Diagnosis of cervical epithelial abnormalities from 'routine' uterine curettings

Fragments of cervical tissue are frequently found in uterine curettings. These may consist of endocervical mucosa, squamous epithelium, or both. To determine the frequency of abnormalities in this epithelium, 4000 consecutive endometrial curettings were examined during the year ending December 1977. Abnormal squamous epithelium was found in 20 cases (0.5%). The abnormalities were defined for the purpose of the study to include dysplasia/carcinoma in situ and warty atypia. Cases in which endometrial curettage was performed during the work-up for known dysplasia or carcinoma in situ were excluded. Subsequent follow-up included cytology, colposcopy, and colposcopically-directed target biopsies; occasionally conization and hysterectomy were performed. The most significant abnormality detected in this way was carcinoma in situ with early stromal invasion. The definitive treatment in most cases was cervical diathermy. As the abnormalities in the initial scrapings were previously unsuspected, it is imperative for the anatomic pathologist to look for and carefully evaluate cervical fragments in all endometrial curettings.