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Updated: Jan 21, 2026

Two Methods for Establishing Primary Human Endometrial Stromal Cells from Hysterectomy Specimens
Published on: May 23, 2014
Selective vs Complete Sampling in Hysterectomy Specimens Performed for Atypical Hyperplasia
Bronwyn H Bryant1, Elizabeth Doughty1, Alexandra N Kalof1
1Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Larner College of Medicine, Burlington.
Objectives:
Atypical hyperplasia of the endometrium is a significant risk factor for uterine endometrioid carcinoma (EC) and an indication for hysterectomy. Standard sampling of these specimens includes evaluation of the entire endometrium to identify possible EC. We evaluated a method of selective sampling in an effort to balance resource utilization with diagnostic accuracy in the detection of EC.
Methods:
Histologic diagnoses based on selective sampling (exclusion of every other block of endometrium) were compared with the original diagnosis based on complete sampling.
Results:
Double-blinded review of these cases using selective sampling detected EC in 92% of hysterectomies, including all high-grade/high-stage carcinomas. Selective sampling had an 82% agreement with the original diagnoses, with most discordant diagnoses attributable to interobserver variability. Adjusting for interobserver variability increased diagnostic agreement between selective and complete sampling to 96%.
Conclusions:
Selective sampling is a feasible method to save time and resources while maintaining diagnostic accuracy.
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