2014 Volume 53 Issue 1 Pages 1-6
Objective : False-negative results of endometrial cytology are often obtained because of scarce nuclear atypia. To increase the diagnostic yield, we tried to prepare cytology slides by the saline washing method.
Study Design : Cell materials obtained by brushing were processed by the saline washing method of Ishii. We focused on structural atypia, especially on the presence of dendritic clusters which is the most significant marker of structural atypia in well-differentiated endometrioid adenocarcinoma. We review our results of five years from 2007 to 2011.
Results : A total of 1680 adequate specimens were classified into four groups as follows ; 118 (7.0%) “malignant”, 26 (1.5%) “suspicious malignant”, 95 (5.7%) “indeterminate” and 1441 (85.8%) “benign”. Histological examinations were performed in 116 of the 118 cases of “malignant” and all 116 cases were histologically confirmed as carcinoma, with no false-positive cases. Of 25 of the 26 cases of the “suspicous malignant” group examined histologically, 23 were confirmed histologically as carcinoma, 1 case as atypical endometrial hyperplasia and 1 case as having no tumor cells. In 107 cases of histologically confirmed as carcinoma (including carcinosarcoma) , the primary cytological diagnoses were as follows ; 76 (71.0%) “malignant”, 13 (12.2%) “suspicious malignant”, and 5 (4.6%) “benign”. The sensitivity of our saline washing method for the diagnosis of uterine corpus cancer was 95.1%.
Conclusion : Use of saline washing method for preparation of the cytology specimens and observation with a high focus on structural atypia are useful to improve the quality of endometrial cytology.
