Utility of cell block preparation in endometrial aspiration cytology: a report of 4 cases

Endometrial aspiration (EA) cytology is a simple yet highly useful diagnostic procedure for uterine and extrauterine malignancies.

Two postmenopausal women underwent EA following ultrasonographic findings of unilateral hydrosalpinx and fluid in the endometrial cavity. A few atypical glandular clusters were detected on cytologic smears. Sections from formalin-fixed, paraffin-embedded (FFPE) cell block preparations revealed fragments of uterine papillary serous carcinoma showing strong positivity of tumor cell nuclei to p53 on immunohistochemistry (IHC). A 78-year-old woman suffering from intestinal Crohn's disease was found to have a cystic lesion of the right adnexa and fluid level in the endometrial cavity on ultrasonography. Acellular, ringlike structures were noted on cytologic smears of the EA. Sections from the FFPE cell block demonstrated the structures to be periodic acid-Schiff-positive Liesegang rings. A 43-year-old woman underwent diagnostic hysteroscopy and EA for prolonged, excessive vaginal discharge. Cytologic features of endometrial cellular clusters were obscured by a dirty background and macrophages. Sections from the FFPE cell block showed normal proliferative endometrium with CD10-positive endometrial stroma, thus ruling out malignancy.

Conclusion FFPE cell block preparation is a valuable adjunctive tool for EA in the evaluation of endometrial lesions, ensuring excellent quality of preparations for special stains and IHC.