The availability of a reporting system for endometrial cytology

Objective : The aim of this study was to develop a new reporting system for endometrial cytology that would standardize the diagnostic criteria and terminology used. Study Design : The requirements of an adequate endometrial cytological specimen for the new diagnostic criteria are discussed first. Then, the diagnostic criteria, standardized on the basis of a combination of conventional and cytoarchitectural criteria, are presented, and, finally, the terminology is introduced. The proposed reporting system was assessed on endometrial cytological specimens from 58 cases that were cytologically under-diagnosed or over-diagnosed compared to the subsequent histopathological diagnosis made on the basis of endometrial biopsy or surgical specimens. Results : Of the 58 cases, 12 cases were re-assessed as being unsatisfactory for evaluation. Of the remaining 46 cases, 25 of the 27 cases that were cytologically under-diagnosed and were diagnosed as endometrial carcinoma or a precursor stage based on subsequent histopathological examinations were re-assessed as requiring endometrial biopsy. On the other hand, the 19 cytologically over-diagnosed cases that were subsequently diagnosed histopathologically as normal endometrium or a non-precancerous lesion were all re-assessed as not requiring biopsy. Conclusion : The reporting system for endometrial cytology proposed in this paper may improve diagnostic accuracy and reduce the number of inappropriately managed patients.