Cytology of Endometrial Cells and Lesions

  • Rosemary H. Tambouret
  • David C. Wilbur
Part of the Essentials in Cytopathology book series (EICP, volume 19)


Accurate diagnosis of endocervical preneoplastic and neoplastic lesions requires the ability to distinguish endocervical lesions from the spectrum of endometrial cells that can appear in cervical cytology samples. In this chapter cytologic features of benign, reactive, atypical, and malignant endometrial cells are discussed and illustrated.


Endometrium Lower uterine segment Exfoliated endometrium Endometrial adenocarcinoma 


  1. 1.
    Greenspan DL, Cardillo M, Davey DD, Heller DS, Moriarty AT. Endometrial cells in cervical cytology: review of cytological features and clinical assessment. J Low Genit Tract Dis. 2006;10(2):111–22.CrossRefPubMedGoogle Scholar
  2. 2.
    Moroney JW, Zahn CM, Heaton RB, Crothers B, Kendall BS, Elkas JC. Normal endometrial cells in liquid-based cervical cytology specimens in women aged 40 or older. Gynecol Oncol. 2007;105(3):672–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Thrall M, Kjeldahl K, Gulbahce HE, Pambuccian SE. Liquid-based Papanicolaou test (SurePath) interpretations before histologic diagnosis of endometrial hyperplasias and carcinomas: study of 272 cases classified by the 2001 Bethesda system. Cancer. 2007;111(4):217–23.CrossRefPubMedGoogle Scholar
  4. 4.
    Koprowska I, George N. Papanicolaou living memories, monuments, and archives. Diagn Cytopathol. 1985;1(1):68–72.CrossRefGoogle Scholar
  5. 5.
    Simsir A, Carter W, Elgert P, Cangiarella J. Reporting endometrial cells in women 40 years and older: assessing the clinical usefulness of Bethesda 2001. Am J Clin Pathol. 2005;123(4):571–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Aslan DL, Crapanzano JP, Harshan M, Erroll M, Vakil B, Pirog EC. The Bethesda System 2001 recommendation for reporting of benign appearing endometrial cells in Pap tests of women age 40 years and older leads to unwarranted surveillance when followed without clinical qualifiers. Gynecol Oncol. 2007;107(1):86–93.CrossRefPubMedGoogle Scholar
  7. 7.
    Beal HN, Stone J, Beckmann MJ, McAsey ME. Endometrial cells identified in cervical cytology in women > or = 40 years of age: criteria for appropriate endometrial evaluation. Am J Obstet Gynecol. 2007;196(6):568.e1–5; discussion 568.e5–6.Google Scholar
  8. 8.
    Kapali M, Agaram NP, Dabbs D, Kanbour A, White S, Austin RM. Routine endometrial sampling of asymptomatic premenopausal women shedding normal endometrial cells in Papanicolaou tests is not cost effective. Cancer. 2007;111(1):26–33.CrossRefPubMedGoogle Scholar
  9. 9.
    Brogi E, Tambouret R, Bell DA. Classification of benign endometrial glandular cells in cervical smears from postmenopausal women. Cancer. 2002;96(2):60–6.CrossRefPubMedGoogle Scholar
  10. 10.
    de Peralta-Venturino MN, Purslow MJ, Kini SR. Endometrial cells of the “lower uterine segment” (LUS) in cervical smears obtained by endocervical brushings: a source of potential diagnostic pitfall. Diagn Cytopathol. 1995;12(3):263–8; discussion 268–71.CrossRefPubMedGoogle Scholar
  11. 11.
    Heaton Jr RB, Harris TF, Larson DM, Henry MR. Glandular cells derived from direct sampling of the lower uterine segment in patients status post-cervical cone biopsy. A diagnostic dilemma. Am J Clin Pathol. 1996;106(4):511–6.PubMedGoogle Scholar
  12. 12.
    Sauder K, Wilbur DC, Duska L, Tambouret RH. An approach to post-radical trachelectomy vaginal-isthmus cytology. Diagn Cytopathol. 2009;37(6):437–42.CrossRefPubMedGoogle Scholar
  13. 13.
    Zhao C, Austin RM, Pan J, Barr N, Martin SE, Raza A, et al. Clinical significance of atypical glandular cells in conventional pap smears in a large, high-risk U.S. west coast minority population. Acta Cytol. 2009;53(2):153–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Zhou J, Tomashefski Jr JF, Sawady J, Ferrer H, Khiyami A. The diagnostic value of the ThinPrep pap test in endometrial carcinoma: a prospective study with histological follow-up. Diagn Cytopathol. 2013;41(5):408–12.CrossRefPubMedGoogle Scholar
  15. 15.
    Larson DM, Copeland LJ, Gallager HS, Gershenson DM, Freedman RS, Wharton JT, et al. Nature of cervical involvement in endometrial carcinoma. Cancer. 1987;59(5):959–62.CrossRefPubMedGoogle Scholar
  16. 16.
    DuBeshter B, Warshal DP, Angel C, Dvoretsky PM, Lin JY, Raubertas RF. Endometrial carcinoma: the relevance of cervical cytology. Obstet Gynecol. 1991;77(3):458–62.PubMedGoogle Scholar
  17. 17.
    Roelofsen T, Geels YP, Pijnenborg JM, van Ham MA, Zomer SF, van Tilburg JM, et al. Cervical cytology in serous and endometrioid endometrial cancer. Int J Gynecol Pathol. 2013;32(4):390–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Brown AK, Gillis S, Deuel C, Angel C, Glantz C, Dubeshter B. Abnormal cervical cytology: a risk factor for endometrial cancer recurrence. Int J Gynecol Cancer. 2005;15(3):517–22.CrossRefPubMedGoogle Scholar
  19. 19.
    Diaz-Rosario LA, Kabawat SE. Performance of a fluid-based, thin-layer papanicolaou smear method in the clinical setting of an independent laboratory and an outpatient screening population in New England. Arch Pathol Lab Med. 1999;123(9):817–21.PubMedGoogle Scholar
  20. 20.
    Misdraji J, Vaidya A, Tambouret RH, Duska L, Bell DA. Psammoma bodies in cervicovaginal cytology specimens: a clinicopathological analysis of 31 cases. Gynecol Oncol. 2006;103(1):238–46.CrossRefPubMedGoogle Scholar
  21. 21.
    Costa MJ, Kenny MB, Naib ZM. Cervicovaginal cytology in uterine adenocarcinoma and adenosquamous carcinoma. Comparison of cytologic and histologic findings. Acta Cytol. 1991;35(1):127–34.PubMedGoogle Scholar
  22. 22.
    Snyder MJ, Robboy SJ, Vollmer RT, Dodd LG. An abnormal cervicovaginal cytology smear in uterine carcinosarcoma is an adverse prognostic sign: analysis of 25 cases. Am J Clin Pathol. 2004;122(3):434–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Tambouret R, Pitman MB, Bell DA. Benign glandular cells in posthysterectomy vaginal smears. Acta Cytol. 1998;42(6):1403–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Rosemary H. Tambouret
    • 1
  • David C. Wilbur
    • 1
  1. 1.Department of PathologyMassachusetts General HospitalBostonUSA

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