2012 Volume 51 Issue 2 Pages 93-104
In recent years, about detection of the increased endometrial carcinoma in Japan, it is well known that use of cytologic examination is initial method. However, because it is reported that 30-60% of a suspicious diagnosis are overdiagnosis, endometrial cytological diagnosis was not accomplished as the role enough. As the reason, because hormonal influence and cellular change (metaplasia) are added to endometrial glandular cell and endometrial stromal cell, various cytologic findings appeared, and those cytologic findings were misdiagnosed as endometrial hyperplasia or carcinoma. Therefore, as for the improvement of precision in endometrial cytology, grasp of a characteristic of a cytological findings for dysfunctional uterine bleeding due to anovulatory cycle (Endometrial glandular and stromal breakdown ; EGBD, Disordered proliferative phase ; DPP) is important.
As a result of study, the following was clarified ; it was revealed that “fragmented cluster” and “condensed cluster of stromal cells” and “metaplastic clumps with irregular protrusion which contains condensed stromal clusters” were useful for the cytologic assessment of anovulatory EGBD. In addition it was considered that a diagnosis is negative and in need of follow-up if EGBD was suspected. As for a DPP case, the occurrence of “cell clumps with dilated or branched” was same as an endometrial hyperplasia case, and discrimination of both in cytology is difficult. Therefore, if criteria of suspicious diagnosis is satisfied about the occurrence of “cell clumps with dilated or branched”, the histological diagnosis must be confirmed.
Dysfunctional uterine bleeding due to anovulatory cycle happens frequently, and many patients need cytological examination in gynecology outpatient clinic.
