Cytological evaluation of endometrial hyperplasia in relation to histological pictures

The Authors analyse possible parameters of cytological evaluation which can be used for the grading of endometrial hyperplasias and the diagnostic differentiation between atypical hyperplasia and adenocarcinoma. They consider 77 women who underwent endometrial cytology by aspiration just before diagnostic examination of the uterine cavity. Results show that in atrophic endometrium desquamation in clusters of less than 100 cells prevails whereas proliferative and secretory endometrium presents mainly clusters of 100-500 regularly stratified cells. Hyperplasia show progressive increase in isolated cells; "branched" glands appear rarely in hyperplasia with minimal atypia while prevailing in hyperplasia with severe atypia and adenocarcinoma. Simple layers prevail in atrophic endometrium, stratified regular layers prevail in proliferative and secretory endometrium; three-dimensional clusters appear in hyperplasia with minimal atypia and become significant with severe atypia. Adenocarcinoma is characterized by haematic and necrotic background, high percentage of isolated cells and prevalence of clusters of less than 100 cells, mainly three-dimensional. In addition it shows a significant incidence of papillary and rosette-like arrangements and abnormal cytoplasmic vacuolization.