Objective: To assess the accuracy of the cervical smear in the diagnosis of endometrial cancer in women with postmenopausal bleeding, with an emphasis on the diagnostic relevance of normal endometrial cells.
Study Design: Women presenting with abnormal postmenopausal bleeding, not using hormone replacement therapy, were included prospectively. Cervical cytology was coded according to both the Papanicolaou (Pap) classification and the Dutch coding system (CISOE-A), which classifies endometrial and other cell types separately. For both classification systems, likelihood ratios (LR) for the presence of (pre) malignancy of the endometrium were calculated.
Results: We included 543 women with postmenopausal bleeding. A (pre) cancerous endometrial lesion was present in 64 women (11.7%). A Pap III increased the probability of (pre) malignancy (LR 3.5), whereas Pap IV and Pap V virtually proved the presence of carcinoma. The CISOE-A classification showed similar results. The presence of normal endometrial cells did not increase the probability of endometrial (pre) malignancy.
Conclusion: Adding the results of the cervical smear to endometrial thickness could detect incidental endometrial cancers that are missed by transvaginal sonography (< 5 mm). In women with postmenopausal bleeding the presence of normal endometrial cells is not predictive of endometrial cancer.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1159/000325308 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Rare histopathological diagnosis of malakoplakia and Rosai‑Dorfman disease in the same uterus mimicking malignancy: A case report.
Exp Ther Med
February 2025
Department of Histopathology, Specialty Hospital, Amman 11194, Jordan.
In the present case, a 66-year-old woman presented to the Specialty Hospital (Amman, Jordan) with recurrent post-menopausal bleeding. A pelvic ultrasound scan showed an abnormal endometrial thickness of 8 mm and no adnexal masses. An endometrial biopsy revealed abundant foamy histiocyte infiltration features suggestive of xanthogranulomatous endometritis.
View Article and Find Full Text PDFUltrasound and blind endometrial sampling for detection of endometrial cancer in women with postmenopausal bleeding.
Cochrane Database Syst Rev
June 2024
Women and Children's Services, West Hertfordshire Hospitals NHS Trust, Watford, UK.
This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To assess the diagnostic accuracy of endometrial sampling with histology in the diagnosis of endometrial cancer in women with postmenopausal bleeding and thickened endometrium on ultrasound. Diagnosis will be verified by the reference standards, hysteroscopy with histology, obtained by targeted (such as grasp biopsy of the endometrium or resection of focal pathology) or global sampling (with dilation and curettage), and histology of hysterectomy specimens.
View Article and Find Full Text PDFPrimary malignant melanoma of the vagina: A case report of a rare disease that is difficult to diagnose.
Medicine (Baltimore)
January 2025
Department of Obstetrics and Gynecology, Dong-A University, College of Medicine, Busan, Republic of Korea.
Rationale: Malignant melanoma is a rare cancer that accounts for approximately 1% of all cancers. Primary malignant melanoma of the female genital tract accounts for approximately 3% to 7% of all malignant melanomas, and 0.3% to 0.
View Article and Find Full Text PDFConcomitant Uterine and Bilateral Adnexal Torsion in a Postmenopausal Woman: A Case Report.
Cureus
November 2024
Obstetrics and Gynecology, University of Colorado School of Medicine, Denver, USA.
Adnexal torsion is a well-recognized gynecologic emergency; however, uterine torsion is less well-known. The majority of uterine torsions occur in gravid uteri; torsion in postmenopausal patients is rare. We report a case of uterine and bilateral adnexal torsion in a postmenopausal woman due to a large leiomyoma.
View Article and Find Full Text PDFApplication of the Morphological Uterine Scoring Assessment in Ultrasound for Abnormal Uterine Bleeding.
Cureus
November 2024
Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND.
Abnormal uterine bleeding (AUB) is a common gynecological condition that disrupts women's health due to irregularities in menstrual frequency, duration, and volume, often resulting in a significant impact on daily life and productivity. Accurate diagnosis of AUB is critical but complicated by its varied etiologies and presentations. Recent advancements in imaging techniques, particularly the Morphological Uterus Sonographic Assessment (MUSA), have enhanced the diagnostic precision of uterine pathologies such as fibroids and adenomyosis.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!