15,[17][18][19][20][21][22] In fact, many clinicians feel that this diagnosis creates confusion and management challenges. 15,23 In the current study, we explored the significance of E40 identified on a cytology Pap test in identifying EC.…”