Diagnostic Efficacy of Endometrial Aspiration Cytology with Histopathological Correlation

Abstract Introduction: Endometrial cytopathology is a powerful tool for the detection of a wide variety of benign atypias, inflammatory changes, and infectious organisms. It is also helpful for the cyto-hormonal evaluation of patients and the detection of endometrial malignancies. Aims: To assess the diagnostic accuracy of endometrial aspiration technique and to compare the cyto-morphology of aspirated smears with histopathology Materials and Methods: Endometrial aspiration was performed using Karman’s cannula in 100 cases who presented with abnormal uterine bleed, infertility and postmenopausal bleed. The endometrial specimens obtained by D&C were processed and evaluated histologically. The endometrial aspirated smears were reviewed for cytomorphological findings and were correlated with histopathological findings for diagnostic accuracy. Results: The study cases included 70 patients in reproductive age group and 30 patients in the perimenopausal and postmenopausal age groups. The diagnostic accuracy on cytology was 90% when compared to histology. Adequate material was obtained in 86% of cases on aspiration. Proliferative endometrium was the most common pattern (50%) observed. There was an overall 100% correlation in case of proliferative endometrium, atypical hyperplasia and endometrial carcinoma and 93.75% correlation in case of secretory endometrium between cytological and histopathological findings. The sensitivity and specificity of endometrial aspiration was 84.54% and 98.89% respectively. Conclusion: Endometrial aspiration technique with Karman’s cannula is simple, safe, cost effective and well tolerated outpatient procedure. The endometrial aspiration cytology proved to be effective diagnostic modality in the interpretation of normal and abnormal endometrium. The present study emphasizes the need for early screening to diagnose pre-invasive lesions and endometrial malignancies in peri-menopausal and post-menopausal patients.